a time to heal

THE MAGAZINE OF WEILL CORNELL MEDICAL COLLEGE AND WEILL CORNELLGRADUATE SCHOOL OFMEDICAL SCIENCES

weillcornellmedicineSUMMER 2012

A Time to HealPsychologist JoAnn Difede uses virtual reality to help veterans with PTSD

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weillcornellmedicineTHE MAGAZINE OF WEILL CORNELLMEDICAL COLLEGE AND WEILLCORNELL GRADUATE SCHOOL OFMEDICAL SCIENCES

SUMMER 2012

22 WAR AND REMEMBRANCEBETH SAULNIER

With an $11 million grant from the Depart -ment of Defense, psychologist JoAnn Difede,PhD, is testing virtual reality as a treatment forPTSD in veterans of the wars in Iraq andAfghani stan. Using the sights, sounds, vibra-tions, and even smells of combat, the technol-ogy is designed to allow survivors of suchtraumas as sniper attacks and roadside bomb-ings to process their memories and begin toheal. “Humans,” says Difede, “don’t work bycognition alone.”

28 LIFE OF THE MINDSHARON TREGASKIS

Each year, 1.7 million Americans suffer trau-matic brain injury. For most, the effect is fleet-ing—but thousands wind up in nursinghomes, their grip on consciousness tenuous atbest. For twenty-five years, professor of neurol-ogy and neuroscience Nicholas Schiff, MD ’92,has investigated the structural biology andelectrical circuitry of human consciousness.Working closely with medical ethicist JosephFins, MD ’86, he seeks clues to predict whichpatients might awaken—and explores noveltherapies to promote recovery.

34 HEARTS AND MINDSANDREA CRAWFORD

The Ronald O. Perelman Heart Institute atNYP/Weill Cornell is dedicated to patient care,education, and—above all—prevention. Housedin a soothing, light-filled, seven-story space, itfeatures such patient-friendly amenities as acafé, a medical concierge, and an informationcenter on heart health. The Heart Institute,funded by a $25 million gift from its namesake,aims to be a “medical town square,” unitingWeill Cornell’s cardiovascular services—andallowing physicians, surgeons, and researchersto work more closely together.

FEATURES

•Twitter: @WeillCornell •Facebook.com/WeillCornellMedicalCollege •YouTube.com/WCMCnews

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Cover image courtesy of JoAnne Difede, PhD

Weill Cornell Medicine (ISSN 1551-4455) is produced four times ayear by Cornell Alumni Magazine, 401 E. State St., Suite 301,Ithaca, NY 14850-4400 for Weill Cornell Medical College and WeillCornell Graduate School of Medical Sciences. Third-class postagepaid at New York, NY, and additional mailing offices. POSTMASTER:Send address changes to Public Affairs, 525 E. 68th St., Box 144,New York, NY 10065.

2 LIGHT BOXFrom Between Seminar Rooms

4 CAPITAL CAMPAIGN UPDATE

6 DEANS MESSAGESComments from Dean Glimcher & Dean Hajjar

8 SCOPEDean Glimcher’s first Commencement. Plus: Braintumor biotech conference, new vice dean, virtualsuggestion box, a Living Heart sequel, PresidentSkorton mentors faculty, cancer surgery certificate,$50 million for stem cell research, autism centerbegins construction, ABC documentary includesNYP/ Weill Cornell, informatics center founded,and honors from the American Academy.

12 TALK OF THE GOWNPreventing blindness in preemies. Plus: MDs in thehealth-care debate, malaria nets for kids, sweettemptation, pass/fail report card, aiding asylumseekers, environmental illness, and WCMC-Q’s literary journal.

40 NOTEBOOKNews of Medical College alumni and GraduateSchool alumni

47 IN MEMORIAMAlumni remembered

48 POST DOCCandid career advice

DEPARTMENTS

Weill Cornell Medicine is produced by the staff of Cornell Alumni Magazine.

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Jim Roberts

EDITOR

Beth Saulnier

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Printed by The Lane Press, South Burling ton, VT. Copyright © 2012. Rights for republication of all matter are reserved. Printed in U.S.A.

Published by the Office of Public AffairsWeill Cornell Medical College and Weill Cornell Graduate School of

Medical Sciences

WEILL CORNELL SENIOR ADMINISTRATORSLaurie H. Glimcher, MD

The Stephen and Suzanne Weiss Dean, Weill Cornell MedicalCollege; Provost for Medical Affairs,

Cornell University

David P. Hajjar, PhDDean, Weill Cornell Graduate School

of Medical Sciences

Myrna MannersVice Provost for Public Affairs

Larry SchaferVice Provost for Development

WEILL CORNELL DIRECTOR OF COMMUNICATIONS

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2 W E I L L C O R N E L L M E D I C I N E

Clockwise from top:Dar Al-Hajar by MinKyung Choi ’15; FunkyStyle by RufaydaMarmar ’14; Flippingby Tariq Abdalla ’15; Untitled by NoorAnabtawi ’16; andUmar Ibn AlKhattabMosque, Qatar byTasnim Khalife, MD ’11

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Light BoxArtistic side: Photos from thesecond issue of BetweenSeminar Rooms, the Qatarbranch’s student-run literaryjournal, include Al Shaqab(right) by Tasnim Khalife, MD’11, and Supermoon (below) byAbdelaziz Farhat ’14. For moreon the journal, see page 21.

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Of Crystal Balls andAgents of Hope

Deans Messages

Laurie H. Glimcher, MD, Dean of the Medical College

A s a physician-scientist, I don’t believe you can seethe future in a crystal ball. Yet as I prepared toaddress the Class of 2012 at the recent Com -mence ment ceremonies in New York and Qatar, I

found myself searching for a reliable lens through which thesetalented doctors and scientists might glimpse the complexworld that awaits them as they embark on their careers.It was not an easy task. With advances in medicine happening

so quickly, discovery cycles compressing so tightly, and theincreasingly influential role of technology in everything we do, Ican only imagine what the world will look like ten, twenty, evenfifty years from now. As the Nobel Prize–winning physicist NielsBohr said: “Prediction is very difficult, especially about the future.” With that in mind, I focused my remarks on these things I

know to be certain: As graduates of Weill Cornell, members ofthe Class of 2012 are among the best prepared in the world totake on whatever the future holds. They are smart and skilledand capable, and they have global opportunities and a worldview that many others don’t. Most important, embedded in all the work they have done

at Weill Cornell is this essential thread: The patient is at thecenter of everything we do. This commitment to patient-centricity will be their beacon as medicine evolves and becomesmore complex, more technology-driven, and more demanding.Since there is no roadmap to the future, a beacon is a very goodthing to have.This is relevant no matter what discipline they pursue,

including a research path. In fact, it is even more important forthose who go into research because they may find themselvesfeeling disconnected from the bedside, unable to see for them-selves the impact of their work. Medicine is a journey of discovery. Almost every great

advance in medicine began with an observation by a curious,committed, and aware physician who let the patient and thepatient’s condition speak to him or her, and who knew how tolisten. With the implementation of the Patient Protection andAffordable Care Act, the legality of which was recently affirmed bythe United States Supreme Court, new models of patient care willbe tested that place greater emphasis on patient-physician andphysician-physician communication. As the next generation of dis-coverers, the Class of 2012 must observe and listen to their patients,and seek new ways of doing things, new cures, new processes, andnew paradigms of care.Theirs is a journey that is, by nature, full of risks. Discovery

doesn’t come from complacency. As the nineteenth-centuryScottish author Samuel Smiles said: “We learn wisdom from failuremuch more than from success. We often discover what will do, byfinding out what will not do; and probably he who never made amistake never made a discovery.”

Complicating the future for the Class of 2012 is the role of tech-nology. Some experts suggest that technology is moving so fast thatwe will experience 20,000 years of progress in the twenty-first cen-tury. These young medical professionals must be aware of technol-ogy’s challenges as well as its advantages. Technology is a great tool;they must use it, leverage it, and make it work for them. But theymust never let it come between them and their patients.I left our graduates with this Arabic proverb: “He who has

health, has hope. And he who has hope, has everything.” While itis not a prediction of the future, it is an eloquent and inspiringguideline. It is a reminder that ultimately they are treating people,not disease—and that as agents of good health, they are also agentsof hope.

AMELIA PANICO

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Researchers Without Borders David P. Hajjar, PhD, Dean of the GraduateSchool of Medical Sciences

A t the Graduate School of Medical Sciences, we havealways sought to recruit the best students in theworld. Thus, outstanding international students

have long made their way to York Avenue, historically comprisingat least one-third of our doctoral student body. For decades, thesescholars from abroad have populated labs, enhanced researchefforts, and developed close partnerships with faculty—playing anessential role, as all our students do, in the advancement of bio-medical research. When our students graduate and return to theirhome countries, many—about 60 percent—go into academicresearch, educating the next generation of scientists while helpingto build a global network of WCMC-trained researchers.

In recent years, however, we have seen an increase in the propor-tion of our students coming from abroad—even as the economicdownturn has prompted many more U.S. students, who in earlieryears might have chosen other careers, to pursue biomedical doctor-ates. Applications are up across the board—greater than 700 a yearfor sixty-five available positions in the class. Over the last five years,the number of international students applying to the GraduateSchool has doubled. The composition of our student body is nowsplit evenly between U.S. citizens and international students.

This increase results from concerted efforts to enhance globalrecruitment. For example, we have long had students from thePasteur Institute in Paris, France; from Tianjin and Beijing medicaluniversities in China; and from other institutions of higher learn-ing. Most recently, the Indian Institutes of Technology (IIT)—theworld-renowned collection of universities that count some of ourfaculty members among their alumni—has also been an academi-cally rich source of students for us. A few years ago Randi Silver,PhD, associate dean of the Graduate School, began visiting the IITcampuses to strengthen our institutional ties. Likewise, throughthe help of Brazil native Thomas Maack, MD, professor emeritusof physiology biophysics and medicine at Weill Cornell, theGraduate School is now developing new partnerships in SouthAmerica. Last fall, Dr. Silver and Assistant Dean Francoise Freyrevisited top universities in Brazil through its “Science WithoutBorders” program, a large, government-funded initiative toenhance science and research.

In the past couple of years, the Graduate School has also hadsuccess with our master of science program in clinical epidemiologyand health services research, under the direction of chair MaryCharlson, MD, and with assistance from Daniel Fitzgerald, MD,associate professor of medicine, and Warren Johnson Jr., MD, direc-tor of the Center for Global Health. The program recruits top med-ical professionals from abroad to train under the supervision ofWCMC faculty. They return home as clinical researchers able toteach investigative methods and conduct studies in a variety of

populations. In the last two years, we have graduated nine profes-sionals from South Africa, India, Tanzania, Haiti, and Brazil; seventrainees are currently enrolled in the program and three more arrivethis summer.

In a sign of the important role international students play inthe advancement of biomedical research, last year the HowardHughes Medical Institute launched a pilot program, the Inter -national Early Career Scientists Award, to identify foreign-born scientists with the potential to become leaders in their fields. Whilefederal training grants for biomedical research still require U.S. citi-zenship, HHMI has led the way in showing that scientific advancesknow no international borders.

At the Graduate School, we are very proud of our long traditionof educating international students. We look forward to furtherstrengthening our relationships with our “global” alumni—andreaching out to more potential students from all around the worldwho are the very best.

Study abroad: Alessia Deglincerti, an Italian grad student in phar-macology, works in the lab of Professor Samie Jaffrey, MD, PhD.

JOHN ABBOTT

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D ean Laurie Glimcher, MD, presidedover her first Com mence ment sea-son in May, when Weill Cornellconferred 144 MDs—thirty-two ofthem earned on the Qatar cam-

pus—as well as thirty-seven PhDs, twenty-sevenphysician-assistant degrees, and eleven master’s ofscience. “As graduates of Weill Cornell, you areamong the best prepared in the world to take onwhatever the future holds,” Glimcher said inCarnegie Hall. “You are smart and skilled and capa-ble. You are curious and open-minded. You are goodcommunicators and colleagues. And you have globalopportunities and a world view that many othersdon’t. Most important is that embedded in all thework you have done while studying here is thisessential thread: the patient is at the center of every-thing you do.” The Qatar campus celebrated its ownCommencement in early May, when seven womenand twenty-five men received their MDs. SaidWCMC-Q Dean Javaid Sheik, MD: “Nothing givesus greater pleasure than witnessing our talented stu-dents fulfill their dream of being called ‘Doctor’ forthe first time.”


ScopeNews Briefs

Two Campuses Celebrate Commencement

WCMC-Q

Academic regalia: The dignitaries at the WCMC-Q Commencement included (from left) Cornell University President David Skorton, MD, WeillCornell Dean Laurie Glimcher, MD, and Bakr Nour, MD, the Qatar branch’s associate dean for clinical affairs, who held the WCMC-Q mace.

WCMC Hosts Brain Tumor Biotech ConferenceAccording to the American Cancer Society, more than 22,000 people in the UnitedStates are diagnosed with brain or spinal tumors each year, and more than 13,000die from malignant growths. Reductions in federal grants have made private researchfunding all the more vital—prompting the Medical College to host the inauguralBrain Tumor Biotech Summit in June. The daylong conference, co-sponsored by theWeill Cornell Brain and Spine Center and the Weill Cornell Cancer Center, was con-ceived and chaired by associate professor of neurological surgery John Boockvar, MD,director of the Brain Tumor Research Group. It brought together leading brain tumorand biotech industry experts with the aim of accelerating more effective treatmentsand promoting funding for emerging therapies. Leaders from biotech, venture capi-tal firms, finance, foundations, and pharmaceutical companies discussed ways to getresearch noticed and funded, while scientists and clinicians presented findings onsuch topics as novel agents, gene therapies, and nanotechnology.

The event’s luncheon keynote speaker was Representative Patrick Kennedy, sonof the late Senator Edward Kennedy, who discussed his “One Mind for Research”initiative, a national coalition he co-founded to seek new treatments and cures fordiseases of the brain. He also shared his personal reflections about his father’s bat-tle with a brain tumor, noting that when the senator was diagnosed with glioblas-toma, he was given less than two months to live—but that thanks to theintervention of a bold surgeon, his life was extended by two years. “My father knewthat his days were coming to an end,” he said, “but he had the ability to say hisgoodbyes, to leave life the way he wanted to.”

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TIP OF THE CAP TO. . .Stewart Named WCMC’s First Vice DeanMichael Stewart, MD, the E. DarracottVaughan Jr., MD, Senior AssociateDean for Clinical Affairs and chair man of the Department of Oto -laryngo logy–Head and Neck Surgery,has been named to the newly createdposition of vice dean of the MedicalCollege. Announcing the position,Dean Glimcher said: “Dr. Stewart willwork closely with me, administration,department chairs, and directors of ourcenters and institutes to enhance theacademic and clinical missions of theMedical College.” Stewart’s duties willinclude assisting with academic and clinical program development,leading strategic planning initiatives, and serving as liaison to aca-demic partners and affiliates, including WCMC-Q. Glimcher callsStewart—a general otolaryngologist with expertise in nose andsinus disease, sleep breathing disorders, and head and neck trau-ma—“a dedicated teacher, an innovative researcher, and arenowned expert in outcomes research and evidence-based medi-cine in otolaryngology.”

‘Dean’s Challenge’ Seeks Innovative IdeasDean Glimcher has launched the “Dean’s Challenge,” an initiativeto gather and assess ideas for improving Weill Cornell throughinnovative policies and programs. Through the end of August, stu-dents, faculty, and staff can use their Weill Cornell credentials to logonto a website (ideas.med.cornell.edu) to make suggestions, or tocomment and vote on those made by others. In a college-wideannouncement, Glimcher said that she aims to “establish a mecha-nism that will enable the institution to develop innovative yet prac-tical and community-tested ideas to ensure that the MedicalCollege continues to provide excellence in education, research, andclinical care.”

Gotto Releases New‘Living Heart’ BookDean Emeritus Antonio Gotto, MD,has published another volume in hisbest-selling “Living Heart” series ofcardiovascular health books. Co-authored with the late MichaelDeBakey, MD, The Living Heart in the21st Century is geared toward a gen-eral audience—both people who areundergoing cardiac treatment andthose aiming to stay healthy.“Cardiovascular medicine has seenmajor advances since the first ‘LivingHeart’ book was published in 1977,” says Gotto, co-chairman of theBoard of Overseers, the Lewis Thomas University Professor at WeillCornell, and vice president and provost for medical affairs emeritusat Cornell University. “This new volume contains the latest infor-mation on how to prevent, diagnose, and treat heart disease in thetwenty-first century.” Previous books in the series include The LivingHeart, The New Living Heart, The Living Heart Diet, and The LivingHeart Cookbook.

Donald D’Amico, MD, the Betty Neuwirth Lee and ChillyProfessor in Stem Cell Research and chairman of theDepartment of Ophthalmology, who was invited to a Vaticancongress on blindness and met Pope Benedict XVI.

Professor of clinical neurology and NYP/Weill Cornell neurologist-in-chief Matthew Fink, MD, elected a fellow ofthe American Academy of Neurology.

Oncology researcher Paraskevi Giannakakou, PhD, associateprofessor of pharmacology in medicine and director of labora-tory research in the Division of Hematology and MedicalOncology, given the Mary Kalopathakes Award from theHellenic Medical Society of New York.

Dean Emeritus Antonio Gotto, MD, co-chairman of theBoard of Overseers, winner of the Pasarow Foundation Awardin Cardiovascular Research for his contributions to the field.

Helen Hobbs, MD, a professor of internal medicine andmolecular genetics at the University of Texas SouthwesternMedical Center, recipient of the first Antonio M. Gotto Jr.Prize in Atherosclerosis Research.

David Lyden, MD, PhD, the Stavros S. Niarchos AssociateProfessor in Pediatric Cardiology, winner of the I. J. “Josh”Fidler Innovation Award from the Metastasis Research Society.

Pediatrics professor Jeffrey Perlman, MD, named NYP/WeillCornell’s Physician of the Year.

Mukesh Prasad, MD, associate professor of clinical otolaryn-gology, winner of the Patients’ Choice Award from thephysician-assessment website vitals.com.

Andrew Schafer, MD, the E. Hugh Luckey DistinguishedProfessor of Medicine and chair of the Department ofMedicine, winner of the Robert H. Williams, MD,Distinguished Professor Award from the Association ofProfessors of Medicine, considered the most prestigious prizein the field of academic internal medicine.

Peter Schlegel, MD, the James J. Colt Professor of Urologyand chair of the Department of Urology, who received theBarringer Medal from the American Association ofGenitourinary Surgeons.

Cornell University President David Skorton, MD, winner ofthe Exemplary President in Governmental Relations Awardfrom the Association of Public and Land-Grant Universities’Council on Governmental Affairs.

Ashutosh Tewari, MD, the Ronald P. Lynch Professor ofUrologic Oncology and director of the Lefrak Center forRobotic Surgery, winner of the Gold Cytoscope Award fromthe American Urological Association.

Michael Stewart, MD

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Autism Center Under Way in WestchesterThe Westchester campus has begun construction on its new Centerfor Autism and the Developing Brain. To be located in a formergymnasium on the historic psychiatric campus in White Plains, theresearch and treatment center will feature design elements friendlyto people with autism—including open, light-filled spaces, roomsidentified by color, and ample carpeting and soundproofing toreduce noise. Its treatment protocols will take an integratedapproach, with a combination of applied behavior analysis andother therapies to improve social communication and motor andadaptive skills. “Our focus on the lifespan and interdisciplinarycombination of evidence-based approaches to both assessment andtreatment is unusual, even among the most highly respected pro-grams in the country,” notes autism authority Catherine Lord, PhD,the Center’s director. “We’re also proud of our innovative approachto diagnosis and treatment, and our core identity is as a hub fromwhich we can connect patients and families to the wealth of pro-grams and services in the community.” Slated to open in early2013, the 11,000-square-foot Center is a joint initiative of NewYork-Presbyterian Hospital, Weill Cornell, and Columbia UniversityCollege of Physicians and Surgeons, in collaboration with the NewYork Center for Autism.

