2010 BluePrint

BLUE PRINT Duke Anesthesiology

HTTP://BLUEPRINT.DUHS.DUKE.EDU

Innovation at work Duke Regional Anesthesia | Web Casting | New Tactics in the War on Pain Joining Forces To Meet A Global Need | Built For Battle

Volume 2 | 2010

8 floors

48 ICU rooms patient resource center

intraoperative surgical imaging

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16 operating rooms 580,000 square feet

64 step-down/intermediate beds

In 2013, Duke Medicine will open its doors to the Duke Medicine Pavilion.

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Volume 2

2010

Editor: Elizabeth T. Perez, RN, BSN Copy Editor: Lauren E. Marcilliat Creative Director: Elizabeth T. Perez, RN, BSN Photography Contributions: Elizabeth T. Perez, RN, BSN, editor Lauren E. Marcilliat Holly Muir, MD Anthony Roche, MB ChB J. Brandon Winchester, MD Gavin Martin, MB ChB Jerry Reves, MD Janeen Drinkard Rebecca Hinshaw, RN www.iStockphoto.com www.army.mil Contributing Illustrator: Lauren E. Marcilliat Production: Elizabeth T. Perez, RN, BSN Lauren E. Marcilliat Duke Anesthesiology Alumni & Development Affairs Your comments, ideas, and letters are welcome.

Please contact us at: BluePrint Magazine Anesthesia Alumni & Development Affairs DUMC 3094 Durham, NC 27710 blueprint@mc.duke.edu Follow us on Twitter and Facebook!

Twitter: Duke_Anesthesia DukeDREAM Facebook: www.facebook.com/duke.anesthesiology www.facebook.com/dreamcampaign

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Our Mission Extraordinary care through a unique culture of innovation, education, research, and professional growth.

Chairman's Welcome

One of our greatest strengths as a department is our ability to use innovative thinking to propel us forward in addressing both old and new challenges.

It is flexibility, along with our ambition, sense of reverence, ingenuity, and humanity, which enables us to grow. As a department, we are continuously developing—and not just in a metaphorical sense.

The background noise provided by construction machinery we work in concert with daily serves as a reminder of progress.

Our vision of becoming a world leader in advancing perioperative medicine and pain management is one that we continually strive toward. We have shown signs of annual progress in attaining this goal. At home, we seek out ways to better treat our patients.

We have become more attuned to the needs of the U.S. Military as thousands of young war veterans, often amputees, return home from war in need of the advanced pain management care we can provide. We continue to establish our identity on a global level, as alumni, faculty, residents and fellows become increasingly involved in missions overseas and explore exciting new educational tools with the potential to change how we learn.

This year we celebrate the opening of our exciting new hybrid OR, as well as four new cardiac operating rooms. We anxiously await the unveiling of several more state-of-the-art facilities in 2013, with the opening of the new Duke Medicine Pavilion and Cancer Center. We are excited not only for the advanced level of patient care these facilities will make possible, but also for the quiet work atmosphere which will be restored to us upon its completion.

I am delighted to share this edition of BluePrint with you. I hope that as you flip through the pages, you will share in my pride of this department and the outstanding qualities that make us unique.

Sincerely,

Mark F. Newman, MD Merel H. Harmel Professor of Anesthesiology and Professor of Medicine Chairman, Department of Anesthesiology

In addition to celebrating our current achievements, we look to the past for clues on how to increase our efficacy. Our alumni not only provide us with an important support system, they serve as ambassadors of our department. We continue to establish endowed professorships that honor eminent leaders and encourage current and future faculty to pursue similar greatness.

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DEPARTMENT OF ANESTHESIOLOGY

FACULTY As chairman of Duke Anesthesiology, Mark F. Newman, MD, serves as an example of the integrity, intellect, and clinical expertise necessary to position Duke as a world-class leader in advancing perioperative medicine and pain management. With this goal in mind, he guides and nurtures his team to the best of his ability.

The Senior Cabinet is responsible for defining the overall strategy necessary to implement the department’s mission. The Executive Team is charged with the management of the day-to-day

Chairman

Cardiothoracic Anesthesia

Mark F. Newman, MD

Joseph P. Mathew, MD, Chief

Merel H. Harmel Professor of Anesthesiology and Professor of Medicine

operations of each clinical division. Through their service and dedication, these individuals ensure the future success of our department.

Within the department, each subspecialty is comprised of expert faculty members who are dedicated to extraordinary patient care, research, and education. These outstanding individuals are the pride of Duke Anesthesiology.

