Mission Spring / Summer 2016 by Epubs

SPRING/SUMMER 2016

WARRIORS for health Sometimes it takes an army to save a life

SPRING/SUMMER 2016 | Vol. 42, No. 1

In this Issue 04 05 29 30 33 38

PRESIDENT'S MESSAGE UNIVERSITY IN MOTION ALUMNI PROFILE ACCOLADES PHILANTHROPY PARTING SHOT

Just kick it A PTSD researcher works to convince patients to substitute exercise for narcotics.

And then there was light Though common, near-death experiences are often discounted by health care professionals. One assistant professor is working to change that.

Out of the dark One in five children has a mental illness, yet often they go untreated as communities and families battle the stigma.

COVER STORY

Warriors for health On battlefields around the world, they faced their own mortality multiple times a day as explosions erupted around them. Today these military service members and veterans serve a different mission. Photo by Joel Spring

“

If I could go back and do it all over again, even considering the unfortunate circumstances I endured, I wouldn’t hesitate for a second to lace up my boots and get back at it. This is what we do.” —Rudy Gomez (see story, Page 16) Photo by Noell Vidaurri

We have a long, stellar tradition of uniting for a common purpose with our military medicine community. Through this stalwart commitment of minds, talents and hearts, we are able to make better the lives of hundreds of thousands of our servicemen and servicewomen. These heroes then pay it forward—through their sacrifice, humility and fraternity—in order to ensure the freedoms and opportunities that sustain our nation. From our internationally renowned PTSD research and treatment, to the expert training we afford medical personnel from all branches of the armed forces at the San Antonio Military Medical Center of Fort Sam Houston, to the compassionate care our faculty members deliver to our revered veterans at the Audie L. Murphy Memorial VA Hospital, our Health Science Center remains steadfast in its commitment to serving our military, their families and the military medicine community that has transformed San Antonio into Military City, U.S.A. We know no truer honor or privilege than to keep whole, and help make more resilient, our veteran, active duty and retired military members—patriots all—as they ennoble our university’s mission through their lives of courageous service to country and humanity.

William L. Henrich, M.D., MACP President and Professor of Medicine UT Health Science Center at San Antonio

UNIVERSITY in motion Healing in flight By Joe Michael Feist

Getting wounded soldiers the fastest, most skilled emergency medical care possible and transporting them to forward units or hospitals has long been a priority in warfare. To that end, the Army turned to the School of Medicine and its expertise in emergency care. After a yearlong pilot project in 2011, the Department of Emergency Health Sciences was selected by the Army in 2012 to train all Army flight medics. A five-year contract calls for the university to provide four paramedic certification courses and four critical care transport courses per year for flight medics. This year, due to the success of the program, the department will offer six courses. It’s a charge that Lance Villers, Ph.D., LP, associate professor and chair of the department, doesn’t take lightly. “All of these soldiers are EMTs who were trained at Fort Sam,” Dr. Villers said, explaining that San Antonio’s Fort Sam Houston is the center for all medical training for the Army. “Many of them have been deployed and have combat experience. Then all of the designated flight medics for the Army are brought back here for our training.” Intensive classroom instruction covers anatomy/physiology, patient assessment, advanced airway procedures, cardiovascular emergencies, medical and trauma emergencies, EMS operations, hospital clinicals and EMS field practicums. “When they finish our program, they’re prepared for national certification for paramedic,” Dr. Villers said. And then immediately “they start an eight-week, critical care transport program. This is even more advanced training that prepares them for a national certifying program to be flight paramedics.”

The Department of Emergency Health Sciences was selected by the U.S. Army to train all Army flight medics . Photo courtesy of the U.S. Army. Photo by Sgt. Duncan Brennan, 101st Combat Aviation Brigade public affairs.

Rotations include the operating room for airway procedures, various intensive/critical care wards, the burn unit, cardiac catheterization lab, neonatal intensive care unit and pediatric intensive care unit, and obstetrics for delivering babies. This phase emphasizes the development of critical thinking skills. All clinical time is done at civilian hospitals and specialty clinics in the San Antonio area. Lt. Col. Neil B. Davids, M.D., LTC, Critical Care Flight Paramedic Program director at Fort Sam Houston, said the program's quality is reflected in its high first-time pass rate on the National Registry Paramedic certification

exam—nearly 20 percent higher than the national average. “Getting the clinical experience, both in the hospital and riding out with various EMS agencies, has been crucial in meeting our goal of having paramedics with critical care training [available] to the fighting force,” he said. Dr. Villers finds significance in the work his department does for the Army. “This training makes a difference for soldiers,” he said. “Once these soldiers complete our training, they go right back out to their deployments, many to a combat zone. And they’ve been given a new set of tools, of knowledge, to save people’s lives. We’re proud to be part of that.” Spring/Summer 2016 | UTHSCSA.EDU/MISSION | 5

UNIVERSITY in motion

Do hold your breath A woman’s risk of long-term cardiac side effects from radiation therapy when treating left-sided breast cancer could be reduced through the use of a new form of surface imaging, available at the Cancer Therapy & Research Center (CTRC). By taking a deep breath and holding it, the space between the breast and the heart widens, minimizing or eliminating radiation exposure the heart may receive during radiation therapy. The technique, called Deep Inspiration Breath Hold, isn’t unique, but the CTRC is one of only a handful of centers nationwide that pair it with surface imaging that allows the treatment team to see exactly when the maximum separation occurs. “Conventional techniques of radiation therapy for left breast cancer give a dose of

radiation close to the surface of the heart,” said CTRC radiation oncologist Richard L. Crownover, M.D., Ph.D., professor in the School of Medicine. “This is significant because coronary arteries are on the surface of the heart. The exposure may lead to other effects, basically the acceleration of atherosclerosis or ‘hardening of the arteries.’ This becomes a risk factor for heart attacks years later, especially for younger women.” Deep Inspiration Breath Hold enables the treatment team to accurately position the patient each time a treatment is done. They can position the patient into the same exact spot, to within a few millimeters, each day during a course of treatment. The radiation is “gated”—the system does not allow the radiation beam except

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Radiation exposure to the heart during radiation therapy is minimized or eliminated by practicing Deep Inspiration Breath Hold. The technique causes the space between the breast and the heart to widen. Special goggles tell the patient when to breathe. Photo by Noell Vidaurri

when the patient is in the correct deep breath hold position, Dr. Crownover said. Special goggles tell the patient when to breathe. The patient sees a bar and a box in her field of vision, and when she breathes the bar goes up and down. The care team practices this with the patient at a simulation session prior to the start of treatment. “This reduces radiation exposure to the coronary arteries, which is expected to reduce the risk of problems down the road,” said radiation oncology physicist Alonso N. Gutiérrez, Ph.D., associate professor in the School of Medicine.

H PE

for the sickest patients Only part of the story It’s been dubbed the Angelina Jolie gene, the BRCA1 gene mutation that put the actress at higher risk for invasive breast cancer and led to her undergoing a double mastectomy to prevent it. BRCA1 is known to suppress cancer by repairing breaks in DNA, the molecule that contains the genetic blueprint of each cell. DNA damage occurs with aging and environmental insults. In a new study, published in Nature Communications, Cancer Therapy & Research Center researchers found that BRCA1 also serves as a limiter or governor on a gene called COBRA1 that regulates breast cell growth. “We now have solid and compelling evidence that BRCA1 in breast tissue is doing something independent of DNA repair,” said study lead author Rong Li, Ph.D., professor of molecular medicine. “We still think DNA repair is important for BRCA1 to suppress tumor development, but we just don’t think it’s the whole story.” Since DNA repair is needed in every cell of the body, scientists have puzzled over why loss of BRCA1 function predisposes women to only breast and ovarian cancers. Also, diminished BRCA1 activity doesn’t affect men significantly, as it does women. “From very early on, we and others in the field speculated that maybe there is a DNA repair-independent function associated with BRCA1 that can better explain this tissue and gender specificity,” Dr. Li said. The new finding provides at least part of that answer, he said, and could one day translate into better diagnostic and treatment tools for this form of breast cancer. “The ultimate goal would be to slow down or even prevent breast cancer development in BRCA1 mutation carriers,” he said.

A clinical trial of a new immunotherapy agent for children and young adults who don’t respond well to traditional therapy or whose cancer returns is being offered at the Health Science Center—the first study site in the U.S. to offer the trial. The study, led locally by AnneMarie Langevin, M.D., evaluates the drug atezolizumab, which has shown promising results in adults. It is being offered to children ages 2 to 17 and young adults up to age 30 who have pediatric cancers. The focus is on solid tumors and two types of lymphomas, Hodgkin lymphoma and non-Hodgkin lymphoma. In May, the university joined the Pediatric Oncology Experimental Therapeutics Investigators’ Consortium (POETIC), a group of 11 academic medical centers in North America whose pediatric oncology studies focus on the biologic basis for anti-cancer therapy, and investigate new agents and novel combinations of therapies early in clinical development. “We joined POETIC to offer children the newest therapies that are not available yet at other centers,” said Steven D. Weitman, M.D., Ph.D., principal investigator. “If we were not involved in this, our patients would have to wait years before these treatments would be available commercially to the public.” Two more studies are expected to open by the end of summer, said Virginia Diaz, lead research associate for the POETIC study. The first trial of the drug atezolizumab has already proved promising. Based on results from several clinical trials in adults, the U.S. Food and Drug Administration in February granted Breakthrough Therapy Designation for atezolizumab for treating non-small cell lung cancer in adults. Atezolizumab also has shown good results against a type of bladder cancer called metastatic urothelial carcinoma. The drug is being tested with numerous other types of cancer in adults.

“Even though we’ve had some great advances over the past 40 years in treating cancer with chemotherapy, radiation and surgery, there have been few new treatment options for children and young adults who do not respond well to traditional therapy or whose cancer relapses. This is our sickest group of patients because the standard therapies no longer work,” said Dr. Langevin, professor of pediatric hematology/oncology. “Atezolizumab uses the body’s own immune system to fight the cancer. The new trial will look at how pediatric tumors and children’s developing bodies react to the new medication,” she said. The study eventually will be offered at 50 study sites in Europe and the U.S. For a list of clinical trials offered by Health Science Center researchers, go to vpr.uthscsa.edu/findastudy.

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UNIVERSITY in motion

No cracking under pressure Patients who need dental implants but have thin gums or are allergic to titanium may benefit from a new, stronger ceramic dental implant approved by the U.S. Food and Drug Administration in January. While there have been other ceramic dental implants in the past, these did not always hold up to the bite pressure needed for normal use, said Stefanie Seitz, D.D.S., assistant professor of comprehensive dentistry. The new ceramic implants, now available through UT Dentistry, have shown comparable strength to titanium, the standard material used for dental implants. “This is somewhat of a niche product for patients who have special circumstances,” Dr. Seitz said. “By their nature, titanium implants can compromise aesthetics by showing gray through the gum tissue. This ceramic implant is ivory in color, thereby mimicking the natural color of teeth, making it more aesthetic. The ceramic implants are also helpful for patients who are allergic to titanium or, for whatever reason, do not want to have metal in their bodies.” New imaging technology is used to plan and place both ceramic and titanium implants in a way that results in precise placement, less pain for the patient and faster healing. The technology calls for dentists to perform a digital scan of the teeth instead of using a thick, pasty dental material to get an impression of the mouth. The digital data

A stronger ceramic dental implant, approved by the U.S. Food and Drug Administration, is offered at UT Dentistry. New imaging technology is used to plan and place implants precisely.

are put into a 3-D implant planning software program to determine the exact location, appropriate depth and angle for the implant. The program provides coordinates for the manufacturer to make a 3-D resin “guide,” or template, to place the implant. A hole in the template for the implant guides the dental surgeon for exact placement. The ceramic implant is placed with a

protective cap to allow for the three- to fourmonth healing phase before the tooth can be used for chewing. Ceramic implants can be used for single implants or groups of teeth. Although the ceramic implant is available to all implant patients, the cost is higher than titanium implants, Dr. Seitz said.