ABC Documentary Highlights HospitalWeill Cornell faculty are featured in a medical documentary seriesthat began airing on ABC in July. “NY Med,” which chronicles storiesof patients and staff at NYP/Weill Cornell and NYP/Columbia,debuted on July 10. The eight-part program marks the first time thata New York hospital or academic medical center has been profiled ina documentary series.

Skorton Attends Faculty Mentoring ProgramIn April, President Skorton was the featured guest at the monthlysession of the Department of Medicine’s Faculty DevelopmentMentoring Program. Established in 2010, the novel program aimsto offer peer mentorship to faculty in the early stage of theircareers. At the meeting, Skorton—also a professor of medicine and

of medicine in pediatrics at Weill Cornell—told the ten assistant professors in atten-dance at the Cornell Club in Midtown thattheir success as faculty members is funda-mental to the Medical College’s mission. Tofacilitate career development, he said, facul-ty must reflect on their choices and rely on their values to lead them in the right direction. “Academic medicine can be dehumanizing,” Skorton said. “You thinkabout your career instead of your life andpersonal values.”

The ten-month mentoring programcomprises monthly eight-hour group ses-sions where participants learn how to aligntheir career and life goals with their valuesand receive practical guidance on oral pres-entation, writing skills, team building, lead-ership, negotiation, and more. “I think it’sbeen fantastic,” says participant Tara

Bishop, MD ’02, the Nanette Laitman Clinical Scholar in PublicHealth–Clinical Evaluation. “I’ve never had an opportunity to havetime set out to think about my career and where I want to be in thenext decade and what it’ll take to get there.”

Michelassi Champions Cancer Surgery CertificateThanks in part to the efforts of Department of Surgery ChairmanFabrizio Michelassi, MD, the American Board of Surgery will soonoffer a subspecialty certificate in complex general surgical oncology.Michelassi, the Lewis Atterbury Stimson Professor of Surgery andcurrent chair of the Surgical Oncology Board, led the SurgicalOncology Advisory Council’s 2009 examination of the feasibility ofthe certificate—which, he says, “opens a new chapter in the historyof the American Board of Surgery.” The certificate, to be offered asearly as 2013 to graduates of accredited two-year training programsfollowing completion of general surgery residencies, comes after aquarter-century of advocacy by surgical oncologists. It’s the firstnew certificate the Board has offered since 1984.

Starr Gives $50 Million for Stem Cell ResearchContinuing its support for stem cell research, the StarrFoundation has made a $50 million gift in support of the Tri-Institutional Stem Cell Initiative (Tri-SCI), a collaborative effort ofWeill Cornell, Sloan-Kettering, and the Rockefeller University.Established in 2005 through a grant from the Foundation, Tri-SCIfunds interdisciplinary research, technology development, semi-nars, symposia, and fellowships. “Stem cell research has under-gone a remarkable expansion and transformation in the sevenyears since this initiative was launched,” says Maurice Greenberg,chairman of the Starr Foundation and a member of the WeillCornell Board of Overseers. “There are many exciting develop-ments on the horizon, and I am delighted that the StarrFoundation can renew its support of this important collaborativeeffort at such a promising time.”

CorrectionDue to a production error, Aasim Padela, MD ’05, was given anincorrect first name in “Making Accommodations” (Talk of theGown, Special Issue 2011). Our apologies to Aasim.

DASILVA ARCHITECTS / WWW.DASILVAARCHITECTS.COM

David Skorton, MD

AMELIA PANICO

Welcoming space: A rendering of an activity room at the Centerfor Autism and the Developing Brain


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FROM THE BENCH

New Technique ImprovesMelanoma DiagnosisA new staining technique is more than 90 per-cent accurate in identifying melanoma. The test,described in the Archives of Dermatology, uses asoluble adenylyl cyclase (sAC) expression patternto determine if a specimen is benign or cancer-ous. “The sAC stain is either positive or negativein the cell’s nucleus,” says the study’s seniorauthor, Jonathan Zippin, PhD ’05, MD ’06, assis-tant professor of dermatology. “Other stainsrequire an interpretation of the staining intensity,which means that a diagnosis of melanoma canrest on a pathologist’s opinion.” A benefit of thenew test, which can be used in conjunction withcurrent methods, is that it offers a clear indica-tion of where a cancerous lesion ends andhealthy tissue begins. “What I hope,” Zippinsays, “is that five years down the line, this andother stains will help pathologists remove anyuncertainty as to whether a biopsy is worrisome.”

Preventing Cervical Cancerin HIV-Positive WomenAspirin may keep HIV-positive women from devel-oping cervical cancer. In a study of Haitianwomen infected with HIV, researchers led byDaniel Fitzgerald, MD, associate professor of med-icine, discovered that HIV induces expression ofthe COX-2/PGE2 inflammatory pathway in cervicaltissue. “These young patients—many of whomwere mothers and the sole support for their fami-lies—had worked hard to have their HIV con-trolled with antiretroviral therapy, only to developand die from cervical cancer,” Fitzgerald notes.Aspirin is one of the cheapest and most effectiveCOX inhibitors—making the discovery especiallyvital for patients in developing countries.

Compound Offers TargetedCancer TreatmentA collaboration among Weill Cornell, Sloan-Kettering, and the National Cancer Institute hasyielded a compound, PU-H71, that binds toabnormal protein complexes in cancer cells—pointing the way to more targeted treatmentswith fewer side effects. Associate professor ofmedicine Ari Melnick, MD, director of the SacklerCenter for Biomedical and Physical Sciences, andcolleagues are exploring the compound’s poten-tial for treating diseases such as breast cancerand lymphoma. The work was published inNature Chemical Biology. “The holy grail in thefield was to develop some way to figure outwhat factors keep cancer cells alive, regardlessof whether they have mutations,” Melnick says.“In this paper, we presented a method to dojust that.”

Head Size Gene Related toParkinson’s and DementiaDennis Mook-Kanamori, MD, a geneticist on theQatar campus, has found that a gene previouslyknown to be associated with dementia andParkinson’s disease is also related to head size.Mook-Kanamori and colleagues identified thehead-size gene by measuring the head circumfer-ence of 10,000 children and scanning theirgenomes. In a separate MRI study of 8,000 peo-ple, Mook-Kanamori found that the same gene islinked to intracranial volume. Both studies werepublished in Nature Genetics. “Although it’s onlyresponsible for a small variation in head size, itmay still give you an idea of why people getdementia and Parkinson’s,” he says of the gene.“It’s the beginning; it’s the first step to under-standing biological pathways.”

Pay-for-PerformanceIncentives May Not Pay OffThe financial incentives to improve health careknown as “pay-for-performance” may not havesignificant effects, reports a Weill Cornell assis-tant professor of public health. In HealthAffairs, Andrew Ryan, PhD, the Walsh McDermottScholar in Public Health, and colleagues lookedat the first two phases of the Medicare andMedicaid hospital pay-for-performance pilot pro-gram. The first phase, which began in 2003,rewarded only high performers and showedpromising results; the second, launched in2006, increased incentive payments by 50 per-cent and included three tiers of reward. Basedon quality measures related to heart attack,heart failure, and pneumonia, the researchersfound that improvement rates flat-lined—andeven, in some cases, decreased—in the secondpilot program compared to the first. “I’m franklynot very optimistic that, as it is currently struc-tured, hospital pay-for-performance is going tomake much of an impact,” Ryan says.

Meta-Analysis ComparesProstate Surgery MethodsRobot-assisted prostate cancer surgery comparesfavorably to other techniques, reports a study inEuropean Urology. Ashutosh Tewari, MD, theRonald P. Lynch Professor of Urologic Oncologyand director of the Lefrak Center for RoboticSurgery, and colleagues performed the first largemeta-analysis of three types of prostatectomies:open radical, conventional laparoscopic, androbot-assisted. The analysis included a review of400 original articles and treatment informationon nearly 290,000 patients. It found that com-pared to the two other approaches, robot-assistedsurgery offered lower complication rates, lessblood loss, and fewer transfusions.

Healthcare Informatics Center FoundedWith a keynote address by New York State health commissionerNirav Shah, MD, Weill Cornell marked the establishment of theCenter for Healthcare Informatics and Policy in March. The Center,which is designed to foster interdepartmental collaboration toaddress issues at the intersection of health-care informatics and pol-icy, will be led by Rainu Kaushal, MD, the Frances and John L. LoebProfessor of Medical Informatics and chief of the Division of Qualityand Medical Informatics at Weill Cornell. “Through collaborativeefforts, the Center for Healthcare Informatics and Policy conductsresearch and offers services and programs that drive innovation,educate, and provide critical insights into how technology applica-tions, solutions, and devices can improve the quality, safety, andefficiency of health care,” says Kaushal, who is also executive direc-

tor of New York State’s Health Information Technology EvaluationCollaborative. The Center’s members—drawn from such depart-ments as pediatrics, public health, medicine, radiology, pathology,and urology—have expertise in informatics, clinical medicine, bio-statistics, public health, computer science, economics, and more.

Weill and Fins Elected to American AcademyForemost benefactor and Board of Overseers Chairman SanfordWeill and ethicist Joseph Fins, MD ’86, have been elected to theAmerican Academy of Arts and Sciences. Weill and Fins, a professorof public health and the E. William Davis Jr., MD, Professor ofMedical Ethics, are among the 220 new fellows set to be inductedinto the Academy in October. Cornell University President DavidSkorton, MD, was elected to the Academy last year.

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Talk of the GownInsights & Viewpoints

In an outpatient medical clinic in Ulaan -baatar, Mongolia, last summer, motherswere lined up with their babies outside anexam room. Inside was R. V. Paul Chan,MD, associate professor of ophthalmology,

who was screening the children for retinopathyof prematurity (ROP), a retinal vascular eye dis-ease that can cause blindness. Chan was on oneof the seven trips he’d make in 2010–11 to devel-oping countries where improvements in neo -natal care have paradoxically led to a veritableepidemic of ROP. The scene before Chan wassobering, with a third of the children sufferingthe most severe forms of ROP—the ones that aredifficult or impossible to reverse. One mother,refusing to accept her child’s prognosis, stoodoutside the door to the exam room all day, cry-

Global Vision

Ophthalmologist R. V. Paul Chan, MD, combats

an eye disease that strikes premature infants

ing. “Is my baby going blind?” she asked Chanover and over.

Her grief reinforced what for Chan is anurgent mission. In the United States, guidelinesstipulate which babies should be screened for ROPbased on their birth weight and gestational age;today, ROP-related blindness is mostly limited tothe tiniest. In Mongolia and many other middle-income countries, no such parameters exist, andROP may account for 60 percent of cases of blind-ness, according to a 2007 study in the journal Eye.“Had a system been in place, that child wouldnot have been blind,” says Chan, the St. GilesAssociate Professor of Pediatric Retina. “You gointo a country that never managed ROP beforeand see babies who need treatment right now,and your heart drops.”

R. V. Paul Chan, MD

JOHN ABBOTT

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leading the charge.”Chan remains New York-based. But

through his work with ORBIS, the ArmenianEye Care Project, the Insight Foundation,and other nonprofit organizations, he’s pro-moting the need for permanent expertiseoverseas. “It’s a team effort,” he says, “andwe have a committed group of collaboratorsfrom the U.S., Mexico, Thailand, and anumber of other countries.”

Chan often travels with colleagueswho specialize in neonatology andtelemedicine with the idea of disseminat-ing their knowledge to local providers whocan pass it on to others. From the U.S.,Chan and his colleagues then keep upwith the doctors they’ve trained, mentor-ing them via Web-based platforms on theimages they send of their patients’ retinas.“They take the picture; I get it on myphone and reply to tell them what Ithink,” he says. “After a certain period oftime, they’re recognizing and treating kidson their own. Our in-country partnershave learned how to manage ROP, and bycapitalizing on the technology we have atour disposal, we all stay connected.Through digital imaging and education,we have the potential of keeping a genera-tion of children around the world fromgoing blind.”

— Jordan Lite

tional health-care force appeals to Chan,who was raised by ophthalmologist par-ents who dedicated their careers to train-ing doctors in the U.S. and Asia. Last year,he traveled to Peru, Vietnam, Mongolia,Armenia, Mexico, and Thailand to screenand care for children and work with localproviders to recognize and treat ROP. Heexpects to return this year to all of thosecountries, and will go to China as well.“Education leads to sustainability,” he says.“If you teach someone to manage ROP,they’re better equipped than if you wentthere and did it for them.”

Chan, a Philadelphia native who didhis residency at Weill Cornell followed bya fellowship at Harvard, knew that hewanted to make global health part of hispractice, but he initially wasn’t sure how.After he returned to Weill Cornell in 2006,he began studying ROP, and the followingyear traveled to Mwanza, Tanzania, on afact-finding mission to help the MedicalCollege prioritize its ophthalmology workwith partner school Weill Bugando. Thetrip underscored his belief that to be effec-tive, global health requires a long-term,full-time commitment. “It galvanized thisconcept of, ‘education is one of the mostimportant things we can focus on,’ ” hesays. “And we’re not going to change theworld unless you have someone in-country

S U M M E R 2 0 1 2 1 3

The retinal blood vessels are notmature at birth, and exposure to too muchoxygen before they have fully formed cancompromise their development. In theU.S., newborns are screened for ROP ifthey weigh less than 1,500 grams at birthand are delivered at less than or equal tothirty weeks gestation; titrating oxygenwhile a preemie is in the NICU is a crucialform of risk reduction. But prematureinfants in developing countries often arenot screened for ROP and may be givenconstant 100 percent oxygen, elevatingtheir chance of developing the disease.While many children who develop ROPcan have their condition regress, if treat-ment is required and it’s caught in timelaser surgery can halt its progression.However, very little can be done to com-pletely preserve the sight of those whoseretinas have completely detached.“Children who are blind don’t live as long,are ridiculed, and live a life of depend-ence—and you take a person [who caresfor them] out of the workforce,” Chansays. “If you catch it, you can preventthem from living a life of blindness. If youdon’t treat it in time, it’s game over: thischild will go blind.”

In two short years, Chan has become akey resource for the nonprofit group ORBISInternational, which trains health-careworkers in developing countries to preventand treat blindness. “Whenever our proj-ects need expertise in ROP, that’s when wegive Paul a call,” says Danielle Bogert, theorganization’s director of faculty relations.“He’s spearheading dialogue at nationaland regional levels in terms of screeningprotocols, human resources, and infrastruc-ture for countries to create a robust ROPprogram.” As one of 400 volunteer facultymembers, Chan flies to Asia and LatinAmerica for seven- to ten-day trips everyfew months. There, emerging economieshave provided the resources to buy lifesav-ing—and sight-saving—equipment, but notalways the expertise to use it.

Chan’s drive and intensity impressDavid “Hunter” Cherwek, MD, who sits onORBIS’s medical advisory board and hasworked with him in Peru, Mongolia,Guatemala, and Vietnam. “I’ve seen himget off a flight after thirty hours and gostraight from the airport to start seeingchildren,” Cherwek says. “He’s been ableto give children and families hope whenno one else in that country would be ableto diagnose or treat them.”

The potential to seed a skilled, interna-

LESLIE MACKEEN

See how it’s done: Chan in Mongolia, guiding a pediatric ophthalmologist as she performsan eye exam on a young boy



A lice Chen, MD ’05, wasin her first year on thefaculty as an internalmedicine hospitalist atUCLA when she joined a

new group of physicians and medical stu-dents calling themselves Doctors forAmerica (DFA). Today she’s executivedirector of the nonprofit, founded in 2008and self-described as a “national move-ment of 15,000 physicians and medicalstudents working together to improve thehealth of the nation and to ensure thateveryone has access to affordable, high-quality health care.”

DFA is not a lobbying body but a “vastcommunity resource” with members in allfifty states, says Chen, who splits her timebetween the group’s home base inWashington, D.C., and her clinical prac-tice at UCLA. “We rally in our white labcoats, hold educational communityforums, and do just about everything fromhonk-and-waves to speaking with mem-bers of Congress,” she says. DFA membersregularly appear in the media in an effortto make the point that the Affordable CareAct is a critical step that is already helpingmillions of people, including the youngadults who now have health insurancethrough their parents, the seniors who aregetting assistance with prescription drugcoverage, and the communities that arereceiving grants for programs that pro-mote healthy school lunches and otherinitiatives. Chen stresses, however, thatthe group is not affiliated with any parti-san group or the Obama Administration.“Membership is drawn from across thepolitical spectrum, and we encourage our

A Seat at the Table

Internist Alice Chen, MD ’05, leads Doctors for

America, which works to get physicians’ voices

heard in the health-care debate

members to speak out individually abouttheir own beliefs and experiences in thehealth-care system,” she says.

While focused on organizing and train-ing physicians to be advocates, DFA alsoworks with organizations that representnurses, physician assistants, pharmacists,patients, and others who deliver or receivehealth care. In January, the group filed ajoint amicus brief with the Supreme Courtin anticipation of hearings on the consti-tutionality of the Affordable Care Act. Itargues for the constitutionality of the min-imum coverage provision, commonlyreferred to as the “individual mandate,”which requires citizens to carry healthinsurance or face financial penalties. Chenand other DFA members rallied outside thehigh court during its March hearings onthe case—one group among many arguingfor or against the health-care law. “Doctorsare not used to having to play the role of

activist,” she says. “But they are learningthat they have to step up if they want asay in the future of America’s health care.”

When Chen volunteered for DFA, itwas a loose affiliation of physicians andmedical students from across the U.S. whosimply wanted a voice in the roilingnational debate on health-care reform.“None of us knew how to run a grass-rootsorganization,” Chen recalls. “We learned alot from other health-care groups andmedical societies, and we were luckybecause there was momentum in thatdirection.” The groundswell started in2008, when President Barack Obama chosehealth-care reform as his top priority. TheAffordable Care Act, signed into law in2010 and dubbed “Obamacare” by itsopponents, incited an ideological war. Inthe political backlash that followed, doc-tors and medical students found them-selves largely left out of the conversation

Marching for medicine: Doctors for America members demonstrate in Washington, D.C.,in spring 2010. Top left: Alice Chen, MD ’05, the group’s executive director.

NORRIS KAMO


S U M M E R 2 0 1 2 1 5

Net WorthMargaret McGlynn ’14 and her sisters help

Ugandan kids avoid malaria

Talk of the Gown

—frontline personnel relegated to the side-lines. Their collective frustration proved tobe fertile territory for Chen’s organization,whose main goal is to make sure thatphysicians’ voices are heard in the debate.“Health care should not be about politics,”says Chen. “Doctors who have had to turnaway patients who cannot afford propermedical services know firsthand the tragicresults of our broken health-care system.”

According to a group survey, themajority of DFA members are physicians—more than half have been in practice formore than ten years—and most others aremedical students. There is a roughly fifty-fifty split between doctors in private prac-tice and those who work or study inacademic hospitals, community healthcenters, Veterans Affairs, and the IndianHealth Service. DFA’s membership alsoincludes medical school deans and healthpolicy experts.

The group’s varied efforts have gar-nered widespread media and governmentalattention. Members are regular con -tributors to op-ed pages in major newspa-pers (the Associated Press covered theirrally at the high court) and have appearedon CNN, MSNBC, Fox News, and otheroutlets. In January 2011, President Obamaappointed DFA president Vivek Murthy,MD, to a panel that advises the NationalPrevention, Health Promotion, and PublicHealth Council, which is mandated by theAffordable Care Act to devise nationalhealth and wellness strategies. This year,DFA aims to educate one million Ameri -c ans about health-care reform, an initiativethat includes training 1,000 physicians andmedical students on the nuts and bolts ofleading community education events.

As much as DFA’s goal is to inform pol-icymakers and the public on the factsabout affordable care, Chen says that italso serves as a support network for physi-cians and students who feel powerless tochange a deeply flawed health-care sys-tem. “Our common cause is a desire toimprove that system,” says Chen, whoconcedes that she sometimes feels atwinge of guilt for not treating patientsfull time. She has a prescription for thosemoments—a mantra of sorts. It’s the sameone she used to get through the gruelingdays and nights of internship: the closinglines of the Weill Cornell HippocraticOath. “That I will be an advocate forpatients in need,” Chen recites, “and strivefor justice in the care of the sick.”