Pain Clinic

Nicolas Aeschlimann, MD

General, Vascular, High-Risk Transplant & Critical Care Medicine

Solomon Aronson, MD

Richard E. Moon, MD, Chief

Billy K. Huh, MD, PhD

Katherine P. Grichnik, MD

Elliott Bennett-Guerrero, MD

Lesco L. Rogers, MD

Senior Cabinet

Jose Mauricio Del Rio, MD

Tong Joo (TJ) Gan, MD

Dianne L. Scott, MD

Solomon Aronson, MD

Steven E. Hill, MD

Catherine M. Kuhn, MD

Executive Vice Chair

Jorn Karhausen, MD

Amy Manchester, MD

Pediatric Anesthesiology

Tong Joo (TJ) Gan, MD

Miklos David Kertai, MD

Timothy E. Miller, MB ChB

Allison Kinder Ross, MD, Chief

Vice Chair, Clinical Research

Frederick W. Lombard, MB ChB

Eugene W. Moretti, MD

Warwick Ames, MB BS

Catherine M. Kuhn, MD

G. Burkhard Mackensen, MD, PhD

John Nardiello, MD

Guy de Lisle Dear, MB

Vice Chair, Education

Andre S. Motie, MD

Ronald P. Olson, MD

John B. Eck, MD

Director, Residency Program

Mark F. Newman, MD

Nancy W. Knudsen, MD

Heather J. Frederick, MD

Daniel Marcantonio

Alina Nicoara, MD

Anthony M. Roche, MB ChB

Hercilia M. Homi, MD

Chief, Business Administration

Mihai V. Podgoreanu, MD

Kerri M. Wahl, MD

Richard Ing, MB BCh

Holly A. Muir, MD

Mark Stafford-Smith, MD

David R. Wright, MD

Scott R. Schulman, MD

Vice Chair, Clinical Operations

Madhav Swaminathan, MD

Christopher C. Young, MD

B. Craig Weldon, MD

David S. Warner, MD

Ian J. Welsby, MB BS

Orthopedics, Plastics & Regional Anesthesia

Veteran’s Affairs Anesthesia Services

Vice Chair, Research

Winston C. V. Parris, MD, Chief Anne Marie Fras, MD

Executive Team

Center for Hyperbaric Medicine

Gavin Martin, MB ChB, Chief

Jonathan B. Mark, MD, Chief

Karen Entrekin

Richard E. Moon, MD, Chief

Joshua R. Dooley, MD

Atilio Barbeito, MD

Meri Gilman-Mays, CRNA

Barry Allen, PhD

Ellen M. Flanagan, MD

Raquel R. Bartz, MD

Allison Kinder Ross, MD

David J. Doolette, PhD

Jennifer T. Fortney, MD

C. Scott Brudney, MB ChB

Stephen M. Klein, MD

John J. Freiberger, MD, MPH

Brian Ginsberg, MB ChB

Thomas E. Buchheit, MD

Jonathan B. Mark, MD

Claude A. Piantadosi, MD

Stuart A. Grant, MB ChB

Joel S. Goldberg, MD

Gavin Martin, MB ChB

Hagir Suliman, DVM, PhD

David B. MacLeod, MB BS

David R. Lindsay, MD

Stephen J. Parrillo, MD

Terri G. Monk, MD

Srinivas Pyati, MD

Srinivas Pyati, MD

Joseph P. Mathew, MD David L. McDonagh, MD

Duke Raleigh Hospital

Richard E. Moon, MD

Michael Russell, MD, Chief

Daniel S. Thomas, MD

Amy M. Rice, MD

Winston C. V. Parris, MD

Okoronkwo Ogan, MD

J. Brandon Winchester, MD

Rebecca A. Schroeder, MD

Ambulatory Anesthesia

Durham Regional Anesthesia

Stephen M. Klein, MD, Chief

Edward G. Sanders, MD, Chief

Otolaryngology, Head, Neck & Neuroanesthesia

M. Stephen Melton, MD

David S. Bacon, MD

David L. McDonagh, MD, Chief

Women’s Anesthesia

Karen C. Nielsen, MD

John D. Buckwalter, MD

Cecil O. Borel, MD

Holly A. Muir, MD, Chief

Marcy S. Tucker, MD, PhD

Frederick J. Carpenter Jr., MD

Swapna Chaudhuri, MD, PhD

Terrence K. Allen, MB BS

John F. Heath, MD

Kallol Chaudhuri, MD, PhD

Basic Science

M. Luke James, MD

Moyra E. Kileff, MB ChB

John C. Keifer, MD

Peter D. Dwane, MD

David S. Warner, MD, Chief

Eugene E. Lee, MD

Andrew Peery, MD

Ashraf S. Habib, MB BCh

Madan M. Kwatra, PhD

William P. Norcross, MD

Allan B. Shang, MD

Cheryl A. Jones, MD, DVM

Wulf Paschen, PhD

Gary L. Pellom, MS, MD

Bret W. Stolp, MD, PhD

Abigail H. Melnick, MD

Noa Segall, PhD

Earl S. Ransom, MD

Jeffrey M. Taekman, MD

Adeyemi J. Olufolabi, MBBS

Huaxin Sheng, MD

Michael J. Stella, MD

David S. Warner, MD

Cathleen L. Peterson-Layne, MD, PhD

W. Daniel Tracey, PhD

Cathy W. Thomas, MD

Andrew D. Shaw, MD

Melanie C. Wright, PhD Wei Yang, PhD Zhiquan A. Zhang, PhD

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Dana N. Wiener, MD

John R. Schultz, MD

CONTENTS 08

30

24

34

Extraordinary Care 08

Division Spotlight: Regional Anesthesia

Innovation & Education 13 17 22

Web Casting Next Generation Leaders Upright Burdens

Research 23

New Tactics in the War on Pain

Professional Growth 26 30

Jerry Reves, MD: A Stellar Career Faculty & Alumni Spotlight

Outreach & Philanthropy 36 40 44 49

Joining Forces to Meet a Global Need Duke DREAM Campaign Built for Battle: A Survivor's Story An Interview with Rebecca Hinshaw, RN

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Extraordinary Care

DIVISION SPOTLIGHT: REGIONAL ANESTHESIA

Photo from left to right: Gavin Martin, MB ChB, Stephen J. Parrillo, MD, Ellen M. Flanagan, MD, Stuart A. Grant, MB ChB, Brian Ginsberg, MB ChB, Daniel S. Thomas, MD, J. Brandon Winchester, MD, and David B. MacLeod, MB BS. Not pictured: Joshua R. Dooley, MD, Jennifer T. Fortney, MD, Srinivas Pyati, MD, Charles S. Brudney, MB ChB, and Thomas E. Buchheit, MD.