Call to action

21 40 percent of girls and 21 percent of boys in the U.S. have completed the HPV vaccination series.

Human papillomavirus (HPV) is the most common sexually transmitted infection and the cause of most cervical, anal and other genital cancers. In January, officials from the Cancer Therapy & Research Center (CTRC) joined the nation’s top cancer institutes in a call for all children and young adults to be vaccinated against the virus. “In his State of the Union address, President Barack Obama asked the nation’s leaders to embrace cancer prevention,” said Ian M. Thompson Jr., M.D., director of the CTRC. “Encouraging parents to vaccinate their children against HPV is an excellent way to start.” HPV can be prevented by administering the safe and effective three-dose vaccine

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series to preteens, teenagers and young adults. However, a 2015 report by the Centers for Disease Control and Prevention states that only 40 percent of girls and 21 percent of boys in the U.S. have completed the vaccination series. In South Texas, where predominately Latino residents struggle with various cultural and access-to-care barriers, the rates were even lower. With a new $1.2 million grant from the Cancer Prevention and Research Institute of Texas, CTRC researchers are developing professional education and community outreach programs to inform adolescents about the vaccine and encourage them to complete the three-shot series.

When a skeleton fails In Alzheimer’s disease, brain cells die. New research shows that their death is linked to disruption of a skeleton that surrounds the nucleus of the cells, a finding that is expected to open new studies on how to prevent the earliest biological events that result in the disease. The nucleus is the control center of cells. A mesh-like scaffold called the lamin nucleoskeleton acts like a shield, surrounding and protecting it. But in Alzheimer's, this skeleton is disordered, said Bess Frost, Ph.D., assistant professor of cellular and structural biology in the School of Medicine. This dysfunction can cause the death of the brain cells. The discovery first was made in a fruit fly disease model. It was confirmed in postmortem brain tissue of people who had Alzheimer’s disease, whose families had donated their brains to research. “Human brain donation is a very critical part of this work,” Dr. Frost said. “It was

A cell nucleus from a normal, healthy brain is shown at left. The lamin nucleoskeleton forms the perimeter around the nucleus. By contrast, tunnel-like anomalies are evident in the nucleus of the Alzheimer's disease-affected cell shown at right. Image courtesy of the laboratory of Bess Frost, Ph.D.

important to show that what we found in the fly is really relevant to human disease.” Dr. Frost and her colleagues at Harvard and Brigham and Women’s Hospital used a technique called super-resolution microscopy to analyze the fruit fly and human specimens. They found peculiar features that looked like tunnels in the lamin of Alzheimer’s-affected specimens.

The team also studied a fruit fly model of Huntington’s disease and did not find any problems with the lamin. “So, at least compared to one other neurodegenerative disease, lamin dysfunction seems to be specific to Alzheimer’s disease,” she said. The findings were published in the journal Current Biology.

Illustration by Sam Newman

A pox on poxviruses Smallpox virus, which killed millions of humans through the ages, ranks among the world’s most feared bioterrorism agents. Human monkeypox continues to occur sporadically in remote African villages. In a new report, virologists from the School of Medicine and their collaborators at Oklahoma State University demonstrate how poxviruses such as smallpox defeat the body’s host immune defenses. The implications extend beyond viral infections to cancer therapy, said senior author Yan Xiang, Ph.D., associate professor in the Department of Microbiology and Immunology. Dr. Xiang and colleagues revealed how a molecule on the poxviruses defeats a host restriction factor called SAMD9 in humans and animals. SAMD9 protects against viruses, and suppresses tumors. Mutations in the human SAMD9 gene are responsible for a life-threatening cancer called normophosphatemic familial tumoral calcinosis. “There is an ‘arms race’ occurring between pathogens [disease-causing agents] and their hosts,” Dr. Xiang said. “To survive in their hosts, many pathogens utilize specific inhibitors of the host restriction factors. SAMD9 is an evolutionally conserved immune barrier, but it has been successfully overcome by diverse poxviruses.” First author of the study is Xiangzhi Meng, M.D., Ph.D., an assistant professor in microbiology and immunology. The discovery was published in Proceedings of the National Academy of Sciences.

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UNIVERSITY in motion

More than a facelift

The Texas Legislature and the UT System Board of Regents have allocated more than $95 million to modernize and renovate buildings at the Health Science Center. The project is expected to take about three years to complete. Much of the work will center on the 1.4 millionsquare-foot medical/dental education building, one of the oldest buildings on campus, constructed in 1968. The nursing education building, more than 40 years old, also will receive updates. “Even though [the nursing education building] was expanded in 1996, it is quickly becoming obsolete due to increased enrollment, curriculum changes and significant mechanical and safety code changes,” said Michael E. Black, senior executive vice president and chief operating officer. “These system upgrades will allow us to modernize prioritized educational, research and related administrative space within these buildings.” Tuition revenue bonds will cover $80 million of the cost, and another $15.4 million will come from Permanent University Funds. “With these much-needed infrastructure upgrades, we will be able to effectively repurpose space to augment our educational and research initiatives,” Black said. The project also will include laboratory and other renovation projects.

Breaking new ground In the Health Science Center’s newest building, classrooms enable real-time observation of procedures, complex surgeries and clinical simulations in a dynamic, discussion-based learning atmosphere. The $51.2 million Academic Learning & Teaching Center was dedicated in February. At 130,000 square feet, it features more than 33 modern classrooms and strategic learning spaces, and a state-of-the-art digital anatomy laboratory with 3-D interactive imaging capabilities. It also includes a restaurant. “As health educators, we have seen a massive explosion in knowledge,” said Health Science Center President William L. Henrich, M.D., MACP. “The Academic Learning & Teaching Center is one of the

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nation’s most advanced learning environments, a worthy place to train the health care providers South Texas needs.” Classrooms range in size from the area of a football field that can accommodate 280 students to seminar rooms that seat 12 to 18. “Unique to this new teaching environment, there is no front or back of the classroom—it is an integrated space linked by technology,” said Francisco González-Scarano, M.D., dean of the School of Medicine and executive vice president for medical affairs. “The interaction this inculcates will enhance students’ ability to gain mastery of complex concepts of health care, both in the School of Medicine and throughout the Health Science Center.”

Delving deep Gross anatomy students can peel back the layers of a human body with the use of a video game controller. A digital anatomy laboratory in the Health Science Center’s newest building, the Academic Learning & Teaching Center, allows students to view CT scans and MRI images of normal and diseased bodies and view them in 3-D. It’s all controlled through the use of a video game controller attached to a laptop computer. Students can rotate images, zoom in and out, add filters to isolate certain tissues and generate a virtual cross-section in any plane. The images are projected onto multiple screens in the lab, and 3-D goggles allow the images to come to life. The lab contains 84 stations for student learning and will be used to reinforce the concepts and anatomical relationships that students are taught in gross anatomy labs. “This visualization system enhances the educational experience beyond what we can do in the gross anatomy lab,” said Omid Rahimi, Ph.D., director of the human anatomy program and a Distinguished Teaching Professor in the Department of Cellular and Structural Biology. “[In a typical lab] you can’t pick up a set of blood vessels in isolation of other tissues and rotate them in front of your face. This tool allows students to do that. We are certainly excited about it.” The lab, one of only a few in the country, will complement students’ understanding of the structure and function of organs, bones, muscles, nerves and tissues they are studying.

Photo by Noell Vidaurri

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Just kick it

Researcher works to convince patients to sub exercise for meds By Joel Williams

elf-described “pain nerd” Donald McGeary, Ph.D., stood at the finish line at a track where a chronic pain patient had almost walked a complete lap during physical therapy. Suddenly, the patient stopped and said, “I just can’t go any farther.” Dr. McGeary, a clinical health psychologist, had heard him clearly, but recalls telling the man, “‘I couldn’t hear you. Can you come over here and tell me that?’ And he walked over to me and said, ‘I can’t go any farther.’ And I said, ‘You just proved yourself wrong by walking over here to tell me that.’” In his specialty of managing pain without drugs, a fundamental goal is helping patients realize that they can do more than they thought. That’s the focus of his new National Institutes of Healthfunded study involving post-9/11 military veterans suffering

chronic pain and psychological distress. He applied for the grant in response to an urgent NIH call for new programs for managing pain without prescription opioid medications. Those with chronic pain after military trauma often have other chronic symptoms, including post-traumatic stress disorder, traumatic brain injury and depression. Such “polymorbidity” makes all the conditions more difficult to treat, and opioids complicate those multiple conditions and worsen a patient’s ability to function. Yet U.S. prescription opioid sales have increased by 300 percent since 1999, leading to growing dependency on narcotics. In 2014, nearly 2 million Americans either abused or were dependent on opioids, according to the Centers for Disease Control and Prevention. Some prescription opioid users start using street heroin, an opioid often cheaper and easier to obtain, according to reports by the National Institute on Drug Abuse. The NIH, together with the Department of Veterans Affairs and other agencies, wants to reduce this high opioid use. While research shows that primary care doctors dislike prescribing opioids for chronic pain, they don’t know of

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Opioids:

Common prescription opioid pain relievers include:

Best-known narcotic pain medication, found in or derived from opium.

Hydrocodone (Vicodin) Oxycodone (OxyContin) Oxymorphone (Opana) Methadone Fentanyl

Nearly 2 million Americans age 12 or older either abused or were dependent on opioids in 2014.

