07-12-10

http://anesthesiology.duke.edu 1

NewsMonday, July 12, 2010 • Volume 12, Issue 27

NIH Update - Make that Application Complete Upon Initial SubmissionIn the fall (starting with applications submitted for the September 25, 2010 receipt date), NIH will implement a new policy restricting the types of late grant application materials we will accept. The policy will encourage applications to be complete and ready for review upon submission.

We understand that sometimes events happen after the application has been submitted and before the review takes place that reviewers need to know about in order to provide an informed evaluation of the application. To accommodate these unforeseen circumstances, we will continue to allow certain types of late materials, such as:

• Revised budget page(s) (e.g., change in budget request due to new funding or institutional acquisition)

• Biographical sketches (e.g., change in senior/key personnel due to the loss of an investigator)

• Letters of support or collaboration resulting from a change in senior/key personnel due to the loss of an investigator

• Adjustments resulting from natural disasters (e.g., loss of an animal colony)

• Adjustments resulting from change of institution (e.g., PI moved to another university)

• News of an article accepted for publication

As before, these materials must be received 30 days prior to the initial peer review and require the concurrence of the Authorized Organizational Representative to be included in the application. In addition, investigators will be able to submit a one-page explanation to accompany these materials.

NIH will not accept substantial changes to the application such as updates to the Specific Aims or the Research Strategy, late-breaking research findings, supplemental pages, and new letters of support that do not meet the afore mentioned situation. These materials should be included in the initial application submission.

Note that there is an exception for many types of training programs. For these programs we will allow three pages of post-submission materials to present new information or data about the applicants that was not available at the time of application submission.

To read more about these new policies, see the Enhancing Peer Review Advance Notice: New NIH Policy on Post-Submission Application Materials (NOT-OD-10-091 - http://grants.nih.gov/grants/guide/notice-files/not-od-10-091.html) and Enhancing Peer Review: Advance Notice on Post-Submission Application Materials for NIH Training and Related Applications (NOT-OD-10-104 - http://grants.nih.gov/grants/guide/notice-files/not-od-10-104.html).

New Departmental Research PublicationsPeacher DF, Pecorella SR, Freiberger JJ, Natoli MJ, Schinazi EA, Doar PO, Boso AE, Walker AJ, Gill M, Kernagis D, Uguccioni D, Moon RE. Effects of hyperoxia on ventilation and pulmonary hemodynamics during immersed prone exercise at

4.7 ATA: possible implications for immersion pulmonary edema. J Appl Physiol 109: 68–78, 2010.

2010 ASA AccommodationsThe department will not have a hotel room block for this year’s ASA meeting in San Diego, CA. However, you can reserve

a hotel at a discounted rate by visiting: https://www.tphousing.com/r/startres.asp?EICode=1934&AttCode=19

Comings and Goings in the DepartmentPlease welcome the following new Faculty and Staff to the Department of Anesthesiology:

Anran Li (Irene), Non-Duke Student/Intern, Basic Sciences, June 28, 2010.Daniel Thomas, MD, Assistant Professor, Regional, July 1, 2010.John Nardiello, MD, Assistant Professor, GVTCCM, July 1, 2010.Amy Manchester, MD, Assistant Professor, GVTCCM, July 1, 2010.Andre Shanadan Motie, MD, Assistant Professor, Cardiac, July 1, 2010.Jay Ajit Kher, MD, Clinical Associate, Ambulatory, July 1, 2010.C. Andrew Peery, MD, Assistant Professor, OHNO, July 1, 2010.Jose Del Rio, MD, Assistant Professor, Cardiac, July 6, 2010.Marthinus Daneel Heyns, MD, Clinical Associate, Cardiac, July 6, 2010.Tara Sanders, NP, Nurse Practitioner, Duke Raleigh, July 6, 2010.

Congratulations to Richard Vann, MD who has been promoted from Assistant Professor to Assistant Professor Emeritus as of July 1, 2010.

