Illuminations: Spring/Summer: 2010

The Magazine for the University of Utah School of Medicine Alumni and Friends

Illuminations Spring/Summer 2010 The Magazine for the University of Utah School of Medicine Alumni and Friends Volume 6 Number 1 Alumni Association Alumni Weekend University of Utah School of Medicine 2010 Medical Alumni & Community Weekend September 23-2 5 connecting with University of Utah School of Medicine 2010 Medical Alumni & Community Weekend September 23-2 5 Utah's Culture of Health What's Inside 1 Alumni President's Message 2 Letter from the Director 3 Utah's Health Status 4 80 Hour Work Week, Benefit of Hazard? 8 2010 Alumni Weekend • Alumni Reunions • Awards Ceremony • Alumni Events 14 Student Highlights • Journey of a Ballard Scholar • Match Day • Dinner with a Doc • Commencement 17 News Notebook 24 Alumni Notebook • Haiti: Facing Medical and Emotional Challenges • Where are They Now? 28 Alumni News Inside Back Cover • In Memoriam • Save The Date Illuminations The Magazine for the University of Utah School of Medicine Alumni and Friends Visit our Web site: www.medicine.utah.edu/alumni Editor Kristin Wann Gorang Photography University Medical Graphics Illuminations is published by the University of Utah School of Medicine Alumni Relations Office For editorial information or corrections call [phone] Send address changes to: Illuminations Office of Alumni Relations 540 South Arapeen Drive, Suite 125 Salt Lake City, Utah 84108-1298 [e-mail] University of Utah School of Medicine Alumni Association Board of Directors Mark A. Johnston, M.D. 1990, President Hilmon Castle, M.D. 1959, House Staff, Vice President Ronald J. Ruff, M.D. 1981, Secretary Lewis J. Barton, M.D. 1964 Saundra Buys, M.D. 1984, House Staff Christine A. Cheng, M.D. 1997, House Staff Spencer Debry, M.D. 2003 Dale G. Johnson, M.D. 1956 Kirk M. Neuberger, M.D. 1963 Kirtly Parker Jones, M.D., Faculty Donald Pedersen, P.A., Ph.D. 1978 James T. Roth, M.D., M.S.P.H. 1989 David N. Sundwall, M.D. 1969 Hugh D. Voorhees, M.D. 1972 Catherine J. Wheeler, M.D. 1991, House Staff James Williams, M.D. 1969 Lindsay Wilson, M.D. 2009 Medical Student Representatives: Jordan Barker, MS II Ashley Crum, MS II Daniel Bennett, MS IV Patrick Kendell, MS IV Ex-Officio: David Bjorkman, Dean, M.D., M.S.P.H., 1980 Kristin Wann Gorang, Director Stephen Warner, Associate VP for Health Sciences, Development/Alumni Affairs Update your information at: http://app.medicine.utah.edu/SOMAlumni/index.htm [e-mail] To opt-out of Illuminations mailings email: [e-mail] Kristin Wann Gorang, Director; Katie Korte, Administrative Assistant; Melanie Osterud, Associate Director Alumni Presidents Message A central theme of "Deep Survival" is the potential for highly stressful circum-stances to shut down creative, thought-ful problem solving and produce more reactionary, reflexive responses. This constriction of adaptive capacity can often result in individuals and groups traveling in the wrong direction and suf-fering serious, untoward consequences. As governmental and educational institutions face the stress of current economic challenges, they too may be at risk of reactionary or ill advised responses. Cutting back on higher edu-cation funding generally and medical school education funding specifically are examples of attempts to deal with economic problems with a short-term view. The consequences of not providing adequate funding to produce sufficient numbers of physicians for the future will produce serious consequences for the health of Utah which already ranks 47th in doctors per capita. And ironically, any economic savings related to decreasing medical school support will be dwarfed over time by the loss of revenue that will result from fewer physicians practicing in the State. It is clear that many worthwhile State programs have sustained cutbacks in the past two years. Legislators in Utah have had a difficult path as they have attempted to decrease spending while maintaining services. However, the future health needs of the State clearly argue for the restoration of medi-cal student educational funding. The University of Utah School of Medicine has actually incurred a nearly 39% loss of revenue compared to most agencies and departments that have dealt with a 9.5% cutback. This resulted from the loss of Federal Medicaid funds combined with the across-the-board State cutbacks. As with Laurence Gonzales's ex-amples in "Deep Survival", we now face the question of which way to go with the funding of medical education. The stressful circumstances of the economy must not cloud the most adaptive response to our future needs; funding an adequate number of physicians to effectively care for the people of Utah and support the economic health of the State. I invite all Alumni who share this view to contact me with their perspec-tives and concerns. [phone], [e-mail]. Sincerely, Mark A. Johnston, M.D., ‘90 President School of Medicine Alumni Board of Directors In the bestselling book "Deep Survival" author Laurence Gonzales examines how individuals and groups respond to endangering circumstances. The book is more than a collection of survival stories; it is an in-depth look at the psychology and physiology of stress. Mark A. Johnston, M.D., 1990 1 2 As the medical school has grown, but also struggled with financial cutbacks and restraints, our alumni have stepped up their giving, and their involvement with students, to help insure we produce well-qualified physicians and other med-ical specialists. Three years ago many of our Utah and Idaho alums began to give a gift of a Littman Cardio III stetho-scope to each incoming student. Our local alumni have mentored students in their office, and the past couple of years the HOST program has worked con-necting distant alumni with fourth year students as they traveled the country interviewing at residency programs. It is such a gift for our students to have an alumnus/a meet them and introduce them to the city and the medical center where they may be living and working in the future. This year some of our local alumni signed up to host first and second year medical students and their families at a dinner in their home, or at a restaurant, as part of our Dinner with a Doc pro-gram. This gave the student and their significant other a chance to talk informally with the physician about their specialty, what to expect in a medical marriage, and how to prepare to survive the years of medical school and advanced training. On page 14 you can read some of the rave reviews we received from both medical students and hosting physicians about their experiences. The Association is overseen by a board of approximately 20 physicians and other medical practitioners. This year many of them were active in calling alumni across the state in select districts to encourage them to lobby their legisla-tors to pass the increased cigarette tax (which did pass) and educate politicians about the physician shortage in the state and the need to adequately fund the medical school. On other fronts, the Comm-unications and Programs Committees are continually striving to come up with ways to connect with our alumni across the country. We work to keep you abreast of activities at the School of Medicine, along with connecting you with former classmates through our web site, our new E-zine newslet-ter, our yearly reunions and alumni weekends, and this magazine. Our Education Committee produces an exceptional CME symposium every fall and started a Transitioning into Practice program for our senior residents in 2009. The Student Program and Awards Committee works with four student board members to come up with ways to assist students, from the stethoscope program to the new Student Emergency Fund, started with gifts from the Class of 2010. I hope you enjoy the articles in this edition of Illuminations, which range from a discussion between a residency director and chief resident about the 80- hour work week, to a report from one of our alums about his experience provid-ing medical care in Haiti right after the earthquake. Feel free to contact me with your ideas for articles or programs, issues and concerns at 801-585-3818, or send an email to me at Kristin.gorang@ hsc.utah.edu. I look forward to hearing from you and meeting more of you at this coming September's Medical Alumni and Community Weekend. Kristin Wann Gorang Director, School of Medicine Alumni Relations Letter from the Director Kristin Wann Gorang Greetings medical alumni! This past week I have been contemplating how the Class of 2010 had just started their four-year journey through medical school as I was beginning my journey as the Director of the School of Medicine Alumni Relations office. It has, for the most part, been a joyful journey, one of working with exceptional alumni and sstudents, while collaborating with a hard-working board to produce some worthwhile initiatives and programs. 3 A Utah's Health Status And of course, much of it is due to the tremendously dedicated and capable public health professionals who work in one of Utah's 13 health departments (12 local and one state). This culture of health was high-lighted in November 2009 by the United Health Foundation (UHF) when it ranked Utah the 2nd healthi-est state in the nation - Vermont was ranked 1st. The UHF is a national non-profit organization dedicated to improving health and health care in our country, and its annual health rankings report is highly regarded in the national public health community. The goal of the annual report is to pro-vide a measurement of the overall health of the nation on a state-by-state basis, with the purpose of educating individu-als, elected officials, healthcare profes-sionals, employers and communities to take action to improve health. As director of the state health department, I take considerable sat-isfaction in this ranking, especially in the report's findings that Utah has the lowest rates in the nation for smoking, cancer deaths, infant mortality and binge drinking. But a closer look at our health rankings reveals a number of challenges, and even some measures for which we receive credit where credit is clearly not due. Specifically, the report gives accolades to Utah for having "only" 23 percent of its population counted as being obese. If you include the number of those Utahn's who are also over-weight, the percentage skyrockets to over 65 percent. Our relatively favor-able ranking on obesity says more about the sad state of the nation than the health of Utah. Obesity has been on the rise in Utah for at least the past twenty years. The fact that we are not yet as fat as the rest of the country is not something we David N. Sundwall, M.D. ‘69 Executive Director, Utah Department of Health I've often thought that my colleagues around the country must be enviable of my position as State Health Officer for Utah. We live in a state that, for one reason or another, has long fostered a "culture of health". Some of this is due to a large segment of our population eschewing such substances as tobacco and alcohol, some of it is due to the natural beauty of our state and the ease with which residents can choose to live an active lifestyle. 