1 in 4 people on

long-term prescription opioids struggle with addiction, even in a primary care setting

Sources: Centers for Disease Control and Prevention, Encyclopedia Britannica, Substance Abuse and Mental Health Services Administration

alternatives, said Dr. McGeary, an assistant professor of The mindfulness part trains patients to allow pain and psychiatry. He believes patients use opioids because they catastrophic thoughts to be, without feeling compelled to see no other way to manage pain, although the drugs don’t try constantly to control them. This helps them separate promote rehabilitation and actually worsen a person’s ability emotion from alarming thoughts. to function. “When you can get people to step away from their His study compares Functional Orthopedic emotional response, they don’t have anything to control Rehabilitation Treatment, or FORT, to VA “treatment as anymore,” Dr. McGeary said. “They can make decisions usual.” In FORT, a psychologist, VA physician, physical otherwise. They can just go be active. I can feel bad and be therapist and occupational therapist communicate closely on active at the same time.” patient treatment and progress in gaining physical function, The program builds on a previous pain study such as walking, bending and lifting. Dr. McGeary conducted with active-duty military. Half The treatment is broken into four parts: psychology, stopped using opioids, although that program did not cognition, behavior and mindfulness. discuss drugs. The psychological part He’s also testing medicationintegrates relaxation, guided free pain management with a exercise, and positive and study launched last year for the Relief without opioids comforting thoughts with Consortium to Alleviate PTSD, Functional Orthopedic Rehabilitation elements of physical therapy, involving Iraq and Afghanistan Treatmentis a team-based approach occupational therapy, pain war veterans with post-traumatic to patient treatment and progress in medicine, pain-related coping and headache and post-traumatic gaining physical function. stress management. Biofeedback stress. The consortium, in measures heart rate, muscle the Health Science Center’s Four parts: tension, perspiration and behavioral medicine division, is 1. Psychological—includes relaxation, respiration—all stress indicators. funded by the VA and Defense guided exercise, positive imagery, The cognitive part targets Department. cognitive and behavioral therapy patients’ thoughts to eliminate “pain Effective, drug-free pain 2. Cognitive—eliminates exaggerated catastrophizing,” mistaken ideas management could save lives. or mistaken ideas about pain or injury such as a back pain sufferer’s belief A recent San Antonio Veterans that excessive activity could cause Integrated Service Network 3. Behavioral—focuses on getting paralysis, which is usually not true. study found that the opioid patients active Dr. McGeary tells patients that hydrocodone is the most 4. Mindfulness—allows pain and the pain is like a constantly ringing prescribed medication in the catastrophic thoughts, without being telephone with no one on the line. service network and that 40 compelled to control them “The signal is useless now,” percent of veterans using an he said. “It doesn’t make sense to opioid had used it for more than pay attention to it or to try to read three months. Chronic opioid use anything into it.” among polymorbid veterans has The behavioral part focuses on getting patients been linked to poor rehabilitation outcomes, abuse of other active—walking around that track, picking up that child, substances and death. going to work. “With so many people transitioning out of the military “You need to teach people to push themselves over to the VA, the VA is going to experience a glut of chronic time, so they can get rehabilitative benefit,” Dr. McGeary pain patients, and they need to solve this fast,” Dr. McGeary said. “You know you’re successful when they’re lifting more said. “The solution is not to give everyone hydrocodone, and they’re telling you they’re lifting more. I want you to be and they know that. They are trying to come up with stronger and know that you’re stronger.” something better.”

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Pat Johnson vividly recalls his near-death experience after a boating accident on the Blanco River nearly six years ago. He speaks of that day in reverential tones, of being “in the presence of God” and “at the edge of heaven.”

By Joe Michael Feist

And he recalls telling his doctor about the experience. “He basically laughed at me,” Johnson said. “He chuckled and said, ‘Oh, it’s just your frontal lobe shutting down that causes you to have this euphoric feeling and you hallucinate.’ I told him that, no, this wasn’t a hallucination, this wasn’t a dream. ‘It was as real as me standing here talking to you.’ At that point I thought, I don’t care what anyone tells me.”

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While near-death experiences are common, so too is the reaction by Johnson’s physician, said Deborah James, M.S.N, RN, CNS, CCRN-K, a clinical assistant professor in the School of Nursing and recognized expert in end-oflife care and near-death experiences. James, who in 2009 co-authored and co-edited the first compilation of research on the subject, Handbook of Near-Death Experiences: Thirty Years of Investigation,

said one in three people who have a close brush with death often order medications because they think the patient is report a near-death experience. psychotic. Often veterans are treated as if they’re suffering And James is on a mission to make sure health care from PTSD.” professionals, nurses in particular, know how to listen So it’s normal for NDErs to be a bit leery of and respond when a patient recounts such a profound communicating the details of what happened. experience. “Some people think you’re crazy,” said Johnson, the Over her decades-long career, most spent in intensive near-drowning victim. “Almost immediately you develop a care units or other critical care settings, James has met sense of who you can talk to about it and who you can’t.” and listened to dozens—if not hundreds—of near-death And if a near-death experiencer is afraid to tell experiencers, or NDErs. All the stories are different, but his story or it’s casually dismissed, the person feels there are many common threads. rejected, becomes more isolated, more apt to question the Johnson’s story begins when he was kayaking with a experience, and more prone to have self-doubts and fears. friend on a swollen river. He was suddenly sucked into a They may keep the experience bottled up inside for years. pipe underneath a lowJames, who teaches a water crossing. Under variety of courses at the water, he fought to pull Health Science Center, himself out but couldn’t. introduces near-death He was drowning, and experiences and the proper soon lost consciousness. response from health care Still, he said, “I felt like providers whenever she can: I knew where I was at, and while talking about anything I was in a good place. And I from end-of-life or palliative thought, I haven’t been that care and hospice to patients great a person, but I felt coming out of resuscitation. like I was in heaven, in the “As nurses,” James presence of God.” said, “we should listen He sensed “a multitude” without judgment. You –Pat Johnson, a near-death experiencer of souls around him. can tell the difference “I didn’t see them but I between someone who is felt a part of them. I knew they were there.” confused and really struggling and someone who’s had a And then there was light, “like looking into a near-death experience.” kaleidoscope,” Johnson said. “I wanted to get to the light, More and more health care professionals are go to the light.” He was at peace, surrounded by love. “It responding positively, James said. So are students. was beautiful. If I had stayed there, I would’ve been fine Brittany Jasso, a nursing student who will graduate in with it.” May, said nurses should always be open to what near-death But somehow the current swept Johnson through the experiencers are saying. pipe and deposited him downstream, where his friend “You should ask them to tell you more, like, what pulled him to safety and resuscitated him. did you see, what did you feel,” she said. “I’m not there to As with Johnson’s experience, a common thread is minimize their feelings. I’m not there to judge them.” the bright light at the end of a tunnel or hallway, and an Despite the skepticism of his doctor, Johnson continues extraordinary sense of love and serenity. to be enthusiastic about sharing his story, meeting others “This is not any laughing matter,” James said. “This is with similar experiences and seeking a deeper meaning as not one of those things that people dream up. This is not a he gets on with life. And he thinks health care providers dream.” are crucial, especially in the beginning, in that search for Years ago, James said, a patient in ICU became irate meaning. after he was resuscitated. After all, he said, “a near-death experience is more “He said, ‘I can’t believe you people made me come about living than it is about dying.” back.’ And everybody is like, ‘We did our job. He must be confused.’” The International Association of Near-Death Studies local It’s not unusual, she said, for health care professionals support group meets at 2 p.m. on the first Sunday of each month and others to consider NDErs to simply be confused, in the Health Science Center’s School of Nursing, Room 1.230. The address is 7703 Floyd Curl Drive, San Antonio, 78229. disoriented or trying to get attention. Parking is free. “What happens many times is those patients get medicated,” James continued. “Health care providers will

A near-death experience is more about living than it is about dying.”

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for Health By Will Sansom and Lety Laurel Photo by Noell Vidaurri

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San Antonio and South Texas have one of the largest concentrations of active-duty military personnel and veterans in the U.S., with estimates totaling 159,000 in Bexar County alone. Veterans comprise 8.73 percent of the city’s total population. —Bexar County Veterans Service Office, U.S. Census Bureau

hey were medical specialists and transport pilots in some of the world’s most hostile regions. They defended the nation in the cyber realm, and faced their own mortality multiple times a day as explosions erupted around them. Today their service is of a different kind. They are in hospital rooms and clinics, classrooms and research labs. They are among the hundreds of students who seek careers in health professions after years of military service. They are the 64 students currently attending classes at the Health Science Center while on active-duty military scholarships, and the 433 faculty and staff members who also carry the distinction of being military veterans. “We are fortunate to have many heroes at the Health Science Center. They bring a maturity and unique perspective to their work, having served in developing nations and combat environments,” said retired Air Force Maj. Gen. Byron C. Hepburn, M.D., director of the Military Health Institute, created in 2014 to strengthen partnerships with the military. Dr. Hepburn’s own military career spanned 38 years. “What we are doing here at the Health Science Center is worthy work and in true service to our fellow man. There’s no greater professional satisfaction than that. No matter what we’re doing at the university, we’re all contributing to that mission.” Here are some of their stories.

Rudy Gomez served six years as a Navy corpsman, an enlisted medical specialist attached to a U.S. Marines infantry unit, before being wounded in Habbaniyah, Iraq. He was medically discharged in 2008.

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“This is all I’ve studied for since Day One. It’s a dream that I’ve made it.”

Rudy Gomez

STUDENT, PHYSICIAN ASSISTANT STUDIES, SCHOOL OF HEALTH PROFESSIONS

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Photo by Joel Spring

udy Gomez suspects it was a high-powered assault rifle that fired the shots. He was in Habbaniyah, Iraq, serving as a Navy corpsman, an enlisted medical specialist attached to a U.S. Marines infantry unit. “The round went completely through my thigh, severed my sciatic nerve and partially affected nerves in my calf,” he said. “It paralyzed part of the calf and I lost about 90 percent of the mobility in my foot.” The year was 2008, and after six years in the Navy, Gomez was medically discharged at Camp Lejeune, N.C. “While I was being discharged, I was surrounded by military medical personnel, many of whom were giving me career options,” he said. “I knew then that I wanted to become a physician assistant.” During his service in Iraq, Gomez went on Humvee and foot patrols with Marines doing security checks. Their health and welfare was largely his responsibility—as the unit’s medic, he was the one who would work to keep the Marines alive if casualties occurred. “I worked as their doc. They call you doctor and they expect you to know everything,” he said. “They expected a lot because I was the only medical guy out there with them.” His own injury gave him even greater perspective on the role of a health care provider. “Prior to my service in the military, I did not have the patient perspective,” he said. “In my early service, I assisted those who helped patients. But when I was injured, I saw up close and personal that all providers are different. Some are incredible and outstanding, and unfortunately some are not. “I got the chance to learn what kind of provider I want to be—the kind who builds trusting relationships with patients.”

Robert De Lorenzo, M.D. PROFESSOR AND RESEARCH DIRECTOR, DEPARTMENT OF EMERGENCY MEDICINE, SCHOOL OF MEDICINE

or Robert De Lorenzo, M.D., working in the leading combat support hospital during the war in Iraq was a lot like living through episodes of M*A*S*H. Working 12-hour shifts usually seven days a week, Dr. De Lorenzo and his colleagues went through calm times when soldiers and civilians weren’t getting hurt, but then frenetic times when the workload surged. “If you watch old reruns of M*A*S*H, there were boring times in their tents and other times when casualties kept coming into the hospital. That’s not far from the truth,” he said. Dr. De Lorenzo, professor and research director of the Department of Emergency Medicine, joined the Army in 1994. He followed his father, grandfather and uncles who had all completed stints in the service. He served tours of duty in Iraq in 2005-06, and 2010, and was assigned to the 10th Combat Support Hospital in Baghdad, the busiest trauma center in the world at the time. “While it was professionally rewarding to lead a team and use the skills of a physician to try and save lives, it was an incredibly sobering experience at the same time,” he said. “Day in and day out we saw shattered young bodies. Many

were U.S. soldiers, but of course others were Iraqi soldiers and citizens, even children.” Veterans, particularly those who have seen combat, provide a unique perspective on the world and clinical care that is particularly useful for a medical student, he said. “As medical providers, both international law and the mores and ethics of medicine demand that we give the same care to everyone,” he said. “The military medical veterans are proud of having accomplished that.” Dr. De Lorenzo’s research interest is shaped by his wartime experience. While in Iraq, he treated numerous trauma patients with injuries to their airways. “The airway remains an important gap area in care,” he said. “There haven’t been many significant innovations or advances in airway management, and our soldiers and the public need better tools in that area.”