We wish a fond farewell and good luck to the following who have left the department effective June 30, 2010:

Daniel Morris, MD, Assistant ProfessorWendy Pabich, MD, Assistant ProfessorSean Dobson, MD, Clinical AssociateMitchell Fingerman, MD, Assistant ProfessorRichard Jacobs, MD, Medical Instructor

Residents:Matthew Atkins Iain Beck James Caswell

Himaniben Bhatt Frederick Cobey Jessica Hathaway

Neil Hanson Robert Lobato Franchesca Meachem

Linda McCleish David Martin Stephanie McGuire

Kristen Randall Robert Swift Thomas Van de Ven

Sean Selig James Walker Dominika James

THIS MoNTH IN THe DePARTMeNT oF ANeSTHeSIoLoGy

July 2010MoNDAy TUeSDAy WeDNeSDAy THURSDAy FRIDAy12 13 14 15 16

7:15-8:00 a.m., RM203-Pain ClinicMRC Pain Conference

2:30-3:30 p.m., VAMCVA EchocardiographyConference

5:30-6:30 p.m., 5680A-HAFSPerioperative Leadership Group Meeting - CANCELLED

5-6 p.m., 5685-HAFSCT Conference: “Comprehensive 2D TEE Exam, Report & Data Flow” - Madhav Swaminathan, MD

5-6 p.m. 6686-HAFSGVTCCM ConferenceSUMMER BREAK

IRB Deadline: Submit 1 originaland 3 copies to Dr. Gan’s office by 5 p.m.

6:15-7:15 a.m., 5685-HAFSCT Anesthesia Fellow/Faculty Preceptor Seminar: “Cardiac: Coronary Byapass, Valves, Heart-Port” - Mark Stafford Smith, MD

6:30 a.m., 2001DNResident Conference Lecture: “Approaches to Acid-Base Dis-orders: Old and New” - Richard Moon, MD

7:15 a.m., 2001DNGrand Rounds: “The teleICU: The Future of Critical Care Medicine” - Ryan Fink, MD

7:15-8:00 a.m., RM203-Pain ClinicMRC Pain Journal Club

4-5 p.m., 5680A-HAFSPediatric Conference

19 20 21 22 23



4-6 p.m., 5685-HAFSExecutive Team Meeting

5-6 p.m., 5685-HAFSCT Conference


6:15-7:15 a.m., 5685-HAFSCT Anesthesia Fellow/Faculty Preceptor Seminar

6:30 a.m., 2001DNResident Conference Lecture: “Physician Impairment” - Cath-erine Kuhn, MD

7:15 a.m., 2001DNGrand Rounds: “What does Your Learning Styles Inventory tell you About your Practice?” - Catherine Kuhn, MD



26 27 28 29 30







6:30 a.m., 2001DNResident Conference Lecture: “Vaporizers” - David Lindsay, MD

7:15 a.m., 2001DNGrand Rounds: “Clinical Case Conference” - Jonathan Mark, MD

5 p.m., Chen Conference RoomNeuroradiology Conference



August 2, 2010 3 4 5 6



5-6 p.m., 5685-HAFSMonthly Faculty Meeting





6:30 a.m., 2001DNResident Conference Lecture

7:15 a.m., 2001DNGrand Rounds



Upcoming:ASA Annual Meeting: October 16-20, 2010 | San Diego, CAAnnual Alumni Reception: Sunday, October 17, 2010 | 7:15 to 8:15 p.m. | San Diego Marriott Marina | San Diego, CA Annual Departmental Holiday Party: Saturday, December 11, 2010 | Bay 7, Downtown Durham | 7 p.m. to 11 p.m.


DUKe ANeSTHeSIoLoGy NeWS - SPeCIAL FeATURe


Retiring MUSC Dean on Cruise ControlBy Adam Parker, The Post and Courier

The vessel is called the Sweetgrass. It’s a 41-foot trawler class made by Roughwater Boats.

The vessel’s captain is Jerry Reves, a modest-looking man with char-coal-gray hair, a ready smile and an adventurous spirit.

Reves and his wife, Jenny Cathcart, are about to embark on a journey as circuitous and lengthy as the path Reves has walked during his professional career: “The Great Loop.”

The pair will travel by ocean, Gulf, interstate waterways, river and ca-nal -- mostly one-way except for a couple of brief excursions that will require but a quick skip in and then back out -- returning to where they started, Charleston.

Home.

early Training

Reves, who turns 67 this summer, is dean of the College of Medicine at the Medical University of South Carolina. He runs the show. After nearly a decade at the helm -- af-ter improvements, expansions, a pivotal accreditation -- he is retiring, walking away from this last in a long series of leadership jobs for some well-earned R&R.