— Franklin Crawford

Many nonprofits strive to help children in Africa. Some provide them withan education, while others work to prevent diseases such as malaria. In2007, Margaret McGlynn ’14 and her four sisters founded an organizationthat aims to do both.

After meeting a Ugandan man visiting their Illinois hometown to spreadthe word about the challenges facing his country, the sisters were alarmed to learn that one ofthe chief barriers to school attendance is malarial infection. So they founded NETwork AgainstMalaria, a nonprofit that provides bed nets to protect children from infected mosquitoes. Thegroup delivers nets directly to rural schools, where local volunteers educate students on theirproper use. “The children and adults of Uganda are the ones who will change their nation,”says McGlynn, who majored in biology at Nebraska’s Creighton University. “We’re justempowering them to develop the talent they already possess.” To date, more than 11,000 ofthe $10 nets have been delivered; another large distribution is planned for August.

Having started small—fundraising through T-shirt sales and individual donations—thenonprofit has expanded over time, now boasting seventeen chapters across thirteen states. Ithas partnered with a foundation that employs Ugandan women to make beads from recy-cled paper; volunteers—some of them Weill Cornell students—use the beads to make jewel-ry, which is sold in shops throughout the U.S., including the WCMC bookstore.

In the summer of 2011, McGlynn traveled to Kampala to study Kaposi sarcoma on aresearch trip sponsored by the Weill Cornell Global Health Program. In her spare time, shetraveled to the town of Hoima, one of NETwork’s primary sites, to distribute nets and visitwith children. “Hearing about the devastating effects of malaria is much different from see-ing them,” McGlynn says. “Knowing the names of these children who are at risk of dyingfrom malaria made what we are doing very personal.”

— Erin Keene

Debugged: Margaret McGlynn ’14 distributes malaria nets to schoolchildren in Uganda.

PROVIDED



Talk of the Gown

Sweet ScienceThe Sackler Institute follows up

the “marshmallow test”

I t was a classic psychological study. In theSixties and Seventies, hundreds of four-year-olds from a Stanford University pre-school were given a choice. They couldhave one cookie or marshmallow now—

but if they waited fifteen minutes, they couldhave two of them.

For some, it was a no brainer. “There was agroup of children who had the cookie in theirmouth even before the researcher left the room;that’s sort of what we’d expect with four-year-olds,” says BJ Casey, PhD, the Sackler Professorand director of Weill Cornell’s Sackler Institutefor Developmental Psychobiology. “But therewas also a group of individuals who could wait—

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and the way in which they waited was reallyinteresting.” Some sat on their hands; othersturned the chair away to avoid looking at thetreat. “One little girl came up with an imaginaryfriend,” Casey says, “and she talked about any-thing but the cookie.”

What came to be known as the “marshmal-low test” turned out to have surprising predictiveabilities. As researchers followed the children intoadulthood, they found that those able to delaygratification tended to do better on certain meas-ures of success. On average, for example, they hadhigher SAT scores and lower rates of substanceabuse; they were more likely to have lasting mar-riages and were less likely to be overweight.

Now, Casey has taken the research a step fur-ther. She and her co-investigators retested fifty-nine of the original subjects—those at the farends of the delayed-gratification spectrum—tosee if their tendencies persisted into their forties.(Since not all adults are tempted by marshmal-lows or cookies, they used a common testing toolin which subjects are drawn to images of smilingfaces.) The result: Casey and her team were“blown away” by the similarities between thechildhood and adult behaviors.

What’s more, they found a biological basisfor the tendencies. As expected, fMRI showedthat the prefrontal cortex—the higher-reasoningregion that Casey jokingly calls the “Vulcan” areaof the brain, in honor of Mr. Spock of “Star Trek”fame—was involved. But even more importantwas a deep region known as the ventral striatum,which has been implicated in addiction. “Thelow delayers were activating that region more,but the area was suppressed in the high delay-ers,” Casey says. “Much as the four-year-olds didwith their hands, the forty-year-olds were doingin their minds.”

The research is ongoing; Casey is especiallyinterested in studying those subjects whose incli-nation did switch from childhood to adult-hood—noting that the work has promise forinterventions into behaviors related to impulsiv-ity, such as drug addiction and over-eating. “Ifthey’re seeing a change in how they can stopthemselves,” she says, “we want to know howthey can do that.”

But Casey stresses that being a low delayerisn’t a recipe for doom; as a group, she says, theoriginal test subjects are doing quite well. “Do Iwant there to be no low delayers in life?” shemuses. “Absolutely not. In science, for example,it’s wonderful to do logical, methodical studies.But usually when we take a step forward, it’sbecause someone does a high-risk experimentoutside the box. And that’s what low delayersmay be doing—making connections quickly andacting on them.”

— Beth Saulnier

BJ Casey, PhD


S U M M E R 2 0 1 2 1 7

Making the GradeNew pass/fail system gets high marks

For years, medical students, fac-ulty, and administrators debat-ed with passion the potentialmerits and pitfalls of a pass/failsystem. Would it lower student

stress or allow them to grow complacent?Was the current system fair in grantinghonors on a curve, so that in every yearand every class a different standard deter-mined who gets an “H” and who merelypasses—even if, as often happened, thedifference amounted to only a tenth of apercentage point?

In fall 2010, after those and other issueswere duly considered, WCMC instituted apass/fail system for the first two years ofmedical school. According to Peter Marzuk,MD, associate dean for curricular affairs,the College made the change to “correctinherent unfairness, improve student colle-giality and collaboration, foster greaterexploration of different learning formatsand materials, and be more in line withour peer institutions.” The new systemdrops the designation of honors for thefirst and second years, thereby removingwhat Marzuk calls artificial cutoffs betweenstudents. “We have such an outstandingclass of high-achieving students that itbecomes very difficult to try to distinguish‘honors’ from ‘pass,’ particularly a ‘highpass,’ in the first two years,” he says. Thethird- and fourth-year clerkships remain onthe system of honors, high pass, pass, andfail—as is the case in the majority of med-ical schools throughout the country.

Most students supported the move,according to Bem Atim ’13, whose classspent its first year in the old system and itssecond in the new. Previously, “there wasno way to know how you compared withyour classmates until the final grade cameout, so people felt it was an arbitrarybenchmark that changed every year,” hesays. “It’s like playing a basketball game butnot knowing the score until the end, so it’simpossible to keep track of your progress.”

With honors granted on a curve, com-petition was inherent. “Now, you don’thave to ‘wish someone else did poorly,’”Marzuk says. Already, Atim says, studentshave sensed a change. “People seem a little

bit more cooperative, more willing to e-mail study guides or form study groups,”he says. Carol Capello, associate director ofthe Office of Curriculum and EducationalDevelopment, says that preliminary resultsfrom an IRB-approved study showed that80 percent of students felt their class envi-ronment had become less competitive,and 92 percent said the changes had a pos-itive effect on stress levels. Capello is sur-veying students and faculty to assess awide range of attitudes and outcomes;complete results will be released in the fall.

Improved collegiality and lower stu-dent stress levels had been cited as reasonsto alter the grading system, but faculty hadfeared it would reduce motivation. Marzuknotes that the medical education literatureshows that has not been the case in otherpass/fail systems. Carol Storey-Johnson,MD ’77, senior associate dean for educa-tion, says that WCMC has seen no evi-dence of students slacking off, noting that“the quiz scores have been as strong asever.” Elan Guterman ’13, who was a stu-dent representative on the basic sciencesfaculty committee while the issue wasunder consideration, agrees. “We’re allmedical students and perfectionists atheart,” she says, “so we wanted to do wellwhether or not there was the hope of get-ting honors at the end.”

The new system is not “pure” pass/fail,since scores for each component—quizzes,

small groups, and clinical work—are stillrecorded in an internal document knownas a performance profile. These scores arebased on established criteria rather thanbeing determined relative to other students’performance; they are not weighted or con-verted into an overall numerical grade.

Students must get above a 65in each component to pass acourse (though the officialtranscript shows only a P oran F). But the performanceprofile allows students to seehow they’re doing and wherethey might need to improve,and it informs the writing ofthe dean’s letter and grantingof Alpha Omega Alphaawards—allowing the dean tosee all individual componentscores and not a final grade.

Problem-based learning,mean while, has gone to apure pass/fail system, withnarrative assessments notconverted into scores. “Our

goal is to accurately capture performance,”says Marzuk. “The dean can see exactlyhow they’re doing across all the courses. Itgives a more rounded picture of students’talents.” Guterman says that studentsappreciate the more nuanced scrutiny,calling it “a good opportunity for the fac-ulty to understand our aptitude on manydifferent levels.”

In the old system, which placed greaterweight on quiz and exam scores, “thequizzes were like the battleground wherethat honors grade was decided,” Atim says.With quiz scores no longer weighted moreheavily than other components, some stu-dents have observed healthier attitudestoward learning and greater self-direction.“It allows some of our basic science activi-ties to become more of an academic play-ground,” says Guterman, “where we’re safeto experiment and question.”

Not only has the new system changedthe way students study, it has also alteredthe way that at least one faculty membergives exams. Now, Marzuk notes, he writesquestions so they mirror learning objectivesand no longer worries about crafting someof them to create a point spread among stu-dents. “I’d like to think our students arehere because they want to be the best physi-cian and learn as much as possible,” saysMarzuk. “It’s not just a matter of needingsome external motivation called a grade.”

— Andrea Crawford

ALLEGRA STUDIO

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Talk of the Gown

Safe Haven

Student group helps refugees seek asylum

A fter suffering years of persecutionand violence in his native countrybecause of his sexual orientation,

the young Gambian man sought asylum in theU.S. But during his interview, a government offi-cial found inconsistencies in his story—for exam-ple, whether his plane ticket to America hadbeen one-way or round-trip. “One of the mainreasons that people have difficulty getting asy-lum is if there is any discrepancy, even withminor details,” observes Ellie Emery ’14. “It canbe a reason to think the client isn’t credible.”

Emery is executive director of the WeillCornell Center for Human Rights, a two-year-oldstudent organization that offers physical and psy-chological exams to support immigrants’ asylumclaims. With the help of volunteer profession-als—most of them WCMC faculty—the groupevaluates asylum seekers and creates medical-legalaffidavits in advance of their hearings. As of thisspring, it’s batting 1.000: of the two dozen clientswhose cases have been adjudicated,all have had their petitions granted.In total, the group has evaluatedmore than fifty people from sometwo dozen countries.

“The feeling you get when youhear that a client you worked withhas gotten asylum is hard todescribe,” says co-founder ShelliFarhadian, who completed her MD-PhD in May and matched in internalmedicine at Yale. “You get chills. Youfeel like you’ve affected a life in aprofound and powerful way. We hadat least one client who was given asylum andwas also able to bring his family here; that reallysticks with you, knowing that an entire familyhas the opportunity to start over in the U.S. Myparents are immigrants—they fled revolutionaryIran in 1979—so I have a personal connection topeople coming to America with very little.”

In the case of the man from Gambia, the stu-dents and their physician mentor found a med-ical reason for his conflicting tale: thein con sistencies in his story could be traced to

head trauma from the many anti-gay beatingshe’d suffered. “When we did a mental statusexam on him, he had huge cognitive disabilities.He couldn’t even remember his own phonenumber,” says Emery, who earned an undergraddegree from the Ithaca campus in 2010. “So wewere able to explain to the judge why, medically,there were discrepancies in the case.”

The program finds its clients through referralsfrom the asylum arm of the nonprofit Physiciansfor Human Rights (PHR). Examinations are done inthe Clinical Skills Center, conducted by a physicianor psychologist and several students. (The causehas proven popular among medical students; in2011–12, more than a quarter of first-years under-went training.) “It’s one of the best things I’vecome across in thirty years of medical education,”says Thomas Kalman, MD, clinical associate profes-sor of psychiatry, one of the faculty volunteers.“The students’ idealism, their enthusiasm, theirdesire to help—it’s inspiring.” Kalman—whose

cases have included a Central American familyclaiming that their children had been threatenedwith kidnapping by gangs—also praises the stu-dents’ organizational skills. “They make it moreinviting for physicians like myself, whose time isat a premium,” he says.

The Center for Human Rights has seen clientsfrom around the world—political refugees fromSyria and China, numerous LGBT cases from cen-tral Africa, victims of female genital mutilation(also mostly from Africa) desperate to spare their

‘Most of our requests are forpsych evaluations, because people torture smarter than theyused to and don’t leave as manyphysical scars—which is a weirdway to think about it.’


S U M M E R 2 0 1 2 1 9

assistant professor of psychiatry and one of thevolunteer medical directors, notes: “PHR is sayingthat this is the model for the future—and it’s awonderful model. For a physician like me whohas been doing asylum work for years, it providesan opportunity to teach the next generation.” In addition to offering a vital service to asy-

lum seekers—of whom there are more in theNew York metro area than anywhere else in theU.S.—the program has myriad pedagogical bene-fits. Ahola says that it gives students a globalhealth perspective, a chance to do satisfying probono work, some hands-on clinical experienceearly in their medical education, and a broadview of human experience. “Asylum applicantsalways come to us with compelling and fascinat-ing stories,” she says. “It’s a privilege to hearthem, and it’s eye-opening. For many years I’vesat with individuals and thought, If only therecould be a wider audience to learn from whatthis person has to teach us—about what theyendured, the conditions where they came from,the consequences of persecution and torture, andthe power and resiliency of the human spirit.”

— Beth Saulnier

daughters the same fate. “Most of our requests arefor psych evaluations, because people torturesmarter than they used to and don’t leave asmany physical scars—which is a weird way tothink about it,” Emery says. “As you’d imagine,we see mostly major depression and PTSD, butthere are also a lot of cognitive injuries.” After the exam, the students draft the medical

affidavit; the licensed professional signs off on itand testifies in court. So far, Emery says, thegroup has doubted a claimant’s credibility onlyonce. “We immediately contacted the attorneyand said we couldn’t write the affidavit, and thencontacted PHR and told them that they neededto look into it,” she says. “The judges know ourphysicians, because they’ve testified repeatedly—and if we testify for a client who turns out not tobe credible, they would never believe testimonyfrom our clinic again. Fortunately, it rarely hap-pens—but when it does, we take it very seriously,because it could totally undermine the workwe’re trying to do.”The group has drawn the attention of students

at other medical schools, who aim to set up similarprograms. Joanne Ahola, MD, an adjunct clinical

In their corner: Center forHuman Rights leaders ShelliFarhadian, MD ’12, PhD ’12(left), and Ellie Emery ’14,whose group offers medicaland psychological exams forasylum seekers.

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Talk of the Gown

intravenous vitamin therapy, oxygen, andsauna detoxification to heal the damage.At the Environmental Health Center ofDallas, Nagy underwent intensive therapythat included intravenous vitamins andprovocation-neutralization allergy testing.She became stronger every day.

Nagy blames mold and trichothecanemycotoxins, associated with that homeaquarium, for launching a cascade of adre-nal and mitochondrial damage responsiblefor the mysterious array of syndromes sheexperienced. “The toxins in the air hadoverloaded my system and made me intol-erant of all chemicals, especially pesti-cides,” she says. “A muscle biopsy showedthat I had severe damage to my mitochon-

A decade after earning hermedical degree, Lisa LavineNagy, MD ’86, had it all.

After stints in the New York CityDepartment of Public Health and as anattending ER physician at TorranceMemorial Medical Center in Los Angeles,she had landed a full-time post at a Kaiserhospital in Southern California. Her hus-band, a pianist and composer, was writingmusic for such shows as “The West Wing,”“Felicity,” and “Spin City.” To celebrate,the couple bought a gorgeous home, com-plete with a large indoor aquarium stockedwith koi and small sharks.

Shortly after moving in, both husbandand wife—and even their dogs—developeda dizzying array of debilitating symptoms.They were plagued by muscle weakness,low energy, pounding headaches, anddeep sadness. The smell of diesel exhaust,cheese, even Nagy’s perfume, induced stag-gering nausea. “I felt like I was dying,” sherecalls. “My arms were so weak I couldn’tfold a towel, wash my hair. My handswould turn blue from the dysautonomia.”Each time she sorted the mail, Nagy(whose name is pronounced nahj) experi-enced maddening bouts of itching andreddened hands. Unopened bills piled up.Nagy left her job and the couple sold theirhome. Meanwhile, her physicians wereflummoxed, speculating that perhaps shehad early Lou Gehrig’s disease. They diag-nosed her with Addison’s disease; she hada positive tilt-table test for postural ortho-static tachycardia syndrome and a biopsythat showed severely anoxic mitochon-dria. What was going on?

Then one day in 2003, Nagy stumbledacross an online account of symptomsshockingly similar to her own, down tothe mail-induced itching she still thinks ofas “bizarre.” Reading further, she learnedof an upcoming meeting on chemical sen-sitivity in Virginia. She dragged herselfacross the country and discovered environ-mental medicine, a field that examines theinfluence of various toxins—includingmold, the volatile organic compounds weknow as the “new car” smell, and evenperfume—on mental and physical health.Practitioners diagnose and treat suchsymptoms as endocrine imbalances precip-itated by certain molds and toxins, anduse a combination of exposure reduction,

‘Believe the Patient’

After toxic mold made her sick, Lisa Nagy,

MD ’86, has devoted her career to validating

and treating environmental illness

Lisa Nagy, MD ’86

PROVIDED

dria.” In 2004, she and her husbanddecamped to Martha’s Vineyard, wherethey had wed and still owned a weekendcottage. “I needed clean air,” she says. “Icouldn’t tolerate the high ozone andexhaust levels in Los Angeles.”

Now fifty-one, Nagy still can’t practiceemergency medicine; the combination ofomnipresent chemicals, as well as patientperfume and scented laundry detergentresidue on clothes, can wreak havoc withher energy level, ability to stand withouttachycardia, and attention span. Instead,she oversees an intensive, fifty-patient pri-vate environmental medicine practice onMartha’s Vineyard. She also travels aroundthe country giving lectures on environ-


S U M M E R 2 0 1 2 2 1

F rom the opening pages of the premiereissue of WCMC-Q’s literary magazine,it’s clear this is no hidebound academic

publication. As the introduction declares, “Be tweenSeminar Rooms accepts creative submissions of anykind in any form: poetry, prose, fiction, non-fiction, creative non-fiction, creative non-poetry,poetic homework, found objects, photographs, sta-tus updates, fine art, bad art, really bad art, ani-mals, vegetables, minerals, recipes, sarcasm, yourshoe, a picture of your shoe, a picture of your shoewriting a poem.”

Launched in 2010 and with its third issue cur-rently in the works, the journal offers a creativeoutlet for the Qatar branch’s premedical and med-ical students. In addition to the wide range of genres listed above, Between Seminar Roomsincludes such features as an “ask the expert” column, a “two lies and one truth” segment,Facebook status contests, and even the occasional recipe. (In the first edition, Noor AlKhori, MD ’10, describes her apple pie cheesecake as “quick, easy, and nutritious, andideal for Ramadan.”) The publication has grown from a debut issue of seventy-six pagesto a second volume of 130, with the third planned for about the same length.

The project is the brainchild of Autumn Watts, director of the WCMC-Q WritingCenter, who serves as the managing editor. A student editorial board vets the submis-sions, but it aims to be inclusive. “We didn’t want to leave anybody out, but we wantedto make sure that the quality would be high,” Watts says. “So if we get a submission that’sa bit rough, we work with the writer and give them feedback so they can improve thepiece.” The magazine’s title, she notes, is meant to capture “the way that students’ cre-ativity spills out between classes.” It was chosen by a campus-wide vote—beating outCorn Aliens, a play on “Cornellians.”

Fathima Zahra Kamil ’14 was active in art, creative writing, and the yearbook commit-tee in high school; now, the Sri Lankan native is on the Between Seminar Rooms editorialboard, has contributed numerous art works (oil paintings, watercolors, and pencil sketch-es), and is helping design the cover of the third issue. “In medical school, it’s easy to getswamped with course work and neglect your hobbies,” Kamil observes. “Medicine tends tobe a very left-brained field, so dabbling in the arts and humanities sparks the creativity andimagination within all of us.”