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Nicolas Walsh, M.D. DEPARTMENT OF REHABILITATION MEDICINE, SCHOOL OF MEDICINE

embers of the Navy’s Sea, Air and Land teams—better known as SEALs—are almost mythical beings. They are able to thrive in situations where others could barely function. They are the group the U.S. military calls in when the margin for error is nonexistent. So it is perhaps no surprise that the final leg of their training has become popularly known as “Hell Week.” “You’re wet and awake for an entire week,” explained Nicolas Walsh, M.D. “You’re basically always in frigid water, and asked to perform at peak levels without fail. Almost everyone who is going to quit, drops out that week.” By the end of Hell Week, almost 75 percent of each class of candidates has withdrawn. “We started with 217 individuals, all fully able to complete this training,” Dr. Walsh recalled. “Only 56 finished.” Dr. Walsh was one of the 56. He served two tours in Vietnam, from 1970 to 1972, as a part of SEAL Team One, and became highly decorated for his service. Dr. Walsh earned two Silver Stars for heroism and a pair of Bronze Stars—among many other commendations.

Navy SEALs in Vietnam packed light, carrying only ammunition and essential weaponry as they became ghosts, working as strike forces to gather—and act upon—intelligence. Out of necessity, SEALs learn to critically analyze and decisively respond to ever-changing environments and situations. This requires one to think outside the box and adapt, before taking appropriate action. That training has served Dr. Walsh well throughout his career as professor and chairman of the Department of Rehabilitation Medicine for 26 years. “SEAL training is one of the hardest challenges one can face both physically and mentally,” Dr. Walsh said. “But not everyone is a SEAL. So the experience is, essentially, no different than one faced by somebody else going through the most difficult trial of their own life. It’s very easy for me to have a great deal of empathy for our patients, whether they’re enduring a spinal cord injury, traumatic brain injury, a stroke or any other kind of physical challenge. Fortunately, we’re able to help a great many people.”

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Roger Weed, D.D.S. DEPARTMENT OF COMPREHENSIVE DENTISTRY, SCHOOL OF DENTISTRY

oger Weed, D.D.S., FACD, flew about 1,000 injured soldiers to safety during the Vietnam War as a dustoff pilot, but on one jungle landing, bullets flying through his helicopter turned him into the patient. “We were going into an area where we always got shot at—a very hostile area close to North Vietnam,” said Dr. Weed, now an associate professor of comprehensive dentistry. “Politically, it was a remote part of the country. The shooters probably didn’t know who we were. They just knew they didn’t want us there.” The chopper landed, and the patient was loaded for transport. Then the shooting began. “Probably 30 rounds went into the back of the helicopter and the back of my seat and me,” Dr. Weed recalled. “Nobody else was hit and when I looked at the sleeve of my fatigues, there were bullet holes in it. I couldn’t move my left arm.” The radial nerve that controls the triceps was severed. “Army medicine put it back together,” Dr. Weed said. “In 1967, microsurgery was rare but a neurosurgeon at Brooke Army Medical Center did the microsurgical reattachment.” It took three surgeries and about a year of therapy for him to return to the field. By 1968, he was again overseas, this time in Korea, where the spy ship U.S.S. Pueblo had been captured by the North Koreans. Now a captain, he assisted with returning the officers and crew to the U.S.

Dr. Weed left active duty in 1969 to attend dental school, but served in the Army Reserves for 34 more years, retiring as a dental corps colonel in 2003. “Overall, I’ve been able to do two careers at once, both dentistry and the military,” he said. Dr. Weed’s military experiences strongly shape his approach to dentistry. “Just as a pilot must have a mission, an objective and route to get there, a dentist must also be well organized and have plans for how things are supposed to be done,” he said. “My flight training has probably been as beneficial as anything.”

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STUDENT, SCHOOL OF NURSING

herita Johnson didn’t think she’d ever want to be a nurse. From her mother’s own experience in the field, she knew it was a difficult job. But while serving in the Air Force, she had a chance to experience nursing firsthand, and it changed her life. “In Afghanistan, I was able to assist with a few things during an attack, and that memory became my driver to get my degree in nursing,” she said. Johnson, an active-duty servicewoman and undergraduate student, has protected network security at U.S. Air Force installations from South Korea to Afghanistan to Germany for most of her 17 years of service. But whenever she could, she volunteered in hospitals and found her true passion. “Caring for someone who can’t necessarily care for

themselves, and being a voice for someone who can’t speak for themselves, advocating for the best possible care for them, was rewarding,” she said. After completing her nursing degree in May, Johnson would like to work in flight or medical evacuation nursing for the Air Force and reach 25 years of service. After she retires from the military, she’d like to open a palliative hospice care management service. “I enjoy the intensity of what I believe those areas of nursing will bring,” she said. “I think I work well under pressure, and I bring leadership and management skills from my years in the military. “I am proud to serve every day, and proud that I can protect people’s families.”

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Photo by Lester Rosebrock

Cherita Johnson

, Mara O Sullivan STUDENT, SCHOOL OF MEDICINE

ara O’Sullivan grew up hearing stories of children playing around landmines—a harsh contrast to her own cheerful sandbox. Her father, an Army officer, and her mother were certified nurse anesthetists and moved their family around the world. “My father came back with stories such as surgery on a person who had stepped on a landmine in Kosovo,” O’Sullivan said. “At 8 or 9 years of age, I was thinking about global engagements, knowing things other children never consider.” Her parents instilled in her the ethical responsibility of health care providers to serve all of humanity, regardless of dividing lines. O’Sullivan, a 2014 graduate of the U.S. Air Force Academy, will serve a minimum of nine years after graduating medical school in 2018 and completing her residency. “The reason I decided to become a military doctor is you get a chance to serve people in combat, and also their families,” she said. She also seeks exposure to the broadest range of military medical experiences, from running a clinic or hospital at a new duty station to setting up a temporary hospital while on deployment. “When you deploy for military medicine especially, you treat anybody who comes through your doors,” she said. “If they’re locals, insurgents or children who just happen to be nearby, you treat them as you treat our own. “We use the same resources on everybody regardless of nationality or sides of the political war. Your service is to be a doctor and an officer, but you don’t need to hold a gun to do that. I don’t need to compromise my ethics to do that.”

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O Families, communities battle stigma of mental illness in children

of the dark

By Lety Laurel Photo illustration by Jennifer Bernu-Bittle

Lisa Sanchez’s darkest days, she hid her family behind closed window blinds. She avoided friends and family. She was embarrassed by the mental illness that caused her preteen son to uncontrollably shout out obscenities. Embarrassed when that son was treated poorly at grocery stores, church and school. She was embarrassed that she didn’t know that bipolar disorder ravaged her daughter, leading to alcohol and drug abuse when the girl was in middle school. That the same daughter, her oldest, the one she always called “the strong one,” would wake up from a drunken stupor on the side of the road, so drunk she couldn’t

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1in5

children

in the U.S. has a mental illness, though many remain undiagnosed.

get home. She was embarrassed that she never knew that daughter had a plan to kill herself until it was almost too late. She’s not embarrassed anymore. When Lisa talks of her three children, all of whom battled decades of mental illness, she cries, the pinwheel medallion that she wears around her neck catching the sun as she wipes away her tears. “I’m happy. It’s a happy sadness that we made it,” she clarifies quickly. They’re tears of relief. And pride. “I’m blessed. God has blessed me with three children with mental illness. And we made it,” she said. “There’s light now.”

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“

There has always been a shortage of child psychiatrists.” Photo by Noell Vidaurri

–Brigitte Bailey, M.D.

Jacob Sanchez was just 4 years and crying. It seemed endless, and for old when his mother first noticed Jacob’s two sisters, it was unbearable. something was different about him. One sister turned to drugs and He made it through four days of alcohol. The other began displaying pre-kinder before she got the call signs of obsessive compulsive saying he wasn’t ready for school. He behavior in elementary school. screamed continuously. He needed to “I was so overwhelmed with Jacob be carried by a staff member all day that I never picked up on it,” their long. He was disruptive. mother said. “‘Dear God,’ I remember Once he began staying with his thinking, ‘How did it get to this?’” of all lifetime cases of grandmother, Lisa began noticing mental illness other things. The constant throat A nation in crisis clearing. The repetitive motions that They call it a crisis. San Antonio, started at his face: first touching one along with the rest of the country, is cheek, then the other, before going facing an epidemic. to his chin. Beginning again. Increasing in frequency and Across the country, one in five children has a mental speed as he grew agitated, nervous or excited. Then the illness. In Bexar County, that translates to 80,000 kids who barking began. Spitting. Whistling. Shouting. are struggling with behavioral, emotional or mental illness. Jacob was diagnosed with Tourette Syndrome, a Lisa had three in her small family. She never saw it neurological disorder characterized by motor and vocal coming. There was no family history of mental illness, no tics, sometimes obscenities. Then came the potentially substance abuse problems. She, like many parents, was crippling triad that so often develops with Tourette: unaware of the prevalence of mental illness in children. obsessive compulsive disorder, anxiety and depression. “If one in five kids in Bexar County had leukemia By the time he was in middle school, he had been or some kind of cancer, we’d be having bake sales, and admitted to Clarity Child Guidance Center for emergency doctors and researchers would be working diligently to find inpatient care twice, and had two intensive partial cures,” she said. “But we have one in five kids who could admissions. After two failed attempts at high school, he was potentially end up suicidal or in jail or dropping out of withdrawn and homeschooled. school or using drugs and alcohol, but the concern is not Those years were marked by constant fits of screaming there.

1in2

begins by age 14.

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ecoming a child and adolescent psychiatrist isn’t fast and it isn’t easy. Following medical school is a grueling five-year residency program, with three years spent in adult psychiatry and a two-year child and adolescent psychiatry fellowship. That’s the same number of years required to become a general surgeon, said Brigitte Bailey, M.D., training director of child and adolescent psychiatry.

medicine because you’re going to spend long hours and you’re going to invest a lot to do it,” Dr. Bailey said. “We need that idealistic spirit to come into this because we want to work with families and do good work.” The average wait time for a child to see a psychiatrist in the city is more than three months. Community assessments estimate San Antonio is 45 beds short on any given day.

“Not only do we train them, but because we’re in the community, that commitment continues long after they leave here,” said Rene Olvera, M.D., M.P.H., division chief of child and adolescent psychiatry at the Health Science Center and outpatient medical director of Clarity Child Guidance Center. In April, Clarity opened an outpatient therapy facility that now houses the Health Science Center’s child and adolescent psychiatry program.

“There has always been a shortage of child psychiatrists,” said Dr. Bailey. “It’s a lengthy road.”

Still, the city is better off than other areas of the country, said Dr. Bailey.

Dr. Olvera estimates that 90 percent of Clarity’s staff was trained at the Health Science Center.

Once they’re out of school, they face other challenges: Insurance reimbursement rates are notoriously low. Unless you work in private practice, it isn’t lucrative. And it’s a lot of work.