4 should be proud of. Obesity poses a significant public health threat to our communities, and an even greater threat to the health of those individuals who struggle with the significant medical conditions that often accompany obe-sity. As a state we can, and should, do more to combat this epidemic. A good first step would be to increase education about and prevention of obesity by urging more businesses, communities and schools to develop strategies to address the issue. Here at the state health department, we operate an employee-owned fitness center and provide employees with three 30-minute periods of paid leave time each week to exercise. Many other Utah companies have similar worksite-wellness initiatives. Anecdotal data suggest such policies are effective tools in managing employee weight, and in turn improving their productivity, their mental health, and satisfaction with their jobs. Employers can find more information on creating programs and policies by visiting www.health.utah.gov/obesity. Another significant challenge pointed out in the report is the health disparities that exist between Utah's ma-jority white population and our ethnic minorities. It is exciting to see our state grow and become more diverse; at the same time, however, it's disappointing that problems with access to affordable health care and health insurance lowers the overall health status of minority populations. When it comes to important public health issues like infectious disease, mental health, alcohol abuse, and vio-lence, our racial and ethnic communities vary greatly from the general population. Understanding why some communities have higher rates of STDs or unvac-cinated children, and why others fare better when it comes to mental health or physical activity, are key to develop-ing culturally-appropriate public health services that may ultimately reduce or eliminate such disparities. The Utah Department of Health adopted a vision statement in 2005 ac-knowledging our growing and complex population, and what we would like to become: "Utah is a place where all can enjoy the best health possible and where all can live, grow and prosper in clean and safe communities." While most that live here are healthier than most that live in other parts of our na-tion, we have a long way to go before we can claim that "all" enjoy the same good health. One more ranking that we are not proud of is the number of pri-mary care physicians to population, 45th lowest in the nation. The UHF lists this as one of our state's most important public health challenges in that limited availabil-ity of primary care physicians poses serious problems with access to appropriate and timely care. We can be proud of our state's efforts to enact "health reform" legislation, the goal being to ensure that eventually all Utah citizens have access to afford-able (and "portable", i.e. not necessarily linked to employment) health insur-ance. And with the recent passage of the Patient Protection and Affordable Care Act [HR 3590] at the federal level, there will be significant expansions of individuals who have health insurance in our state (we estimate that with the required Medicaid expansions alone, more than 110,000 Utahns will be added to the roles of this program). But what good is health insurance if you can't get an appointment with a doctor to provide care - preventive, primary, or specialty care? Our state needs to face the fact that we already have a doctor shortage, and that it is likely to get much worse soon, due to public policies that will expand health insurance cover-age in both public and private sectors. I have had the opportunity to work at the national level in public policy and public health, and know what challenges my peers face in most states. I wouldn't trade places with any of them, and even with our gaps in care, problems related to health disparities, and workforce shortages, we can call upon our tradi-tions of fairness and working together to address them. I look forward to the day when the United Health Foundation ranks Utah as the healthiest state in the nation. The Utah Department of Health adopted a vision statement in 2005 acknowledging our growing and complex population, and what we would like to become: "Utah is a place where all can enjoy the best health possible and where all can live, grow and prosper in clean and safe communities." 80 80-Hour Workweek, Benefit or Hazard? By Mike Draper, M.D., Program Director, Department of Obstetrics and Gynecology and Hillary Moore, M.D., Chief Resident, Obstetrics and Gynecology The past decade has been ripe with discussion over how many hours a resident should work. Interest in this issue was amplified in 1984 by the case of Libby Zion, the 18 year old daughter of a prominent journalist who died in a New York hospital, allegedly due to the actions of overworked and under-super-vised trainees. From that case stemmed contentions that resident working con-ditions were often unsafe for residents and patients alike. This prompted a set of work hour rules designed to increase patient and resident safety. These were initially implemented in New York, and then on a national basis in 2003. As a Residency Program Director, when it comes to resident duty hour regulations, I'm a bit conflicted. I subscribe to principles that support duty hour reform as well as to principles that recognize them as meddlesome. I feel like Groucho Marx, who said, "Those are my principles, and if you don't like them - well, I have others." One of the principles that can-not change is our concern with patient safety. If patient safety is enhanced by entirely changing the way physicians are trained, then let's embrace such change. We're duty bound to rid ourselves of traditions that conflict with the best care of our patients, and medical training is no stranger to these traditions (take, for instance, blood-letting or diethylstilbes-trol). Another non-negotiable principle is that we should act in a way that is humane to our trainees. Our residents should be physically safe. They should not work such unrelenting schedules that they are routinely in danger of falling asleep while driving home from work. They should be trained in a nurturing environment where it is safe to learn and should not spend excessive time inundated with menial tasks. To address the safety of both pa-tients and residents, duty hour regula-tions were imposed, and the first set of rules showed some real promise. The rules included: a 24 hour period off every 7 days, no more than 80 hours per week, overnight call no more frequently than every 3rd night, shifts no longer than 24 hour (with a few extra hours to finish up leftover work, but not take ad-ditional patients) and time off between shifts of no less than 10 hours. The first three time regulations may be averaged over a 4 week period, allowing some flexibility in alternating time-intensive rotations with less demanding rotations. It also allows residents to take larger blocks of time off if they have worked harder in the preceding days or weeks. More recently (and without evi-dence that it will improve patient care or resident safety) public opinion has prompted a revised set of regulations that were proposed last summer. These have been posted for public comment, will be revised if necessary, and then forwarded to the ACGME Board of Directors for approval in September 2010, with implementation scheduled for July 2011. Although resident protection is impor-tant in determining duty hour regula-tions, we may have lost some of the benefits of the old system along the way. I have some concern that we may be robbing our trainees of having the expe-rience of being required to dig deep and reach their potential, which sometimes means working longer hours than would be allowed in the present system. In an open letter dated 10/27/2009, ACGME CEO Thomas Nasca, MD said, " ‘Do you want a tired doctor?' is a conve-nient sound bite…. Did the patients in Charity Hospital during Hurricane Katrina want a tired doctor…? It is difficult for the public to understand …. that we can and must be trained to function at high levels of performance under trying circumstances, including the circumstance of fatigue.…." While the duty hour regulations may protect our residents from danger, and I'm fairly convinced that the latter The new regulations include: n One full 24 hour period off EVERY week (not averaged over 4 weeks). n No more than 80 hours a week (may still be averaged over 4 weeks). n One full 48 hour period off each month. n Maximum of 4 nights on in a row, with mandatory 48 hours off after 3 or 4 night shifts in a row. n Maximum shift length of 30 hours, with a mandatory 5 hour sleep period between the hours of 10 pm and 8 am for shifts longer than 16 hours n Time off between shifts: 10 hours after a day shift,12 hours after a night shift, and 14 hours after an extended duty period of 30 hours. n All internal and external moonlighting is governed by these same rules and counts against the hours. 5 From the Program Director: 6 has happened, there is no convinc-ing data that these regulations have done anything to protect patients, and some evidence to show that patient care suffers due to residents carrying increased patient loads and being forced to participate in more frequent pass-offs. I'm equally convinced that the newly proposed regulations will bring no fur-ther benefit, and a lot of consternation. I think we've gone too far in regulating residents (and, in the process, resi-dency programs) with the new (perhaps nit-picky) duty hour proposals. As we train residents, the principles of graded authority and progressive responsibility should apply not only to their clinical skills and medical knowledge, but to their ability to function in the post-residency working environment as well. For example, we introduce our interns into clinics by asking them to see only a few patients, adding progressively more patients until they are able to man-age full clinics by the time they finish training. In surgery, we give residents simple tasks, followed by more complex ones, expecting them to operate inde-pendently by the time they leave. If we used a similar approach to duty hours we would design the regulations to ap-proximate the expectations of practice after residency, but the proposed rules are increasingly less compatible with the reality of that practice. Residents trained under a system of markedly decreased work hours may be less able to fulfill the role expected of them in practice. Dr. Nasca also says, "…resident duty hour standards…. have had in some settings the unintended consequence of removal of the resident from the previously held ‘pivotal role' in the care of patient. This, it is feared, will lead to inadequately trained clinicians entering the unsuper-vised practice of medicine." All in all, I recognize the benefit of protecting our trainees from abuse and improving the care of our patients. I'm happy with the effect that the current duty hours regulations have had on resident satisfaction, their safety, and their ability to be alert in educational activities. But the newly proposed duty hour regulations have a strong potential to suffocate residents' ability to provide continuity to their patients, and when seen through the prism of the proposed revision of duty hours regulations, I fear that we might be seeing more of a dis-tortion of the reality of medical practice than a clarification. Michael Draper, M.D. has been residency Program Director for 7 years. He did his residency at the University of Utah and fellowship in Maternal Fetal Medicine at Wake Forest University. Work hours restrictions have mixed ef-fects from a resident perspective. It plac-es young doctors in the difficult position of choosing between following through on patient care, which may take longer than a thirty hour shift, and adhering to rules set forth by the residency program. Especially early in residency when still becoming proficient at basic patient care, fulfilling obligations to patients and "getting out on time" is extremely difficult. Clearly work hours restrictions have added an additional dimension to resident education-the pursuit of effi-ciency. Undoubtedly being efficient as a first- or second-year resident is difficult, but becoming efficient early on certainly helps to be a more effective and produc-tive clinician in the future. This may be an asset that work hour restrictions bring to physician training. In addition to fulfilling obligations to patients, the importance of hand offs to colleagues introduces an additional element to our training. One realizes early on that the only way to overcome the challenge of upholding one's obliga-tion to hand off services with patients' issues adequately addressed is to be Residents trained under a system of markedly decreased work hours may be less able to fulfill the role expected of them in practice. From the Chief Resident: 7 Best of State Award efficient; to anticipate what colleagues will want to know about the patients; and to have the plan of care well documented. Arguably team work and collegial interactions are areas deserv-ing improvement within the field of medicine, and this renewed emphasis on team work and communication is a good addition to physician training. Despite the complexities that work hours restrictions introduce for young physicians in training, emphasizing the importance of maintaining one's own health and family life is important for the longevity of physicians' careers and quality of life. It's evident from published literature that lifelong satisfaction with a physician's career is directly related to the balance of personal and professional life. Although not historically prioritized during medical training, making the practice of medicine more sustainable for physicians' lifetimes begins with establishing this paradigm early in one's career. Patient safety was the initial motiva-tion behind work hour restrictions, but the additional effects and positive outcomes that result are complex and were not foreseen from the outset. Hillary Moore, M.D. is a chief resident, and has accepted a faculty position in the Ob Gyn department in the general division. Opposite page left: Hillary Moore, M.D. and Mike Draper, M.D. Opposite page right: Resident at work. Residents reviewing cases. University of Utah School of Medicine Alumni Board BEST OF STATE Winner! Mark Sheffield and Tamara Lewis Sheffield, M.D., and Mary Ellen and Tom Caine, M.D. at Best of State Gala Awards Banquet Chris Towson, Lindsay Wilson, M.D., Kristin Wann Gorang, Melanie Osterud, Jenifer Ruff, Ron Ruff, M.D., Linda Castle, Hilmon Castle, M.D., Joan Johnston, Mark Johnston, M.D., Katie Johnston Current School of Medicine board members, past board presidents and staff celebrated at the Best of State Gala Dinner and Award ceremony on May 29. The Best of State awards seek to recognize the people, organizations, and businesses that are achieving, innovating, and improving the quality of life in Utah. For its work supporting medical students, residents and alumni of the University of Utah Medical School, improving medical education, and educating the public and the Utah legislature about statewide health concerns and physician shortage issues, the School of Medicine Alumni Board was awarded a Community Development: Education/Advocacy Organization Best of State designation. 