Fellow board member Sally Elgazar, who completed her second premed year thisspring, says that seeing other students’ creative work inspires her to produce her own—andthat it broadens her horizons. “It’s very important, even essential, that a doctor—or anyother person, for that matter—understands the huge diversity in people and is able toaccept these diversities,” says Elgazar, an Egyptian who has contributed a fiction story andtwo interview pieces. “It definitely makes for a much better doctor-patient relationship.”

Between Seminar Rooms is available in both hard copy and electronically via the WritingCenter’s page on the WCMC-Q website. Each issue is celebrated with a launch party atwhich contributors have exactly two minutes each to present their work; the long-windedrisk being “chickened off” the stage by the squeaky rubber poultry that Watts keeps in heroffice. “The students are complex people who have lives and abilities outside of medicine,”Watts says. “I think many faculty are surprised by the quality and range of the work. Oneof the most common reactions is, ‘Wow, who did that? I had no idea.’”

— Beth SaulnierFor more images from Between Seminar Rooms, see page 2.

mental illness as a member of theAmerican Academy of EnvironmentalMedicine and serves as an appointedmember of the National Institutes ofHealth’s Roundtable on Health andBuildings and as a delegate of theMassachusetts Medical Society. “Whenthey hear hoof beats, some medical stu-dents are taught to hear horses; others aretaught to hear zebras,” says Nagy, whothinks of herself as an ambassador forenvironmental medicine. “The rare dis-ease, the bizarre situation I went throughand that my patients have, with all ofthese multiple symptoms—they all fit inthis basket of environmental illness,which is becoming very common today.What was once a zebra is now a horse!”

Nagy has been approached about doinga movie based on her story and is drafting apractical guidebook called How to Be a BetterDoctor and Patient. In the process, she hasbeen meditating on the diagnostic mindsetpromoted by Weill Cornell neurologistsFred Plum and Jerome Posner, co-authors ofDiagnosis of Stupor and Coma. “They alwayssaid, ‘Believe the patient,’ ” says Nagy,recalling the case they presented during hermedical training of a woman who inexpli-cably waved her arms when walkingthrough doorways. It might have been easyto dismiss the patient’s symptoms as psy-chiatric, she says, yet a scan revealed a thal-amic tumor that was altering the woman’sspatial awareness. “When I became sickwith a condition that is never taught,nobody believed me,” she says. “You don’teven believe yourself, because you’re a doc-tor and you didn’t learn about it in school.”

Nagy acknowledges that many of thesymptoms common in environmentalmedicine present as behavioral—and thatit would be easy to slap a psychiatric diag-nosis on the people who come to her as alast resort. To honor Plum and Posner’sdictate, she starts out with a comprehen-sive medical history and a complete bat-tery of tests analyzing metabolic andendocrine function. “Why give them apsychiatric label and walk away,” she won-ders, “if there are fifteen things you cancheck to see if they have physiologicalabnormalities causing the psychiatricsymptoms—and fix them both?”

— Sharon Tregaskis

For more information, go towww.lisanagy.com and the website of theAmerican Academy of EnvironmentalMedicine at www.aaemonline.org.

Rooms with a ViewLiterary magazine showcases

WCMC-Q’s creative side


WarandRemembrance

With an $11 million DOD grant,JoAnn Difede, PhD, is testing virtual reality as a treatment for PTSD in veterans of Iraq and Afghanistan

By Beth Saulnier

Photographs by John Abbott

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A military convoy inAfghanistan

is struck by a roadside bomb.Soldiers on patrol in Fallujahare attacked by a sniper.Marines are killed in aHumvee rollover. Solderswalking the streets ofBaghdad are gravely injuredby an improvised explosivedevice.

American service members have facedthose and other dangers over the pastdecade of conflict in Iraq and Afghanistan.And in recent years, some of them havecome to the corner of 70th and York torelive those traumas—their sights, sounds,even smells—in an effort to heal.

In a treatment room on the fourthfloor of Payson House, current and formersoldiers, Marines, and National Guards-men don virtual reality (VR) goggles andearphones and are transported back to awar zone. A subwoofer installed under aplatform mimics the vibrations of explo-sions; a scent machine can approximatesuch aromas as cordite, Middle Easternspices, and burning flesh. For some veter-ans, the illusion is incomplete unless theycarry a faux M16 rifle—made of plastic,but believably weighty.

In addition to having served in Iraqand Afghanistan—or, in many cases,both—these treatment participants haveone thing in common: all suffer frompost-traumatic stress disorder (PTSD), achronic, often debilitating conditionwhose personal and societal tolls arebecoming increasingly known as this gen-eration of veterans returns home. InDecember, with the aim of evaluating anovel form of therapy, the Department of

Inner life: In the VR treatment, subjectswear goggles and earphones thatimmerse them in the circumstances oftheir trauma, such as a Baghdad patrol.



Defense awarded a four-year, $11 million grantto a Weill Cornell team led by JoAnn Difede,PhD, professor of psychology in psychiatry anddirector of the Program for Anxiety andTraumatic Stress Studies at NYP/Weill Cornell.Collaborating institutions include the Universityof Southern California and Emory University.

For more than a decade, Difede—who led aseminal study published in the Journal of ClinicalPsychiatry using virtual reality to enhance treat-ment for World Trade Center survivors—hasbeen studying the use of virtual reality to treatpeople with trauma and anxiety disorders. Thetreatment is a high-tech take on imaginal expo-sure therapy, the current standard of care fortreating PTSD. (SSRIs such as Zoloft and Paxil areused palliatively, for symptoms like anxiety andsleeplessness; a committee of the Institute of

Medicine has found that exposure therapy is theonly treatment for PTSD with a strong evidencebase.) In exposure therapy, patients are guidedin reliving their trauma in a safe environment,with the goal of facilitating “extinction learn-ing”—consolidating the experiences as memo-ries rather than as volatile, emotionally fraughtepisodes that can re-emerge as flashbacks.

Difede cites that classic Psych 101 example ofoperant conditioning, Pavlov’s dog—but insteadof hearing a pre-dinner bell, the animal receivesan electric shock each time a light goes on. “Overtime, the dog will get frightened and have thesame reaction he would have to the shock itselfwhen he sees only the light,” she says.“Extinction learning would be teaching thatlights aren’t scary in general—just in this particu-lar context. What you do is repeatedly show the

JoAnn Difede, PhD


S U M M E R 2 0 1 2 2 5

dog the light without a shock, and he learns thatlights aren’t scary after all; it was the shock. Thesame thing happens with people. Let’s say youworked in the World Trade Center and escapedwith your life on 9/11; stairwells are suddenlyfrightening places. You’ve developed a condi-tioned response that stairwells can be scarybecause you escaped down the stairs that daywondering whether or not you were going tomake it out, hearing mayhem outside, maybeeven one of the buildings collapsing. Stairwellsare no longer neutral for you.”

By recalling the traumatic memory in thetherapist’s office, Difede says, the patient caneventually uncouple stairwells—or, say, the sightof a plane flying over the city on a cloudlessday—from the horrors of 9/11. “Over and overagain, we’re extinguishing the cues to fear in asafe environment,” she says. “In theory, thatwould allow the person’s autonomic nervous sys-tem—which went into fight-or-flight mode whenit perceived danger—to go back to homeostasisand say, ‘Okay, every time I see a plane in a bluesky, I don’t need to think there’s going to be aterrorist attack. It’s just another plane.’”

But imaginal exposure therapy is by nomeans easy. It requires PTSD patients to do whatthey dread most: relive the traumatic memory.One of the advantages of the virtual reality treat-ment is that it provides the mnemonic cuesrather than requiring participants to summonthem up. “Part of PTSD is being avoidant ofthings that remind you of your trauma—people,places, things, memories, emotions,” Difede says.“So when you tell someone that part of the treat-ment is going over what happened to them—that they have to will the memory into theirmind and go over it—they’re reluctant to dothat. But this way, we’re putting them back inIraq or Afghanistan in a Humvee or on patrol intown, or at the World Trade Center, and the cuesare being delivered to them. You have remindersin the context that your trauma occurred—youcan see, hear, smell, feel. They’re powerful sensorycues, and we think that will help emotionalengagement and make it easier for people toprocess their memories. Humans don’t work bycognition alone. We don’t just think about whathappened to us or remember it, we apprehend itin multi-sensory dimensions.”

In the DOD-sponsored study, which willinclude 300 participants, veterans will receiveeither standard imaginal exposure therapy or thevirtual reality version. The work will be conductedat Weill Cornell, at a VA medical center in LongBeach, California, and at Bethesda Nat ionalNaval Medical Center outside Washing ton, D.C.The protocol calls for nine treatment sessions perparticipant; for the VR group, seven of the ses-sions will include thirty to forty-five minutes of

immersion in virtual Iraq or Afghanistan. “A common experience we hear of is being

part of a convoy, maybe the second vehicle, andseeing one of the other vehicles get hit by anIED, and running to try to save the people in it,”says Judith Cukor, PhD, assistant professor of psy-chology in psychiatry, who is a co-investigatorand the Weill Cornell site’s primary clinician. “Sowe have them describe in great detail what theysaw and did and thought and felt during thosemoments, because that’s what’s in their brains—that’s what’s replaying itself through nightmaresor constant thoughts, is triggered easily, and isn’table to be consolidated as a memory. And asthey’re describing it, we’ll use the virtual realityto help bring them back there. They’ll be sittingthere with a helmet on, in a virtual Humvee, andtalking in the present tense, as if it’s actually hap-pening—knowing that it’s not happening, buttrying to put themselves there. They’ll say, ‘I’mtraveling, it’s eight o’clock in the morning, it’sjust a regular day. We’re joking about something.I look up and I see smoke.’ At the appropriatetime in the treatment—when they’re ready forit—we’ll play an IED or have smoke in the dis-tance. We do it in a gradual way, and they’re ableto engage in their memory and habituate to theemotions around it.”

The virtual-reality versions of Iraq andAfghanistan were designed and refined withinput from veterans who served there. The sce-narios have the feel of a modern video game—but are even more immersive, because when theuser turns his head, the perspective shifts accord-ingly. The virtual worlds are highly detailed, withatmospheric elements like calls to prayer, groupsof chatting civilians, and piles of refuse (whichare often used to conceal IEDs). By manipulatinga joystick, the user can walk around and explore,climbing stairs and entering rooms. “In thisworld, you can play out a variety of scenarios atany time of day,” Difede says. “We can add heli-copters or airplanes that might come for backupsupport. We can add cues that are relevant to awide variety of experiences that happen onpatrol—going back to this idea of PTSD as a dis-order of emotional learning.”

The VR technology has other benefits intreating veterans, the researchers say. For onething, notes Cukor, “it gives them a sense thatwe understand where they’ve been. Eventhough we’re civilians, we have this environ-ment that is very similar to what they wentthrough, and they feel like, ‘Oh, they get themilitary,’ which is helpful.” Then there’s the factthat the current crop of veterans grew up onvideo gaming, and many are avid fans of combat-oriented titles like Call of Duty. “Video gameshave a lot of validity with the generation ofyoung men and women who went to Iraq and

‘Over and overagain, we’reextinguishing thecues to fear in asafe environ-ment. In theory,that would allowthe person’sautonomic nerv-ous system—which went intofight-or-flightmode when itperceived dan-ger—to go backto homeostasis.’



sor at the Weill Cornell site for the DOD studyand is therefore not treating its participants, inorder to preserve double-blind status. “I said,‘There wasn’t an explosion in your original trau-ma, so there won’t be one now.’ But he was reallyvigilant as he was moving the Humvee down theroad—concerned about mines and IEDs. He wastransported back as though he were driving inAfghanistan, with all the dangers.”

In 2008, the RAND Corporation published a500-page report on PTSD and major depres-sion among Iraq and Afghanistan war veter-ans. It calculated the rate of prevalence ofone or both conditions at nearly 20 per-

cent—and noted that in the two years followingdeployment, PTSD and depression among return-ing service members cost the nation as much as$6.2 billion in medical bills, lost productivity, andother factors. The condition raises the risk of avariety of social ills—including suicide, substanceabuse, and domestic strife. “There are lots of inter-personal costs, including compromised socialfunctioning,” Olden says. “Emotional constrictionis one of the common features of PTSD—so peo-ple are not able to feel loving or happy feelings,which makes it very difficult to function in a mar-riage or as a parent. Often people feel anger andirritation, and that also causes interpersonal diffi-culties. Avoidance is a strong feature of PTSD, sopeople work hard to not approach anything that’sgoing to trigger their anxiety, which can narrowyour life in an extraordinary way—avoiding driv-ing, crowded places like malls, going out withgroups of friends.”

While PTSD has always been part of war’slingering cost—whether known by its modernlabel or more antiquated terms like “soldier’sheart,” “shell shock,” or “battle fatigue”—itseems to be striking veterans of the current con-flicts especially hard, researchers say. “One factoris that people have been repeatedly deployed, sothey’re encountering dangerous and traumaticsituations again and again,” Olden says. “Also,the nature of the wars is different than some pre-vious conflicts. There is more of a chronic threatlevel. It’s not just when you’re in battle; at anytime there could be IEDs or a suicide bomber, soit’s more difficult to know when you’re safe.Some of the soldiers I’ve worked with report notfeeling safe even on base. They’d be mortared allthe time, or were interacting with local soldierswho they thought were tipping off the enemy.So they felt like they could never relax.”

Given the financial and human costs, find-ing an efficient and effective treatment for PTSDis a pressing national health issue. With the aimof maximizing treatment benefits, the DOD-funded study is also looking at the efficacy of a

Afghanistan,” Difede says. “They know how touse the technology. They’re comfortable with it.This isn’t the psychotherapy of Freud that theymight have learned about in college or in popu-lar culture; it doesn’t even look like psychologi-cal treatment. And there’s evidence that if aperson thinks the treatment is going to work,they’re more likely to stay with it. They’ll give ita chance.” Cukor adds that for many partici-pants, the technological learning curve isappealingly flat. “The patient is able to movearound with a joystick—and let me tell you,they’re able to do it a lot better than I am,” shesays with a laugh. “I have trouble gettingthrough some doorways, and I try to explain itto them, but they don’t even need to hear it.They’ve got it in a second.”

Unlike a video game, though, the VR scenar-ios avoid the unexpected. The therapist pro-grams the computer to reflect the details of theveteran’s trauma—employing them gradually astreatment progresses. For example, someone whowas in a vehicular accident or attack might startout by spending time just driving down a desertroad. Megan Olden, PhD, an instructor of psy-chology in psychiatry, recalls working with onesuch patient (outside the DOD-funded study),who’d been in a Humvee rollover. “I told him inadvance that nothing surprising was going tohappen,” says Olden, who is serving as the asses-

Treatment team: The mentalhealth professionals workingwith Difede on the projectinclude (from left) MeganOlden, PhD, Francis Lee, MD,PhD, and Judith Cukor, PhD,seen with the treatment equip-ment, including a faux rifle.

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SUMMER 2 0 1 2 2 7

pharmacogenetic approach has tremendousapplications for multiple psychiatric conditions,”Lee says. “Treatments for almost all types of anx-iety disorders that involve phobias—fear ofheights, for instance—are all built on the sameprinciple of exposure therapy. Treatment forobsessive-compulsive disorder involves learningthat having dirty hands, for example, is not dan-gerous. All these have a common theme ofretraining the brain that things that were anxietyprovoking are no longer dangerous.” For Lee,customizing treatment according to a patient’sgenetic makeup represents the future of psychia-try. “You won’t just give them a drug or thera-py,” he says. “You give them both, and you do itin a way that isn’t just flooding the system.”

In his clinical practice, Lee has seen anincreasing number of PTSD patients over thepast few years, mostly as part of Difede’s studies.Their cases have spurred his research efforts.“The fact that I’m still seeing patients who havesuffered traumas from 9/11, and they’re still aprominent part of my clinical work, suggests thatthis is an extremely chronic disorder and it canhave debilitating effects,” he says. “And eventhough 50 percent or more recover to somedegree, I was struck by how severe the disordercan be. The therapies that are currently availablecan help some patients, but not all, and we needto find better ones.”

In recent years, both the military and themedical establishment have made concertedefforts to destigmatize PTSD and encourage suf-ferers to seek help. But while strides have beenmade, Cukor says, there’s still much work to bedone. “We can say, ‘It’s a real thing, get treat-ment for it,’ but there’s still a perception thatneeding help might signify weakness,” she says.“That’s part of the psychoeducation that we needto do—that it’s not the weak people who havePTSD. In fact, very often it’s people who’ve beenthrough so much, who have an exceptionallylarge load on their shoulders because they’re socapable.” But because of the lingering stigma,Cukor laments, patients often don’t come forhelp until they’re suffering acutely. “It’s very sad,because we have many people come into ouroffices five to ten years after their trauma, andtheir lives are falling apart. They’re hesitant toseek treatment, and often when they come in it’sbecause their spouse has filed for divorce or theyhaven’t gotten out of bed for months. Their livesare crumbling. It’s a shame to see it take such atoll, because treatment can really help. And ofcourse it’s extremely gratifying to sit with some-body who’s in so much pain and ten weeks latersee them so much better. People often ask, ‘Howdo you listen to all these terrible things?’—butwe’re part of the healing. We don’t see the terri-ble things. We see people getting better.” •

drug called D-cycloserine (DCS), which preclini-cal studies have shown to enhance extinctionlearning, the presumed mechanism underlyingexposure therapy. An antibiotic approved by theFDA a half-century ago to treat tuberculosis,DCS is thought to facilitate learning by bindingto an important glutamate receptor in key brainregions and enhancing its function. In the cur-rent trial, half the participants will receive DCSin addition to either imaginal exposure therapyor VR—making for a total of four experimentalgroups. Either a placebo or the drug, which isshort acting, will be given only prior to eachtreatment session. “The hypothesis is that thosewho get D-cycloserine will get better faster andmay have a lower relapse rate—and the implica-tions of getting better faster are significant whenyou think about the associated costs of post-traumatic stress disorder,” Difede says. “If peoplestart to get better faster, it may also lowerdropout rates.”

DCS may prove especially useful in patientswith a particular variant of a growth factor,BDNF (brain-derived neurotrophic factor), a formthat impedes extinction learning. Psychia try pro-fessor Francis Lee, MD, PhD, co-investigator andthe primary psychiatrist at the Weill Cornell siteon the DOD project, has been studying BDNF ina mouse model as part of his work on the genet-ics of anxiety disorders. In the DOD study, par-ticipants will give a saliva sample from whichtheir DNA will be analyzed for the BDNF vari-ant. “If this therapy were 100 percent perfect,everyone would be cured of PTSD,” says Lee,who has published two papers in Science onrelated topics, including the genetic basis forlack of response to SSRIs in PTSD patients. “Butsome people respond and some don’t. As is thehope of many in modern psychiatry, we’re try-ing to predict who will respond to standardtreatment and who will not. In the future, wewould want to be able to take a DNA sample,say, ‘This person’s got this variant, they’re notgoing to respond to this drug, therefore we’regoing to make a treatment decision based onthis biomarker,’ and put them on D-cycloserineand give them exposure therapy. Even thoughit’s more time-consuming for the patient, there’senough data out there that this is going to giveyou a better outcome.”

To approximate traumatization and extinc-tion learning in humans, Lee’s rodent studieshave included a version of the Pavlovian sce-nario. Mice hear a tone and receive a minorshock; soon, they become anxious simply at thesound of the tone. Then the tone is repeatedlyplayed without the shock. When the experi-ment is concluded, the mice are examined andLee does histochemical and electrophysiologicalstudies of their brains’ synaptic activity. “This

‘Avoidance is astrong feature ofPTSD, so peoplework hard to notapproach any-thing that’s goingto trigger theiranxiety, whichcan narrow yourlife in an extra-ordinary way—avoiding driving,crowded placeslike malls, goingout with groupsof friends.’


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Terry Wallis was nineteen years old in 1984 when thepickup truck he was riding in careened off a backwoodsroad, crashing through a guardrail before it plunged

more than thirty feet to the bottom of a dry riverbed in theOzark Mountains. One of his companions died; the other wasunscathed. Wallis, a gifted mechanic whose wife had given birthto their daughter just six weeks earlier, would spend nearly twodecades in a nursing home, paralyzed and unable to talk or carefor himself—or to recognize the child he once adored.