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Venture down to the Pre-Op holding

area and

take a look at J. Brandon Winchester, MD’s video equipment setup, precariously assembled by layer upon layer of silk tape, and you will see innovation at work.

Listen to Ellen Flanagan, MD, recount her experiences in Haiti offering humanitarian aid to the victims of the earthquake, or David MacLeod, MB BS, talk about his plans to travel to Mount Everest to engage in altitude research, and you will detect a remarkable spirit of ambition and adventure. Should you find yourself in the care of an anesthesia fellow or resident, you will experience firsthand the compassion and expertise these highly trained physicians have to offer.

What do all of these people have in common? They all play a role in the Division of Orthopedics, Plastics, and Regional Anesthesiology, also known simply as Regional Anesthesia. They are exemplary of the innovation, ambition, compassion, and level of expertise that has empowered this division to become one of the leading regional anesthesia programs in the nation.

INNOVATIVE TREATMENTS The division is constantly challenging itself to discover more effective ways to manage postoperative pain. Brian Ginsberg, MB ChB, director of Acute Pain Services, is internationally known as one of the earliest advocates of multimodal analgesia. Additionally, Ellen Flanagan, MD, recently developed a topical formulation of the long-acting local anesthetic, ropivicaine, used to treat painful oral mucositis or ulcerations 10

common in patients undergoing chemotherapy or bone marrow transplantation. Currently, the only drug on the market provides less than one-hour of pain relief.

This topical formulation, on the other hand, can provide up to six hours of relief.

Regional Anesthesia has been providing superior pain management for Duke’s Acute Pain Services for the past two decades, performing far more nerve blocks than the vast majority of institutions—5,000 to 7,500 a year. Many are performed on those undergoing total joint replacement surgery.

Ultrasound Technology

Furthermore, the use of peripheral nerve blocks increases the level of patient safety simply by eliminating the need for additional procedures associated with general anesthesia, such as airway manipulation and intubation. In addition, the need for IV and oral narcotics is often reduced in the perioperative period, resulting in fewer incidences of pain, nausea, and vomiting.

Acoustic Radiation Force Imaging

The division was recently awarded the prestigious Coulter Grant for translational research to investigate the use of a new ultrasound technology known as Acoustic Radiation Force Imaging. This type of ultrasound produces an extremely clear image. Stuart Grant MB ChB, and a team within the

In 2001, Duke was one of the first institutions to utilize ultrasound technology to administer peripheral nerve blocks. Ultrasound allows physicians to see the position of the needle relative to the nerve, making it easy to monitor the spread of the local anesthetic and identify the peripheral nerves they wish to block, as well as structures that they wish to avoid (such as major blood vessels and the pleura). The use of ultrasound has increased the success rate of nerve blocks at Duke to 95 percent—a dramatic improvement when compared to peripheral Brian Ginsberg, MB ChB, (right) is internationally known as one of the nerve stimulation, the earliest advocates of multimodal analgesia. former standard.

Division Spotlight: Regional Anesthesia

division have been working on the continued development and application of this technology in conjunction with a team led

by Mark Palmeri, MD, PhD, assistant research professor in the Department of Biomedical Engineering at Duke.

Peripheral Nerve Block Catheters

In addition to the use of ultrasound, Duke was one of the first institutions to utilize continuous peripheral nerve block catheters. These catheters continuously infuse anesthetics in the postoperative period through a dedicated pain pump. Patients recovering from surgeries, such as ankle and shoulder replacements, can now go home with a disposable pain pump that will last three-days.

These patients are given detailed information regarding the care of their pain pump and catheter, and are closely monitored by Acute Pain Services. As a result, more hospital beds are available for those who need them, and patients have a convenient way to manage their pain from the comfort of their home.

RESEARCH The division is looking for research collaboration in areas of chronic pain. Duke is currently investigating whether a continuous peripheral nerve block throughout the perioperative period will adequately treat acute pain and subsequently prevent developing chronic pain. With the success of peripheral nerve block catheters, the division is working on is what could be the next big step in pain management: slow release local anesthetics. This would eliminate the use of a catheter, thereby cutting down on the risk of infection.

Perioperative Database

Furthermore, they are undertaking a research project to look at

David B. MacLeod, MB BS, monitoring a healthy volunteer undergoing research in the Human Pharmacology Lab.

whether the avoidance of general anesthesia will have an effect on postoperative cognitive decline, similar to what has been demonstrated in previous studies. The new departmental perioperative database is expected to launch later this year. One of the major emphases of this database will be to examine outcomes research including: mortality, functional outcome, acute and chronic pain, and postoperative cognitive decline. This technology will provide a full-time researcher with a fascinating opportunity for a long-term, in depth study.

cerebral devices. HPL Investigators are involved in many other phase one pharmacological trials. The division is looking for additional ways to engage with industry to study pharmacological devices.

The lab also offers a unique opportunity for a young MD or PhD investigator to begin a career in medical research.

Human Pharmacology Lab

The Human Pharmacology Lab (HPL), directed by MacLeod, is a phase one research lab that uses arterial lines, pulmonary artery catheters, and advanced respiratory monitors to study the effects of anesthesia on healthy volunteers.

Researchers, like Keita Ikeda, PhD, utilize the lab to study devices like RespirAct速, a computer controlled gas delivery system that allows the precise control of end-tidal concentrations of oxygen and carbon dioxide. RespirAct速 is used in the calibration of new

The introduction of ultrasound has increased the success rate of nerve blocks at Duke to 95%.