7 Community Development : Education/Advocacy Organization 8 Alumni Weekend University of Utah School of Medicine 2010 Alumni and Medical Community Weekend The SOM Alumni and Medical Community Weekend will be held in conjunction with Homecoming Weekend which offers medical alumni a variety of School of Medicine and main campus activities in which to participate during the weekend. Registration material will arrive by mail in mid- July, or go online to register for events at http://medicine.edu.utah/alumni. Thursday Evening, September 23 Medical Alumni Awards Banquet at the Grand America Hotel , 555 S. Main, Salt Lake City, 6:30 p.m. Social, 7:00 p.m. Dinner Presentation of Distinguished Awards James L. Parkin, M.D., '66 Distinguished Alumni Award Dr.Parkin is a Professor Emeritus in the Department of Surgery. He was division chief for nearly twenty years in the Division of Otolaryngology-Head and Neck Surgery, and served twice as acting Chair of Surgery before being named chairman in 1993. His major research areas were in the de-velopment of multichannel cochlear implants for the profoundly deaf and the application of lasers in head and neck surgery. He served as president or as an officer in a number of his specialty organizations including the Association of Academic Departments of Otolaryngology-HNS and the Society of University Otolaryngologists-HNS. At the time of his retirement he was an Associate Vice President of Health Sciences at the University of Utah. John M. Matsen, M.D. Distinguished Service Award Dr. Matsen came to the University of Utah in 1974 as a Professor of Pathology and Pediatrics. During his tenure at Utah he served as the head of the Hospital Clinical Laboratories, Director of the Clinical Microbiology Laboratories, Associate Dean for Academic Affairs, Chair of the Department of Pathology and Vice President for Health Sciences. Dr. Matsen was the founding President and CEO of ARUP Laboratories and served as Chairman of its Board of Directors. He is an emeritus Fellow of five specialty societies and has authored 216 articles/chapters. He also served as the President of the Academy of Laboratory Physicians and Scientists and of the National Association of Pathology Chairs. William H. and Patricia W. Child Distinguished Service Award Bill and Pat Child were both raised in Salt Lake City and graduated from the University of Utah. They were married in 1967 after Bill's first wife, Darline Willey passed away in 1965. When Bill started working for his former father-in-law's appliance business he had one employee and a 600 sq-ft cinder block building in the corner of a corn patch in rural Syracuse. Forty years later, Bill sold the company to Warren Buffett, the second richest man in the world. This sale enabled Bill and Pat to give back to the community. They have established two endowed chairs in medicine, and helped fund the University Orthopaedic Hospital and the University Hospital expansion project. They are proud to have invested in such an amazing facility that contributes so greatly to our community. 50 Year Celebration and Induction into the Half-Century Club Presentation of Medallions to the Class of 1960 Photo Credit: Robert Dyer Photography 9 Friday Morning, September 24 School of Medicine Department Events 7:30 a.m. - 10:30 a.m. We welcome current or former faculty, house staff, and reunion class members to attend one of these department programs for a morning of information, instructional lectures and gather-ing of colleagues. Continental breakfast served. Site and speak-ers detailed in your registration packet coming in July. Department of Internal Medicine Department of Surgery Department of Ophthalmology Dean David J. Bjorkman, M.D., M.S.P.H., ‘80 State of the School Address 11:00 a.m. Friday, Reunion Evening 6:00 p.m. Reception, 7:00 p.m. Dinner Little America Hotel, 500 S. Main, Salt Lake City General reception first then individual groups will dine together in private rooms. MD Classes of: 1960, 1965, 1975, 1980, 1985, 1990, 1995, 2000 The Class of 2005 will be hosting a family picnic at Sugarhouse Park. Department of Family and Preventive Medicine 40th Anniversary Celebration-Officers' Club at Fort Douglas, 6:00 p.m. Saturday, September 25 Continuing Medical Education 7:30 a.m. - 12:15 p.m. Current Challenges in Caring for Patients & Improving Their Health Receive 4 CME credit hours AMA Category 1 Richard Sperry, M.D., Ph.D. ‘83 Associate Vice President for Health Sciences, Academic and Clinical Affairs. The Impact of Health Care Reform on Major Health Issues Paul C. Young, M.D. Professor, Department of Pediatrics, University of Utah School of Medicine. Childhood Obesity, Problems and Solutions Sherman Smith M.D., ‘76 Fellow of the American College of Surgeons, Fellow of the American Society for Metabolic and Bariatric Surgery, Staff surgeon at LDS and St. Mark's Hospitals. Surgical Treatment of Obesity and Metabolic Disease Donald McClain, M.D., Ph.D., Professor of Medicine and Associate Vice President for Clinical and Translational Research, University of Utah School of Medicine. Diabetes Update: Goals of Therapy and How to Safely Achieve Them Douglas Gray, M.D., Associate Professor, Department of Psychiatry, University of Utah. Myths of Youth Suicide Mark Supiano, M.D., Professor and Chief, Division of Geriatrics; University of Utah School of Medicine Director, Veteran Affairs; Salt Lake City Geriatric Research , Education and Clinical Center Executive Director, University of Utah Center on Aging. Aging Successfully AMA Credit: The University of Utah School of Medicine designates this educational activity for a maxi-mum of 4.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. OEO/AA Statement: The University of Utah does not discriminate on the basis of race, color, national origin, sex, disability, age, veteran's status, or sexual orientation and provides access to all its programs and activities. The following person has been designated to handle inquiries regarding the non-discrimination policies: Manager, OEO/AA, [phone], 201 S President's Circle, RM 135, Salt Lake City, UT 84112. ADA Statement: The University complies with the Americans with Disabilities Act Amendments Act of 2008 and Section 204 of the Rehabilitation Act by providing qualified individuals with disabilities access to University programs, treatment, services and activities. A request for accommodation or auxiliary services for: faculty or staff can be made by contacting Manager, OEO/AA, [phone], 201 S President's Circle, RM 135, Salt Lake City, UT 84112; students and other participants by contacting Director, CDS, [phone], 162 Olpin Union Building, Salt Lake City, UT 84112. Reasonable prior notice for accommodation requests is required. 10 Alumni Weekend University of Utah School of Medicine 2010 Alumni and Medical Community Weekend Saturday, September 25 - Football! Football! Football! Homecoming Tailgating Party Alumni House - 4:00 p.m. Make your plans now for an afternoon of food, fun and foot-ball! Join us for our pre-game festivities at the Alumni House where parking is free and the BBQ is hot! Then take the short walk over to the Rice Eccles Stadium where your seat (with a back) is waiting. Time, cost and everything else you need to know will be in your registration packet or check on-line at http://medicine.utah.edu/alumni. Utah vs. San Jose State-Homecoming Game Rice Eccles Stadium 6:00 p.m. Join your colleagues and cheer Utah on to victory at their Homecoming Game! The SOM Alumni Association has a block of seats reserved. Seating is limited and on a first-come, first-serve basis. The Utah Physician Assistant Program 40-Year Celebration-University Park Marriott Hotel, 5:30 p.m. Reception, 7:00 p.m. Dinner and Program, 9:00 p.m.-midnight Live Music and Dancing. Weekend Sponsors Reunion Class Gifts Celebrating the anniversary of your graduation from medical school is a wonderful time to reflect on what your medical education has meant to you over the years and to consider giving back to the school by making a gift to the School of Medicine Alumni Association. Below are totals of reunion 50-year class gifts for the past five years: Class of 1955 $ 9,195 Class of 1956 $11,460 Class of 1957 $ 5,210 Class of 1958 $ 3,782 Class of 1959 $ 3,645 Class of 1960 You Decide! Your registration packet will be mailed to you in mid-July. A registration form is also available on-line at: http://medicine.utah.edu/alumni where locations, fees and more details are available. Questions? Call [phone] 11 Just ten steps outside the emergency room, in the company of eager spring blossoms and a moss kissed stone wall, I await the results of my grandmother's blood work. With a spiked fever and in-creasing somnolence, they've once again cancelled her discharge. One complica-tion after another exposes the mysteri-ous silhouette behind medicine, making every day a new adventure. Taking a moment away from the frustrations, I find myself reminiscent of the journey that had shaped my present pursuits. At ten years old, frequent walks to the library were made in search for explanations of my father's reaction to chemotherapy. Being the only family member who was somewhat familiar with medical terms, it was helpful for me to be a part of conversations involving words like "malignant" and "inoperable". During this vigorous three year battle with his brain tumor, the doctors and surgeons became my heroes. Repetitious rounds of treatments lead a roller coaster of emotions, encompassing both faith and despair. Their com-munication about what to expect and how things were advancing provided a baseline of understanding, even if it was news my ears dreaded to hear. In retro-spect, I now appreciate the vulnerability of the patient and family, as they pass trust and hope into the hands of their physician. It was common for me to wish upon a star to grow up instantly as a doctor and take matters in my own hands. Common side effects such as edema, sporadic vomiting, and patchy hair loss were at least manageable. Unfortunately, no hat was fancy enough to conceal my father's punctured pride. I had assisted my mother with carrying him into the shower one evening, and supported his back as she bathed him. Without saying a word, his eyes were zapped of sparkle. Being a proud man of tradition, it was degrading to show such weakness to his twelve year old daughter. That marked the beginning of frequent lashes of anger, revealing an evident sense of defeat. This first-hand lesson in treating a loved one with ulti-mate sensitivity taught me the value of empathy and compassion. Once my father passed away, a new role as secondary mother to three younger siblings led to an adventure that would further season my palate in life. During my second year in college, the family business went down in flames. The psychological effects it had on my mother left me next in line to lead our young family. My new goal was to finan-cially and emotionally support them through growth into young adulthood. Providing strength and security was a priceless lesson in survival. The obstacles of life, the challenges of hardship, and the true meaning of sacrifice became integral fibers of my core. After a decade, the most precious lesson I've learned is that perseverance rewards in unique ways. Now I am simply in awe of my reality, finding myself immersed in a world full of inspiring heroes. The great-est one of all is Dr. Robert H. Ballard, an orthopaedic surgeon who continues to be influential long after his successful career. His medical philanthropy is a prime example of the fuel that feeds the cycle of giving. For me, being a Ballard Scholar signifies a second chance in life -- a time to finally pursue my dreams. Vivacious and witty, Dr. Ballard has also reminded me of the value of enjoying little things in life. With an incredibly sharp memory, a great sense of humor, and independence in every sense of the word, he is a true role model to all those fortunate enough to be around him. Emerging from the stroll along memory road, I initiate my return to the hospital. Unknowing of what the day may bring, my heart braces for another battle with the mysteries of medicine. Not yet a doctor, my job excludes inter-preting lab results or deciding on action plans. That day will come. For now, it is simply to hold my grandmother's hand and show her my love. Perhaps we can take our minds off of blood draws and antibiotics. Instead, we should talk about things that make us smile. I'll tell her about the millions of pink blossoms on the trees, the crispness of the air after a downpour, and the rich green aroma of the beautifully plush moss. That'll surely do it. Student