By Sharon Tregaskis

Doctors told Wallis’s family that he was in a persistent vegetative state from whichhe would never recover. Nursing home staff monitored his feeding tube, guardedagainst bedsores, and tended to his other basic physical needs, but therapy was virtuallynonexistent. Over the years, his parents saw glimmers of the old Terry and pled forneurological assessments, but their requests were rejected. Then one day in mid-June2003, when his mother arrived in his room for a visit, Wallis said “Mom.” “Milk” and“Pepsi” followed—and in subsequent weeks, the words returned in a torrent. Headlinesdeclared the thirty-nine-year-old a modern-day Lazarus and reporters from around theworld flocked to Arkansas to herald his miraculous recovery.

MAN WANTS PEPSI AFTER 19-YEAR COMA trumpeted the USA Today headline abovea front-page story on July 9, 2003. That morning, Weill Cornell professor of neurologyand neuroscience Nicholas Schiff, MD ’92, was at a conference in Lake Tahoe, slated topresent his latest insights on consciousness. As he stood at the podium, the colleagueintroducing Schiff waved a copy of the complimentary newspaper that had beenslipped under the door of each attendee’s hotel room—and promised that Schiff wouldexplain the science behind Wallis’s extraordinary recovery. “I said, ‘It’s probably fake,’”recalls Schiff, now director of Weill Cornell’s Laboratory of Cognitive Neuro -modulation. “‘Nobody is in a coma for that long, then regains language.’”

Schiff—a co-author, with the late Fred Plum, MD ’47, and Jerome Posner, MD, ofthe fourth edition of the classic textbook The Diagnosis of Stupor and Coma—nowknows he was half right. “The case was real and fascinating, and of course he wasn’t ina coma or a persistent vegetative state,” says the physician-scientist, who has sinceexamined Wallis several times and authored studies on his continued recovery. Unlike

Physician-scientists seek clues to consciousness

Life of the Mind

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that other famous, severely brain-injured Terry—Schiavo, whosefamily’s decade-long battle over her end-of-life care ultimatelyinvolved the U.S. Congress and President George W. Bush—Wallishad been misdiagnosed. “He was in a minimally conscious state fortwenty years,” says Schiff, whose latest work on Wallis’s ongoingrecovery is slated for presentation in November at the Society forNeuroscience meeting. “He has recovered not only full conscious-ness, but fluent language and a level of cognitive function that hasmade him testable on standard neuro-psychometric measures,which is amazing. We’re still learning things about his brain.”

Each year, 1.7 million Americans suffer traumatic brain injury.For 75 percent, the effect is fleeting—a concussion that causes a badheadache or brief blackout. But for the remainder, disability persists.They experience cognitive or emotional problems or have difficultycommunicating, moving, or processing sensory stimuli like touch,smell, or sound. Statistics are tough to verify, but perhaps as manyas 300,000 Americans—including more than 6,000 veterans injuredin Iraq and Afghanistan—wind up in nursing homes, their grip onconsciousness tenuous at best. Occasionally, like Wallis, their brainsheal enough to allow for communication, even self-care. For fami-lies, the uncertainty can be agonizing. What are their loved one’sprospects for a meaningful recovery? On what time scale? Would

the person want to be kept alive or should carebe withdrawn? Would therapy help? The answersrely on credible guidance from physicians—butuntil recently, they’ve had little insight to offer.

For twenty-five years, Schiff has investigatedthe structural biology and electrical circuitry ofconsciousness, seeking clues to predict whichpatients might regain consciousness and exploringhow some combination of therapy, pharmaceuti-cals, and surgical interventions might promoterecovery. With a team of Weill Cornell scientiststhat includes medical ethicist Joseph Fins, MD ’86,he has conducted a series of studies using magneticresonance imaging and electroencephalography toreveal brain activity and explore ways in whichpeople unable to speak or write might be able toreveal their capacity for thought.

Recently, Schiff and Fins have worked withphysicians at the Cleveland Clinic and Harvard,

testing the potential of a pacemaker-like device to stimulate func-tion of the thalamus, a region of the brain that integrates sensorysignals and regulates consciousness. Their goal: to promote recoveryof functional communication, allowing patients to express theirneeds and enhance their caregivers’ ability to respond. “I focus onthe central thalamus not because it will explain consciousness,” saysSchiff, “but because it’s an economical focal point for manipulatingstates of consciousness and understanding some aspects of it.”

Expanding on the issues raised by their collaborations, Fins—chiefof the Division of Medical Ethics at NYP/Weill Cornell and a profes-sor of medicine, of public health, and of medicine in psychiatry—hasinterviewed the family members of forty patients from around thecountry, including Wallis’s mother, for a book tentatively titled RightsCome to Mind: Brain Injury, Ethics, and the Struggle for Consciousness.“The fundamental issue is the residual cognitive capacity of thesepatients to actually mount a recovery and communicate,” says Fins,the E. William Davis Jr., MD, Professor of Medical Ethics. “Thatspecter haunts me—of people being conscious and taken as if they’renot, left alone and sequestered in chronic care, labeled as vegetativewhen they’re not. What’s the potentiality to intervene?”

Consciousness exists on a spectrum. We sleep and wake; anes-thesiologists put us under for surgery, then bring us back. Between

‘We use neuroimagingso the brain can talk tous whenever it happensto activate and give ussome response,’ Schiffsays. ‘But interpretationof the results is a trickyprocess.’

Nicholas Schiff, MD

JOHN ABBOTT


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those end points, our alertness ebbs and flows—evident in how farwe open our eyes, how quickly and appropriately we respond to ourenvironment. After a brain injury, neurologists rely on behavioralassessments at the bedside—yes/no responses (or nonverbal signals)from the patient to a series of questions—to guide diagnosis andoffer families a prognosis. “Consciousness is a black box,” saysSchiff, the Jerold B. Katz Professor of Neurology and Neuroscience.“If we don’t have gesture or verbal communication, then we havethe problem of making an assessment. What is the level of cogni-tion within that box?”

Schiff was an infant in 1966 when Plum, the AnneParrish Titzell Professor and chairman of theDepartment of Neurology at the Medical Collegefrom 1963 to 1998, coined the term “locked-in syn-

drome” to describe individuals who retained full cognitive capacitybut due to profound paralysis were limited—to the flutter of an eye-lid or a shift of their gaze—in their ability to demonstrate conscious-ness. Schiff was in elementary school when, in 1972, Plum andScottish neurologist Bryan Jennett, MD, published their first articleon “persistent vegetative state,” a dour diagnosis they described as“wakeful unresponsiveness,” reflecting the absence of activity abovethe brain stem but clinically distinct from coma. Karen AnnQuinlan was in a vegetative state, and Plum was the court-appoint-ed neurologist in Quinlan’s case, a landmark court battle thathelped to establish the right to die.

Throughout the Nineties, as Schiff completed his medical train-ing and Fins delved into the issues attending ethics and end-of-lifecare, physicians remained fundamentally dismissive of the prospectfor meaningful recovery from profound brain injuries. Bedsideobservation was the only tool available to a doctor seeking clues toa patient’s condition—and ultimately to the prospect of recovery.“Some of the clinical truths that I learned about the vegetative statewhen I graduated from Cornell twenty-five years ago are no longertrue,” says Fins. “This is a moving target. I was more certain aboutneurologic outcome and what ethically followed from that certaintyten years ago than I am now. Everything is in flux.”

Today, such tools as electroencephalography, magnetoencepha -lography, magnetic resonance imaging, functional MRI, and diffu-sion tensor MRI allow scientists to examine the real-time electrical,metabolic, and blood-flow changes in a living brain. Comparison ofthe patterns of activity after a brain injury with those of intact sub-jects has the potential to reveal not only such subtle conditions aslocked-in syndrome, but also more evidence of consciousness thansome patients are able to demonstrate in a bedside examination.

Schiff’s studies have analyzed responses to auditory recordings ofa voice familiar to a patient, the ability to recognize matched play-ing cards, and the capacity to follow a command—such as “Imagineyourself swimming”—that stimulate the neurons involved in phys-ical activities, even if the limbs required for the activity itself havebeen stilled. “We use neuroimaging so the brain can talk to uswhenever it happens to activate and give us some response,” saysSchiff, who has published multiple papers on the possibilities andchallenges inherent in assessing consciousness using such tech-niques. “But interpretation of the results is a tricky process.”

Schiff and his team are investigating novel methods to fine-tuneanalyses of consciousness that can be done in the nursing homesand community hospitals where most brain-injured patients receive

care. In 2011, Clinical Neurophysiology published the laboratory’s lat-est work on EEG by Andrew Goldfine, MD, assistant professor ofneurology; he had started working with Schiff as a third-year resi-dent, helping to analyze EEG data from the newly loquacious TerryWallis. Unlike MRI, which can’t be done on patients whose bodiescontain metal—not uncommon among people whose bones weredamaged in the incident that caused their traumatic brain injuries—EEG doesn’t require that a patient remain still and generates usefuldata even during sleep.

Much of Schiff’s work has centered on a state known as minimalconsciousness, first codified by his collaborator Joseph Giacino,PhD, now at Harvard, in 2002. By the time Giacino’s paper on thesubject was published, Fins notes, the diagnosis had probably fitTerry Wallis’s condition for more than eighteen years. People in aminimally conscious state have some awareness of the outside worldand some capacity to interact, verbally or nonverbally. Diagnosisrequires multiple assessments over a period of time—because just asan office worker’s attention level ebbs and flows over the course ofthe day, the alertness of someone in a minimally conscious statevaries and can be influenced by such factors as medication, tired-ness, pain, and even recovery. Scientists estimate that perhaps 40percent of the people diagnosed as being in persistent vegetative

Black box: When normal subjects wereinstructed to imagine themselves swimming,scans showed the areas of activation withintheir brains. They were predominantly in thesupplementary motor area, partially extend-ing laterally into the premotor areas andparts of the posterior parietal cortex.

PROVIDED



after his mentor’s retirement. “Dr. Rasmussenexplained to me the importance of the role ofthe central thalamus and how studies of itscontributions to organizing consciousness inthe brain had been stymied by a confluence ofscientific and political factors,” says Schiff.Feindel told him there was only one neurolo-gist who was seriously investigating the neuro-physiology of consciousness: Fred Plum.

Feindel’s urging lingered in the back ofSchiff’s mind when he enrolled at Cornell, andhe met Plum during his white coat ceremony.As a medical student, he worked in the lab ofJonathan Victor, MD ’80, now the Fred PlumProfessor of Neurology, who combines mathe-matical and computational analyses of brainwave patterns to investigate sensory process-ing. In 1990, Schiff began testing some of thequestions Penfield had raised about the role of

the thalamus, using electroencephalography to measure brain activ-ity during a type of epileptic seizure known as absence, in which aperson briefly loses consciousness. “I knew that anything I couldlearn about that seizure could feed right back into this general prob-lem of consciousness,” says Schiff, whose paper on the topic withVictor was published in Biological Cybernetics in 1995. “The absenceseizure is like a momentary vegetative state.”

As a third-year neurology resident, Schiff served on MemorialSloan-Kettering’s neuro-oncology service, headed by Jerome Posner,MD, Plum’s longtime collaborator. In a setting where few patientscould be cured and most had only weeks or months to live, Posnertrained Schiff to look for what he could do for patients, rather thanwhat he couldn’t. “You can make their lives a lot better, forestall lossof function, and make a tremendous difference for patients andfamilies,” says Schiff, “and you can do it systematically, building onscience.” After Schiff finished his residency, Plum invited him to col-laborate on a project with NYU colleagues using magnetoen-cephalography (MEG) to quantitatively measure electromagneticactivity in the brains of people in persistent vegetative states and tocorrelate those observations with bedside assessments.

In 1999, the Journal of Cognitive Neuroscience published “WordsWithout Minds,” a case study by Plum, Schiff, and NYU collabora-tors Urs Ribary and Rodolfo Llinas, of a woman whose brain hadbeen extensively damaged by blood clots and who, despite being ina persistent vegetative state, blurted out intermittent expletives.Using structural imaging, PET scans, and MEG, the team demon-strated that isolated regions of the brain might retain function—andthus fragments of behavior might linger—even after the capacity forthought has been erased. The case begged the question of whetherlocked-in wasn’t the only diagnosis in which thought might remain,even after the capacity for engagement with the outside world—whether verbal or non-verbal—has been lost.

A few years earlier, Schiff and Fins had crossed paths in aNewYork-Presbyterian coffee shop. Fins needed a neurologist to pro-vide commentary for a case in which there was a debate aboutwhether pain medication should be given to a patient who was in acoma. “We started getting into the questions of brain mechanisms,how the diagnostic categories were organized, what the correlativemeasurements were,” recalls Schiff, who told Fins about his work

states are in fact minimally conscious. “The minimally consciousstate is important for lots of reasons, but probably the most impor-tant is the ambiguity of outcome,” says Schiff. “You can have peo-ple who can achieve good outcomes, but they might remainminimally conscious long beyond the current time points forwhich their health insurance will provide therapy or treatment.”

Buffalo, New York, firefighter Don Herbert spent a decade in aminimally conscious state after the roof of a burning building col-lapsed and nearly suffocated him in December 1995. As in Wallis’scase, Herbert’s doctors told his family there was no hope of a mean-ingful recovery—yet ten years after he was pulled from the rubblehe suddenly regained the ability to recognize and converse with hiswife and four sons, as well as former colleagues. The disparitybetween what doctors initially told the Herbert family and his even-tual improvement, says Schiff, are a “calibration of our ignorance”regarding the latent potential for people with brain injuries torecover. “When Don Herbert emerged, he was not only conscious,fluent in language, and able to ambulate,” he says, “he had insightinto the fact that he had been out for ten years—he had remorse,frustration, and anger about it.”

As an undergraduate at Stanford, Schiff wrote hissenior thesis on the work of Canadian neurosur-geon Wilder Penfield, MD, founder of theMontreal Neurological Institute and author ofthe landmark 1951 book Epilepsy and the

Functional Anatomy of the Human Brain. Schiff was most interested inPenfield’s late-career musings interpreting this work, which focusedon using electrical stimulation to diagnose and treat epilepsy andon the role of the thalamus in consciousness. Schiff spent a summerin Montreal on a research grant, sifting through Penfield’s papers,including an early draft of his 1975 book, The Mystery of the Mind: ACritical Study of Consciousness. Schiff was captivated by the questionof why scientists sometimes abandoned—or their colleagues failedto award grant funding to—potentially promising lines of inquiry.

That summer Schiff also spent hours interviewing neurosurgeonsWilliam Feindel, MD, then the Neurological Institute’s director, andTheodore Rasmussen, MD, a Penfield protégé who held the post

‘If we can improve their functional status justa little bit because they’re moving aroundand don’t get bedsores, or can eat bymouth and forego a feeding tube, thatreduces the cost of care,’ says Fins, ‘andmaybe some of those resources could beredirected to therapy or to devices thatmight maximize their cognitive potential.’


that reduces the cost of care—and maybe some of those resourcescould be redirected to therapy or to devices that might maximizetheir cognitive potential.”The research is still in its earliest, academic phases—tweaking

algorithms for analyzing the vast reams of imaging data, refiningstaged consent forms that allow for the possibility that a formerlyincapacitated patient might regain the ability to guide treatment.“The generalizability of this work is completely unknown,” saysSchiff. “We have to figure out the logic, rules, and selection criteriafor when we do fMRI communication experiments, for how wesequentially investigate pharmacological therapies, for how we iden-tify patients who might benefit from deep brain stimulation andselect them into these trials.” Further, says Schiff, the team has to understand the risks to

which experimental treatments might expose individual patients—and whether the goals of such interventions are proportionate tothose risks. Fins notes that for patients and their loved ones, thestakes couldn’t be higher. “The burden that these families liveunder—the inability to get a credible diagnosis and secure adequate,basic medical care for their loved ones—is an unspeakable tragedy ofAmerican medicine,” says Fins. “If we really believe in informedconsent, we have to share the nuance and complexity of these diag-noses with families in a transparent way.” •

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with Plum. “Joe immediately saw how this could have implicationsfor the ongoing conversations in his field about vegetative state andend-of-life care and self-determination, and many of the issues thatwere present in the right-to-die movement.” Both humanitiesmajors as undergraduates, the two men shared a common vocabu-lary and soon they were talking daily—first in person and morerecently, since Fins’s office moved a few blocks away, by telephoneat the end of every day. The partnership, says Schiff, is a better-together, “Reese’s peanut butter cup kind of thing.” Their closest partnership to innovate together in science and

ethics has arisen from efforts to pilot the first test of deep brainstimulation of the central thalamus in minimally conscious statepatients. Using a combination of funds from the NIH, private foun-dations, and medical device makers, they designed the frameworkfor judging the entry point of patients for study, based on principlesof risk and benefit and considering both scientific knowledge andethical principles. Fins further innovated an approach to the prob-lem of surrogate consent for an invasive procedure in this patientpopulation, who could not provide their own consent. Of threepatients studied, only one responded—but that patient regained anability to speak and feed himself. Says Fins: “If we can improve theirfunctional status just a little bit because they’re moving around anddon’t get bedsores, or can eat by mouth and forego a feeding tube,

Working relationship: Longtime collaborators Joseph Fins, MD ’86 (left), and Schiff communicate daily.

WCMC ART & PHOTOGRAPHY



Warm welcome: Patients at the Perelman Heart Institute are greeted by a medical concierge.

34-39WCMsummer12heart_WCM redesign 11_08 7/3/12 11:30 AM Page 34

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In a physiological reaction probably honed a fewmillion years ago, the human body responds tostress as if in imminent danger: adrenalin surges to

release reserves of energy, cortisol increases to heightenvisual and auditory responses, digestion decreases toredirect energy toward the large muscles needed forrunning and fighting, and arteries in the arms and legsconstrict while blood clots more quickly—all in antici-pation of serious bodily harm.

Hearts andMinds

With the aim of im prov ing cardiachealth in the city and beyond, theRonald O. PerelmanHeart Institute is dedicated to patientcare, education, and—above all—prevention

By Andrea CrawfordPhotographs by John Abbott

Such impressive biochemical responses remain useful in certain situations;people do still get chased by wild animals once in a while. But unfortunately forcardiovascular health, the stress caused by reading an angry e-mail in an officecubicle or getting stuck in traffic triggers the same reactions. This helps explainswhy, as Weill Cornell clinical assistant professor of psychology in medicineRobert Allan, PhD, told a rapt audience at NewYork-Presbyterian Hospital/WeillCornell in early April, a recent PubMed search of the terms “stress and cardio-vascular disease” yielded more than 58,000 citations.

Allan’s audience had gathered in the large, wood-paneled boardroom of theWhitney Pavilion for his lecture on the role stress, anger, and depression play incardiovascular health. He was one of two guest speakers in that week’s three-hour seminar, whose participants were learning how to teach others about heartdisease prevention. These were not medical students, but eighteen pastors andhealth-ministry leaders from underserved congregations in Manhattan, Queens,Brooklyn, and Staten Island—the inaugural class of the HeartSmarts faith-basedcommunity outreach program, an initiative of the Ronald O. Perelman HeartInstitute at NewYork-Presbyterian/Weill Cornell.

When the Perelman Heart Institute opened in 2009—funded by a $25 mil-lion gift to the hospital from Perelman, chairman of MacAndrews & ForbesHoldings Inc.—it united NewYork-Presbyterian/Weill Cornell’s cardiovascularservices under the leadership of Karl Krieger, MD, the Philip Geier Professor ofCardiothoracic Surgery, and Bruce Lerman, MD, the H. Altschul Professor ofMedicine and chief of the Division of Cardiology. It was conceived as a “medicaltown square,” notes O. Wayne Isom, MD, the Terry Allen Kramer Professor ofCardiothoracic Surgery and chairman of the Department of CardiothoracicSurgery at NYP/Weill Cornell. Patients check in with a medical concierge in asoothing, light-filled, seven-story space, and the windows of their rooms lookdown onto the atrium’s cream-colored travertine floor and its gardens of soaring


bamboo trees. Families and friends await patients in a café area orthe many intimately arranged sitting areas, in an atmosphere thatbears no resemblance to a typical hospital waiting room andinstead feels like the lobby of an elegant art museum. After onepatient’s procedure is complete, interventional cardiologistGeoffrey Bergman, MD, still in scrubs, greets three people havingcoffee at a sleek white table, and tells them that everything wentwell. Moments after he leaves, a nurse arrives to escort the familyto the recovery room, like a gracious friend showing them aroundan unfamiliar guest house.