He says most serious jobs require about 10 years to accomplish one’s main goals.

Reves, whose father taught math and coached tennis at The Citadel, grew up on campus and swam in the Ashley River. He attended the

Gaud School for Boys at South Adgers Wharf and East Bay Street, then spent the 11th and 12th grades at the Darlington School for Boys in Rome, Ga.

Having The Citadel for a playground was great fun, he said. His bosom buddy was Joe Harrison, whose father taught English at the school.

Harrison said it was a protected, safe environment that had a lot to of-fer a couple of rambunctious boys. Pedestrians were respected. Large fields were available to play on. The boys played basketball, football and tennis.

“It was quite colorful,” Harrison said. “There was plenty of nature around, trees to climb.”

Football was a favorite pastime.

“We actually played on a team that was coached by a couple of Cita-del cadets who had spotted us on the field,” Harrison said. “Jerry was always quarterback. I was the end. We spent hours practicing pass patterns, which I still to this day remember.”

When they were old enough, they double dated a little, then it was off to college. Reves went to Vanderbilt University in Nashville, Tenn. Har-rison attended The University of the South in Sewanee, Tenn., not too far away. Reves tried to get him to go to the Grand Ole Opry, but he resisted.

“At the time, I didn’t like country music,” Harrison said.

After college and during the years Reves was working in Birmingham, Ala., and the 17-year period he spent at Duke University, the two men lost touch. But when Harrison heard that his friend had been recruited in 2001 for a position at the Medical University, that he was coming home, they got back in touch.

“It was just like we’d seen each other yesterday,” Harrison said.

Responsibility

Reves’ father had gone to Vanderbilt, and now the son followed in dad’s footsteps, majoring in English and minoring in philosophy. He was good enough at tennis to make the varsity team. William Faulkner was (and is) his favorite writer.

“I had been in a cocoon until then,” Reves said. “It was the first time I’d ever heard a point of view different than what I’d grown up with.”

He graduated from Vanderbilt in 1965. But it was doctoring that soon caught his imagination. He enrolled at the Medical University in 1969 to study anesthesiology, landed an internship and residency at the Uni-versity of Alabama Hospital and Clinics in Birmingham, then decided the combination of medicine, academics and research suited him.

For two years, 1972-74, he worked at Bethesda Naval Hospital before returning to Alabama, where he spent 10 years as a professor of an-esthesiology. He helped develop a sedative-hypnotic called Midazolan, which soon was marketed by the pharmaceutical company Roche and was called the new drug Versed.

It became the standard anesthetic used during surgery, replacing Pentothal, which had been most widely used since 1942. Pentothal, though, made patients feel like they were “being spun into oblivion,” Reves said. The newer anesthetic provoked a more natural sleep, he said.

In 1984, he went to Duke University Medical Center, becoming first director of cardiothoracic anesthesia, then director of the heart center and later chairman of the department of anesthesiology.

Reves said being an anesthesiologist is akin to being the conductor of a big orchestra, calling on one drug, then another, adjusting inflow to achieve just the right effect.

Photo by Grace Beahm The Post and Courier

Dr. Jerry Reves has over-seen hundreds of future doc-tors who have graduated un-der his tenure as dean of the College of Medicine at the Medical University of South Carolina.

Reves played on the tennis team at Van-derbilt University when he was a student there in the mid- 1960s.


DUKe ANeSTHeSIoLoGy NeWS - SPeCIAL FeATURe

The helpless patient relies completely on the doctors.

“It’s like seeing a baby born,” Reves said, “and realizing -- oh, my God -- that baby depends on me.”

The Coach

At the Medical University, Reves is a multitasker. Besides being dean of the College of Medicine, he is professor of anesthesia and periop-erative medicine, professor in the department of cell and molecular pharmacology and experimental therapeutics, and vice president for medical affairs.

He’s recruited top people, such as Andrew Kraft, who runs the Hol-lings Cancer Center and oversaw the process that secured its National Cancer Institute designation. He ensured that the Medical University reached the top third of the medical schools recognized by the National Institutes of Health. He helped bring in millions of dollars in funding.