Highlights From Challenges to Awe; the Journey of a Ballard Scholar Ballard Scholarship Recipient Linh Ho Dr. Robert H. Ballard and Linh Ho 12 Match Day 2010-Reaching a Milestone Anesthesiology Christensen, Kim Daniel Dartmouth-Hitchcock Medical Center, Anesthesiology, New Hampshire Daniels, David Wade University of Virginia, Anesthesiology, Virginia Hanifi, Mohammed Tariq Brigham & Women's Hospital, Anesthesiology, Massachusetts Herway, Seth University of California - San Diego Medical Center, Anesthesiology, California Munro, Anastacia Pavlovna University of Florida College of Medicine, - Shands Hospital, Anesthesiology, Florida Newberry, Cynthia McCarty University of Utah Affiliate Hospitals, Anesthesiology, Utah Pelletier, Pete Lynn Brigham & Women's Hospital, Anesthesiology, Massachusetts Randall, Benjamin Richard University of Iowa Hospital and Clinics, Anesthesiology, Iowa Risenmay, Benjamin William University of Utah Affiliate Hospitals, Anesthesiology, Utah Wright, Kyle David Wayne State University Residency Program, Anesthesiology, Michigan Dermatology Lowe, Garrett C. May School of Graduate Medical Education, Dermatology, Minnesota McCaughey, Cort University of Wisconsin Hospital and Clinics, Dermatology, Wisconsin Sunseri, Jeremy Alexander Rhode Island Hospital/Brown University, Dermatology, Rhode Island Emergency Medicine Dorais, Andrew John University of Utah Affiliate Hospitals, Emergency Medicine, Utah Londer, Casey Beaty Hennepin County Medical Center, Emergency Medicine, Minnesota McCune, Rohn David Loma Linda University, Emergency Medicine, California Widdison, Julie Stanford University Programs, Emergency Medicine, California Williams, Holly Marie Nelson Michigan State University- Kalamazoo, Emergency Medicine, Michigan Family Medicine Aardema, Critt Farr McKay-Dee Hospital Center, Family Medicine, Utah Atkin, Joseph Sterling Halifax Medical Center, Family Medicine, Florida Beck, Cameron McKell Memorial Hospital, FamilyMedicine, Indiana Esplin, Andrea Clark Family Medicine Residency of Idaho, Family Medicine, Idaho Hamblin, Tracy University of Utah Affiliate Hospitals, Family Medicine, Utah Holman, Nathan L. Ball Memorial Hospital, Family Medicine, Indiana Inouye, Samuel Isaac Lau Utah Valley Regional Medical Center, Family Medicine, Utah James, Roland Wayne Ball Memorial Hospital, Family Medicine, Indiana King, Sarah Marie Utah Valley Regional Medical Center, Family Medicine, Utah Larsen, Scott Rex McKay-Dee Hospital Center, Family Medicine, Utah Lunn, Joshua Sven Idaho State University, Family Medicine, Idaho Ninefeldt, Robin Lynn Montana Family Medicine Residency, Family Medicine, Montana Rasmussen, Isaac Rand Utah Valley Regional Medical Center, Family Medicine, Utah Spain, Chad Alan University of Utah Affiliate Hospitals, Family Medicine, Utah Welsh, Stephen Andrew Utah Valley Regional Medical Center, Family Medicine, Utah West, Wyatt Jonathan McKay-Dee Hospital Center, Family Medicine, Utah General Surgery Hauschild, Tricia B. University of Utah Affiliate Hospitals, General Surgery, Utah Hawkes, Patrick John University of Nebraska Affiliate Hospitals, General Surgery, Nebraska Healy, Aaron Harris University of Utah Affiliate Hospitals, General Surgery, Utah Kendrick, Ian James Mary Imogene Bassett, General Surgery, New York Meagher, Ashley Danielle University of North Carolina Hospitals, General Surgery, North Carolina Mohebali, Jahan Massachusetts General Hospital, General Surgery, Massachusetts Stone, Allyson Heather-Noelle Dartmouth-Hitchcock Medical Center, General Surgery, New Hampshire Internal Medicine Banerjee, Nikhil Georgetown University Hospital, Internal Medicine, Washington D.C. Buchanan, Jonathan Maine Medical Center, Internal Medicine, Maine Graves, Kencee Kay University of Utah Affiliate Hospitals, Internal Medicine, Utah Greene, Magdelena Wake Forest Baptist Medical Center, Internal Medicine, North Carolina Kabir Lodin, Yasmeen University of California Los Angeles Olive View Medical Center Internal Medicine, California Oliver, Stacie Lynnette University of Oklahoma College of Medicine - Oklahoma City, Internal Medicine, Stephen Welsh Oklahoma Carl Scott Swendsen celebrates going to Texas A & M in Internal Medicine with his family. 13 Sailer, Carrie Ann Oregon Health & Science University, Internal Medicine, Oregon Stayner, James LaVar University of Utah Affiliate Hospitals, Internal Medicine, Utah Swendsen, C. Scott Texas A&M - Scott & White Hospital, Internal Medicine, Texas Trinh, Tiffany T. Cedars-Sinai Medical Center, Internal Medicine, California VanWoerkom, Ryan C. Oregon Health & Science University, Internal Medicine, Oregon Internal Medicine/ Pediatrics Omura, Emily Miyuki University of Southern California, Internal Medicine/Pediatrics California Thomas, Joshua Ryan University of Oklahoma College of Medicine - Tulsa, Internal Medicine/Pediatrics, Oklahoma Vu, Judy University of Utah Affiliate Hospitals, Internal Medicine/ Pediatrics, Utah Internal Medicine/ Psychiatry Reed, Matthew Joseph University of California - Davis Medical Center, Internal Medicine/ Psychiatry, California Medicine Barlow, Robert Bradley Medicine Program Candidate Brownell, Alexander Arthur Medicine Program Candidate Gibson, Jonathan Medicine Program Candidate Hoffman, Matthew Scott Medicine Program Candidate Lehnardt, Michael Douglas Kurt Medicine Program Candidate Power, Gabriel John Medicine Program Candidate Reid, Jason Kirkwood Medicine Program Candidate Thomas, Stephanie Chambers Medicine Program Candidate Young, Jason Russell Medicine Program Candidate Yu, William Joel Medicine Program Candidate Neurology Raleigh, Todd Michael University of Vermont - Fletcher Allen, Neurology, Vermont Obstetrics - Gynecology Martin, Jared C. Saint Louis University School of Medicine, Obstetrics-Gynecology, Missouri Sharshiner, Margarita Yakovlevna University of Utah Affiliate Hospitals, Obstetrics-Gynecology, Utah Sok, Christina Jenny University of Utah Affiliate Hospitals, Obstetrics-Gynecology, Utah Ophthalmology Owen, Leah Anne University of Utah Affiliate Hospitals, Ophthalmology, Utah Schliesser, Joshua A. University of Missouri - Kansas City, Ophthalmology, Missouri Schmutz, Joseph Seymor University of Wisconsin Hospitals and Clinics, Ophthalmology, Wisconsin Sorensen, Tyler Kent University of Oklahoma Ophthalmology Oklahoma Orthopaedic Surgery Amundsen, Spencer Hayden Dartmouth - Hitchcock Medical Center, Orthopaedic Surgery, New Hampshire Anderson, Lucas Aaron University of Utah Affiliate Hospitals, Orthopaedic Surgery, Utah Lilyquist, Michael Bradley University of Missouri - Kansas City Programs, Orthopaedic Surgery, Missouri Lloyd, Jarem Barry SUNY Upstate Medical University, Orthopaedic Surgery, New York Schannen, Andrew Phillip University of Arizona Affiliate Hospitals, Orthopaedic Surgery, Arizona Pathology/Anatomy Konnick, Eric Quentin University of Washington Affiliate Hospitals, Pathology/Anatomy and Clinics, Washington Pediatrics Bishop, Bradley Grant Eastern Virginia Medical School, Pediatrics, Virginia Bixby, Billie Ann Vanderbilt University Medical Center, Pediatrics, Tennessee Bradford, Laurel Kristen University of Michigan Hospital - Ann Arbor, Pediatrics, Michigan Davis, James Brent Tufts Medical Center, Pediatrics, Massachusetts Edwards, Randi Leigh University of Utah Affiliate Hospitals, Pediatrics, Utah Rawlings, Julia Ann University of Utah Affiliate Hospitals, Pediatrics, Utah Sweeney, Ann Boley University of Rochester/Strong Memorial, Pediatrics, New York Tuan, Teresa Jasmine University of California - San Francisco, Pediatrics, California Turney, Elizabeth Caroline University of North Carolina Hospitals, Pediatrics, North Carolina Physical Medicine & Rehabilitation Christensen, Bryt Alan Johns Hopkins Hospital, Physical Medicine and Rehabilitation Maryland Psychiatry Andersen, Claire Elizabeth University of Washington Affiliate Hospitals, Psychiatry, Washington Johnson, Amber Lynn Duke University Medical Center, Psychiatry, North Carolina Lund, Heidee Lynn University of Utah Affiliate Hospitals, Psychiatry, Utah Moffat, J. Craig Loma Linda University, Psychiatry, California Thueson, Jeremy Easton University of Washington Affiliate Hospitals, Psychiatry, Washington Winder, Gerald Scott University of Michigan Hospitals -Ann Arbor, Psychiatry, Michigan Radiation-Oncology Arce-Larreta, Maria Teresa Medical University of South Carolina, Radiation-Oncology, South Carolina Bair, Ryan James University of Chicago Medical Center, Radiation-Oncology, Illinois Radiology-Diagnostic Mills, Megan Kara University of Utah Affiliate Hospitals, Radiology-Diagnostic, Utah Wright, Brad University of Utah Affiliate Hospitals, Radiology-Diagnostic, Utah Randi Edwards, Tricia Hauschild, and Kencee Graves Student Highlights 14 Dinner with a Doc Dinner with a Doc at the home of Saundra Buys, M.D. After a hiatus of five years, the popular Dinner with a Doc program started up again this spring. The purpose of the program is to connect alumni physi-cians in the community with first- and second-year students over dinner at the doctor's home or a selected restaurant, allowing for an informal discus-sion of medical practice, home life and any other questions a student and his or her significant other might have. Here are a few of the comments from both the students and the host physicians: " " "This past week my wife and I had the opportunity to meet with Dr. Hammon and his wife. I wanted to let you know how thankful I am for that experience. It is the first time my wife and I have ever been able to sit down with a doctor one-on-one and discuss concerns and questions. Within a couple of hours I had so many ques-tions answered, and I know that my wife did as well." - Spencer Naser "I had an excellent time at dinner with Dr. Sundwall. I have since gone to the Department of Health to shadow Dr. Sundwall, and both experiences have helped reinforce my desire to go into public health. Thank you so much for setting up this dinner for me." - Jesse Powell "I was able to have dinner with a psychiatrist and his wife, and had a great time and thought it was a very valuable experience. I've been interested in psychiatry for awhile, and this was a unique chance to be able to sit down with an experienced practitioner in a casual setting and explore his perspective and ask for advice. I feel I learned a lot about the field that I wouldn't have access to in the structured setting of medical school, and I think I made a good contact for the future. - Katherine Leaver "The three students who came to dinner were very delightful and pleasant. My wife and I greatly enjoyed the chance to get to know them and talk shop about medical school and medical practice. Thanks for the chance to do this; we'd like to be on your list for next year." - Stephen Lamb, M.D. "Dinner was fun and we all had good conversation. If these two are indicative of medical students-WOW! They not only are well-rounded and intelligent, but have great people skills-kudos to the selection committee! Just my humble opinion after working with residents for 11 years!" - Clare Valles, M.D. If you are interested in participating as a host family for Dinner with a Doc contact Melanie Osterud, Associate Director, School of Medicine Alumni Relations, [e-mail] 2010 Student Highlights 15 Commencement Medical Class of 2010 Nate Holman, Joe Schmutz and Joshua Lunn PA graduates Rachel Alpern and Rachel Gonzales with program director, Don Pedersen Student Body President Jeremy Sunseri with Drs. Sara Lamb and Barbara Cahill Judy Vu and Dean David Bjorkman Alumni President Mark Johnston welcomes graduates to the Alumni Association 16 The School of Medicine Alumni Association celebrated twenty-years of presenting the 4th Year Student Award by recognizing Pete Pelletier at the Dean's Reception on May 20. Pete received a plaque and a $500 gift from the SOM Alumni Board. The awardee is nominated by the 4th year class and selected by the School of Medicine Alumni Student Programs and Awards Committee as a student who has dem-onstrated concern for his or her peers, the community, and who exemplifies the ethical, moral, and academic skills deemed necessary to make an outstand-ing physician. The nominators stressed Pete's all-encompassing concern for his patients, not only on the diagnostics, procedures and treatments regarding their care; but also on the minute details of the patient's emotional state, their satisfaction, as well as their circumstances. Pete showed a strong dedica-tion to medical education by serving as a classroom assistant, supplemental instructor, and personal tutor for many medi-cal students. Outside of the classroom, he pursued other medical education opportuni-ties by being a book reviewer for Lippincott, Williams & Wilkins, as well as McGraw-Hill Medical. He has excelled in research, with two retrospective studies with the Department of Surgery at the Huntsman Cancer Hospital. Pete took his research skills to Ghana where he worked with laboratory professionals to provide rapid diagnosis and treatment for parasites in rural villages. He has demonstrated