Cardiovascular disease is the leading cause ofdeath in the United States and around the world—not only in urbanized, wealthy countries, but also indeveloping countries outside of sub-Saharan Africa.According to Arash Salemi, MD ’97, assistant profes-sor of cardiothoracic surgery, the creation of thePerelman Heart Institute was “a great way to bringtogether all the services we’re providing in cardiovas-cular care. It’s the central point from which we canorganize and provide care to patients, and patientsreally appreciate that.” The integration also helps inways that laypeople may not realize, by allowingphysicians, surgeons, and researchers to work moreclosely together. “We can take the science to thebedside,” says cardiologist Holly S. Andersen, MD,clinical associate professor of medicine.

In addition to these benefits, a key mission ofthe Perelman Heart Institute is its focus on educa-tion and preventive care. In the atrium, while fam-ily members wait, they have access to aninformation center staffed by a nurse educator,with computer kiosks for research and an exhibit(modeled after one at the National Institutes ofHealth and written by Weill Cornell physicians)covering the history of and latest developments onheart disease. Andersen, who was named thePerelman Heart Institute’s first director of educa-tion and outreach, emphasizes that early educa-


tion is vital in the battle against heart disease. “We’re really good attreating it, and we’re pretty good at getting people to practice pre-vention and get them on medicines and doing the right things oncethey are diagnosed with heart disease,” she says. As a result, overalldeath rates from the disease have decreased. “But when you look atour younger population—that’s where we’re losing the battle.”

At the Ronald O. Perelman Heart Institute, edu-cating the public involves a multi-pronged strat-egy that includes lectures, outreach to New YorkCity elected officials and corporate leaders, andeducation campaigns for hospital employees.

The Institute has mapped two “Perelman Miles,” one indoors andone out, to help employees and guests get more exercise. Aiming toreach people in their teens and twenties, Andersen is now workingwith Julianne Imperato-McGinley, MD, the Abby Rockefeller MauzeDistinguished Professor of Endocrinology in Medicine and chief ofthe Division of Endocrinology, Diabetes, and Metabolism, toinclude cardiovascular disease prevention in a satellite outreach pro-gram that Imperato-McGinley runs for members of the NationalGuard, African American churches in underserved areas, and seniorcitizen centers. And this year, the Institute launched the HeartSmarts program, with the pilot group receiving external fundingfrom the Fridolin Charitable Trust and IRB approval to investigatethis “train-the-trainer” peer-educator model. “Pastors hold moreauthority in terms of behavior change than a doctor would,”explains Naa-Solo Tettey, EdD, the Perelman Heart Institute’s cardio-vascular health education and community outreach coordinator.“Research has shown that having a pastor tell a congregation to eatbetter and exercise has more value.”

After Tettey—one of the principal investigators of the study

Holly S. Andersen, MD


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“Perelman HeartSmarts: Utilizing a Faith-Based Approach toImprove Cardiovascular Health”—reached out to potentialparticipants through the city’s Office of Minority Health, agroup representing some 200 churches attended the infor-mation session. For the pilot program, the Institute enrolledeighteen community leaders, some of whom representedcongregations with as many as 1,000 members. For twelveTuesdays this spring, they attended a three-hour seminar inthe hospital’s boardroom, taught by Tettey and featuringguest speakers. Using a curriculum adapted from theNational Heart, Lung, and Blood Institute—plus passagesfrom the Bible and faith-based discussion points—they covered nutri-tion, physical activity, diabetes management, and methods to miti-gate stress and depression. “They are learning to eat healthy on therun or on a budget, learning to cook healthy foods when they’refaced with different barriers,” Tettey says.

Over the summer, the participants are using that curriculum tolead their own ten-week programs for members of their congrega-tions, with Tettey on hand each week to guide them. The classes arebeing taped for quality assurance and data-gathering purposes.

“Working with faith-based organizations is increasing in popularity,”Tettey adds. “So observing how this information is received—when it’staught by a peer versus by someone they may see as more of an expertin the field—is good feedback for us.” At the outset, participants hadtheir blood pressure, waist circumference, and BMI recorded. Theyfilled out questionnaires about depression, sleep, and overall knowl-edge about heart disease and prevention, and each was issued apedometer or other exercise equipment, such as fitness trainingvideos. Their outcomes will be measured at the end of the summer.

The Perelman atrium features an educationcenter (below left) and comfortable seating(above). Right: Naa-Solo Tettey, EdD, the HeartInstitute’s cardiovascular health education andcommunity outreach coordinator.



For fifty years, cardiothoracic surgeons have been managing diseases of theaortic valve the same way: replacing the valve during open-heart surgerywhile the patient is on the heart-lung machine. “It’s a well-refined procedure,and patients have fared very well through the years with that approach,” saysArash Salemi, MD ’97, assistant professor of cardiothoracic surgery. But the

procedure can’t help everyone, as many people are too sick to undergo open-heart sur-gery. “There’s no medication, no exercise regimen, and no diet to treat aortic stenosis,”he says, “so the intervention has to be surgical.”

In the last few years, a minimally invasive technique has arrived on the scene, offeringwhat Salemi calls “an exceptionally good and viable alternative to patients who otherwiseare left just counting their days.” Called the Transcatheter Aortic-Valve Implantation (TAVI),the procedure either uses access points in the femoral vessels in the groin or takes atransapical approach that includes an eight-centimeter incision in the chest wall. The pro-cedure obviates the need for a sternal incision and the cardiopulmonary bypass machine.Cardiothoracic surgeons and interventional cardiologists work together to thread a newvalve, using catheters and wires, which is crimped around a balloon; once across the aorticannulus, they expand the balloon to put the valve in place.

To do so, some two dozen professionals work together in the hybrid operatingrooms of the William Acquavella Heart Valve Center at NYP/Weill Cornell. Cardiologychief Bruce Lerman, MD, says that such a cooperative, cross-disciplinary approach is vital.“It’s the only way you can do this effectively and well,” says Lerman, the H. AltschulProfessor of Medicine. Lerman explains that some patients’ vessels are too small to allowthe experimental device (known as the Edwards SAPIEN Transcatheter Heart Valve) to beinserted through the femoral artery, as is traditional in interventional cardiology; instead,a transapical approach is required, via an incision under the left nipple.

For Salemi, the procedure represents a paradigm shift in the treatment of aorticstenosis, and he is thrilled to be able to help a much wider range of patients. “It is rarein medicine,” he says, “that you can be part of a transformational treatment strategy.”

Paradigm Shift

With minimally invasive surgery for aorticstenosis, the Perelman Heart Institute offershope for previously inoperable patients

Nonsurgical treatments of the aortic valvebegan in the Eighties in France, but the idea didn’ttake off until the initiation of the transcatheterapproach. As interventional cardiology technolo-gy—the catheters, wires, and stents—improvedabout a decade ago, the idea germinated toreplace a valve within a stent similar to one usedon the aorta or a coronary vessel. Salemi admitsthere was initial reluctance. “At this institution,we’ve had a 1 percent mortality for twenty yearsusing the traditional method,” he says, “so wewere very skeptical about getting into this newtechnique, thinking ‘how can you do better?’”

Three years ago, the hospital joined a multi-center trial, known as PARTNER, which randomlyassigned high-risk patients to receive the TAVIprocedure. Salemi and Shing-Chiu Wong, MD,professor of medicine and director of cardiaccatheterization laboratories at NYP/Weill Cornell,have now done more than 150 cases, with a mor-tality rate of just 0.6 to 0.7 percent. “That’s proofof concept—that this procedure is safe and it canstand to help a very sick group of patients,”Salemi says. As the initial PARTNER study con-cluded with good outcomes, the FDA approvedthe procedure last fall. Salemi and Wong nowhave a new study under way to look at patientsof intermediate risk.

Salemi notes that the procedure has showna slightly higher risk of stroke. Unlike in standardsurgery, when the heart is stopped and the calci-fied valve is cut away, in TAVI physicians expandthe new valve with force against the annulus,which can result in embolism. Nationally in thetrial, the rate for stroke has been about 3.5 to 4percent at thirty days. “We’re fortunate that, inour hands, the stroke risk is much lower, in linewith the [less than 1 percent] stroke risk associatedwith standard open-heart surgery,” Salemi says.“I believe that with further iterations of thedevice and technological developments such ascerebral vessel filters and smaller devices, out-comes will continue to improve and the strokerate will decrease even further.” As technologyimproves, he adds, the Perelman Heart Institutewill be able to provide this type of care to morepatients—not only for the aortic valve but forother heart valves as well.

Lerman notes that the SAPIEN valve madeimportant progress this summer, when an FDAadvisory board voted eleven to zero (with oneabstention) that its use be expanded. The votetook the procedure, now an experimental proto-col, one step closer to becoming a routine partof patient care. “It’s not an automatic [FDA]approval,” Lerman says, “but it is often a verystrong indication.”

Arash Salemi, MD ’97


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teens and twenties, is now rising in the youngest adults and increas-ing fastest in women—yet Andersen notes that two-thirds of womennever hear about prevention. While men develop heart disease abouta decade earlier than women, women catch up after menopause—though researchers still don’t know why. Cardiologists see morefemale patients than males; women under fifty are twice as likely asmen to die following a heart attack; and African American womenare at higher risk than white women. “Women are more likely to dieof heart disease once diagnosed, and they get treated less aggressivelyevery point along the way,” says Andersen. That’s why education—not only for patients, their families, and the general public, but alsofor physicians—is so important. “Even women cardiologists don’ttreat women as aggressively as they treat men,” she says.

One challenge is that the symp-toms of heart disease in women aredifferent than in men. Between 40and 45 percent of women who havea heart attack experience no chestpains, yet the medical professionstill considers chest pain the tell-talesign of an attack; cardiac care clinicsare even officially accredited as“chest pain centers.” And for reasonsnot fully known—although anyonefamiliar with a busy working mothermight venture a guess—manywomen don’t take the symptoms asseriously as they should. A survey ofthe American Heart Associationfound that just 53 percent of womenwho think they’re having a heartattack will call 911. “Which means,”Andersen notes, “that 47 percent ofwomen who think they’re having aheart attack won’t call.” She’s heardpatients say they don’t have time tohave a heart attack. “Physicians arewell meaning, but they’ll treat blackmen more aggressively than whitewomen and white women moreaggressively than black women.There’s a pecking order, and it trans-lates into mortality rates.”

Hence the need for another facetof the Perelman Heart Institute’s educational mission: training futurepractitioners in a variety of specialties. For example, it teachesob/gyn residents and fellows to include heart disease prevention intheir patient conversations, since relatively common pregnancycomplications like gestational diabetes and pre-eclampsia significantlyincrease the risk of future cardiovascular events. And with childrendeveloping diabetes at ever-greater rates, the Institute’s physiciansare educating pediatricians-in-training as well. Since one of everytwo Latinas born in the U.S. today will develop diabetes, Andersensays, it’s a conversation that can’t start early enough. “What we’restarting to do, in a small way, is make it a responsibility of physi-cians and medical communities to take on the role of not just put-ting out fires and treating heart attacks, but to be responsible aboutworking on prevention,” she says. “As a medical community, wehave all this information, but we’re not getting it out there as well aswe could.” •

For educated health-care consumers, the way to prevent heartdisease—not smoking, eating well, exercising—is fairly well known.But the information isn’t being widely disseminated, Andersen says.“There’s little opportunity to broadcast to the community, in aninformed way, what we know and translate it into good preventivemedicine. So we’re training these leaders to be our messengers.”When Tettey speaks at outreach events, she’s often struck by howmuch people appreciate the knowledge she shares. “It is actuallynew information for them,” she says. “Some people are genuinelysurprised to learn that you shouldn’t deep-fry your vegetables.”

But knowing what to do and actually implementing change aretwo different things. So Tettey teaches participants motivationalinterviewing techniques—for example, responding to someone who

says there’s no fresh fruit available near their home by asking, “Areyou sure there is absolutely no place at all to buy a single banana orapple anywhere in your entire neighborhood?”

“It has to be done in small steps,” Tettey says, by setting realis-tic goals and adjusting them weekly based on people’s currenthabits; someone who eats no vegetables at all might set a goal ofadding just one serving a day. The next phase of the Institute’s pre-vention program will take these educational practices to anothergroup of city institutions with strong communal ties: beauty salons.

The importance of such outreach cannot be overstated. Whilethe impression of heart disease as a man’s problem—an incorrectnotion partially caused by misinterpretation of initial results fromthe Framingham Heart Study—has begun to change over the lastfifteen or so years, many people are still surprised to learn that heartdisease kills more American women than all cancers combined.Death due to heart disease, an ailment that actually begins in the

Coffee break: Visitors and staff alike enjoy the atrium’s café.


Dear fellow alumni:Recently, I met with Dean Laurie Glimcher, MD, and found that her acclimation to Weill Cornell is

commendable. She is eager to expand the research done here and to support the students and engagealumni in every possible way.

I am also pleased to report that she is most appreciative of the support expressed by alumni—bothfinancially and by way of personal engagement with the institution and our medical students. She is wellaware that, with such busy schedules, time is in short supply and is often our most precious resource.

In April, yet another group of alumni demonstrated their commitment to Weill Cornell by participat-ing in the latest ASK (Alumni-to-Student Knowledge) session. This event, hosted by the Alumni

Association, allows students to meet alumni in an informal setting and ask candid questions aboutlife in their specialty. (See story, page 48.) We look forward to hosting more ASK sessions in the com-ing academic year. Should you have an interest in participating, please contact the alumni office.

Weill Cornell Medical College in Qatar’s commencement celebration took place in early May,and thirty-two bright graduates joined the ranks of our Alumni Association. The board and I wel-come them with open arms. Dean Glimcher and Cornell University President David Skorton, MD,were in attendance; Spencer Kubo, MD ’80, who represented the Alumni Association, wasimpressed by the students’ intelligence and enthusiasm. Most have matched in great residency pro-grams here in the United States and eagerly look forward to this new challenge.

Your Alumni Association supported the International Fellows Reception, which was held inmid-May to recognize the 2012 fellows and the donors who make these opportunities possible.Later in the month, we honored Michael Gershon ’58, MD ’63, at the annual Alumni AwardsDinner. The Award of Distinction was formally presented at Commencement—when we saw theClass of 2012 receive their MDs in Carnegie Hall and become the newest members of the AlumniAssociation. In the Class of 2012, there were 100 matches to “top fifty” hospitals around the coun-try. We are so proud of our students! This fall, the Medical College will welcome the Class of 2016and the cycle will begin anew.

In June, the Alumni Association hosted an alumni and friends dinner in Chicago in conjunc-tion with the annual meeting of the American Society of Clinical Oncology. We will be planningmore of these regional events during the 2012–13 academic year, so be on the lookout for eventsin your region. Also in June, we hosted the annual Dean’s Circle Dinner with Dr. Glimcher. Thisspecial event recognizes the Medical College’s most generous alumni. It is never too late to join the

Dean’s Circle and help our students in need. Please contact the alumni office for further details.Please make plans to attend Reunion, which is scheduled for October 19 and 20. Meet old friends and

colleagues—and make new ones as you tour WCMC’s facilities and hear from a fascinating group ofReunion speakers. You will receive further information in the weeks ahead.

Again, thank you for your continued support of the Alumni Association, the Medical College, andour students. Without you, Weill Cornell would not be the special place it is.

Best and warmest wishes,Michael Alexiades, MD ’83 President, WCMC Alumni [email protected]


NotebookNews of MedicalCollege and GraduateSchool Alumni

1940sFrancis S. Greenspan ’40, MD ’43: “I retired

as clinical professor of medicine, University ofCalifornia, San Francisco, in July 2010, and mywife and I are now residing in a retirement cen-ter in Alameda, CA. I was chief of the thyroidclinic and active in practice and teaching for 60years. My training at the Medical Center gaveme an excellent basis for my life’s work.”

Charlotte, MD ’45, and David Brown, MD’45: “We’re retired and relatively robust at 92and are enjoying the continuing rewards of our60 years of active physician participation bothin our community’s affairs and in the lives ofmany of its people. We recognize that our edu-

Michael Alexiades, MD ’83

PROVIDED

cation was basic to that success, but we wouldlike our classmate marriage also to be seen as agreat plus.”

Edwin M. Knights, MD ’48: “Ruth and Imoved into Hunt Community’s retirement facili-ty in Nashua, NH, about nine months ago. We’resatisfied with the Hunt and have made manyfriends here. We still have three condos in Bostonand Nashua, but fortunately they are all leased.Our grandson, Dan, just received his PhD in com-puter sciences from the University of Coloradoand will be moving back East next fall (with twokids and a dog) to Cambridge, where he has apostdoctoral position at Harvard. After he com-

40-47WCMsummer12notebook_WCM redesign 11_08 7/3/12 11:36 AM Page 40

S U M M E R 2 0 1 2 4 1

pletes that, they will move to Minnesota,where he has a faculty appointment.”

1950sDavid Barr ’47, MD ’50: “I’m still retired,

raising orchids, walking the dog, and goingstrong at 85.”

Ames L. Filippone ’50, MD ’53: “Somerecent activities that have helped keep meout of my wife’s hair: I’ve been making archi-tectural models from basswood and clay.”

Bertram S. Brown, MD ’56: “Joy and Iare celebrating our 60th wedding anniver-sary this year. We have four daughters, fourgranddaughters, and one grandson—they’reour prime accomplishment. For the past fiveyears, we have spent six months in KeyWest and six months in Philadelphia. I amstill a failure at retirement. After my careerin the Public Health Service as director ofNIMH, I went to the Rand Corp. and startedmy second career in anti-terrorism. Fiveyears of training as the president ofHahnemann University equipped me tofound the National Security Health PolicyCenter at the Potomac Institute. From 1990to 2005, I worked for the Pentagon in qual-ity assurance for military health care. I’d behappy to hear from any of my classmates.”

Albert Z. Kapikian, MD ’56, was one of80 microbiologists elected to fellowship inthe American Academy of Microbiology. Dr.Kapikian researches epidemiologic infec-tious diseases with special emphasis on viralgastroenteritis and vaccine development.

Donald P. Goldstein, MD ’57: “I am stillgainfully employed as a gynecologic oncolo-gist at Brigham and Women’s Hospital,where I was recently honored for 53 years ofcontinuous service, first as a resident inob/gyn and now as an attending. During thattime I’ve devoted most of my clinical andresearch activities to the New EnglandTrophoblastic Disease Center, which treatspatients with molar pregnancy and gestation-al trophoblastic disease. I founded the centerin 1965 after returning from a clinical fellow-ship at the National Cancer Institute.Although I no longer perform surgery, I seeconsults at the Dana Farber Cancer Instituteand at Brigham and Women’s, and I amactive in the Pre-Invasive Tumor Service.Connie and I are active with the Boston EarlyMusic Festival, which produces Baroqueoperas here and in Europe and sponsors per-formances of early music groups in theBoston area. We enjoy visiting and sharingthe lives of our three children and six grand-children, three of whom are now in college.We are looking forward to attending my 55th

Reunion in October. Afterreading a list of all the WCMCClass of 2011 graduates whomatched in New England, Ithought it would be fun to getthe Boston contingent togeth-er for a mini-reunion. Four ofthe ten were able to joinConnie and me for drinks anddinner at the Harvard Club onMarch 16. Those who attendedwere Will Gordon ’05, MD ’11,Bracken Babula, MD ’11,Jonathan Robbins, MD ’11,and Aaron Goldberg, MD ’11.If you continue to notify me ofeach year’s graduates who aretraining in Boston, I will planto sponsor a mini-reunionannually.”