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March 6-11, 2011—The 5th Annual Anesthesia & Critical Care Review, Park City, Utah June 12-17, 2011—The 4th Annual Emerging Technologies in the OR & Great Fluid Debate, Lake Buena Vista, Florida Beginning in January 2011, the division will host an Ultrasound Guided Regional Anesthesia Preceptorship Course the second week of every month. They are in the process of developing a virtual preceptorship course in ultrasound guided regional anesthesia.

Anesthesia residents Corey Maxwell, MD, and Ryan Fink, MD, performing a nerve block.

Duke Advance is expected to become available to the public in the winter of 2010. For more information, see Brandon Winchester, MD’s article, Web Casting on the next page.

EDUCATION Regional Anesthesia is attracting some of the brightest minds the medical community has to offer.

In their three years at Duke, residents perform four times as many peripheral nerve blocks as the average resident and receive maximum hands-on exposure to advanced nerve blocks. Upon completion of the program, students are highly familiar with: neuroanatomy, the peripheral nervous system anatomy, the use of ultrasound in the execution of a nerve block, symptoms of local anesthetic toxicity, and effective clinical management.

Regional Anesthesia offers a fellowship program in conjunction with the Ambulatory Surgical Center. This nationally acclaimed fellowship program trains two to three fellows annually. At the conclusion of this training, many of the fellows advance to leadership positions at other institutions.

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CME OPPORTUNITIES WITH REGIONAL ANESTHESIA

December 4-5, 2010—American Society of Regional Anesthesiologists (ASRA) regional meeting at the Duke School of Nursing, Durham, North Carolina

Academic centers simply Duke Advance

Regional Anesthesia also provides a significant amount of Continuing Medical Education (CME) training completed by physicians worldwide.

They are currently exploring innovative teaching methods that are forecasted to change the way students and health care providers learn, both at Duke and abroad. Grant, Winchester, and Joshua Dooley, MD, are collaborating on a project known as Duke Advance. This new technology will encompass a repository of the division’s educational material, grand round lectures, educational conference notes, and CME material, serving as a invaluable resource to the medical community. After Duke Advance has been in place for a significant period of time, it will become key to scientifically evaluate the success of this new educational tool.

Division Spotlight: Regional Anesthesia

cannot continue to rely on old techniques. We must be constantly moving forward.

- Gavin Martin, MB ChB

CONCLUSION Regional Anesthesia has enjoyed national esteem thanks to its success in superior pain management, adaptation of new technologies, administration of peripheral nerve blocks, and its strong educational program.

Leaders in the division focus on future advancement and look to the future with high hopes for continued greatness.

Innovation & Education

Web Casting Multimedia Education at Duke Anesthesiology at Duke: Part One J. Brandon Winchester, MD Director of Web Video Education, Assistant Professor of Anesthesiology Katherine Grichnik, MD Professor of Anesthesiology

Traditional educational venues utilize primarily didactic teaching methods in the form of lectures, or Socratic teaching methods, in which trainees are questioned in a clinical setting.

With the knowledge that every physician has an individual learning and communication style, Duke Anesthesiology has developed blended educational programs (information presented through multiple formats), which have proven to be far more effective in facilitating learning than unimodal presentations. Our technological capabilities have progressed and sharpened. We are now able to provide web based education not only to learners here at Duke, but to select audiences around the world. This article, part one of two articles, is about live web casting for regional anesthesia education. Part two will discuss the process of capturing, editing, and delivering other types of educational formats including: live lectures, desktop media, and educational movies.

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How did this all come about? The Winchester story in his own words.

Last summer from my 104 degree garage in front of a green screen, I made a web cast of an ultrasoundguided regional anesthesia lecture series to a group of physicians in China with a live Mandarin interpreter sweating profusely beside me. I learned many important lessons that day: lectures do not have to happen in person to still be effective; the value of American medical education travels well beyond the borders of our nation; and wearing a suit and tie in a 104 degree garage is a very bad idea. Most importantly, I learned that I wanted to find out more about live Internet streaming and medical web video education… and I bought an air-conditioner for my garage.

Why will web based education work for regional anesthesia education?

In their Practice Pathway in the Jan/Feb 2009 issue of Regional Anesthesia and Pain Medicine, Sites B et al. state that “the novice’s initial clinical experience (should) be monitored and supported by an individual experienced in ultrasound-guided 14

regional anesthesia (UGRA).”

Like learning a new language, regional anesthesia education requires exposure, repetition, and practice to be maximally beneficial.

Until now, such repetition and exposure was not possible unless you were a resident or fellow, or you were fortunate enough to have an experienced regional anesthesia provider in your group who could provide mentoring.

Sure, anesthesiologists have the option to attend a two-day cadaver workshop or a threeday ultrasound preceptorship, but are they returning to their home institution skilled enough to avoid causing a pneumothorax during a supraclavicular block, or to avoid major OR delays while they try to remember the dozen steps they learned to place a continuous popliteal sciatic catheter? Live web video allows regional anesthesiologists to continue their education after these introductory one to two day courses are completed. And for instructors, affordable software and hardware options exist which allow for the creation of live web video in just a few clicks. In the next several paragraphs, I will share with you the key steps involved to live stream regional anesthesia video education to the web.

Web Casting: Multimedia Education

How is this done?

Lights, camera, block!

The simplest way to create a live video stream of a regional anesthesia procedure is to turn on a camcorder or webcam, connect it to your computer with a video capture card, and use streaming software to encode it live to the web. Although relatively simple, this form of onecamera live video is of limited value when teaching a nerve block. If you only film the big-picture shot, you will miss the high-resolution clarity of the ultrasound image and the fine details of hand positioning seen only with a close-up shot. And if you shoot only the ultrasound image or a close-up shot, it is impossible to appreciate the overall patient position and key actions of the doctor performing the procedure.