cultural and leadership skills by being the found-ing member and co-president of the Students for Humanities, Arts and Ethics in Medicine Club, and founding mem-ber and president of the Gay Straight Medical Alliance. He also volunteers in the community as an HIV prevention counselor at the UT AIDS Foundation. The Alumni Board was pleased to honor Pete for his talent, compassion and intelligence by presenting him with this award. Pete Pelletier Receives Alumni Association Award Pete Pelletier and President Mark Johnston, M.D. Megan Mills, Christina Sok, Scott Winder, Jeremy Thueson, Tracy Hamblin, Tiffany Trinh, Michael Lilyquist Match Day2 010 Celebrations Tracy Hamblin, Casey Londer, Christina Sok, Tiffany Trinh 17 The Department of Psychiatry has embarked on a remarkable time of growth and development. With the appointment of Dr. William McMahon as chairman in July of 2007, the size of the faculty has grown, a new building is underway, education for residents and medical students has blossomed and re-search activities have markedly increased. Perry Renshaw, M.D., Ph.D., and Deborah Yurgelun-Todd, Ph.D. are internationally acclaimed brain imaging research scientists that are among our 15 new faculty members. They were recruited by the Brain Institute from McLean Hospital, a Harvard hospital, with funds from the Utah Science, Technology and Research (USTAR) program. They have built a world-class team focused on discovering the brain mechanisms underlying bipolar disorder, schizophrenia, addiction, traumatic brain injury and functional changes over the life span. Besides conducting their own research, Drs. Renshaw and Yurgelun- Todd are accomplished research mentors for young faculty. With their guidance, Dr. Bill Marchand recently received VA Career Development and Merit awards. They have also provided im-portant leadership for the Mental Illness Research, Education and Clinical Center (MIRECC) at the Salt Lake VA Medical Center, a program focused on the topics of suicide and traumatic brain injury in veterans. In addition, they have joined ongoing research in the epidemiology and prevention of suicide conducted by Doug Gray, M.D., and Michelle Moskos, Ph.D. Currently, the Department con-tinues to provide important leadership in autism research. Drs. Hilary Coon, Judith Miller, Dale Cannon, Reid Robison and Bill McMahon have con-tributed to new genetic discoveries. Dr. Janet Lainhart is studying brain imaging in collaboration with researchers at BYU and Harvard. Dr. Judith Zimmerman is working with the Utah Department of Health and the CDC to study the epide-miology of autism spectrum disorders. As part of the expansion of the University Neuropsychiatric Institute (UNI), the Department of Psychiatry will gain new academic space. Scheduled for opening in September of 2011, the UNI expansion includes 72 new private rooms, conference rooms for teaching, faculty offices and space for clinical trials and brain imaging research. According to Dr. McMahon, "The new Department space in the UNI expansion will acceler-ate progress in our clinical, research and teaching missions toward becoming one of the premier academically-oriented Psychiatry programs in the world." Imaging, Autism and Expansion Dr. William McMahon Breast Reconstruction: Moving Toward Wholeness The concept of reconstructing the breast has become more accepted as a stan-dard procedure for women who have had mastectomy for breast cancer. A complete breast reconstruction includes restoring the breast mound, recreating the nipple-areola complex, and proce-dures to achieve symmetry in shape, size, and projection. Plastic surgeons have always been involved in breast reconstruction and have developed multiple techniques to achieve this goal. These procedures include implant based reconstruction with tissue expanders, pedicle flaps, and free flaps. Several factors may influence the preference for one procedure over another. One key issue is whether or not radiation therapy is needed. The use of radiation therapy is important in treating certain breast cancers, but it does cause changes in the small blood vessels of the skin and surrounding tis-sue. These radiation induced changes increase the risk of infections and wound healing problems, and flap based procedures are preferred to minimize these problems. A common reconstruction method selected by many women is implant based reconstruction with tissue expand-ers. This procedure is performed in stages, but has shorter operative and recovery times. After the mastectomy, a pocket is created under the pectoralis muscle to allow placement of the tissue expander. The process of expansion begins when the skin is well healed, and is repeated at intervals until the desired volume is achieved. Following "I am excited that there is an option out there to look and feel more like a woman." - Shelley Terrell 2010 News Notebook By W. Bradford Rockwell, M.D., Chief, Division of Plastic and Reconstructive Surgery 18 complete expansion another operation is performed to remove the tissue expander and place a permanent implant. This re-stores the breast mound, and the process of reconstructing and tattooing the nipple is performed later. In patients who need radiation, a pedicled flap or free flap is considered more appropriate. These operations are more complex and create additional donor site scars away from the breast, but flaps are more resistant to infec-tion in patients who have had radiation. Pedicle flaps consist of tissue rotated from another part of the body and shaped into a breast mound on the chest. A com-monly used pedicle flap is the lattisimus dorsi muscle flap which can be rotated to the anterior chest wall. This reconstruc-tion often requires the use of an implant to achieve the desired volume. A free flap requires the use of tissue from a different part of the body, typically the abdomen. In this type of flap, skin and fat, and sometimes a portion of muscle, is detached from the abdo-men and transplanted to the chest. Small blood vessels supplying the abdomi-nal tissues are carefully dissected and preserved and connected to blood vessels in the chest. This operation involves microsurgical techniques to reconnect the blood vessels and typically takes 6-10 hours to perform. One of the most significant effects of this surgery is the impact it has on patient's lives. Cheryl Wright, Chair of Family and Consumer Studies at the University of Utah delayed her recon-struction because she was overwhelmed with decisions when she was diagnosed with breast cancer in the summer of 2009. She commented, "My mastec-tomy scar was a constant reminder of my dreaded disease. My breast reconstruc-tion is a step towards wholeness both physically and psychologically and it has provided me with a feeling of control over my illness." As a result of continued interest and experience with breast reconstruc-tion, there are now many options available to women for reconstruction. No single procedure is considered best. In choosing breast reconstruction it is important to review the procedures available with a plastic surgeon, and select the procedure that best meets the individual patient's needs. Brad Rockwell, M.D., University of Utah Plastic Surgeon and patient Shelley Terrell News Notebook Michael Matlak, M.D. : Training Pediatric Surgery Residents in East Africa In January 2010 Dr. Michael Matlak and his wife Rosemarie Matlak left for East Africa where he is serving as a senior surgical mentor-missionary for World Medical Missions in a fully accredited pe-diatric surgery residency program at AIC Kijabe Hospital in Kenya. Dr. Matlak was invited personally to participate in pioneering, and expanding a program that will train general surgeons to become children's surgeons. The goal is to train two residents a year to be excellent sur-geons and educators, and Dr. Matlak will begin by working with residents from Ethiopia and Tanzania. These trainees will then return to their home country to establish training programs in pediatric surgery. "It is an incredible privilege for me to participate in the training of the first generation of pediatric surgeons for East Africa," said Dr. Matlak. "Please pray that I will be able to transfer what I know in my head, my heart, and hands to these very talented surgeons." Kijabe Hospital was founded in 1916 and is operated by Africa Inland Church. It is a renowned teaching facility, hosting the best nursing school in Kenya. The hospital services 180 million people from Kenya, Somalia, and oc-casionally Sudan and Uganda. It is staffed by Kenyans and expatriate missionaries from Africa Inland Mission, which is a non-denominational Protestant mission that has been working in Kenya since 1895. Kijabe Hospital is a 250-bed facili-ty; one-fourth of which are pediatric beds with funds allocated to add 80 additional pediatric beds in the near future. There are only five intensive care beds, and the hospital owns only four ventilators. Five thousand surgical cases are performed every year, and there is no MRI or CT scanner at the hospital. Many of the patients suffer from HIV, AIDS, malaria, tuberculosis, typhoid fever, inadequate prenatal care, and trauma caused by poor working conditions, dangerous roads, and civil unrest. Dr. Matlak and his wife live in an apartment on the Kijabe Hospital campus. His service includes travel to camps where he is providing medical care for refugees of Somalia and Sudan. It is expected that they will stay for one year; however, their stay may be extended to 18 months if Dr. Matlak is needed to help orient three replacements expected to arrive in late 2010/early 2011. News Notebook The Division of Genetic Epidemiology has existed at the University of Utah School of Medicine for almost 40 years. Although still physically located in Research Park, it has recently relocated administratively to the Department of Internal Medicine. With the move to the Department of Internal Medicine, the Genetic Epidemiology and Cardiovascular Genetics groups are now combined, resulting in a highly collab-orative Division with active DNA and biochemistry laboratories and high-risk pedigree studies. The group now includes eleven faculty members, twenty staff, two post docs and three graduate students. (www.genepi.med.utah.edu/ genepi.html) The field of Genetic Epidemiology covers a wide range of research relating to genetic resources and genetic analysis, and the Division has had many signifi-cant contributions to this discipline. In the early 1970s the Division created the original Utah Population Database (UPDB), linking cancer and death cer-tificate data to a computerized genealogy of Utah. Members of the Division re-main the most active users of this unique resource and have published extensively in defining the genetic contribution to diseases, including, among others: influ-enza mortality, benign pituitary tumors, diabetes, rotator cuff disease, several cancer sites, and asthma mortality. The Division directed the high-risk cancer pedigree studies that resulted in localization of several major cancer genes, and collaboration with Myriad Genetics led to the identification of BRCA1, BRCA2, and p16. This successful research has brought millions in related royalty dollars to the University of Utah School of Medicine. In addition, the Division has directed high-risk cardio-vascular disease studies and clinical trials investigating genetic and environmental contributions to early heart disease, lipid disorders, hypertension, diabetes, and morbid obesity. They have also been the international coordinating center for MEDPED, a program to identify and effectively treat all persons in the world with mutations in the LDL receptor leading to very high cholesterol and early heart disease. The Cardiovascular Disease Prevention Clinic specializes in high-risk family lipid disorders and is engaged in linkage analysis of high-risk pedigrees and genome-wide association studies for several phenotypes. The Division has created and publi-cally shared several software packages that are versatile and uniquely suited to genetic analysis of related individuals in close or extended pedigrees, and for esti-mating a person's disease risk from their family history of disease. The Division is currently collaborating with the VA to build a genealogy of the United States and link it to data for 25 million veterans to expand their ability to study the genet-ic contribution to disease and health. The new Division of Genetic Epidemiology in the Department of Internal Medicine looks forward to sharing their expertise in new and exciting collaborations and research. Collaboration Increases: Genetic Epidemiology and Cardiovascular Groups Combine New Technologies to Develop Better Cancer Models Despite the recent good news that cancer incidence and death rates for men and women in the United States continue to decline, cancer is projected to overtake cardiovascular disease and become the leading cause of death worldwide in 2010. Twelve million new cancers were diagnosed worldwide in 2008 with more than seven million deaths. The