“What (all this) really does is puts you in the elite,” he said, proudly crediting these successes to the many people who did most of the heavy lifting.

“I’m more like a coach, I select the players,” Reves said. “But they have the talent, they have to perform, they have to perform like a team.”

At Duke, his emphasis was on helping to advance careers, he said. At the Medical University, it’s more about improving the institution.

Harrison said his friend has a great work ethic and is helpful, generous and honest. “I don’t think anyone can push him around,” he said.

Two hospitals in the South with the best reputations are Duke and Em-ory, Reves noted. That’s where people with serious health problems historically have gone for specialized treatment.

Not so much anymore.

“We want to make it so Charlestonians don’t have to leave Charleston,” he said.

A Big Job

Kraft was recruited by Reves in 2004 from the University of Colorado. As director of the Hollings Cancer Center, he has worked closely with his boss to make the center a world-class institution.

“Being dean is a complicated job,” Kraft said.

Reves is responsible for students, the clinical apparatus and the re-search scientists. “It’s a big job,” and it’s people-oriented, Kraft said, which plays to Reves’ strengths. “He’s a good listener.”

He marries his own abilities and experiences with those of others, em-powering people and guiding them at the same time, Kraft added.

Reves also has worked hard to build bridges between departments, which tend to work in silos, Kraft said. Among other things, the dean has encouraged his colleagues in other departments to get their pa-tients into trials. There are more than 100 trials under way at any given time, Kraft said.

More than half of all doctors in South Carolina were educated at the Medical University. During the past nine years, since Reves became dean, the school has turned out 1,200 doctors.

A decade ago, the university admitted about 135 people a year; today, it enrolls 165 annually.

About 40 percent of the graduating class is focused on primary care: family medicine, pediatrics, internal medicine, psychiatry and OB/GYN. The rest pursue more lucrative specialties.

Dr. Etta Pisano a radiologist and breast imaging pioneer from Duke Medical School, was hired to replace Reves. She will be the Medical University’s first female dean of the College of Medicine.

The Great Loop

Next month, Reves and his wife will hit the waterways.

They’ll take the Intracoastal Waterway to Chesapeake Bay, float their way to New York, head up the Hudson River to Montreal, cross the Ca-nadian canals into the Georgian Bay and Lake Huron and pass through the Great Lakes to Chicago.

Then they will track down the Illinois River to the Mississippi River, turn southward and ride the great Mississippi current until they reach the Tennessee River, hop onto the Ohio briefly to get to the Cumberland River, which they’ll take to visit Nashville, then find their way to the Tombigbee River. They’ll float south twixt Mississippi and Alabama to Mobile, hit the oil-slicked Gulf of Mexico to get to New Orleans for a spell, continue on to Houston, where an old college roommate lives, then head back along the coast, down the Florida peninsula to the Keys and around the bend to the Intracoastal Waterway on the east side of the state, riding north until Charleston is back in their sights.

The Sweetgrass has a single diesel engine that will take them the full 5,500 miles at an average of 10 mph.

But don’t think it will be all pleasure. Reves is conducting a medical research project during the cruise to learn about injury and illness. It’s been approved by the Institutional Review Board.

“Nobody’s ever done this before,” he said.

Dr. & Mrs. Jerry Reves’s great loop adventures can be followed on their blog at http://sweetgrassadventures.com/

Reach Adam Parker at 937-5902 or [email protected] with permission.

Jerry Reves and wife Jenny Cathcart on their boat, the Sweetgrass. The couple are about to embark on a post-retirement journey.

ClassifiedsReal estate and Rentals

A lovely home in Hillsborough for sale. 4 Bedroom, 2.5 bath, 2152 sq ft, 0.38 acre, private backyard, 1st floor all hardwood and 2nd floor new carpet. 15 min to Duke and UNC, 3 min to shopping center. Fridge, washer, dryer, custom curtain, and a shed are free and stay with the house. Offered at $229,900. Call 919-633-0632 or visit the following website for more info.

http://www.circaproperties.net/Hillsborough/North_Carolina/Homes/1732521/Becketts_Ridge/Agent/Listing_18646261.html