“Our program here has an overwhelming impact,” she said. “We’re quiet, but we’re everywhere. And our trainees are everywhere in San Antonio.”

“It’s a dual function while they’re here, as our fellows are learning while providing patient care,” he said. “The beauty is that the payoff to the community goes on for decades.”

“You need to wake up loving your field of

Those trainees tend to stay in the area after residency, helping keep the psychiatrist-to-child ratio lower.

“There is a stigma about “What we’ve tried to do is create an mental illness, and that has led to a environment that allows our residents lack of resources.” to see a full breadth of child psychiatry. Nationally, there’s a “severe And at the same time, we’re filling that shortage” of practicing child and gap for our community,” Dr. Olvera said. adolescent psychiatrists, according Mental illness can start as early to the American Academy of Child as when a toddler takes its first steps. and Adolescent Psychiatry. In The most common illnesses are Texas, there are eight psychiatrists attention deficit hyperactivity disorder, for every 100,000 children. depression, bipolar disorder and anxiety. “There is a huge need,” said Suicide is the second leading cause of Rene Olvera, M.D., M.P.H., division for 10- to 24-year-old youth death in children in Texas, and the third chief of child and adolescent nationwide. nationwide. psychiatry at the Health Science “I think society forgets or they don’t Center and outpatient medical like to think about the fact that kids do director of Clarity Child Guidance Center, where the kill themselves,” said Brigitte Bailey, M.D., training director university’s child and adolescent psychiatry program is of child and adolescent psychiatry. housed. But every appointment is an opportunity to save a life, About 5 percent of medical students nationwide said William Lee, M.D., a child and adolescent psychiatry continue fellowships in child psychiatry. At the university, fellow at the Health Science Center. In medical school, he that number hovers around 4 percent, with the program decided to change his specialty from pediatrics to child capped to allow four fellows a year. psychiatry when he realized his favorite part of a patient Before they leave medical residency, child and appointment was asking how that patient was doing, how adolescent psychiatry fellows spend months in mandatory school was going, how things were at home—the questions rotations at Clarity, as well as the San Antonio State Hospital, that a physician doesn’t have much time to explore, but that Bexar County Juvenile Detention Center and the Cyndi Taylor he felt were the most critical. Krier Juvenile Correctional Treatment Center. They also train “To hear a child articulate their problems to you and at area schools, an emergency shelter and neurology clinic, what they are struggling with, I think that is a very powerful and offer pediatric consultations for University Health System. moment,” he said. “When we think about childhood, it’s

Suicide is the

leading cause of death

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The story of the pinwheel Often tied to images of childhood fun and innocence, the pinwheel is a prominent symbol at Clarity Child Guidance Center, the region’s only nonprofit provider of mental health care exclusively for children. For Clarity patients, it serves as a reminder that it is possible for them to turn their luck around. For families, it symbolizes hope and healing, even in the face of seemingly insurmountable challenges. Lisa Sanchez wears a sterling silver pendant of a pinwheel on a necklace for this purpose. If you have a child who needs mental health care, call (210) 616-0300.

Jacob

Hollie

Allie

Hollie Sanchez, Jacob Sanchez and Allie Sanchez battled years of mental illness. Through psychiatric intervention, they now manage their illnesses.

all the innocence, the fun, the play. If they cry, we think we can give them some ice cream and they’ll feel better. But that’s not always the case. And to be able to have someone sit across from you and tell you that they’re really struggling, they can be 8 or 9 years old, but their problems are real. That’s a real moment.” It’s not sad, he said, though the circumstances that bring a child to the point of needing help often are. “What I feel is hope,” he said. “When a child comes to you for help, you have the opportunity to make a difference for the rest of their lives. You have the chance to change their trajectory. That is something that is both a very powerful responsibility and an important responsibility.” Lisa spent years visiting different neurologists, running every kind of medical test to determine the cause of Jacob’s muscle and vocal spasms. She didn’t feel hope until she arrived at Clarity. Like the name promises, a sense of clarity overcame her, she said. “We shouldn’t be so stigmatized and so worried about what people are going to think and get the help our children need,” she said. “Just like you worry about your child getting the flu or meningitis, worry about your child having mental health issues. And don’t be afraid to question doctors if you feel something is wrong with your child and no one is listening. Because no one knows better than you. “I waited too long.” It wasn’t that Lisa didn’t know there was a problem— she was working so hard to fix it herself. She thought if she was a better parent, the problems would go away. “I just didn’t think I was doing it right,” she said. The night Jacob was admitted to Clarity was the first night in years that Lisa got a full night’s sleep. She was at peace.

With new eyes Lisa’s home is a different place these days. It’s been a decade since her darkest days of hiding. Mental illness doesn’t go away, but it can be managed. Jacob, now 22, still spits. He still barks and has other noticeable motor tics. But he also has a full-time job at a local hospital as a transport tech in the emergency room. He goes to movie theaters again, something he stopped doing at the height of his illness. Years of psychotherapy, behavioral interventions, medications and electroconvulsive therapy got him this far. Through psychiatric care, his oldest sister learned how to manage her bipolar disorder. She no longer selfmedicates with drugs and alcohol. She now travels around the world on mission trips and hopes to someday join the Peace Corps. She’s 24. Their younger sister is 19, and has devoted her life to helping fellow students with special needs. Her hope is to become a psychiatric nurse practitioner. They’ve all been touched by mental illness, their futures shaped by it. Jacob says he’s blessed with it. Just before the Easter holiday, Lisa saw her family with new eyes. Her daughters were home for the holiday. Jacob had taken time off from work. They all sat together on the oversized sectional in their living room, the evening light filtering through their open window blinds. There was laughter as they swapped stories. And she thought, it’s taken us a long time to get here, but finally we have arrived.

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Alumni Profile

A second calling By Kate Hunger

fter losing both of his legs above the knee in an IED blast during his deployment to Afghanistan in 2005, U.S. Army Special Forces medic Roland Paquette received a Purple Heart, underwent rehabilitation and took a government job. But the same desire to serve that drew Paquette to join the military after 9/11 is what pulled him back to patient care. He enrolled at the Health Science Center and earned his master of physician assistant studies degree in 2012. Paquette is now a physician assistant in the Department of Emergency Medicine at the Health Science Center and adjunct faculty in the Department of Physician Assistant Studies. “I had felt that kind of bug before where I just needed to go do something,” he said. “I was feeling the same thing about getting back to patient care and doing medicine.” Paquette, 37, said his own experience shapes the care he gives patients, but he is careful to keep the focus on them.

After Roland Paquette ’12 was injured while serving as a medic in Afghanistan in 2005, he enrolled at the Health Science Center and earned his master of physician assistant studies. He is a physician assistant and adjunct faculty member at the university.

“At least once a day on a shift, when I see a patient who is experiencing pain or has experienced an injury or whose family seems more stressed out than others, I think I can empathize with that,” Paquette said. His experience allows him to foster trust with patients that can be tough to build when medical professionals are sometimes viewed as adversaries. “I’m not just somebody in a white coat on the other side of things,” Paquette said. If people ask about his prosthetics, Paquette will share his story, when appropriate. “What I don’t want to do is make someone feel like I’m minimizing what they are going through,” he said. Sometimes patients or their families with whom he hasn’t shared any of his background will ask if he injured his back—something he takes as a compliment. “I take it as a sign of success,” he said. “I don’t have any legs and this person thinks I may have hurt my back.” His experience in physical and occupational rehabilitation enables him to give patients a sense of what to expect in their own journey. It is hard to accept limits on physical ability, and there are low points along the way, he said. What made a difference for him was having clear goals for his rehabilitation. He urges patients to focus on the “why” of recovery. “It is hard, painful and very frustrating,” he said. “If you can, put it into a better context: Why is it you want to rehab? Why do you want this wound to get better? Why do you want to get more mobile?” Aside from his clinical work, the father of three also trains first responders through a company he started last year. He also mentors soldiers through the nonprofit Green Beret Foundation, which his wife, Jennifer, heads as executive director. Recently, he served as the principal investigator on a study comparing the effectiveness of tourniquets to hemorrhaging clamps in massive extremity hemorrhages. “I feel really satisfied with what I’m doing,” Paquette said. “I think you just keep swimming upstream and that’s what I’m doing. You just keep trying to work with what you’ve got.” Spring/Summer 2016 | UTHSCSA.EDU/MISSION | 29

Accolades

Primary Care Physician Nurses & Nurse Educators Physical Therapist

Physician Specialist

Awards

Pharmacist

You Occupational Psychologist Therapist

It’s all about you UT Medicine San Antonio received national praise for its approach to health care. The clinical practice of the School of Medicine received Patient-Centered Medical Home recognition from the National Committee for Quality Assurance. In a patient-centered medical home model, the patient is served by a primary care physician and health care team that takes a holistic approach to care, taking into account the patient’s family and job situation, health history and spiritual needs. The team may include physician specialists, nurses, physical therapists, nurse educators, pharmacists, psychologists and occupational therapists. The recognition was earned for using evidence-based, patient-centered processes that focus on highly coordinated care and long-term, proactive relationships. “This recognition is an important milestone that reflects on the quality of the care we deliver to our patients,” said Carlos Roberto Jaén, M.D., Ph.D., professor and chairman of the Department of Family and Community Medicine and interim director of the UT Medicine Primary Care Center. “This is not a finished product. We will continue to work on improving our care of our patient population. This national recognition fuels our efforts to lead primary care in our community and among the families we serve.” The NCQA is a private, nonprofit organization dedicated to improving health care quality.

EDWARD ELLIS, D.D.S., received

the first American Association of Oral and Maxillofacial Surgeons Clinical Research Award for Fellows and Members. The award recognizes leaders in the specialty who are researching new and innovative diagnostic and therapeutic interventions that will advance clinical practice.

CRAIG MANIFOLD, D.O., clinical

assistant professor in the Department of Emergency Medicine, received the Michael Copass Leadership Award from the Major Metropolitan Medical Directors for his efforts in leading emergency management services nationwide.

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On the quest to eradicate cancer The Cancer Prevention and Research Institute of Texas awarded five new grants totaling $5.7 million to fund research and prevention programs. The projects are conducted in the Health Science Center’s Cancer Therapy & Research Center, Greehey Children’s Cancer Research Institute and Institute for Health Promotion Research. Peter Dube, Ph.D., associate professor of microbiology and immunology in the School of Medicine, will receive $859,620 to study aspects of immunity in colorectal cancer. The title of his project is “Integrin-Mediated IL-18 Signaling in the Prevention and Treatment of Inflammation-Associated Colorectal Cancer.” Yuzuru Shiio, M.D., Ph.D., associate professor of biochemistry, is receiving $1.2 million for a research project to study a type of cancer, Ewing Sarcoma, which usually is diagnosed in children and adolescents ages 10 to 20. His project is “Cytokine Signaling in Ewing Sarcoma.” Michael Wargovich, Ph.D., professor of molecular medicine who holds the CTRC Council Distinguished Chair in Oncology, will receive $899,619 for his prevention and early detection research program. The study is titled “Chemoprevention of Colon Cancer by Anti-Inflammatory Blockade Using Neem.” Neem is a botanical herb. Deborah Parra-Medina, Ph.D., M.P.H., professor of epidemiology and biostatistics, will receive $1.2 million in the category of evidence-based cancer prevention services. Her program is titled “Using Best Practices to Promote HPV Vaccination in Rural Primary Care Settings.” Gail Tomlinson, M.D., Ph.D., professor and chief of the Division of Pediatric Hematology/ Oncology, is receiving a $1.5 million competitive continuation grant for “GRACIAS Texas: Genetic Risk Assessment for Cancer in All South Texas.”