For that reason, I recommend that live demonstrations utilize multiple simultaneous video inputs. My own live nerve block demonstrations usually involve four inputs: 1) a bigpicture camcorder to see the overall patient and doctor positioning, 2) a close-up camera to appreciate hand and needle positioning, 3) an ultrasound input (when applicable), and 4) a PowerPoint presentation.

To switch between multiple inputs in real time and live stream, the

Innovation & Education

output to the web requires a video switcher. For the budget conscious doctor, there are multiple software and hardware options that can accomplish this task.

What is web casting? Streaming live to a computer near you….or China.

Using a switcher to capture and live encode multi-camera video is only half the battle for live streaming. In order for the video to be seen by your target audience around the world, a content delivery network (CDN) must be utilized to deliver video to a web site. There are many providers of live streaming services on the web (see table 1). Some companies’ standard services are free, but

these options typically throttle the maximum resolution, limiting video clarity to your audience. What appears to be an excellent view of a femoral nerve to you might look like a Rorschach inkblot test to your web viewers. Free streaming services also come at the expense of control.

Producers such as anesthesiology departments and Continuing Medical Education (CME) programs cannot control who logs in to view the broadcast and they do not have control over advertisements that play over the videos. Therefore, these are not good options for live medical education. Fortunately, there are many reasonably priced, white label live streaming services, which give full control back to the doctor producing the video (see table 1).

You control the web site destinations of your live-streamed video, the users who are able to login to the site, and what advertisements do or do not play. This includes the ability to self-serve a preroll advertisement for your department’s own CME courses.

Time-out! Permission to stream: name, procedure and consent.

Before you click “go live,” it is important that you have all the appropriate consents to live

stream a procedure. First, and foremost, you need the patient to consent to the videography and live web dissemination by having him or her sign a protected health information release form (speak to your hospital compliance office to formalize one for your institution).

Although you should make every effort to de-identify the patient in every case, there are no “do-over’s” in live demonstration; therefore, the safest plan is to have the patient sign a HIPAA release. Next, you must consult with your risk management division to obtain the permission of your department and hospital.

When considering your request, risk management will undoubtedly ask you, “Who is going to be able to watch this live procedural web cast?” If your answer is, “anyone in the world who visits our web site,” your request will probably be denied. Therefore, it is imperative to implement a mechanism to control your audience access by ensuring a login process on the web site where you will stream. Ultimately, your risk management team will assess the overall risk associated with your web casting plan, and it will be the role of your department chairman to authorize the broadcasts and to assume responsibility.

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How do people know this is happening?

Table 1: Live Streaming Services Ustream.tv Stickam.com Livestream.com Justin.tv * Ustream Watershed * StreamAPI * Livestream Premium * Ooyala

*white-label

Table 2: Webcast RSVP Services MyEvent.com ConstantContact.com PlugMyEvent.com RSVPMeNow.com RSVPBook.com RegOnline.com

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Live streaming regional anesthesia education has no value if there is no one watching. It is critical to alert prospective viewers that you are going to be on the air, but without bloating your budget by hiring a PR agency. Fortunately, many free and inexpensive avenues exist to let your potential fan club know when to tune in to your show. Your web site should post your calendar of upcoming live events. And every scheduled web cast should give your viewers the option to RSVP for the event in advance (table 2). This action will create a mailing list with which you can send reminder emails as the web cast approaches.

Social networking sites such as Twitter and Facebook allow you to update your followers about your upcoming calendar of events and your viewers can even opt to receive text messages and emails when you post an update. These instant Twitter and Facebook updates are especially helpful to alert viewers when you are about to go live for a non-scheduled event, such as an interscalene nerve block where there is no way to predict in advance the exact time you will start the procedure.

a web cast is best accomplished using text chat rooms and polls, both of which can be embedded with widgets that reside next to the live streaming video window on your chosen web site.

Regional anesthesia web video education: conclusion This article highlights the value of live web video for regional anesthesia education and the methods by which it can be accomplished.

I have discussed inexpensive social networking options for promoting your live events and impromptu web casts, and I also reviewed multiple methods for communicating with your audience in real-time. We hope that this article will stimulate interest among potential medical video producers and will motivate the world’s best regional anesthesia instructors to bring their live message to the web.

Like the shortcomings of regional anesthesia workshops, I realize that this live streaming overview is less than a comprehensive education on the topic. I encourage anyone who would like more information to contact me directly via any of my listed social networking avenues. I would welcome the opportunity to relax in my air-conditioned garage and video chat with you about it via Skype.

Audience interaction One is often asked the question, “Why stream it live when you can just record it and let someone watch the video any time they want?” While pre-recorded video-ondemand is an important weapon in any web video education arsenal, it is the element of audience interaction that makes live demonstration so special. There are multiple ways to interact with your audience in real-time. Videoconferencing is a fantastic, albeit traditionally very expensive option, and allows zero latency point-to-point video communication. With Skype's introduction of high definition video, a free video chat software application, videoconferencing during a live web cast is now an option for all budgets. But for broadcasts to an audience of five hundred, it is not feasible for all participants to be on the video phone with you simultaneously. Real-time communication with larger audiences during

Web Casting: Multimedia Education

If you would like to be one of the first to be notified when this technology becomes available to the public, follow us on: Facebook: www.facebook.com/docstream Twitter: @docstreamtv J. Brandon Winchester, MD Katherine Grichnik, MD Email: blockjocks@gmail.com grich002@mc.duke.edu Skype username: blockjocks Phone: 919.612.3682 Bibliography 1. Sites B, Chan V, Neal J, Weller R, Grau T, Koscielniak-Nielsen Z, Ivani G, The American Society of Regional Anesthesia and Pain Medicine and the European Society of Regional Anaesthesia and Pain Therapy Joint Committee Recommendations for Education and Training in Ultrasound-Guided Regional Anesthesia, Reg Anesth Pain Med 2009;34: 40Y46

Innovation & Education

Next Generation Leaders

Education, the enrichment of minds, is given the highest priority at Duke. The Department of Anesthesiology's acclaimed educational program is known for the significant clinical experience trainees and students obtain under the guidance of world-class faculty, its unique culture of inquiry, a strong research environment, and its commitment to technology in research, clinical care, and education.