numbers projected for the year 2030 are 20-26 million new diagnoses and 13-17 million deaths. According to the International Agency for Research on Cancer (IARC) World Cancer Report 2008, the burden of cancer doubled globally between 1975 and 2000. This translates to far greater numbers of people living with - and dy-ing from - cancer. Since President Richard Nixon signed the National Cancer Act to make the "conquest of cancer" a national crusade in 1971, around $200 billion in public and private spending has bought us an estimated 1.5 million scientific papers, containing an extraordinary amount of knowledge about the basic biology of cancer. Despite these discover-ies the ratio of useful therapies per basic science discovery is very low. While about 20 percent of new compounds aimed at cardiovascular diseases are eventually approved as new drugs by the FDA, only 8 percent of drugs targeting cancer reach the clinic. Despite these concerns, from 1975 to 2005, death rates from breast cancer 19 By Lisa Cannon-Albright, Ph.D., Chief, Division of Genetic Epidemiology and Cardiovascular Genetics By Margit M. Janát-Amesbury, M.D., Ph.D., Associate Professor, Gynecologic Oncology Division 20 fell from 31 to 24 per 100,000 people. This has been attributed to earlier detec-tion as well as more effective treatment. Additionally, mortality from colorectal cancer fell from 28 to 17 per 100,000 people, due to increased screening and chemotherapy improvements. Other cancers, however have not fared as well. Death rates from lung cancer rose from 43 to 53 per 100,000 people from 1975 to 2005, and melanoma deaths rose nearly 30 percent. Death rates for liver and bile-duct cancer have almost doubled, from 2.8 to 5.3 per 100,000. Why haven't we had more success in the war on cancer? Some would point to the animal models used. Unfortunately, few of the successes noted in mice are rel-evant in humans. It appears that the lack of relevant cancer models has become a primary rate-limiting step in cancer research. Investigators at the University of Utah are in the process of developing more predictive models using genetically and bioengineered tissues, stem cells and models that more accurately replicate the human cancer being studied. Researchers and clinicians here at the University of Utah, recognizing the need for better models of human cancers, have initiated discussions aimed to create more effective cancer models. Based on cutting edge technologies from the fields of drug delivery, nanosciences and tissue engineering, professors Margit Janat- Amsbury and You Han Bae formed a group, consisting of John Mauger, Dean Chris Ireland, C. Matthew Peterson, Jindrich Kopecek, David Grainger, Glenn Prestwich and Jack Taylor to foster existing and new international collabo-rations with leaders in the field to join in the University of Utah's endeavors. Recently, Prof. Teruo Okano (TWIns Women's Medical University's Center for Advanced Biomedical Sciences, Tokyo, Japan) provided a seminar where he described new innovations in tissue engineering that will have an important role in the development of new cancer models. The University of Utah plans to be a prominent player in these efforts and is embarking on collaborative projects with Professor Okano and the TWIns Women's Medical University, to create more useful models of human cancers by assembling novel technology platforms from our respective institutions. In the past DNA sequenc-ing has been very expensive, costing more than $3 Billion in 1990. Now using newly affordable technology Dr. Lynn Jorde of the University of Utah's Human Genetics Department in partnership with other institutions has sequenced for the first time an entire family of four's genome. Due to confidentiality agreements the identity of the family had remained anonymous, however, the family decided to come forward and identify themselves. Debbie Jorde, who met Dr. Jorde at a function and later married, has two adult children, Heather and Logan Madsen. Heather and Logan, who suffer from numerous physical limitations due to Miller's syndrome, felt that by coming forward they would be making a difference for others. The Madsen children also inherited Primary Ciliary Dyskinesia (PCD), a rare condition that affects the mucus removal in the lungs. The odds of having both conditions are one in 3 billion. These factors made the family ideal for participa-tion in the study. "Until now we didn't know what caused Miller's syndrome." Dr. Jorde was quoted saying, "We didn't even know if it was genetic, now we have the causal gene and we understand how it was transmitted." The genome sequencing found that parents pass on about half of the genetic mutations to their children than previ-ously thought. And they also found the genetic causes of these two rare diseases, opening the door for the discovery of other mutations leading to genetic dis-orders. The children are two of only 30 people worldwide to have been diagnosed with Miller's Syndrome, and they are the first family to report the occurrence of the condition within siblings. Since this study was published there has been another fam-ily from New Zealand identified to have the same occurrence within siblings. Heather (33 years old) has had 34 reconstructive surgeries and suffers from fatigue and endures daily therapy for her lungs. Logan (29 years old) has had 24 surgeries and lives with chronic back pain. Although both siblings are considered to have autism spectrum disorders, they are both very intelligent and highly gifted in the arts. Logan's paintings have been featured in the media and Heather is considered to be a gifted poet. Through these discoveries and by comparing the DNA sequences of the children to their parents (who are unaf-fected by the condition) scientists were able to pinpoint the gene responsible for their condition. These trail blazing discov-eries open the door to finding treatment of these conditions and the discovery and treatment for many other diseases and disorders in the future. A First for Science, Unraveling One Family's Entire Genome! News Notebook Dr. Lynn Jorde News Notebook What is the appropriate screening recom-mendation for your patient whose father had colon cancer at age 48? Under what circumstances should you offer tamoxi-fen to the sister of a woman with breast cancer? If your patient has melanoma, are other family members at increased risk? If so, how much of an increased risk, and is there a way to specifically classify family members into risk categories? The Family Cancer Assessment Clinic, a resource for physicians, patients, and families, can provide answers to these questions. Family history is one of the most significant risk factors for many adult conditions, including major killers such as cancer and cardiovascular disease. During the process of obtaining a family history, it is not uncommon for patients to men-tion several family members with cancer. Cancer is common in the population: about a third of women and half of men in the U.S. will eventually be diagnosed with cancer. With such a high prevalence of cancer in the population, most families will have one or several cases of cancer. Most cancer is due to the interac-tion of genes and environmental factors including diet, tobacco and alcohol use, physical activity, reproductive history, and other (generally) modifiable factors. Risk for these "sporadic" cancers sharply increases with age. Approximately 5-10% of cancer, however, is due to mutations in specific cancer predisposition genes, usually tumor suppressor genes. When not mutated, these genes protect against cancer. If mutated, however, the risk for cancer is substantially increased. Over 30 family cancer syndromes have been identified and for most, specific causative genes have been identified. Most of these syndromes are autosomal dominant, and the gene mutation can therefore be passed down from either parent. When should physicians suspect that cancer in a family is due to a specific in-herited genetic factor? In general, a family cancer syndrome should be suspected in the following situations: • Cancer occurring at a younger age than usual, such as breast cancer under age 40, colon cancer under age 50, or endometrial cancer in pre-menopausal women • Multiple different cancers in one individual • Family history of cancer of the same type, or related types, in close relatives • Occurrence of rare cancers such as male breast cancer, medullary thyroid cancer, adrenocortical carcinoma, or pheochromocytoma If a family cancer syndrome is suspected, patients may be referred to the Family Cancer Assessment Clinic. This clinic is staffed by genetic counselors in collaboration with Dr. Randall Burt from the Division of Gastroenterology, Dr. Saundra Buys from the Division of Oncology, Dr. Sancy Leachman from the Department of Dermatology, and Dr. Joshua Schiffman from the Division of Pediatric Hematology/Oncology. Prior to being seen in the FCAC, genetic coun-selors obtain a careful family pedigree and, when needed, medical records to document cancers and other relevant conditions. If genetic testing for a condi-tion may be appropriate, FCAC staff can investigate whether insurance will cover part or all of the cost of testing. Patients are then scheduled for a clinic visit. The family history of cancer and personal risk factors are reviewed. The possibility of genetic testing to clarify risk for the fam-ily and individual is also discussed. If genetic testing is an option based on the family characteristics, genetic counselors and physicians discuss a wide variety of issues relating to genetic testing, including: • Genetic education: what is a gene, what is a mutation, inheritance of mutations, risk for developing cancer if a mutation is present. • Possibility of various test results: positive, negative, indeterminate. • Implications of various test results on medical management, including screening, chemoprevention, and risk-reducing surgery. • Benefits, risks, and cost of undergoing testing. • Who in the family is the most appro-priate testing candidate. • Duty to disclose test results to family members whose medical manage-ment may also be impacted by the test result. • Genetic counseling: past experience with cancer and its emotional impact, possible psychological reactions to various test results. For more information, or to refer a patient or family to the FCAC, please call 801-587-9555. Family Cancer Assessment Clinic: A Resource for Physicians and Families 21 By Saundra Buys, M.D., Professor, Oncology Division, Medical Director, High Risk Breast Cancer Clinic 22 News Notebook When Don Pedersen is really committed to something, he can make it work…take PA school. As a first-year student at the Utah MEDEX Project at the University of Utah School of Medicine (today the University of Utah PA Program), Pedersen every Monday morning would drive three hours from his home in Pocatello, Idaho to Salt Lake City so he would be in class by 9 o'clock. Then from Monday through Thursday night he lived in his van. He had a meal ticket for breakfast in one of the dorms (the cafeteria packed him a lunch), showered at the gym, and most nights stayed at the library until it closed at 10-11 at night, when he conveniently found a place to park his van on campus for the evening. "I lived in my van," laughed Pedersen, who slept in a sleeping bag through his didactic year in 1977. "But other than campus security finding me a few times and making me move it really worked out well for me. Friday after class I would drive back to Pocatello and have the week-end with my family." "Don is an experience," said David S. Anderson, past president of the Utah Academy of Physician Assistants, "to really know his value, you need only meet him." First serving as Training Coordinator for 10 years and later Program Director for 21 years with the University of Utah PA Program, Don's work elevated the quality of education from a program on the brink of extinction in 1989, to what US News and World Report recently ranked as the 4th top Physician Assistant graduate school in the United States. But his work did not stop there. As president of the Association of Physician Assistant Programs (now the Physician Assistant Education Association), he founded the official journal Perspective on Physician Assistant Education (now the Journal of Physician Assistant Education). As PA Foundation President, Don initiated the Combat Medical Corpsman Memorial Sculpture project, raising $100,000 for the life-sized image of a combat medic tending a fallen soldier. He established the R.K. Pedersen Global Humanitarian Outreach Grant Program that provides funding for PA's to work in clinical care settings overseas. In 2004 he traveled to southern Thailand following the Asian tsunami and worked in a make-shift morgue to help identify victim's re-mains. And as chair of the Utah Physician Assistant Licensing Board, he played a key role in establishing a Comprehensive PA Practice Act in Utah, which provide PAs in the state with some of the best laws governing PA practice in the