Accolades

TOP

20 A paper published by Sunil K. Ahuja, M.D., was ranked as one of the top 20 scientific advances made by National Institute of Allergy and Infectious Diseases-funded researchers in 2015. The paper demonstrates the immunehealth benefits of early HIV treatment.

Getting Realce Over the next five years, more than $2.5 million will be given to the School of Nursing to improve first-time pass rates on a nursing licensure exam and faculty instruction. The U.S. Department of Education funding began in October and supports the Realce: Academic Skills Enhancement for South Texas Nurses project through the school’s newly created Student Success Center. The school educates and graduates a racially and ethnically diverse group of students and Hispanic enrollment numbers continue to increase, with a 169 percent increase in the accelerated track between 2012 and 2015. The school also is one of the largest educators of male nurses. To address the increasingly diverse student body, Realce will develop and improve academic support programs. It also will provide tailored faculty development activities, and a new summer undergraduate research program that will connect Hispanic, first-generation, low-income and at-risk students with faculty engaged in groundbreaking research in nursing. “These funds allow our Student Success Center to deliver narrowly tailored support programs that address academic issues commonly faced by our diverse undergraduate learners, and improves faculty-student engagement in the school through undergraduate research and faculty development initiatives,” said David A. Byrd, Ph.D., associate dean for admissions and student services in the School of Nursing. “In the end, this grant enhances the student learning experience and ultimately improves the School of Nursing to better prepare nurse leaders who will help address the health care needs of our South Texas community.”

Expanding networks to shrink waistlines MICHAEL MILLS, D.M.D., M.S., received the American Academy of Periodontology Outstanding Periodontal Educator Award. Dr. Mills is a clinical associate professor with teaching responsibilities in the postdoctoral division of the Department of Periodontics in the School of Dentistry.

Salud America! has received a one-year, $1.3 million grant from the Robert Wood Johnson Foundation to develop new, culturally tailored educational content to promote and support the health of Latino children. Salud America!, which was established in 2007 with funding from the foundation, is a project of the Health Science Center’s Institute for Health Promotion Research. It has recruited a national online network of 50,000 parents, school personnel, health professionals and community leaders who support its mission to reduce obesity among Latino children. The new funding will allow Salud America! to expand its network and engage members with enhanced educational content including multimedia role model stories, social media events, online resources, digital action campaigns and marketing. “We are excited by RWJF’s support, which will help us continue to push the boundaries of communication to empower Latinos to develop healthy changes in their schools and communities,” said Amelie G. Ramirez, Dr.P.H., director of Salud America!. More than 38 percent of Latino children ages 2 to 19 are overweight or obese, compared to 28.5 percent of white youth and 35.2 percent of black youth. Latino children also face barriers in access to healthy foods and drinks and physical activity, especially among those ages 0 to 5.

1in3

BASIL A. PRUITT JR., M.D., FACS, a

clinical professor and burn surgeon, received the Lifetime Achievement Award from AMSUS, the Society of Federal Health Professionals.

children and teens ages 2 to 19 are considered overweight or obese

2 out of 3

children don't get any daily physical activity

96%

of elementary schools don't offer daily, year-round physical education

7 hours

is the amount of time kids spend in front of TV or computer screens daily

source: federal government reports

Spring/Summer 2016 | UTHSCSA.EDU/MISSION | 31

Accolades

JANIE CANTYMITCHELL, PH.D.,

has been named chair of the Healthcare Diversity Council board of directors. Dr. Canty-Mitchell serves as professor and chair of the Department of Family and Community Health Systems and interim chair of the Department of Health Restoration and Care Systems Management in the School of Nursing.

Philanthropy

LUCI K. LEYKUM, M.D., professor of

medicine, was named chief of the newly created Division of General and Hospital Medicine. Dr. Leykum was associate dean for clinical affairs since 2010, and has been division chief of hospital medicine since 2008. In her new position, she will work with the 60 faculty from the combined divisions to support and build on their educational, clinical and research endeavors.

DAVID SENN, D.D.S., clinical

assistant professor of comprehensive dentistry, was named president of the American Society of Forensic Odontology. Dr. Senn is the director of the Center for Education and Research in Forensics, director of postdoctoral fellowship in forensic odontology, director of the Southwest Symposium on Forensic Dentistry, and chief forensic odontologist for the Bexar County Medical Examiner’s Office.

DEBORAH L. CONWAY, M.D.,

has been appointed interim chair of the Department of Obstetrics and Gynecology. She currently is associate dean for curriculum in the Office of Undergraduate Medical Education. Dr. Conway is a Fellow of the American College of Obstetrics & Gynecology and is board certified in obstetrics and gynecology and maternal-fetal medicine. Her clinical and research area of focus is diabetes in pregnancy.

W. BRIAN REEVES, M.D.,

was named chair of the Department of Medicine in the School of Medicine. Dr. Reeves is a former professor and vice chair of medicine and chief of the Division of Nephrology at Penn State College of Medicine.

Ann and Glenn Biggs

DAVID WEISS, PH.D., was named

a University of Texas System Chancellor’s Health Fellow in Graduate Education. The program was established in 2004 to recognize high-impact work at individual health institutions that are aligned with the overarching mission of the UT System and have potential for broad societal impact on health care education and research.

32 | MISSION | The University of Texas Health Science Center at San Antonio

were married almost 60 years when he died as a result of Alzheimer’s disease. Biggs, the founding development board chairman of the Health Science Center, was the inspiration behind the university’s quest to develop a comprehensive care center for patients with Alzheimer’s and other neurodegenerative diseases, and their families. After his death in 2015, university officials announced they would name the institute in honor of Biggs. To learn more about the Biggs Institute for Alzheimer and Neurodegenerative Diseases, go to makelivesbetter.uthscsa.edu/biggs.

Building a strong foundation Momentum continues for Alzheimer’s disease institute By Will Sansom

With several million dollars in new gifts, momentum continues to grow for the Biggs Institute for Alzheimer and Neurodegenerative Diseases launched in September. “This has been an effort our community has supported in an unprecedented way,” said Health Science Center President William L. Henrich, M.D., MACP. Recent gifts include $3 million from the Greehey Family Foundation, $2 million from the Valero Energy Foundation, $1 million from the Kronkosky Charitable Foundation and $1 million from the Baptist Health Foundation of San Antonio, along with $1 million from the J.M.R. Barker Foundation that is an accelerated payment toward a $5 million pledge for the institute. He also announced a $1 million gift for Alzheimer’s disease research and patient care from an anonymous donor. The Greehey Foundation gift will further cutting-edge research into the causes of and treatment for Alzheimer’s disease. The Valero Foundation gift supports care for patients with Alzheimer’s and other neurodegenerative diseases, and provides important services for caregivers. The Kronkosky Foundation funding is for facilities and equipment and will establish a biorepository of tissue and blood specimens that is of critical importance to clinical trials. The Baptist Health Foundation gift endows a distinguished chair for the institute. The Barker Foundation gift is for recruitment of the new institute director that is now underway, Dr. Henrich said. Total giving for the institute has grown to more than $24 million for endowments and more than $17 million from other gifts and support that will advance the institute and its faculty and programs. “The Biggs Institute will provide early diagnosis and then coordinated patient- and family-centered care for individuals with Alzheimer’s disease, other dementias and other neurodegenerative

diseases through all disease stages,” said Francisco González-Scarano, M.D., dean of the School of Medicine and executive vice president for medical affairs at the Health Science Center. Dr. González, a neurologist, said the institute will lead basic, translational and clinical research studies, including clinical trials that benefit patients both immediately and in the future. Educating the next generation of clinicians, scientists and health professionals is another focus, because they will lead innovation in the treatment and prevention of neurodegenerative diseases. The institute honors the memory of Glenn Biggs, the San Antonio philanthropist who was the founding chairman of the Health Science Center Development Board. Mr. Biggs, who died last May, had a diagnosis of Alzheimer’s disease. “Glenn Biggs was the inspiration for our vision to establish the Institute for Alzheimer and Neurodegenerative Diseases, and we are committed to the promise we made to him and so many other families to see this vision achieved,” Dr. Henrich said. The Biggs Institute will initiate patient and caregiver support services and enhance public awareness and community engagement about the diseases. It will build on the work already underway at the Barshop Institute for Longevity and Aging Studies, the aging research center at the Health Science Center. Research of neurodegeneration is an emphasis of the Barshop Institute. “The community has invested in seeding a strong foundation that we have in the neurosciences,” Dr. Henrich said. “They have positioned us to be strategic in building a program that will support long term the tremendous need our community has for specialized care of the person with Alzheimer’s disease and other neurodegenerative disorders such as Parkinson’s and Huntington’s diseases.”

Spring/Summer 2016 | UTHSCSA.EDU/MISSION | 33

Philanthropy

Beyond w ords One cou ple’s c

ommitm educatio ent to n has ch anged co untless l ives By Joe Michael Feist

One by one, the students line up to write notes of gratitude to a couple who many haven’t met but who has made a profound impact on their lives. Many say that “words can’t describe” their feelings, but they try. They pen their notes, adding personal stories and details sprinkled with expressions such as “amazing,” “inspiring,” “generous.” They are messages for Joe R. and Teresa Lozano Long, and the occasion is the annual lunch for the Austin philanthropists who have changed the lives of countless Health Science Center students and, by extension, the thousands who have benefitted from the health care provided by those who have received and will receive scholarships from the Longs. The Longs have supported Health Science Center students through scholarships since 1999. In 2008, the couple made a gift of $25 million to establish the Joe R. and Teresa Long Scholarship Research and Teaching Fund endowment, which resides in the Office of the President. As of August 2015, the market value of the Long fund exceeded $28 million. Earnings from the fund were awarded in scholarships to 50 students in 2015-16, including medical, nursing, physician assistant and graduate students. In addition to scholarships, the Long fund also supports the creation of new chair endowments for faculty. So far, the fund has established the Long Distinguished Chair in Metabolic Biology, held by Yuguang (Roger) Shi, Ph.D. It also is building a new Long Distinguished Chair in Diabetes. It will create a new chair every few years, in perpetuity. The fund also supports investments in research. The Longs routinely receive countless thanks from their scholars, but the couple has a message for them too: “Being a health care provider is a rewarding profession,” Mr. Long said. “You’ve got your whole life ahead of you and when you finish, you’ll be glad you did it.” Travis Hayden, a first-year medical student and Long Scholar, remembers “being in a state of disbelief for almost a whole month after hearing the news” that he had been selected for a scholarship. He said the Longs have left a legacy that will live on for generations. “I hope the Longs are assured that their investment in

Austin philanthropists Joe R. and Teresa Lozano Long have supported Health Science Center students through scholarships since 1999.

our education has impacted students in a special way,” he added, “inspiring us to carry on the hard-working, selfless and empathetic values that embody their legacy.” Jill Heisler, a Long Scholar, is a student in the joint M.D./Ph.D. program. She finished the graduate studies portion of the program in 2014 with a Ph.D. in pharmacology/neuroscience and received her medical degree in May. “Thanks to various funding sources such as the Long scholarship fund, I am able to get through my eight years of medical and graduate training without an insurmountable amount of debt—without any debt, in fact,” Heisler said. “That is an incredible gift that I am truly grateful for.” The couple has a passion for education and the arts. He was a highly successful lawyer, having attended UT Austin School of Law, and was a banker; she was the first in her family to attend college and went on to earn her doctorate in education from UT Austin. Both come from workingclass backgrounds, and both are proponents of sacrifice and hard work. Health Science Center President William L. Henrich, M.D., MACP, addressed the couple at the April 15 appreciation lunch: “When the next chapters are written and the history of our UT Health Science Center San Antonio is chronicled, one chapter will certainly be devoted to you, Joe and Terry, for all that you have done to transform and enrich our university and the education of students in San Antonio and South Texas.”