The beautiful Gothic campus of the Duke Blue Devils is located in Durham, North Carolina.

Although Durham exudes the charm of a classic Southeastern city, it is actually a rapidly growing hot spot for some of the most innovative minds.

Durham, along with Raleigh and Chapel Hill, makes up what is referred to as the Triangle.

Poised perfectly between the North and South, the mountains and ocean, and the countryside and city, this location truly has something for everyone. In addition to its favorable geographic

location, the Triangle is home to the world-famous Research Triangle Park (RTP), and several major universities. As a world leader in the field of medicine, Duke University draws faculty, students, and patients from around the globe. In addition to the culturally rich environment, trainees have several resources close at hand including Duke Medicine's state-of-the-art facilities. Medical students, residents, and fellows alike acquire hands-on experience working at the rapidly expanding Duke University Health System.

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The Human Simulation and Patient Safety Center is comprised of two simulation rooms, a multimedia classroom, and a high-tech communications and control room. This lab enables medical students, residents, and fellows to learn valuable skills before using them on real patients—increasing the level of efficacy and decreasing the level of error.

Photo at left: Catherine M. Kuhn, MD, assists resident, Brian Barrett, MD, with an intubation. Below: Jeffrey M. Taekman, MD, director of the Human Simulation and Patient Safety Center (HSPSC), lectures to residents, Cory Maxwell, MD, Miles Berger, MD, PhD, and Elizabeth Malinzak, MD.

“The faculty displays a firm dedication.

They really invest in their students."

-Dionne F. Peacher, Anesthesia Intern

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As the only medical school in the Southeast ranked in the top 10 this year

by U.S. News and World Report, Duke

are additional opportunities for medical students to engage with the anesthesiology department in the second, third, and fourth

University Medical School (DUMS) attracts not only extremely bright students, but humanistic, well-rounded students with a genuine desire to help others. Medical school students receive significant exposure to anesthesiology early in their training due to the heavy involvement of anesthesiology faculty members in the first-year basic science curriculum. Additionally, all students complete a cardiovascular physiology lab in a unique training facility of the department—the Human Simulation and Patient Safety Center (HSPSC). There

year as well. Most students describe their contact with Duke Anesthesiology to be extremely positive, and typically eight to ten percent of a medical student class goes on to pursue a career in anesthesiology.

Next Generation Leaders

The Residency Program Although there is no formal ranking system for residency programs, Duke’s program is considered by many in the medical community to be one of the top programs in the country. Of the medical students who choose to pursue a career in anesthesiology

Cardiothoracic anesthesiologist, G. Burkhard Mackensen, MD, PhD, and fellow, Timothy Mooney Jr., MD, performing a Transesophageal Echocardiography (TEE) to monitor heart and valve function during cardiac surgery.

while enrolled in DUMS, typically one to four students choose to stay at Duke for their residency.

The application process for anesthesiology residency is similar to the application for medical school, with an initial online application process followed by personal interviews. It is also similar in that it is extremely competitive. Applicants must display excellent achievement in medical school, in addition to diverse life experience, an altruistic nature, and an inquisitive approach to life. From an initial pool of 800 applicants, 14 residents eventually match with the Duke Anesthesiology program.

Upon entry into the program, residents are provided with a faculty advisor who works with them during their time at Duke to help build an individualized study plan that will be useful throughout the entire

course of their career. In addition to a faculty mentor, junior residents are paired with senior residents to help guide their transition from medical student to resident.

Faculty members employ a wide variety of different teaching modalities specifically aimed at residents.

Didactic experience is provided through a dedicated weekly resident lecture series, a weekly department grand rounds presentation, monthly journal club and morbidity and mortality conferences. Residents gain valuable experience from simulation activities, both in the HSPSC (which they receive exposure to quarterly), and with the Transesophageal Echocardiography (TEE) Simulator Program. Simulator programs help prepare residents for the challenging patient population (often featuring extremes of age, and/or high acuity) they are exposed to while at Duke.

19

Duke Anesthesiology BluePrint | BluePrint.duhs.duke.edu

Duke, however, is interested in more than just passing boards. “We try to grow leaders,” Catherine Kuhn, MD, residency program director and vice chair for education, says. “We want trainees to aspire to do great things and provide excellent patient care, so that they go on to become leaders in their own right in the specialty of anesthesia.”

classroom were cemented in my mind.

-Robert L. Lobato, MD Fellow, Cardiothoracic Anesthesia 2009-2010

196

Number of faculty members in basic sciences

99

9 Number of buildings on Duke Medical Center Campus

5

20

3

Next Generation Leaders

1

5

2

3

1,560

presented to me in the

Number of faculty members in clinical programs

care, the concepts

891

teaching with patient

Number of house staff (residents and fellows)

By combining formal

In addition to a challenging patient demographic, residents are exposed to cutting-edge surgical procedures.