Department-member owned 3 floor luxury townhouse in Kure Beach NC available for rent. Six bedroom, four bath townhouse with private elevator, granite kitchen, stainless appliances, fully-stocked chef’s kitchen (All-Clad pots and Kitchen Aid appliances). Master has private balcony, King bed, walk-in closet with ocean views, spa -like bathroom with jetted tub, glassed-in shower, other bedrooms have two twins,

one queen, one queen, one queen and two twin sleeper chairs. flat panel HD TVs and wireless internet. 2 blocks to the Kure beach pier and restaurants, beach access diagonally across the street. Ocean views from living room and master bedroom. May 1 to October 31 $2300/week November 1 to April 30 $1800/week. Visit http://web.mac.com/bford71/Brad_and_Neil/the_Sandpiper/the_Sandpiper.html for more info.

Free Stuff

I have 12 thermo-safe and styrofoam shipping containers that I need to give away. Contact Keita Ikeda, PhD at 593-1174 or [email protected].

July 5-18 Birthday WishesEmma Crumpler Julie RosatoLarry Dowell Dr. Michael RussellCatherine Dunston Horacio SalgadoJanet Goral Dr. Andrew ShawGerri Harris Justin ShoreKathryn Newman Jessie Swain IIIDebra Riley Mark Wright

Note: If you do not want your name listed here, please send a removal notice to [email protected].


THe BACK PAGe

Upcoming CMe Activities

13th Annual Duke Cardiothoracic Update and Tee Review CourseAugust 5-8, 2010 | Sea Pines Resort, Hilton Head Island, SCFor more information, email: [email protected] your calendars for another year of cutting-edge research and updated information designed for medical personnel of all skill levels. NEW FOR THIS YEAR! Critical Care Track!

3rd Annual UNC-Duke Pediatric Anesthesiology Conference“Best Practices in Pediatric Anesthesia Care”September 25, 2010The William & Ida Friday Center for Continuing education | Chapel Hill, UNCInfants and young children constitute a high risk population for undergoing anesthesia and surgery due to unique anatomic, physiologic, and developmental differences compared to adults. A collaborative approach to pediatric anesthesia requires that all team members function with the most up-to-date information on caring for this challenging population. This conference will provide the anesthesia care team with current information on a variety of common pediatric anesthesia problems.

Ultrasound Guided Regional Anesthesia Preceptorship Course2010 Dates Available | Duke University Medical Center, Durham, NCFor more information, email Katherine Siler: [email protected] in the Duke Preceptorship will spend three days in the regional block area, op-erating rooms and on the floor with post surgery patients observing ultrasound guided single shot nerve blocks and catheter techniques in a wide variety of clinical scenarios. They will learn how to set up the block area for maximum efficiency in the OR environment, improve their decision making ability and make choices in the performance of regional anesthesia. A one-on-one discussion with the Duke Faculty member reviewing cases, scanning techniques and the image library as well as covering handout materials will augment the preceptorship experience.

Visiting Preceptorship in Intraoperative Transesophageal echocardiography2010 Dates Available | Duke University Medical Center, Durham, NCFor more information, email Jaime C. Cooke: [email protected] in the Duke Intraoperative TEE Preceptorship spend one three-day session in the cardiac operating suites, observing techniques of intraoperative TEE and interpretation of images. Preceptors will participate in active discussions with cardiothoracic anesthesia faculty and fellows, and learn the basic TEE exam. They will also learn how to troubleshoot difficult cases and enhance their decision-making skills in the operating room. Cases will be reviewed with fellows and faculty and images from pathology libraries will be used to aug-ment the preceptorship experience.

5th Annual Winter Anesthesia and Critical Care ReviewMarch 6-11, 2011 | The Canyons Resort | Park City, UtahFor more information, email Katherine Siler: [email protected] five-day course will focus on reviewing concepts and new advances in pain manage-ment, regional anesthesia, critical care, cardiac anesthesia and pediatric anesthesia.

4th Annual emerging Technologies in the oRJune 13-16, 2011 | Disney’s Grand Floridian Resort & Spa Lake Buena Vista, FloridaFor more information, email Katherine Siler: [email protected] four day course will focus on awareness among anesthesia providers concerning the function, use and limitations of new technologies and medications currently being used in the operating suites.

07-12-10

Documents

initial application

time of application

new policy

new nih policy

new funding

new policies

new letters of support

initial peer review