Bernie Siegel, MD ’57: “Ifind it disturbing that no medical studentis ever told that Carl Jung interpreted adream and correctly diagnosed a braintumor. It had to do with the flow of milkyfluid from a pond being obstructed, andhe diagnosed a tumor in the area of mam-mary bodies obstructing the flow of cere-brospinal fluid. He was also fascinated bythe somatic aspects of patients’ drawings.”

Howard R. Francis, MD ’58: “Aftergraduating from and taking residency atLDS Hospital in Salt Lake City, I was in aprivate ob/gyn practice in Provo, UT, for30 years. After retiring from private prac-tice, I served as the medical director forthe missionary training center for ourchurch. I served in the Army and retiredas a major. My wife, Deanne, and I havebeen married for 52 years and have sixchildren, 29 grandchildren, and twogreat-grandchildren. We have ownedthree ranches in the past, and I am cur-rently involved in the day-to-day opera-tion of a ranch in Ely, NV, where we raise800 cows with calves, and 6,000 sheepwith lambs. Instead of delivering babies,I am now delivering calves and lambs.There is definitely less liability involved,but no less night call.”

Ann Huston Kazarian, MD ’58: “I’vemoved again. I’m (happily) back in Con -nec ticut, this time in Southington, about20 miles from where we lived andworked for decades before a brief sojournin Texas following family. I retired frommy practice of psychiatry in the GreaterHartford community at the end of 2004before the move south. My mobility is abit sketchy, thanks to MRSA discitis as a

complication of surgery in Texas in 2007,but otherwise I am doing well and happyto be back here.”

George Shambaugh III, MD ’58: “My lifeis currently occupied with three differentendeavors. The first is continuing withteaching fellows and residents in the generalendocrine clinic at Emory University’s teach-ing charity hospital. I relive my medicalschool experiences weekly, and it’s as if Inever really left. I try to keep up with someof the literature, but no longer do research.The second is learning to play bluegrassthree-finger style on a five-string banjo. Ittakes coordination between right and lefthands, one’s eyes to read the music, andone’s ears to hear. This takes time and con-stant practice. I like to think it helps newareas of synaptic development, but after aparticularly trying week I really don’t know.The third is owning a farm of 14 acres of tartcherry trees in Northern Michigan. Theworn-out soil has been rehabilitated and mytrees are into their fifth year. In a couple ofyears, they will be ready for their first har-vest. Here in Atlanta we live in a large houseand would welcome any of you to stay withus. I look forward to our 55th in 2014. Fondregards to everyone.”

1960sWilliam Winn, MD ’61: “I’m still in

active private medical practice here inVisalia, CA. I’m phasing out of the activepractice of pulmonary medicine over thenext year, but will still be doing some sleepdisorder medicine after that. I’ve noticedthat years of experience are definitelyworth something at this stage of the game.

A good start: The New York Commencement ceremonyincluded grads from the Qatar campus.

WCMC FLICKR.COM



retired for 12 years, but I can’t say I misspractice with what is happening to medicalcare in our country. Grace and I are lookingforward to my 50th, and we hope to seemany friends in October.”

Barry D. Smith, MD ’62: “I retired frombeing the long-term chair of the ob/gyndepartment at Dartmouth Medical School atthe end of 2004, but I returned to work sixmonths later after my wife died. I workedhalf time doing patient safety, qualityimprovement, and risk management for aproject that extended from a planned twoyears into six years. Since my second retire-ment in June 2011, I’ve remained medicallybusy on several regional and national com-mittees while also doing some teaching atDartmouth Medical School. I’m fortunate tobe able to still ski, play tennis, golf, andtravel. Recently I spoke at an ACOG meet-ing in San Diego and then attended myson’s wedding just up the road in Del Mar.It was wonderful that my daughter and herchildren were able to travel from Germanyto join us in the celebration.”

Donald Catino, MD ’64: “I’m continuingmy globetrotting locum tenens medicaladventures again in New Zealand. I’ve beenworking in Southland at the Invercargill dis-trict hospital. Nationalized health care isalive and pretty well here, though I’m sure itwould not do as well in America. Whatmakes it work here is that there are only 3million Kiwis, they do not feel entitled, norare they litigious, and they are patient andwilling to wait for their non-urgent care. So,the medical experience has been very posi-tive, and the travel throughout the SouthIsland amazing—by foot (‘tramping’), horse-back, kayak, and whitewater raft.”

Gus Kappler ’61, MD ’65: “I’m in my13th year of retirement from a general andvascular surgery practice in Amsterdam, NY.The first few years allowed me to commit

I have many good memories of helping apeople manage their chronic illnesses andeven get better sometimes. It’s to theMedical College’s credit that we werealways told that we would need to learnnew medical things as time went by.

I first heard of sleep apnea in 1969, wellthrough my residency and fellowship train-ing. Now it’s considered a significant clini-cal problem for about 4 percent of ourmiddle-aged and elder population, and Ispend a good deal of my time caring forpatients with sleep disorders. I’m a CPAPuser myself, as are a number of other physi-cians in this medical community.

Tulare County, where I live, is famousfor having more cows than people (about350,000 to 320,000 currently). We are thenumber two county in the US for dollarvalue of agricultural production. Our hospi-tal in Visalia is an inner-city hospital in arural setting, as 25 percent of our popula-tion has no medical insurance. Our first res-idency programs (under the auspices of UCIrvine) will begin next year. San JoaquinValley Fever is still with us, but as far as Iknow the first case of human tularemiaremains to be diagnosed here in the countywhere that disease was first described in theearly twentieth century.

It has mostly been a lot of fun to workhere and see what a community that caresabout its health care is able to accomplish.We have seen a lot of changes in medicinesince 1961—most of them good. But we doseem to be pricing ourselves and ourpatients out of the marketplace. Access todiagnosis and treatment is not all that itshould be. Also, the breakdown of “conti-nuity of care” (which we learned aboutfrom Dr. Reader in our fourth yearComprehensive Care rotation) seems to

have become the rule rather than theexception.

Our class has been out in the realworld for more than 50 years now, andwe have pretty much passed the baton toour younger colleagues. They deal withthe problems of their patients (who areincreasingly likely to be us) and thehealth-care system itself just as we oncedid. The medical systems issues seem tobe more numerous and harder to dealwith than they once were. We can onlyhope that most patients will be at least aswell cared for in the future as they arenow. Will our recent Weill Cornell gradu-ates be able to enjoy the practice of med-icine as much as most of us once did? Wecan certainly hope and pray that this willbe the case. Medicine was never supposedto be easy, and as always, those who fol-low us are not only younger and stronger,but they may be better at balancing theirpriorities. Wouldn’t it be fascinating to hear what they will have to say aboutall of this in 2061?”

William Chaffee, MD ’62: “I’ve been

We want to hear from you!Keep in touch with your classmates.

Send your news to Chris Furst:[email protected] by mail:Weill Cornell Medicine401 East State Street, Suite 301Ithaca, NY 14850

Red and ready: Graduates in Carnegie Hall during the ceremonyAMELIA PANICO


S U M M E R 2 0 1 2 4 3

my full efforts to helping my wife, Robin,and daughter, Kim, deal with life-alteringevents. God works in mysterious ways.Robin and I spend our winters on East65th Street in the City. She suggested Ibecome involved at Weill Cornell. Iresponded, ‘Not a chance, I’m not an aca-demician.’ Well, Dr. Alonso, who was deanof academic affairs, invited me to become afacilitator in Problem Based Learning:Human Structure and Function. I’ve volun-teered in that capacity for 13 years as away of giving back to the Medical College.I believe it an honor being involved in thedevelopment of new physicians of WeillCornell’s caliber. I’ve even received theExcellence in Teaching Award. Lecturing inthe third-year surgery rotation on the acuteabdomen is also a thrill, for I visit with thestudents that I facilitated in their first year.The annual lecture on my trauma surgicalexperience at the 85th Evacuation Hospitalin Phu Bai, Vietnam, follows our study ofhemorrhagic shock.

Life in Amsterdam is somewhat red-neck-ish, with lots of shooting sports, hunt-ing, four-wheeling, kayaking, planting foodplots to attract deer, hiking, and scoutingthe game around my farm in MontgomeryCounty and at Ohmer Mtn. Club’s 15,000-acre hunting camp in the Adirondacks. Sofar the turkeys are winning.

Daughter Kim Kappler Fine’s son,Declan,14, shot his first buck at Ohmer lastfall and my son’s three daughters enjoyequitation lessons in the area. They allenjoy our land and the pool, and it’s quiet.Last September Robin and I visited theNormandy Coast, a really moving experi-ence, having served in Vietnam. See SavingPrivate Ryan to experience the bloody real-ity of a beach invasion. Bayeux is a beauti-ful jumping off point to Omaha Beach,Utah Beach, Colleville, as well as Honfleurand Deauville. After a few days in Paris, wecruised the Soane and Rhone from Beauneto Avignon with a bus trip to Nimes andalong the Cote d’Azur to Monaco. ThisSeptember is the 42nd-year reunion of the85th Evacuation Hospital in Las Vegas. Weall share loving but brutal memories.”

Jackie Parthemore, MD ’66: “My hus-band, Alan Blank ’59 (CUMC ob/gyn resi-dent 1967–72), and I enjoyed visiting theruins of many ancient cities while travelingthrough western Turkey last fall. We nowhave four grandkids, from 1 to 6 years ofage, and are very fortunate that their par-ents decided to settle in the San Diegoarea. At this year’s American College of

Physicians meeting, I was inducted as aMaster of the College. I am planning toattend my 45th Reunion in October.”

Charles H. Hennekens, MD ’67, the firstSir Richard Doll Research Professor in theCharles E. Schmidt College of Medicine atFlorida Atlantic University, has been rankednumber 81 by ScienceHeroes.com for sav-ing more than 1 million lives. He wasranked behind Edward Jenner (5), whodeveloped the smallpox vaccine, but aheadof Jonas Salk (83), who developed the poliovaccine. Dr. Hennekens played seminalroles in the discovery of the net benefits ofaspirin in the primary prevention of a firstmyocardial infarction, first stroke, prematuredeath in the treatment of acute MI, as wellas in secondary prevention in a wide rangeof over 170,000 male and female survivorsof occlusive cardiovascular disease events.He has done research on statins, angiotensinconverting enzyme inhibitors, and receptorblockers, as well as beta-blockers. Dr. Hen -nekens says his chief motivation was thepremature and sudden cardiac death of hisfather.

Ronald Rankin, MD ’68: “I’m workingfor my old group in a satellite hospital inIdaho and also for St. Peter’s Hospital inHelena, MT. I recently visited PaulWasserman, MD ’69, former roommate andnow oncologist, at his gorgeous home inScottsdale, AZ. What would I rather bedoing? Literally selling the ranch and mov-ing to our lake house in Coeur d’Alene, ID.The things I remember most are howengaged the supremely talented facultywas; also, learning sterile technique from ascrub nurse on surgical rotation. (I think ofher nearly each time I glove up for a proce-dure.) I’d like to hear from Robert Koehler,MD ’68, retired chairman of radiology atthe University of Southern Alabama, andbest man at my wedding.”

Reed Dunnick, MD ’69, received theGold Medal from the Association ofUniversity Radiologists this past April.

John Hirshfeld ’65, MD ’69: “I’m work-ing at Penn Med at an 80 percent work-load, a terrific balance that has enabled meto continue to do all the things I like to do,including diagnostic and coronary inter-ventional procedures, attending in theCCU, teaching the cardiovascular course,and serving on the FDA CirculatorySystems Advisory Panel (where I see JeffBorer, MD ’69, from time to time). Thereduction to 80 percent has given Barbaraand me more time to do things together.We recently saw Jim Foster, MD ’69, and

his wife, Elaine, during a stopover at theirhome in Chapel Hill, and I’ve had thepleasure of dropping in on Bill Davidson,MD ’69, and his wife, Carolyn, when inSan Diego for a meeting. I have no currentplans to retire or slow down further.”

1970sRonald K. Harris, MD ’71: “I’ve been in

general surgical practice for almost 34years. My wife, Helen, and I have beenmarried 44 years. Daughter Kimberly HarrisGreiner ’00 is a University of Pennsylvaniaveterinarian; daughter Skye Harris Hawk isan ICU coordinator; son Jonathan is anevent coordinator.”

Richard Lynn, MD ’71: “First I want tothank Frank Bia, MD ’71, for helping mewith the plans for the 40th Reunion. I’moverjoyed by the response. As of June 1,here is the list of those who have responded:Frank and Peggy Bia, MD ’72, Lou Rambler,MD ’71, Charlie Rance, MD ’71, EricGutnick, MD ’71, Arnie Cohen, MD ’71, KenSchwartz, MD ’71, Henry Pitt ’67, MD ’71,Steve Rosenblatt, MD ’71, Theo Manshreck,MD ’71, Fred Chu, MD ’71, Peter Robinson’68, MD ’72, John Perlmutter, MD ’71, RonHarris, MD ’71, and Bob Laureno, MD ’71.Peter Monoson, MD ’71, may be coming.Ivan Login, MD ’71, sends his regrets, asdoes Nancy Ronsheim ’64, MD ’71.Unfortunately our classmate Angel Ola -z abal, MD ’71, in Puerto Rico, will be unableto come. His wife called me to tell me thatlast year he was diagnosed with a glioblas-toma and has had radiation and nowchemo and has had to close his practice. Itold her our prayers are with them. If everthere was a reason to smell the roses, now—after this sad news—is the time for thosewho have not made plans to please do soand get in touch with me. A private classdinner is being planned for Friday evening.On a personal note, my youngest son, Peter,34, who is an Ortho dox rabbi and dean ofstudents at a yeshiva in Jerusalem, justreceived a master’s degree from theUniversity of Pennsylvania in applied posi-tive psychology. He flew in once a month(ten times) from Israel to Philly to accom-plish this. Needless to say, I am very proud.I hope to see you in October.”

Neil MacIntyre, MD ’72: “I’m enteringmy 32nd year on the Duke faculty, current-ly a full professor in pulmonary/criticalmedicine. It has been a wonderful careerand I’ve had the opportunity to visit manyparts of the world. Susie and I have raisedsix children, with three of them going into



medicine, two in finance, and one whoflies planes for NOAA. We also have threegrandkids and look forward to more. Hopeto see as many classmates as possible at thereunion.”

Mike Anger, MD ’75: “My big news is Ihave decided to retire from active practiceas of August 15. I have lots of ideas abouthow to fill the time: more songwriting;playing music with my brother, Jim; sail-ing; and I might see if I can still managesome downhill skiing. I hear lift tickets aresometimes free for us old guys. I may alsohave a volunteer teaching gig at Children’sMemorial Hospital, which is moving soonto a new building close by in downtownChicago. Best to all my classmates.”

Milagros Gonzalez, MD ’75: “I’m doingwell at Providence Pediatrics in Phoenix,Arizona. My husband, Keith Bracht, and Iare awaiting with great anticipation ourupcoming cruise to the Panama Canal inOctober of this year. Hello to everyone.”

Carlyle H. Miller, MD ’75: “I’m the asso-ciate dean for student affairs and equalopportunity programs at Weill Cornell, andI’ve been promoted to associate professorof medicine as of July 1, 2012.”

Greg Everson, MD ’76, just completed anew book for patients and families, CuringHepatitis C, and is professor of medicine anddirector of hepatology at the University ofColorado, Denver (visit HepQuant.com).His wife, Linda, has a fine arts career pro-ducing abstractions of nature and imagesfrom the Southwest and other places (visitlindaeverson.com). Son Brad is working inDenver, started CNOME.LLC, and is a long-distance runner. Son Todd is getting hisPhD in epidemiology at the University ofSouth Carolina and is a shark fisherman.

Richard S. Nenoff ’72, MD ’76, wasinducted as a fellow in the American Collegeof Radiology (ACR) at the annual meeting inWashington, DC, in April. Dr. Nenoff is themedical director of the Breast ImagingCenter at X-ray Associates of New Mexico.He is a member of the ACR, the RadiologicalSociety of North America, the AmericanRoentgen Ray Society, and the GreaterAlbuquerque Medical Association.

Leon Fay, MD ’77: “I retired from familymedicine practice in June 2011, with the last15 years being the best, at a communityhealth center in Lawrence, MA. I have donea lot of global health in Latin America andEastern Europe. I try to keep up with medi-cine and am teaching in first-year courses atthe Tufts University School of Medicine inBoston. My wife, Francesca, who I met when

(primary care), teach at UAlbany School ofPublic Health, and serve on the faculty of theNYS Preventive Medicine Residency pro-gram. I also work in public health outreachand education at a local rescue mission. Butthe most exciting update is that in May Iwent to Honduras on my first medical mis-sions trip. I recently received the Universityat Albany Alumni Association’s 2012 Excel -lence in Community Service Award. (Ireceived my MPH from UAlbany when Icompleted a residency in preventive medi-cine in 2006.) Here is a link to my profile:http://www.albany.edu/alumni/excellenceawards.php#Grosvenor.”

Mark Landon, MD ’80, is professor andchairman of obstetrics and gynecology atOhio State University College of Medicine.He works closely with Steven Gabbe, MD’69, who is senior vice president of HealthSciences for Ohio State and CEO of itsWexner Medical Center. Mark writes: “I havebeen in Columbus for 25 years and, despitemy New York roots, I consider myself aBuckeye, especially on Saturday afternoonsin the fall. I recently met Peri Petras, MD’80, and Jeff Kocher ’76, MD ’84, for dinnerin New York. We continue to share so manywonderful medical school memories.”

Robert Naparstek, MD ’80: “I havemoved to Providence, RI, with my wife, Lisa.Our kids, ages 21 and 23, are doing well. Allin all, we are pretty fortunate and blessed.”

Douglas F. Buxton, MD ’82: “I’m prepar-ing for my third annual two-week surgicalmission to Zimba, Zambia, at the eye clinic,where we perform more than 200 surgicalprocedures and see more than 700 patientsin an underserved area of southern Africa.We see patients from as far afield asTanzania and Angola. This has been themost rewarding work I have ever done,though physically and often emotionallyexhausting. I urge all my classmates fromCornell to become involved and give backin any and all ways they deem appropriate.We can change the world’s health and con-sciousness one patient at a time. Un abrazo.”

Jonathan Javitt, MD ’82: “I’m the CEOand founder of Telcare Inc. We’re buildingthe world’s first commercial enterprise tofocus on connecting patients to their care-givers via wireless medical devices. Our firstproduct is a cellular-enabled glucose meterthat has already shown a 10 percentimprovement in glucose control among kidswith type 1 diabetes. All of this started whenI got commissioned by President Bush tolead the President’s Information TechnologyAdvisory Committee. The policy we wrote

she was on the faculty of the Cornell-NewYork Hospital School of Nursing, and Ihave been married for 34 years, live inNew Hampshire, and have two sons whoare doing well in their chosen fields.Retirement is definitely a work inprogress.”

Steve Koenig, MD ’77: “Just a note tolet you know that I recently got togetherwith classmates Kurt Oester ling, MD ’77,and Mark Kris, MD ’77, while Mark waslecturing in Milwaukee. Both look greatand have changed little since medicalschool. In fact, Mark was about to com-pete in a triathlon in NYC. On the homefront, the honeybees are active and thebuds have broken at River Road Vine -yards, my latest horticultural project.Academic cornea continues to be fun.”

Thomas Kosten, MD ’77: “I’m livingin Houston, TX, after spending 28 yearsat Yale in psychiatry, including chief ofpsychiatry for four years. Now I’m at MDAnderson Cancer Prevention Center andBaylor College of Medicine, where I havehad various positions over the past sixyears including vice president for clinicalresearch. In my laboratory, I’ve beendeveloping vaccines for addictions andstudying the pharmacogenetics of addic-tion treatments. I also established a newInstitute for Translational Research atTexas Medical Center and direct theadult components with a co-director forpediatrics. Publications seem to helpwith keeping funding, and last year Ipassed the 500 mark of papers with thehelp of my laboratory in Beijing, China,at Peking University, where I maintainmy Distinguished Professorship inPsychiatry and Addictions. Great oppor-tunities in China just seem to keep accel-erating, and I may need to move therebefore I retire. I’m doing a few otherthings at the Institute of Medicine ofNAS with what seems monthly trips toWashington, DC. I rarely make it back toNYC, but hope everything is going wellthere. My wife of almost 40 years contin-ues to happily conduct her research atBaylor, my daughter is getting married,and my son is considering where hewants to go to college here in Texas.”