Some examples include cardiothoracic surgeries with circulatory arrest, awake craniotomies, complex neurovascular cases, peripheral nerve blocks, and transplant surgeries. The typical resident completes between 500 and 600 clinical cases a year. After completion of the program, graduates are confident in their ability to work independently in any setting. Nearly 100 percent of residents pass their boards on the first try.

7

CA3 resident, Nam-Kha Pham, MD, in the hybrid OR.

Faculty members do their best to help develop and nurture the career paths of residents.

Residents with an interest in developing academic anesthesiology careers are provided with a unique opportunity through the Academic Career Enrichment Scholars (ACES) program, a special curriculum that combines all of the requirements of an internship, the core residency, a sub-specialty fellowship, and a year of dedicated research time over the course of five years. Additionally, there are several international opportunities for residents with an interest in global medicine.

In the past, Duke Anesthesiology has had multiple winners of the Society for Education in Anesthesia (SEA)/Health Volunteers Overseas (HVO) Traveling Fellowship, an honor which provides students with the opportunity for advanced training abroad.

Additionally, several departmental faculty and residents have traveled to Ghana, Uganda, Russia, Haiti, and Central America in a variety of global health initiatives.

Innovation & Education

2

4

7 9 6

8

$2 Billion

Annual operating revenues for Duke University Health System

81,233

Upon completion of our residency and fellowship program, graduates enjoy tremendous success in their professional lives. Our alumni are highly sought after in both private practice and academic medicine, where they often assume leadership positions. Duke Anesthesiology is proud of the medical students, residents, and fellows we have trained. These individuals reflect positively upon our program in their many successes, and are a part of Duke University’s tradition of excellence.

1,616,956

8 9

Number of surgical procedures in 2009

Number of inpatient admissions in 2009

7

63,223

Several of the fellowships within Duke Anesthesiology are accredited through the Accreditation Council for Graduate Medical Education (ACGME). The fellowship in Cardiothoracic Anesthesia is the most comprehensive program in the country, providing an unrivaled balance between clinical exposure and academic development. In 2009, Duke University Hospital performed approximately 1,200 thoracic surgeries, 1,600 cardiac surgeries, and 5,600 cardiac catheterizations. The TEE training program is an integral part of both the Cardiothoracic Anesthesiology Fellowship and the Critical Care Fellowship. Duke Anesthesiology is also well-known for its Pain Management Fellowship Program, where fellows not only learn pain management techniques and the use of the fluoroscope, but advanced interventional techniques, such as spinal cord stimulation, radiofrequency lesioning, intrathecal pump insertion, diagnostic discography, and neuro-ablative techniques for cancer pain management as well.

Number of outpatient visits in 2009

There are eight different fellowship programs within Duke Anesthesiology: Cardiothoracic Anesthesia, Critical Care Medicine, Pain Management, Pediatric Anesthesia, Neuroanesthesia, Regional and Ambulatory Anesthesia, Obstetric Anesthesia, and Undersea and Hyperbaric Medicine. Duke Anesthesiology currently has over 20 fellows.

Recently, Duke Anesthesiology has placed increased emphasis on research productivity during fellowship training. Each fellow now identifies a specific research project to pursue during his or her fellowship time.

Fellows develop strong bonds within their own fellowship programs, as well as a group identity thanks to a bi-weekly core fellow seminar series.

These seminars cover topics like the principles of research, mentorship, patient safety topics, and how to succeed at oral exams. Individuals interested in the fellowship program must apply online or submit a written application. If approved, the written application is followed by a face-to-face interview.

5

Fellowship Programs

21

Reprinted with permission from DukeHealth.org

UPRIGHT BURDENS

Most of us will experience back pain in our lives, but for most of us this pain is resolved on its own in a few weeks. Of people who see a doctor for lingering back pain, medication and physical therapy will usually do the trick.

Only a fraction will ultimately need surgery to treat their troubled spine.

Winston C. V. Parris, MD And of those who undergo surgery, 95 percent will enjoy a much improved quality of life after the procedure.

Parris notes that there are a variety of ways to treat back pain, many of which incorporate exercise, physical therapy, and lifestyle changes. The Duke Pain Clinic is one of the few places in the United States that offers a new procedure called percutaneous neuroplasty to patients with spinal stenosis and failed back surgery.

The Duke Pain Of the millions of Americans who say they live with pain every day, the most common source of pain is in the low back. Winston Parris, MD, says the back, by design, is the perfect place for chronic pain to start. “The good Lord made us, tragically, on two legs,” he says.

places in the United States that offers

“Twenty years ago, everyone

a new procedure called percutaneous with back pain essentially got the same procedure or the same neuroplasty to patients with spinal pain medicine,” he says. “Now physicians know how to tailor their approach to what’s going on in each patient’s body.”

stenosis and failed back surgery.

Walking upright means the network of 33 vertebrae that protect our spinal cords endure more pressure than the spines of four or more legged animals. As a result, over the course of a lifetime, almost every human spine suffers degenerative changes in either the vertebra or the disks between them.

These disks—the spine’s shock absorbers—are often ground zero for back problems. When a disk begins to wear down, it begins to swell, "bulging like a boxer’s punched lip,"says Parris.

That swelling puts pressure on the nerves nearby, radiating pain as far out as your leg.

Herniated disks are one of the most common causes of back pain, but they certainly are not the only one.

Spinal stenosis, which is pain resulting from a narrowing of the spinal cord, is a common condition that occurs after injury or surgery or as a part of the aging process; it’s the most common reason for back surgery in people over age 60.

22

This treatment, which involves injecting a solution into the affected area of the spinal column, can offer significant relief where traditional approaches to Clinic is one of the few spinal pain have failed.

When to Seek Specialized Pain Care Most cases of back pain can be treated by your primary care provider and will abate in about six weeks, according to Duke back pain experts.