nation. Bob Bunnell, executive director of Utah Academy of PAs stated it best when he recently wrote, "Hundreds of graduates from the Utah PA Program are deeply indebted to Don for the quality of education they have received." In recognition of Don's work as an educator, practicing PA, national and state leader, visionary, humanitarian, philanthropist, pioneer and researcher, the AAPA awarded Don Pedersen the 2010 PAragon Award for Outstanding PA of the Year. Don Pedersen, P.A.,Ph.D., ‘78 Receives National PAragon Award from American Association of Physician Assistants "Hundreds of graduates from the Utah PA Program are deeply indebted to Don for the quality of education they have received." Don Pedersen speaks at American Association of Physician Assistants' conference Photos courtesy of AAPA Receiving the 2010 PAragon Award for Outstanding Physician Assistant of the Year 23 News Notebook University of Wisconsin Honors A. Lorris Betz, M.D., Ph.D. In April of this year, Dr. A. Lorris Betz, M.D., Ph.D., Senior Vice President for Health Sciences, received the Medical Alumni Citation Award from his alma mater, the University of Wisconsin School of Medicine and Public Health. This award honors medical school alumni who achieve distinction in medicine. Achievement is recognized through excel-lence in the practice of medicine, in academic activities and in research accomplishment. Dr. Betz is a distinguished re-searcher, with many achievements in the neurosciences, and an extraordinary leader who has served as dean of two medical schools. After graduating from the University of Wisconsin's School of Medicine and Public Health with medi-cal and doctoral degrees, he completed his pediatric residency and a research fellowship in pediatric neurology at the University of California, San Francisco. He then joined the faculty of the University of Michigan's Departments of Pediatrics and Neurology. In addition to practicing and teaching pediatrics, he conducted research as director of the Crosby Neurosurgical Laboratories. His research focuses on solute transport across the blood-brain barrier, brain ion homeostasis and biochemical mecha-nisms that lead to brain injury and edema formation in stroke and intracere-bral hemorrhage. Dr. Betz held several top administra-tive posts at Michigan, including interim dean. In 1999, he was named Dean of the School of Medicine at the University of Utah, Senior Vice President for Health Sciences and Chief Executive Officer of University of Utah Health Care. In 2004, he served as interim president of the University of Utah. Honored with many awards, Dr. Betz has been asked to serve on the boards of several organizations. He currently chairs the Council of Deans at the Association of American Medical Colleges. A. Lorris Betz, M.D., Ph.D., Senior Vice President for Health Sciences Chief Executive Officer of University of Utah Health Care Elizabeth Joy, associate professor in the Department of Family and Preventive Medicine, has been elected vice presi-dent of the American College of Sports Medicine (ACSM). The ACSM is the largest sports medicine and exercise sci-ence organization in the world, with more than 20,000 international, national, and regional chapter members. In her new role, Joy will work with ACSM's leader-ship team in shaping the direction of the organization. "As vice president, I will strive to promote the integration of medicine, science, and public health to create new knowledge, to translate that knowledge rapidly into practice, and to work with others outside ACSM to promote policies that support participa-tion in sports and physical activity," she says. Joy also serves as a member or chair for several ACSM committees, including her recent appointment as chair of the Clinical Practice Committee for Exercise is Medicine. Liz Joy, M.D. Elizabeth Joy, M.D. Elected Vice President of the American College of Sports Medicine One One month after the devastating earthquake in Haiti, I traveled with an Operation-Smile team to a field hospi-tal at Love-a-Child orphanage in Fond Parisien. Two Quonset hut operating rooms and open-air tents for triage and post-op care were set up. Patients and family members stayed in over a hundred tents. The medical volunteers from 15 na-tions slept on the ground in small tents. We shared open stalled toilets and used buckets of cold water to shower. Our daily meal consisted of rice and beans. Dehydration was our constant compan-ion and anything cold was priceless. The first few days took an emotional toll on me. There were 275 patients in camp with fractures or open wounds and nearly fifty of these patients had amputa-tions. I was one of only two orthopedic surgeons. When I arrived I will never forget seeing two beautiful girls, ages 5 and 8, in wheelchairs with amputated legs. Immediately after the earthquake the initial treatment of extremity injuries consisted of amputations and applying casts or external fixators to stabilize the fractures. Due to the incredible number of injuries and limited x-ray equipment, surgeons were often not able to align the fractures adequately. As I reviewed the x-rays of those in casts or external fix-ators, I found that many of the fractured bones were either offset by several inches or severely angulated and needed surgery to regain functional use. Nearly 50% of those who had already been treated for fractures needed additional surgery. We used a veterinarian's hand held x-ray gun initially but it only gave us a 5" diameter picture. We found a better ma-chine but the images were of poor quality and only 5x10 inches, making it difficult to adequately visualize the fracture alignment. Often the x-rays would only show a portion of the fracture. Many patients had to be brought by stretcher and each x-ray needed to be taken across camp to be developed. Obtaining 20 films a day was difficult. Medical records were non-existent. If you were lucky surgeons had written on the leg or cast the type of fracture and treatment recommendations. We would have around 15-20 patients come to triage each day with orthopedic injuries and many of those individuals needed surgery. I quickly cre-ated a list of over 50 surgical candidates. The OR's were small, dark and over 100 degrees. I initially operated using a backpacking headlight. The autoclave was small so you had to estimate the screws you needed before surgery and 24 Alumni Notebook Haiti: Facing Medical and Emotional Challenges Dan Hammon, M.D. ‘88 The volunteers were dedicated and hard working with unlimited love and compassion. Young amputee walking near medical tents. Dr. Hammon operating. Already cast break showing offset fracture. Carrying injured child from the operating room. Alumni Notebook Dr. Johnson has seen a lot in his 100-years on this planet. Graduating in 1935 with his two-year certificate from the University of Utah's School of Medicine, Dr. Johnson completed his final two years of medical school at Northwestern University in Chicago and did additional training in obstetrics and gynecology in Evanston, Illinois and Utah. "Early on in my practice we didn't have epidurals, we just gave women chlo-roform to help with the pain---the ability to give anesthesia and reduce the pain of childbirth was probably one of the major changes I saw during my years practicing medicine." Dr. Johnson also recalls his days as a resident covering night deliver-ies for established physicians in Weber County. He remembers being directed to the houses by local landmarks; "the second chicken coop down the road on your right," and frequently getting stuck in snowdrifts, counting on local farmers to help free his car so he could get on with the business of delivering a baby. Training to be a physician during the depression meant money was tight for Dr. Johnson and his family. He worked his summers during medical school at medical labs around Salt Lake and Ogden. At Northwestern he cleaned a doctor's office at night in a dangerous area of town, frequently hearing knifings and shootings that occurred nearby. When he graduated from Northwestern in 1937 he was auto-matically made a 1st Lieutenant in the American Army as were all his class-mates, in preparation for war. After Pearl Harbor he trained in Aviation Medicine at Randolph Field in Texas and served during the war in the Aleutian Islands, San Francisco and the Mojave Desert, where he was a flight surgeon for pilots developing and testing the first jet aircraft. He always enjoyed the personal con-tact of medicine and the relationships and friendships he formed with women and their babies. He shared this love with his sons and is proud that all three of them followed him into the field of medicine. Along with his medical practice he enjoyed lapidary work, creating jewelry and playing the organ at the Highland Ward in Ogden for over 50 years. He continues to keep busy by working one day a week as a docent for the Eccles Dinosaur Park and attending Exchange Club meetings and ac-tivities. A lifelong skier, he spent his 100th birthday in January at Snowbasin Ski Resort enjoying the beau-tiful day while being interviewed by local newscasters. Because he remembers his financial struggles during medical school and wishes to encourage current University of Utah medical students, he endowed the Dr. Vernal H. and Athleen Johnson Scholarship in 2000; with priority given to senior medical students intending to pursue a career in obstetrics and gynecology. His wish is to ensure con-tinuing excellence in the field he loved. Vernal Johnson, M.D.: Celebrating 100 Years of Life use a minimum number of surgical instruments. It was so hot you became drenched during the case and your surgi-cal gloves would fill with sweat. One of the surgeons had the nurse pull down his scrubs and operated in boxer shorts. The fractures were all very difficult because they were 4-5 weeks old and also badly shortened and displaced. Every case took much longer than usual leaving you totally exhausted. Our expensive surgical drill burned out quickly and with no other choice we used a standard Ryobi drill. We sterilized the drill with sponges soaked in bleach. Amazingly we did not have a single post-operative infection at one month. We were overwhelmed with patients and our supplies were rapidly dwindling. We also had many patients with femur fractures that we did not have the equip-ment and facilities to fix. I contacted the USS Comfort and over 5 days transferred 26 patients for treatment. These were the last patients accepted before the USS Comfort left Haiti. There were a few patients with severe injuries who were in significant pain for whom I had little to offer. On several occasions I found a quiet place to shed some tears. The Haitian people were so grateful for everything we did for them. They had absolutely no material possessions and yet were still happy. The volunteers were dedicated and hard working with unlimited love and compassion. I will never forget Kathy, a nurse who had just finished her shift and looked ex-hausted, playing baseball with some of the children. This was the most difficult experi-ence of my life but also the most reward-ing. Please remember the people of Haiti. They will be struggling with the aftermath of this disaster for many years. Dr. Johnson enjoys a day at Snowbasin for his 100th birthday. 