1980sCarolyn Heywood Grosvenor, MD ’80:

“My husband, Wayne, took early retire-ment last year and is currently pursuinghis music interests (acoustic bass/jazz). Iwork part-time for the VA in Albany, NY


S U M M E R 2 0 1 2 4 5

was the basis for creating ONC and the HighTech Act. The problem is that we gotnowhere when we talked about connectingpatients to the system. Telcare is the firstdemonstration of what’s possible when youdo that. The testimonials on our websitefrom patients and their parents say it all.Starting Telcare has been the most all-con-suming fun I’ve ever had.”

Evelyn Placek, MD ’82: “I’m an alumnaof the Weill Cornell dermatology program(1988), and I’ve been in a group dermatol-ogy practice in Scarsdale, NY, for the past 24years. I am very happily remarried for thepast ten years to Gary Horowitz. DaughterKerri is currently applying to school (hop-ing to go to Cornell), and son Ryan is justback from an incredible semester abroad inValencia, Spain. Friends have drifted awayover the years, but I’m still in touch withShelley Lanzkowksy Bienstock, MD ’82,who is a pediatrician in Morristown, NJ.”

Bruce Reidenberg ’81, MD ’85: “I’mnow doing house calls at the homes ofadults with developmental disabilities andconsulting with the NYC Dept of Educationon various issues with special needs chil-dren. My wife, Joy Gaylinn Reidenberg ’83,still loves gross anatomy and continues toteach anatomy at Mt Sinai. We have twowonderful graduations this year, one fromMuhlenberg College and one from Rye HighSchool. In the fall, we start empty nesting.”

Stephen P. England, MD ’86: “I’m livingin Minneapolis, MN, and married toSuzanne Paki with one daughter, Olivia, 10.I’m a pediatric orthopaedic surgeon at ParkNicollet Health System and Tria OrthopaedicMedical Center in the Twin Cities.”

B. Sonny Bal, MD ’87: “Since graduatingfrom Weill Cornell, I’ve earned my lawdegree and have a law firm in NorthCarolina. I also have my MBA from Kellogg.I work full time at the University ofMissouri, with service on several corporateboards, and am a law partner in an ortho -paedic niche law firm.”

Carol McIntosh ’83, MD ’87: “I, as thegynecologist, along with several otherphysicians (a breast surgeon, family practi-tioner, and anesthesiologist) traveled toMercy Hospital in Bo, Sierra Leone, with theintent of providing breast cancer screeningand treatment, cervical cancer screeningand treatment, prenatal care, and trainingof the medical staff. Our goal is to pilot acervical and breast cancer screening andtyping methods appropriate for a low-resource setting. All women with identifiedlesions would receive treatment. Our objec-

tives are to establish a collaborativetelemedicine consultation programbetween Mercy Hospital and US-basedclinicians after initial cancer screening isperformed together; to describe a sam-pling of cervical and breast disease seenin the selected population; and to identi-fy potential areas of future cervical andbreast cancer research for further discus-sion with Sierra Leonean researchers.”Thanks to a grant from Helping ChildrenWorldwide, Mercy Hospital opened itsdoors in 2007; today it cares for 10,000patients a year, regardless of their abilityto pay.

Alexander Babich, MD ’88: “I amabout to become an empty nester (apoorer empty nester, as two private-college tuitions await next fall). My olderson will be a senior at Oberlin Collegemajoring in history and creative writing,while the younger will enroll at Stanfordto study (we think) political science. Ienjoyed a recent Brooklyn TechnicalHigh School reunion and hope that our25th Reunion next year will be as muchfun. My pathology practice group hasadded two bright new faces whose youthand enthusiasm is very refreshing. Is thishow others saw us 25 years ago?”

Linda Sanderson LaTrenta, MD ’89: “Iam happily working as a radiologist atGreenwich Hospital. My two kids, Lucas,12, and Alexandra, 10, are thriving inthe ’burbs. I am getting married in

Hawaii in August. I couldn’t be happier.”

1990sDaniel B. Jones ’86, MD ’90: “I was pro-

moted to professor of surgery at HarvardMedical School and vice chairman, BethIsrael Deaconess Medical Center. I’m the co-chair of the ACS-ASE Skills-Based NationalSimulation Curriculum for Medical SchoolsYears 1–3. I chaired the Quality, Outcomes,and Safety Committee, Fundamental Use ofSurgical Energy (FUSE) Task Force, Edu -cational Resources Committee. I edited sev-eral new books released this year includingSAGES Manual for FUSE; SAGES Manual forQuality, Outcomes, and Safety; Mastery ofSurgery; Hernia Surgery; and The Textbook ofSimulation: Skills and Team Training. MyBoston neighbor raves about his Hospitalfor Special Surgery orthopaedic surgeon,classmate Rob Rozbruck, MD ’90.”

Evan Goldfischer, MD ’92, is co-CEOand founder of Premier Medical Group ofthe Hudson Valley, a 22-physician group ofurologists and gastroenterologists thatserves the mid-Hudson Valley region. He isalso the founder of Premier CaresFoundation, a 501(c)(3) charity that pro-vides funding for underserved patients withurologic and digestive diseases.

Roderick K. King, MD ’92, was recentlyappointed deputy director of the FloridaPublic Health Institute (FPHI). Dr. King’straining includes a BS in biomedical engi-neering from Johns Hopkins, an MD from

PANICO

Pomp and Circumstance: Dignitaries on the Carnegie Hall stage



University of Washington School ofMedicine. He served as chief of theOrthopaedic Surgery Service at theUniversity of Washington Medical Cen -ter and vice chair of the department.

Eric C. Burdge, MD ’98: “Here iswhat I have been up to this past year:‘In-theater medical treatment keeps war-riors in the fight.’ You can read about myrecent deployment at the following link:http://www.af.mil/news/story.asp?id=123212620. That work earned me theUSAF Achieve ment Medal. It has been anhonor and my pleasure to serve not onlythis great nation but also the woundedwarriors giving their all to defend free-doms enjoyed by the citizens of ourcountry. I also wanted to give you anupdate on my professional life and sharesome wonderful news. The match resultsfor the Surgical Oncology Breast Fellow -ship have been posted, and I have beenmatched with V. Suzanne Klimberg, MD,Program Director, Winthrop P. Rocke -feller Cancer Institute, University ofArkansas. I am blessed to have beenmatched in such a prestigious program. Iwill be training with Dr. Klimberg, whois one of the top three breast surgeons inthe world. She writes the textbooks forbreast surgery. The fellowship is in LittleRock, AR (University of Arkansas for theMedical Sciences), so that will certainlybe a big change. With these results inhand, I will now separate from active-duty Air Force at the end of June andtransition to the 189th Airlift Wing ofthe Arkansas Air National Guard andfunction as their flight surgeon. I was

awarded my aviation wings and flight sur-geon rating just this past month. This lateralmove will permit me to serve the nationwhile taking care of its citizens, especiallythose afflicted with breast cancer. My familyis growing and maturing by leaps andbounds. I have been blessed with threedaughters (ages 2, 5, and 7) who are in giftededucational programs. I also enjoy the com-panionship and partnership of my lovelywife, Tally. Without her selfless efforts, Icould not serve my country in the deployedenvironment. She truly is the proverbial‘unsung hero’ (or heroine in her case). Ihave never heard her complain once abouthaving to do my job and hers while I havebeen deployed for six months or more.Lastly, thank you, Weill Cornell, for givingme the proper tools to serve not only thisnation, and my patients, but also woundedwarriors and third-world nationals.”

2000sTina Marie Meyer Mayer ’99, MD ’03: “I

am living in New Jersey and working as anacademic medical oncologist at CancerInstitute of New Jersey, with a focus on GUmalignancies and primary brain tumors. Ienjoy my career path and the challenges ofpracticing oncology. I have a 3-year-old sonand a 2-year-old daughter who definitelykeep me on my toes!”

Cara Grimes, MD ’05: “This year hasbeen a big one for me. I will finish my fel-lowship in female pelvic medicine andreconstructive surgery at UC San Diego inJune. In August I will join the Gyneco -logical Surgical Services Division of Ob/Gynat Columbia Medical Center. I’m excited tobe returning to New York City with my hus-band, Justin Marquis, and son, WyattGeorge Grimes Marquis.”

Kate Lampen-Sachar, MD ’07: “I’m fin-ishing my radiology residency at NYP/WeillCornell and starting a fellowship atMemorial Sloan-Kettering in breast andbody imaging. I have fraternal twin daugh-ters, Sophia and Isabelle, who are 20months old. Hope that everyone is doingwell. My e-mail is Kate.Lampensachar @gmail.com.”

Jennifer Inra, MD ’08: “I married Dr. PaulGordon on September 24, 2011, at Blue Hillat Stone Barns in New York. We met duringresidency at Massachusetts General Hospitalin Boston. We were so lucky to celebrate ourwedding with so many WCMC friends.Currently, I’m finishing my first year of gas-troenterology fellowship at Brigham andWomen’s Hospital in Boston.”

Weill Cornell Medical College, where heearned the Honors in Research Award as anNIH Young Investigator, and an MPH fromHarvard School of Public Health. He is cur-rently the president of Next GenerationConsulting Group, an organization thatuses strategic planning, leadership, organi-zational development, and evaluation tobuild healthy communities. In addition, Dr.King serves on the faculty of the Depart -ment of Global Health and Social Medicineat Harvard Medical School and senior facul-ty at the Massachusetts General HospitalDisparities Solutions Center, and is a formerdirector of the Program on Cultural Com -petence in Research in Harvard ClinicalTranslational Science Center (Har vardCatalyst). He most recently served as thedirector for the Health Resources andServices Administration (HRSA), NewEngland Regional Division, and as a Com -mander in the US Public Health Service. In2011, Dr. King was selected as one of 20scholars in the Western Hemi sphere for thenew Fulbright Regional Network forApplied Research (NEXUS) Program toengage in collaborative thinking, analysis,and problem-solving with a focus onimproving the quality of life for communi-ties in the region. His Fulbright projectfocused on “Leadership Innovation forCollective Impact to Address the ChronicDisease Epidemic in the Caribbean.” Hecurrently serves on the US Department ofHealth and Human Services AdvisoryCommittee on Minority Health.

Thomas Ullman, MD ’92: “I live inChappaqua, NY, with my wife, Nona (Cor -nell ILR class of 1988), and my threedaughters. I’ve stayed at Mount Sinai sincecompleting my GI training and am current-ly the director of the IBD Center and med-ical director for the faculty practice for theDepartment of Medicine. Sadly, I don’t getto see my classmates nearly enough, but Ihave nothing but the best memories of ourfour years together.”

Jeff Kauffman, MD ’93: “I’m an ortho -paedic surgeon. After having a busy sportsmedicine practice in Sacramento for ten years,last year I moved back to New York withmy wife and daughter (Uschi and Heidi). Ijoined Orthopedic Associates of DutchessCounty and live in Cold Spring, NY.”

Seth Leopold, MD ’93, was named editor-in-chief of Clinical Orthopaedics and RelatedResearch, a leading international peer-reviewed orthopaedic journal publishedcontinuously since 1953. Dr. Leopold is aprofessor of orthopaedic surgery at the

‘I was awarded myaviation wings andflight surgeon ratingthis past month. This lateral move will permit me toserve the nationwhile taking care of its citizens.’

Eric C. Burdge, MD ’98


S U M M E R 2 0 1 2 4 7

’40, ’43 MD—Harold C. Miles of Naples,FL, February 29, 2012; staff psychiatrist,Community Mental Health Center; clinicalassociate professor of psychiatry, Universityof Rochester; director of CommunityHealth Services of Monroe County; com-missioner of health, Cattaraugus County;fellow in psychiatry, Milbank MemorialFund; medical officer, US Army. Sigma Pi.

’40, ’43 MD—James N. Trousdell ofOyster Bay, NY, January 9, 2012; physician.Beta Theta Pi.

’45 MD—George E. Eddins of Albe -marle, NC, April 4, 2012; physician; helpedestablish coronary care unit at Stanly CountyHospital; veteran; active in community, pro-fessional, religious, and alumni affairs.

’42, ’45 MD—Jay F. Harris of Albu -querque, NM, October 8, 2011; physician;medical consultant.

’46 MD—John J. Bowe of Ridgewood,NJ, March 23, 2012; plastic and reconstruc-tive surgeon; director of plastic surgery, ValleyHospital and St. Joseph’s Hospital; lepidop-terist; research associate, Florida State Col -lection of Arthropods; veteran; artist; active in com munity and professional affairs.

’47, ’51 MD—James D. Allan of WestSpringfield, MA, April 11, 2012; general sur-geon, Providence Hospital; also practiced atNoble Hospital, Springfield Hospital, andBaystate Medical Center; veteran; director,Chamber of Commerce; active in commu-nity affairs. Tau Kappa Epsilon.

’43, ’51 MD—Henry L. Hood of RiverWoods, NH, February 18, 2012; neurosur-geon; director of neurosurgery and presi-dent of Geisinger Medical Center; CEO,Geisinger Health System Foundation; veter-an; active in professional affairs. Acacia.

’49, ’53 MD—Peter D. Guggenheim ofWarwick, NY, March 5, 2012; psychiatrist;associate clinical professor of psychiatryand co-founder of the Forensic Fellowshipprogram, New York Uni versity; veteran; col-lector of Renaissance bronzes and clocks;equestrian. Sigma Alpha Mu.

’56 MD—John H. Prunier of River side,

InMemoriam

CT, February 7, 2012; specialist in inter-nal medicine; genetics researcher,Rockefeller University; veteran; active inalumni affairs. Psi Upsilon.

’59 PhD—June Lee Biedler of Green -wich, CT, April 16, 2012; DistinguishedCell Biology Cancer Research Scientist,Memorial Sloan-Kettering Cancer Cen -ter; professor of medical sciences, WeillCor nell Graduate School of Medical Sci -ences; associate editor, Cancer Research;recipient, G. H. A. Clewes MemorialAward for research in combination ther-apies; lifetime member, In Vitro Biology;author.

’55, ’59 MD—Alfred J. Felice ofSands Point, NY, May 25, 2012; obstetri-cian/gynecologist. Beta Sigma Rho.

’60 MD—George V. Burkholder ofSan Antonio, TX, April 15, 2012; urolo-gist; founding partner, Urology Clinic ofSan Antonio; assistant chief of urology,Brooke Army Medical Center; chief ofstaff, Southwest Texas Methodist Hos pital;teaching staff member, Cleveland Clinic;also worked in pediatric urology at GreatOrmond Street Hospital; veteran; sculptorin bronze; painter; active in community,professional, and religious affairs.

’60 MD—John P. Hayslett of Ham -den, CT, April 15, 2012; professor ofmedicine and chief of nephrology, YaleSchool of Medicine; medical director,Physician Associate Program at Yale;practiced at Yale-New Haven Hospitaland Veterans Administration MedicalCenter; clinical and laboratory resear ch-er; veteran; sailor; active in communityand professional affairs.

’56, ’60 MD—Robert K. HeinemanJr. of Delmar, NY, April 15, 2012; ortho -paedic surgeon; specialist in total hipand knee replacement; team physician,Albany Metro Mallers; adjunct instruc-tor, Dept. of Physical Therapy, RussellSage College; expert witness; veteran;photographer; active in community andprofessional affairs. Delta Chi.

’63 MD—Terrence J. Barry of Miami, FL,formerly of Lindon, UT, May 1, 2012; ortho -paedic surgeon; specialist in arthroscopicknee surgery; airline pilot, TWA; Air Forcefighter pilot; LDS bishop, stake president,mission president, and patriarch.

’68 MD—George Cooper IV of Charles -ton, SC, April 28, 2012; director, GazesCardiac Research Institute, Medical Uni -versity of South Carolina; chief of cardiology,Veterans Administration Medical Center inCharleston; expert in heart physiology andthe causes of heart failure; director of basiccardiovascular research, Temple Uni versity;also taught at University of Iowa; author;recipient, Louis N. Katz Basic Sci enceResearch Prize and the Carl Wiggers Award;active in professional affairs.

’67, ’71 MD—David R. Gutknecht ofDanville, PA, March 31, 2012; associate anddirector, Dept. of General Internal Medicine,Geisinger Medical Center; clinical professorof medicine, Milton S. Hershey MedicalCenter, Jefferson Medical College, andTemple University School of Medicine; edi-tor, Geisinger Bulletin; veteran; chorister;Civil War battlefield guide; active in com-munity, professional, religious, and alumniaffairs. Pi Kappa Phi.

’73 MD—William M. Riedesel II of St.Louis, MO, April 25, 2012; forensic, geri-atric, and addiction psychiatrist; clinicalprofessor emeritus, Washington UniversityMedical School; musician, University CitySummer Band and Florissant Valley Or -ch estra; member, Rat and Mouse Club.

’84 MD—Harold Wenger of Wellesley,MA, April 25, 2012; founder, Baystate Medi -cal and Surgical, an independent physicianstaffing company.

Faculty

Andrew C. Leon of New York City,February 18, 2012; professor and biostatisti-cian in psychiatry at Weill Cornell MedicalCollege; expert in testing and evaluatingmethods of treatment; environmentalist.



ASKed and Answered

Alumni give students

the straight scoop on

their specialties

Post Doc

vate practice, and administrative leadership. The anesthesiologistswere Weill Cornell professors Miles Dinner, MD ’78, and Jill Fong’79, MD ’84; Gregory Liguori, MD ’89, anesthesiologist-in-chief atHospital for Special Surgery; and Lissette Lugo, MD ’00, attendinganesthesiologist at Lawrence Hospital in Bronxville. They began bydiscussing what brought them to the specialty, noting that none ofthem had envisioned being anesthesiologists when they matriculated.“I came into medical school undecided,” said Fong. “I may still beundecided,” she added, eliciting laughter.

Students heard what the alumni like best about their field: thenew and varied directions anesthesiology is taking, particularly interms of pain management; the ability to have a life outside ofmedicine; and the stimulation that comes from working withmany different people in the OR. Liguori noted that the specialtyoffers the flexibility to work as few or as many hours as oneneeds or wants. “In anesthesiology, time is money,” he said. “Ifyou’re working a ton of time in the OR, then you’re makingmore money.” The speakers offered details such as how manyhours they’ve put in at various career stages, how many week-ends they are on call, and what workloads are common. “It wascritical for me to have my kids in all the school sports, and Icoached their teams for seven or eight years,” said Dinner, who isalso a classical pianist. “I can’t imagine too many specialties thatgive you that opportunity.”

— Andrea Crawford

For more information or to participate in the ASK Program, contactClara Cullen at [email protected].

What workload should beexpected in residency? Whatis private practice like? Is fel-lowship training recommend-

ed? Are there research opportunities? How fastcan one pay off student loans?

One evening last spring, a diverse group of working anesthesiol-ogists sat around a conference table over dinner with a dozen WeillCornell students, sharing their stories and advice as part of theAlumni-to-Student Knowledge (ASK) Program. Since its creation in2009, the program has provided a forum for students to talk topractitioners about their fields; recent panels have covered psychia-try, radiology, and dermatology/plastic surgery. “The students reallyonly have access to doctors in academia, but a lot of them will gointo private practice,” says Clara Cullen, director of alumni rela-tions and giving. Plus, she says, “they don’t necessarily feel com-fortable asking the same people who are evaluating them questionsabout their debt when they graduated or the decision to have achild while a resident.” As a result, the discussions at ASK eventsgenerally involve quality of life rather than nitty-gritty questionslike how to secure a specific residency. “It’s more about getting ageneral feel for the specialty,” she says.

At the April event, moderated by Paul Miskovitz, MD ’75, clini-cal professor of medicine, the speakers’ careers represented a mix ofprofessional opportunities: a community hospital, academia, pri-

ROBERT NEUBECKER

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a time to heal

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