34 | MISSION | The University of Texas Health Science Center at San Antonio

Philanthropy

Perfect partners

Professor and president join to fund cardiovascular disease endowment By Kate Hunger

Ed and Linda Whitacre

A gift of hope A $1 million gift from Ed and Linda Whitacre will support the pilot cancer therapeutic clinical trials program at the Cancer Therapy & Research Center (CTRC) as well as fund an education and awareness campaign to highlight the clinical trials and expertise available to patients battling cancer. Increasing the number of clinical trials for cancer patients in San Antonio and South Texas, and raising awareness among patients and physicians of new innovative therapies are among the central goals in the CTRC’s strategic plan. Ian M. Thompson Jr., M.D., director of the CTRC, said the gift is critically important for the CTRC to ensure delivery of the cancer center’s responsibilities to patients in San Antonio and South Texas as the region’s only National Cancer Institute-designated cancer center. “We are deeply grateful to Linda and Ed Whitacre for their generosity in helping us provide the most advanced new therapies for our patients and ensuring that every single patient in San Antonio and South Texas is aware of these unique opportunities,” he said. “Their gift will accelerate the development of new cancer cures through the work of our extensive teams of scientists and physicians, the same ones who treat our patients every single day at the CTRC.”

S. Adil Husain, M.D., and his wife, Rebecca Husain, have established an endowment to fund study and travel for cardiothoracic surgical fellows and pediatric residents. The Husain Family Educational Fund in Pediatric and Adult Cardiovascular Disease was funded by an initial $15,000 gift, with an additional $30,000 to be given over the next two years. Health Science Center President William L. Henrich, M.D., MACP, has designated matching funds S. Adil Husain, M.D., and his wife, Rebecca Husain, have established through community an endowment for cardiothoracic surgical fellows and pediatric gifts to the President’s residents. Council, bringing the and fosters their interest in the area of endowment’s value to $78,750. pediatric heart disease,” he said, adding “It’s a true partnership between that he values his relationships with my family, the university and the pediatricians and appreciates all the gifts community,” Dr. Husain said. “I’m very he has received in his own life, from the honored and humbled.” expertise and guidance of mentors, to The fund will pay for one cardiothe support of fellow trainees and family. thoracic surgical fellow each year to Dr. Husain joined the Health travel for one to two months to other Science Center in 2008. He is a institutions to learn novel techniques. professor within the departments of “We want to afford them the cardiothoracic surgery and pediatrics, opportunity to go to other institutions chief of the Division of Pediatric to learn some unique, surgical technical Cardiothoracic Surgery and holds skills, but we don’t want to burden them the William Randolph Hearst Chair with the financial costs of doing that,” in Congenital Heart Disease funded Dr. Husain said. by The Hearst Foundations, with a The fund will also cover the cost of matching gift from the Greehey Family sending one pediatric resident with an Foundation. Dr. Husain also is associate interest in pediatric heart disease each program director of the Department year to a national pediatric cardiology of Cardiothoracic Surgery Fellowship conference. Training Program and is surgeon-in“They are exposed to people who chief for pediatric services at University are leaders in the field and to a highly Health System. focused set of lectures over a short period of time. I think it fertilizes

Spring/Summer 2016 | UTHSCSA.EDU/MISSION | 35

Philanthropy

President’s COUNCIL

Since 1992, contributions to the President’s Council have provided more than $7.5 million to faculty and student programs. “The vision for our Health Science Center and each of its five schools is to ensure we rank among the elite academic health science centers in the nation,” said Health Science Center President William L. Henrich, M.D., MACP. “Contributions to our President’s Council have propelled our university to prominence in all of our missions of education, biomedical research, patient care and community service.” Gifts are invested in awarding scholarships to students, advancing groundbreaking research, supporting faculty, establishing endowments and more. Diane Solomon, M.D., and Ann Biggs President’s Council Members 2015

Lifetime $500,000+

The Ewing Halsell Foundation Greehey Family Foundation

$10,000+

Malú & Carlos Alvarez Katherine & Walter F. Brown Jr. Mr. & Mrs. James C. Browning Chartis Group Margie & Bill Klesse Lucifer Lighting Company/ Mr. Gilbert Mathews Mr. & Mrs. Harvey E. Najim Robert L. Oliver J. T. Vaughn Construction Company Mr. Mike Simpson Dee & Jack Willome Martha L. Wood, Ph.D.

$5,000+

Robert A. & Kathey K. Anderson Foundation Mr. & Mrs. William D. Balthrope Mr. & Mrs. Russell C. Beard Catherine & Francis Burzik Kris & Jim Ellis Dr. & Mrs. Gilbert J. Garcia Mr. & Mrs. John D. Graham Mr. & Mrs. Jack E. Guenther Mr. & Mrs. Freddy Randall Hiley Jan & Bob Marbut Mr. & Mrs. Thomas I. O’Connor Harris K. & Lois G. Oppenheimer Foundation/Mrs. Claire O. O’Malley Mr. & Mrs. George P. Parker Jr. Dr. Neela Kumari Patel Minnie Stevens Piper Foundation Dr. Sharon Kay Rosenthal Mrs. Mary Patricia Stumberg

$2,500+

Mrs. Barbara J. Banker Mr. & Mrs. Charles E. Cheever Jr. Mr. & Mrs. Bartlett Cocke Jr. Dr. & Mrs. Elias Dickerman

The Douglass Foundation Ms. Lisa Friel Mrs. Helen K. Groves Mrs. Sally Halff Mr. & Mrs. Michael D. Harper Sr. Dr. Peter John Hart Mr. & Mrs. Joe N. Haynes O’Connor & Hewitt Foundation Karen & Tim Hixon Mrs. Juana E. Hollin-Avery Mr. & Mrs. Michael Humphreys Dr. & Mrs. Syed Adil Husain Dr. & Mrs. Charles R. Leone Jr. Drs. Janna Lesser & Richard Usatine Ms. Kim Lewis Mr. & Mrs. Robert S. McClane The Honorable & Mrs. John T. Montford Debbie & Frank Morrill Mrs. Judith N. Morton Dr. John D. & Mrs. Lorraine L. Olson Mr. & Mrs. J. David Oppenheimer Mr. Dan F. Parman Mrs. Marie L. Pauerstein Dr. Carl F. Raba Jr. Dr. Amelie & Mr. David Ramirez Dr. & Mrs. Augusto Ramos Jr. Rodney K. Rayburn, D.D.S. Mr. & Mrs. Carl A. Register Mr. & Mrs. Patrick Stehling Mr. & Mrs. Louis Herbert Stumberg Jr. Mr. & Mrs. Ray Walther Ms. Marilyn L. Weber Mr. & Mrs. J. Tullos Wells Mr. & Mrs. Graham M. Weston

$1,000

Mr. & Mrs. James R. Adams Max F. Adler, M.D. Barbara & Wayne Alexander Dr. & Dr. Rojan M. Amjadi Alison & Jeff Andrews Aaron L. Angel, M.D. Drs. Martha & Rafael Aranda Mrs. Connie Aust Ruth & Edward Austin

Kay C. Avant, RN, Ph.D., FAAN Mr. Robert L. Bailey Dr. Ben Barker Ann Barshop Colleen & Bruce Barshop Dr. & Mrs. Richard A. Becker Louise & Michael Beldon Mrs. Marion Dewar Bell James Vernon Benedict, M.D., Ph.D. Jewel Biedenharn-Crosswell & Henry M. Crosswell, III Mrs. Ann D. Biggs Irene & Michael Black Ms. Donna Block Ms. Margery L. Block Mr. & Mrs. Guy S. Bodine, III Mr. Frank Nelson Boggus Eleanor & Vaughn Bomberger Mrs. Celita Pappas Borchers Mr. & Mrs. P. Joseph Brake Dr. & Mrs. Warren B. Branch Dr. & Mrs. Stephen K. Brannan Drs. Lois L. Bready & Joseph R. Holahan Eileen T. Breslin & Bill L. Israel Drs. Robin Brey & Steve Holliday Mrs. Gloria M. Bryant Louise & Michael Burke Paula & Jim Callaway Mr. & Mrs. Richard W. Calvert Dr. & Mrs. Roger S. Campos Amber & Jorge Canseco Alicia & Vidal Cantu Ms. Cassandra Carr Mr. & Mrs. Raymond R. Carvajal Alicia & Raymond Casillas Judy & Jimmy Cavender Dr. & Mrs. Alfonso Chiscano Mr. & Mrs. Mark Cirinna Drs. Nanette & Nelson Clare Robert A. Clark, M.D. Mr. & Mrs. James Fully Clingman Jr. Ms. Jane L. Coelho Lisa & Don Cohick William T. Coppola, D.D.S. Fred G. Corley Jr., M.D.

36 | MISSION | The University of Texas Health Science Center at San Antonio

Mr. Paul C. Crall Dr. & Mrs. Anatolio B. Cruz Mr. & Mrs. C. E. Davis Laura & Sam Dawson Mr. Luis A. De La Garza & Ms. Sherry Lynn Hatcher Drs. Christine & Andrew de la Garza Mr. & Mrs. Charles Deacon Ralph A. DeFronzo, M.D. Mary & Alan DeLay Julia Delgado, M.D. Dr. & Mrs. Andre Desire Mr. & Mrs. Robert Dewar The Honorable Preston H. Dial Jr. Elia & Armando Diaz Drs. Beverly & Bryan Dickson Dr. & Mrs. William W. Dodge Kevin J. Donly, D.D.S., M.S. Barbara & Alan Dreeben Mr. & Mrs. Gerald Z. Dubinski Sr. Adele & Steve Dufilho Florence Eddins-Folensbee, M.D. Mr. & Mrs. Chris C. Edelen Mr. & Mrs. Robert Louis Elizondo Edward Ellis, III, D.D.S., M.S. Mr. & Mrs. W. Frank Elston Mr. Henry Rugeley Ferguson Sr. Ms. Mary Beth Fisk Dr. & Mrs. Peter T. Flawn Ms. Caroline Alexander Forgason Dr. Marvin & Mrs. Ellinor Forland Mr. & Mrs. John Thomas Franklin, III Dr. Kelley L. Frost & Mr. Patrick B. Frost Mr. & Mrs. Tom C. Frost Dr. Constance Louise Fry & Mr. William R. Kline Ms. Elizabeth Galic Mrs. Candy Katz Gardner Dr. & Mrs. Harold Vincent Gaskill, III Dr. & Mrs. Carl J. Gassmann Barbara & Michael Gentry James E. Gill, M.D. Andrea Giuffrida, Ph.D. Birgit Junfin Glass, D.D.S., M.S. Sandy & Cameron Godfrey Dr. & Mrs. William Gonzaba

Philanthropy

Bettie K. Stone-Reddick and Robert L. Reddick, M.D.