25 26 Alumni Notebook Where are They Now? You Wanted to Know: Where is Neil Kochenour, M.D. Now? Dr. Kochenour retired in 2006 from his position as Medical Director of the University of Utah Hospitals and Clinics, the first at the University of Utah Medical Center. We met up with Dr. Kochenour during his recent visit to Salt Lake City to find out what he has been up to since he retired. For those of us who witnessed first-hand Dr. Kochenour's passion and very fast leg turnover rushing happily between Labor and Delivery and other clini-cal areas, he has not slowed down! His primary residency is at Academy Village retirement community in Tucson; check it out at www.theacademyvillage.com. The focus there is three-fold: health and wellness, lifelong learning, and contribu-tion to society. Not surprisingly, Dr. Kochenour has much to offer with his administrative responsibilities at the Wellness Center, home health program, and the assisted living facility, which is near opening. He spends two to three months per year at his condominium in Montana fly-fishing, a month at his flat in London, and greatly enjoys his international travel. He loves to learn and read, recently at-tending the Conference on World Affairs at the University of Colorado. He contin-ues to be active in the American Academy for the Advancement of Science. He has even picked up cooking, with paella and gazpacho being among his favorites. One of the many highlights of Dr. Kochenour's career was his sabbatical at Queen Charlotte Hospital in London in 1986-7. He described this as a turning point in his life. It introduced him to how other countries "do so much with so little." It was his first over-seas experi-ence, after which he became a committed traveler, now a great joy in his life. He also met lifelong friend, Charles Rodeck, who greatly influenced him through-out his career. One thing Dr. Rodeck impressed on Dr. Kochenour was that life should not be all work. Career-life bal-ance became an important principle that Dr. Kochenour lived by. Dr. Kochenour revealed that the one thing he really misses about his work at the University is "the people". He also thinks being a division chief was "the best job in academic medicine"; developing a group of individuals into a stellar division, being able to imprint your vision and personality on the division, and leaving the big political drama to the department chair (he said with a big smile!). His one regret is that he didn't have a third career, in health policy at the state level. He loves the "Big Picture". Neil Kochenour, M.D. with partner Dianne Engelby in Greece And Where is LeRoy Kuehl, Ph.D. ? The plaques covering the walls of Dr. LeRoy Kuehl's home acknowledge his distinguished career in the Dept. of Biochemistry at the University of Utah and pay tribute to his excellence as teach-er, mentor, and colleague. Dr. Kuehl's gift for making biochemistry clear, interesting and relevant during his 30 years as direc-tor of the biochemistry course culminated in an astonishing array of honors, includ-ing the esteemed Distinguished University Teaching Award. Upon his "retirement" 15 years ago, the Physician Assistant program, where he had taught for several years, prevailed upon him to continue on. He agreed, and taught in that program until just over a year ago when his retire-ment finally stuck. Despite numerous scientific articles, his publication that attracted the most atten-tion was a poem published by The Pharos, the journal of the AOA (see sidebar). His daughter chose to attend medical school at the University of Washington rather than the University of Utah because, he says, she didnt want him as an instructor. On her first day, however, she found her father was a hard man to escape: a copy of his poem was in her Physiology syllabus. As life-long outdoor enthusiasts, he and his wife Barbara chose to retire in Southern Utah, near New Harmony, where they could continue backpack-ing, hiking, canoeing, and cross-country skiing. A longstanding tradition is an annual October "Turkey Trip," a several-day canoeing trip which culminates in a complete traditional Thanksgiving dinner cooked in a campsite along the water. Retirement has also allowed for extensive travel. He and Barbara have visited over 50 countries and all 7 continents, includ-ing spending a month in Antarctica. Dr. Kuehl has very much enjoyed re-tirement but acknowledges that he misses teaching and the camaraderie he enjoyed in the Dept. of Biochemistry. He still, however, occasionally runs into former students. When his wife underwent knee replacement surgery a few months ago, the surgeon, anesthesiologist, and PA were all former students. He reports, "They all did a good job." 26 Three students on the door did knock; With their Professor they would talk. He welcomed them most cordially; Asked: what could their problem be? And in the office of that Saint, They laid before him this complaint: Your course falls short, you can't deny, Since lecture notes you don't supply. So all we do while in your class, Is take dictation, notes amass. Preoccupied with pen and ink, We have no time to learn or think. Your pearls of wisdom, priceless quotes Slip by while we sit taking notes. The good Professor promised this, That they'd have lecture notes forthwith. Six days he toiled and evenings too, And when his task was finally through Then all his lectures without fail Were written up in great detail, And basic concepts were defined, Because they were all underlined. Next year came students as before To knock upon that good man's door; To tell him how he was remiss, And now their grievance read like this: In lecture everything you say Is in the course notes anyway. And since we all know how to read, Of hearing you there's little need. We could as well remain at home And learn the subject on our own. Could you not tell us something new That isn't in the handouts too? The good Professor promised this: To remedy the flaw forthwith. Three days he toiled and evenings too, And when his task was finally through, He added data and more quotes, And minor points and anecdotes To supplement and underscore The topics that he'd taught before. Next year the students came to bleat: His lecture notes were incomplete. For much of what he did expound, Could nowhere in the notes be found. Although this caused him much chagrin, Soon to their braying he gave in, And once again without delay He wrote down all that he would say. And to the old notes this was added- His outline now was quite well padded. When yet another year had passed And he thought he'd found peace at last, There welled a cry from student throats That all he did was read his notes. The poor professor paced the hall Feeling like a ping-pong ball. Thus year by year his lectures grew, And longer were his outlines too. And students found to their distress They had to master an excess Of obscure facts, minute detail; Of information dry and stale. A situation that attained All because they had complained. The moral is easy to observe: Students get what they deserve. Printed with permission from the The Pharos, journal of the Alpha Omega Alpha medical-honor society, Spring 1986 27 Alumni Notebook The Paradox by LeRoy Kuehl, Ph.D. Leroy and Barbara Kuehl in Morocco 28 Alumni News Class of 1965 J. Charles Rich, M.D. Dr. Rich and his wife Jasmine have retired to Palm Springs, California, though they still spend significant time at their home in Salt Lake and enjoy hosting the freshman class of the School of Medicine for a barbeque every August. He retired in 2002 from his neurological surgery practice. He was very involved in his specialty, serving as the President of both the American Association of Neurologi-cal Surgeons and the American Academy of Neurological Surgeons, and as Vice Chairman of the American Board of Neurological Surgeons. He enjoyed par-ticipating in the Salt Lake 2002 Winter Olympic Games as the Chief Medical Officer. He has served the University of Utah on the Alumni Board, the Crimson Club Board, and on the National Advisory Council. He is the proud father of five sons, three of whom are M.D.s. He reports that in his spare time he is a humiliated, but earnest golfer. Class of 1979 Laura Fife, M.D. ‘79 Dr. Fife completed her residency in internal medicine and has been practicing emergency medicine ever since. She has been on the faculty of the University of Washington's Division of Emergency Medicine for the past 15 years. She lives with her partner Lee and two silly Dalmatians in Seattle. Class of 1981 Geraldine M. Jacobson M.D., MPH, FACR Dr. Jacobson is Associate Chair and Clinical Director of Radiation Oncology and Clinical Professor at the University of Iowa Hospitals and Clinics. Dr. Jacobson was recently inducted as a Fellow in the American College of Radiology (ACR). Fellow status is one of the highest honors bestowed by the ACR on a radiologist, radiation oncologist or medical physicist, with only 10% of ACR members achieving this distinction. She lives with her husband, Monroe Reed, in Iowa City, Iowa. Class of 1986 Douglas Malcom, M.D. ‘86 Dr. Malcom reports he's been happily married since 1987 and lives in Shell Beach, which is on the Central Coast of California. He completed his residency in emergency medicine and is board cer-tified and a fellow in the American Col-lege of Emergency Physicians. He served as a medical director for several years and now works in the ER on weekend nights in a central valley rocking and rolling busy trauma center. He completed law school several years ago after seeing sev-eral patients injured by HMO denial of care. He now represents patients during the week and treats patients on weekends! He has four adult children (one making surf movies for Billabong; one in a Ph.D. history program; one is an actress and one is premed). He appreciates the friends he made in Utah and the quality of education he received. Class of 1994 Tiffani Hamilton, M.D. Dr. Hamilton com-pleted a residency in dermatology in 1998, a fellowship in dermatologic surgery in 1999 and a second fellowship in phlegology in 2000. She currently owns and practices at the Atlanta Derma-tology, Vein and Research Center, LLC where she does dermatologic surgery, phlebology and mohs (skin cancer) surgery. Class of 2000 Michael Daily, M.D. Dr. Daily is the Director of Kidney and Pancreas Transplantation at the Univer-sity of Kentucky Medical Center. He completed his General Surgery residency in 2005 and a Fellowship in Transplanta-tion Surgery at the Thomas E. Starzl Transplantation Institute at the Univer-sity of Pittsburgh in 2007. His wife, Heather, also works at the University of Kentucky Medical Center as a Foot and Ankle Surgeon. Class of 2005 Muhammad Khan, M.D. Dr. Khan is cur-rently a postdoctoral fellow in Pediatric Gastroenterology at Stanford University Medical Center. Along with pediatric gastroenterology he specializes in hepatol-ogy and nutrition. He lives in Palo Alto, California, and is glad to share advice with alums and current students on things to do in the Bay area. Class of 2008 Nathan Faulkner, M.D. '08 Dr. Faulkner is currently serving his residency in orthopedic surgery at the University of Wisconsin Hospitals and Clinics in Madison, WI. House Staff House Staff 1961 Donald Millar HS ‘61 Dr. Millar sent an update from Mur-rayville, GA, where he still lives with his lovely wife Joan with children and grand-children living close by. After graduating from the Medical College of Virginia in 1959 he recalled trekking out by car with two other newly minted gradu-ates (Arnold "Fritz" Frederick and Jim Gardner and his wife, Karen) to begin an internship at the University of Utah Affiliated Hospitals. After the internship the Fredericks and Gardners returned to Richmond, but he committed to stay at the U for a year of internal medicine residency. The results were far-reaching. From the Great Salt Lake Valley, his path led to the U.S. Public Health Service and then the Centers for Disease Control in Atlanta--the two-year tour of duty in Utah became a 32-year career and they never did return to Richmond! Their first child was born in Utah and he is still very appreciative of the time he spent in training there. House Staff 1995 Nicholas Sarlis, M.D. HS '95 Dr. Sarlis is cur-rently a Senior Medical Director for Sanofi-Aventis in Bridgewater, N.J. He special-ized in endocrinology and metabolism and received a Ph.D. in molecular biol-ogy from the University of London, UK. He is widely published and has delivered invited lectures worldwide. Dr. Sarlis and his wife have a ten year old son; they enjoy traveling, museum-going, reading, painting, music and photography. Ph.D. and Master's Degrees Class of 1965 Bill Martin, Ph.D. ‘65 Dr. Martin received his Ph.D. in Medical Microbiology and Immunology from the School of Medicine in 1965. He retired from the Centers for Disease Control and Prevention in 1998 as Director of their Scientific Resources Program in the National Center for Infectious Diseases. He and his wife, Nadine, were both ordained as Deacons in the Episcopal Diocese of Arizona in 2006 and are both serving in two Episcopal Churches in the Tucson area. In Memoriam Transitioning Into Practice Wednesday, October 27, 2010 4:00 p.m. - 9:00 p.m. Alumni Hall at the Spencer F. and Cleone P. Eccles Health Sciences Education Building (HSEB) The curriculum will include the following: • Debt Management • Employment Contracts • Practicing Medicine in Utah • Personal Security Insurance • Strategies for Success in Practice and in Life • The Search and The Interview • Panel Presentation: "What I Know Now That I Wish I'd Known Then" Presented by: The University of Utah School of Medicine Alumni Association in collaboration with the University of Utah School of Medicine Graduate Medical Education office and the Utah Medical Education Council. Questions? Call Kristin Wann Gorang at 801-585-3818 or email [e-mail] residents & fellowssave the date John Arnesen, M.D. H.S. 1948 04 Mar 2010 J. Bruce Balken, M.D. MD 1941 08 May 2010 Jack B. Bennett, M.D. MD 1942 24 Mar 2010 John W. Benton Jr., M.D. RES 1957 03 Apr 2007 Gary L. Bills, M.D. MD 1968 03 Apr 2010 Jay S. Broadbent, M.D. MD 1946 03 Feb 2010 O.H. Guymon, Jr., M.D. MD 1954 29 Mar 2010 Wallace V. Jenkins, M.D. MD 1950 02 Mar 2010 Matthew H. Kime, M.D. MD 2008 04 Apr 2010 S. Ross Melgaard, M.D. MD 1940 19 Apr 2010 Don H. Nelson, M.D. MD 1945 11 Jan 2010 Thomas E. Olson, M.D. MD 1952 10 Apr 2010 John M. Peters, M.D., M.P.H., D.Sc. MD 1960 06 May 2010 Milton F. Wilcox, M.D. MD 1945 26 Jan 2010 Alumni Association 540 South Arapeen Drive Suite 125 Salt Lake City, Utah 84108-1298 Please visit our Web site at http://medicine.utah.edu/alumni Becoming an M.D. - High Expectations, Great Responsibility Cert no. SGS-COC-005138 Nonprofit Organization U.S. Postage Paid Salt Lake City, Utah Permit No. 1529