Drs. Francisco A. González-Scarano & Barbara J. Turner GPM Life Insurance Company Marci & Charles Granstaff Robert P. Green Jr., M.D. Mr. Cosmo F. Guido Mr. & Mrs. Curtis C. Gunn Jr. Mr. & Mrs. Robert E. Gurwitz Dr. Glenn A. Halff & Ms. Mindi Alterman Mr. & Mrs. Kenneth J. Halliday Hannah Foundation/Mr. John R. Hannah Holly & Ken Hargreaves, D.D.S., Ph.D. Drs. Denise & Robert Hart Mr. & Mrs. Houston H. Harte Roxie & Jim Hayne Mrs. Karen L. Heintz Mr. & Mrs. William D. Hendricson Dr. & Mrs. William L. Henrich James R. Herbst, II, D.D.S. Karen & Ron Herrmann Dr. & Mrs. Eric Pui Sun Ho Joseph Thanh Hoang, M.D. Mr. & Mrs. Scot Hollmann Mr. & Mrs. Jerome P. Hoog Ms. Betty K. Howard Dr. John P. Howe, III & Ms. Tyrrell E. Flawn Mrs. Billie-Kite Howlett Dr. & Mrs. Michaell A. Huber Dr. Carol Ann Huebner & Mr. Michael F. Huebner Mr. David Humphreys Ms. Dana Ingram Dr. & Mrs. J. Daniel Johnson Dr. & Mrs. David J. Jones Sharon & Ken Kalkwarf Glenda & David Keck Ms. Barbara Keelan Joan & Herb Kelleher Nancy & Ed Kelley Betty & Bob Kelso Joan & Pat Kennedy Mr. & Mrs. Kambiz Khademi Dr. & Mrs. Kevin S. King

Holly and Ken Hargreaves, D.D.S., Ph.D.

Dr. Marsha C. Kinney & Mr. Gregory M. Kinney Mr. & Mrs. Richard M. Kleberg, III Koontz McCombs, LLC Bonnie & John Korbell Mr. Mike Kreager Gretchen & Lance Lahourcade Mr. Marshall Elmer Lasswell Drs. Barbara & Leonard Lawrence Mrs. Susana Leaño-De La Vara Sarah & Milton Lee Dr. & Mrs. Edward J. Lefeber Jr. Dr. Stephanie Levine & Dr. Richard Shaffer Jungran & B. B. Lim Anna & Jon Lowry Mr. & Mrs. Steve Lynch Mrs. Gladys I. Lynch Mr. & Mrs. John A. Malitz Dr. & Mrs. Christopher Scott Manatt Mr. Mike A. Manuppelli Mrs. Janey Briscoe Marmion Dr. Bettie Sue Masters Drs. Karis & Duncan McCarroll Mr. & Mrs. Raymond S. McClellan Mr. & Mrs. Red McCombs Mr. & Ms. Robert McDonald Mr. & Mrs. Joe C. McKinney Drs. Melinda & James McMichael Mr. & Mrs. Laird H. McNeil Yona & Tom McNish Dr. & Mrs. Larry B. Melton Ms. Kathleen A. Messina Dr. & Mrs. Frank R. Miller Dr. Jacqueline Lee Mok & Dr. V. Grayson Dyer Mr. & Mrs. William G. Moll Billy Lorin Morgan, D.D.S. Methodist Healthcare Ministries of South Texas/Mr. Kevin C. Moriarty Sydney & Gregg Muenster Nicolas Musi, M.D. Dr. & Mrs. Claude L. Nabers Mr. & Mrs. John E. Newman Jr. Bay Van Nguyen, M.D. Bavi & Dennis Nixon

Byron J. Nordhus, D.D.S. Dr. T. Michael Nork Drs. Simone & Robert Norris Nancy P. & John A. Oberman Beverly & Will O’Hara Ms. Anne B. Ownby Dr. & Mrs. Paul Pace Mrs. Victoria Paparelli Camilla & Bill Parker Drs. John D. Jones & Norma Partida Jones Dr. & Mrs. Mahendra C. Patel Drs. Jan & Thomas Patterson Mr. & Mrs. Richard M. Peacock Sr. Dr. & Mrs. Dan C. Peavy Mr. & Mrs. Gardner Peavy J. Lee Pettigrew, D.D.S. Mr. & Mrs. Scott Petty Jr. Diane & Philip Pfeiffer Ms. Emilie Pitman-Kreager Stephen H. Ponas, M.D. Rissa Potter, Ph.D. Mrs. Jane Cheever Powell & Mr. Tom Powell Jr. Mrs. Karen Presley Mr. & Mrs. Robert B. Price Shelli Pruski, D.D.S. Drs. Rajam & Somayaji Ramamurthy Drs. Angelita Ramos-Gabatin (USAF,Ret.) & Jose Q. Gabatin Dr. Joan M. Ratner Mrs. Bettie K. Stone-Reddick & Dr. Robert L. Reddick Katie & Jim Reed Rebecca & Bill Reed Mrs. Corinne L. Robichaux Dr. & Mrs. Waid Rogers Mr. & Mrs. Stanley D. Rosenberg Dr. & Mrs. Anthony D. Sabino Drs. Jennifer Sorenson & Edward Sako Mr. & Mrs. William Scanlan Jr. Mr. & Mrs. Louis L. Scantland Mr. Richard T. Schlosberg, III Katherine A. Schwesinger, B.S.N.,M.S.N. Mr. & Mrs. Peter C. Selig

Dr. Pat Semmes Dr. Harbi A. Shadfan Melvin L. Shanley, D.D.S., PA Dr. Phyllis B. Siegel Diane Sinclair/Les Norton (Great Clips) Brian Roy Smith, D.D.S. Dr. & Mrs. Paul H. Smith Jr. Eileen A. Smith, M.D. Mr. & Mrs. Paul H. Smith Mr. & Mrs. Bruce Chad Smith Dr. & Mrs. Kermit Vincent Speeg Jr. Anna & Dennis Stahl Mr. & Mrs. Thomas A. Stephenson Ms. Ann Stevens Ms. Patricia Stout/Alamo Travel Group Joci & Joe Straus Mr. Charles E. Thompson Jr. Dr. & Mrs. Roy H. Trawick Mr. & Mrs. Gustav Nicholas Van Steenberg Mr. Mario A. Vazquez Dr. & Mrs. Carlos Vela Jr. Dr. & Mrs. Raul Vela Mr. Neill B. Walsdorf/Mission Pharmacal Company Drs. Anne & Ken Washburn Mr. Mark E. Watson, III/Argo Group Courtney & Mark E. Watson Jr. Dr. & Mrs. Mark Berton Weinstein Mr. & Mrs. Eric J. Weissgarber Mr. & Mrs. Lewis F. Westerman Colonel Edwin J. Whitney Mr. James A. Whittenburg, III Mr. & Mrs. John Michael Wilkes Barry David Winston, M.D. Mr. Gary V. Woods Mr. & Mrs. Mark H. Wright Mrs. Barbara R. Wulfe Dr. & Mrs. Allison S. Yee Mrs. June A. Young Dr. & Mrs. Miguel Zabalgoitia Mr. & Mrs. Bartell Zachry Mr. & Mrs. David Steves Zachry Mr. & Mrs. James P. Zachry Sr. Dr. & Mrs. Thomas Zgonis

Spring/Summer 2016 | UTHSCSA.EDU/MISSION | 37

Parting Shot

Viva Fiesta!

t’s called the Party with a Purpose, the two-week long Fiesta San Antonio festival that began 125 years ago as a remembrance of the heroes of the Alamo and the Battle of San Jacinto. For the first time in many years, the Health Science Center joined in the festivities by sponsoring a float during the Texas Cavaliers River Parade, themed “River of Champions,” on the San Antonio River downtown. The university’s float, titled “Champions of the Cure,” honored Dot Delarosa, a lung transplant survivor, and 14-year-old Raven Labrador, a patient with acute lymphoblastic leukemia. Others on the float included Health Science Center President William L. Henrich, M.D., MACP, and his wife, Mary; Presidential Ambassador Scholars Award recipients; and the band Morning, led by dentistry faculty member Bud Luecke III, D.D.S., M.S.D. The money raised through the parade is donated to children’s charities in the San Antonio area through the Texas Cavaliers Charitable Foundation.

VICE PRESIDENT AND CHIEF MARKETING & COMMUNICATIONS OFFICER Heather Adkins VICE PRESIDENT AND CHIEF OF STAFF Mary DeLay SENIOR EXECUTIVE DIRECTOR OF COMMUNICATIONS Nancy Arispe Shaw EDITOR/DIRECTOR OF PUBLICATIONS Lety Laurel CREATIVE DIRECTOR Jennifer Bernu-Bittle WRITERS Joe Michael Feist, Rosanne Fohn, Kate Hunger, Will Sansom, Joel Williams PHOTOGRAPHERS Joel Spring, Noell Vidaurri ILLUSTRATOR Sam Newman Mission is published twice a year by Marketing, Communications & Media, and printed by UT Print, UT Health Science Center San Antonio. Letters to the editor, address changes, permission to reprint or to be removed from our magazine mailing and contact lists should be sent to mission@uthscsa.edu or mailed to Lety Laurel, Marketing, Communications & Media, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900. © The University of Texas Health Science Center at San Antonio, 2016. All rights reserved. Not printed at state expense.

Go online! Check out our Mission magazine website for exclusive content including slide shows and videos, and opportunities for you to share your story ideas and comments about our content.

uthscsa.edu/mission For university news you can access anytime, go to news.uthscsa.edu.

38 | MISSION | The University of Texas Health Science Center at San Antonio

Leading the charge against PTSD.

The UT Health Science Center leads the world in the fight against PTSD, a disorder that plagues hundreds of thousands of our military service members and veterans. Through more than 40 research projects studying this problem, depression, insomnia, substance abuse, suicide risk and chronic pain, we serve our psychologically wounded warriors so that they may soon return to their families and healthy, productive lives.

WeMakeLivesBetter.com/PTSD

The University of Texas Health Science Center at San Antonio Marketing, Communications & Media - Mail Code 7823 7703 Floyd Curl Drive San Antonio, TX 78229-3900

Nonprofit Organization U.S. Postage PAID Permit #1941 San Antonio, TX

We make lives better. Every day. From training tomorrow’s doctors, dentists, nurses and other health care professionals, to leading the world in PTSD research and treatment, we remain firm in our commitment to those who have given their all to keep America free. Serving our nation’s heroes is an honor and our privilege—and just one of many ways by which we make lives better every day.

We Make Lives Better.com

U.S. Air Force Master Sgt. Cherita Johnson, School of Nursing ’16, with her son.