You might need specialized attention if you experience: * Severe or persistent radiating pain: back pain that radiates to your legs or that’s accompanied by tingling, pain, or numbness in the arms or legs. * Sudden changes in pain, such as if you’ve had pain while standing or walking and suddenly develop sharp pain shooting down a leg or arm. * Pain accompanied by other symptoms, such as significant weakness in the legs, problems with walking, bowel and bladder issues, weight loss, or fever.

Parris says that if you are experiencing pain of any sort that has persisted for three months or more—and you’ve already received treatment from a specialist—it’s time to seek out the services of a pain doctor.

The Duke Pain and Palliative Care Program treats joint-related pain, migraine headaches, fibromyalgia, sickle cell crisis, and other chronic painful conditions. To reach the Duke Pain Clinic, call 919.684.7246 or 1.888.ASK.DUKE (888.275.3853).

Research

New Tactics in the WAR on Pain

Q

uick trivia question: How many horses has General Petraeus, recently appointed commander of American forces in Afghanistan, had shot out from under him in comparison to Civil War Confederate General Nathan Bedford Forrest?

The answer: General Bedford Forrest has him beat by 30.

It isn’t much of a competition, however, considering that General Petraeus has never had a horse shot out from under him. That’s because generals don’t typically ride horses on the battlefield anymore. If this comes as a great shock to you, pause to consider: when was the last time you saw soldiers armed with bayonets engaged in hand-to-hand combat on the news?

Soldiers don’t tend to cook their meals over an open fire, play dominoes in their free time, or send messages to their loved ones back home via telegram anymore either.

The nature of war has changed dramatically over the past 150 years. So why is it that our modern day soldiers are being treated with essentially the same pain management techniques employed in the Civil War? 23

Duke Anesthesiology BluePrint | BluePrint.duhs.duke.edu

Battlefield Medicine Historically, physicians working with the military have adopted a, “one size fits all” attitude toward pain management. Soldiers are still being treated primarily with aspirin, morphine, and various derivatives to cope with their pain on the battlefield— essentially the same concoction that has been used to treat battlefield pain for years. This approach has proven itself to be unsuccessful time and time again.

Here at Duke, we believe that it’s time to change our strategy.

Technology: The Pros and Cons Thanks to major advancements in technology and medicine, the number of war casualties from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) are lower than ever. Due to the high level of protection provided by modern body armor, soldiers are more likely to survive injuries sustained on the battlefield. Opposing forces, have adapted by tailoring improvised explosive devices (IEDs) to maim rather than to kill. Soldiers are not dying as frequently, but they are sustaining a higher number of peripheral limb blast injuries and traumatic brain injuries.

The Problem With Pain The acute, or sudden sharp pain, veterans experience as a result of these injuries is likely to develop into chronic pain, which can last for years after the actual injury has healed. Opioids like morphine, the current standard in battlefield medicine, are only good at relieving short-term acute pain. They do not remove pain, but they help an individual keep it at a manageable level.

The main problem with opioids is that it doesn’t take very long before a patient will build up a tolerance

toward the drug. In other words, it will require more and more of the drug, and it will become less and less effective. Furthermore, recent evidence suggests that if acute pain goes untreated, or is treated inadequately, it could lead to chronic pain and affect survival rate.

In addition to dramatically decreased quality of life due to constant pain and addiction, opioid use can cause several negative social behaviors to develop. Veterans unable to work may be tempted to sell their medications illegally for their potentially high street value. Homelessness in the veteran population is also common—the U.S. Department of Veterans Affairs (VA) funds almost 500 homeless shelters. Suicide, sought out by those who cannot cope with overwhelming mental and physical pain, is equally prevalent.

These problems are becoming critical as hundreds of young war veterans, both male and female, are returning home each year with debilitating injuries that often require amputation. Soldiers and their families, a group that traditionally considered pain to be a weakness that could be overcome by mental fortitude, are now asking for help.

The War Against Chronic Pain The effort to help solve the problem of chronic pain began at Duke when Duke Anesthesiology alumnus and chief of the Army Regional Anesthesia and Pain Management Initiative at Walter Reed Army Medical Center, Chester C. “Trip” Buckenmaier, III, MD, began to advocate for help. The development of chronic pain is a significant problem for the U.S. Military, particularly the Army, the branch that has incurred the largest number of blast related injuries. Not only does chronic pain take a huge toll on the individual soldier and his or her family, treating chronic pain and the various problems associated with it are incredibly expensive. This is a problem not just for our military— it’s a problem for our nation.

Military physicians like Buckenmaier are interested in Duke because of our expertise in perioperative and critical care medicine. Our doctors have experience caring for a large volume of patients undergoing thoracic surgery. Although the connection may seem strange, there are many similarities between

24

New Tactics In The War of Pain

Research the pain experienced after a thoracotomy, and the pain experienced as a result of an amputation.

Surgery is actually nothing other than a controlled injury. Both procedures involve large, unilateral peripheral nerve damage. They probably share a common pathophysiology (or cause), and are equally disabling. This relationship has not been well studied in the past, but researchers at Duke believe that through further investigation, we can find novel solutions to this type of pain.

Duke Responds Two organizations have been created to address this problem. A new center for perioperative medicine based at the Durham VA Medical Center is investing in research studies aimed at improving our knowledge of the epidemiology and treatment of pain by studying how patients recover after serious injury and surgery. In parallel, the Durham VA Medical Center is opening new clinics specifically dedicated to working with amputees and post-thoracotomy patients. A new 10,000 square foot lab, scheduled to open at the Durham VA Medical Center in 2010, will focus on the basic science portion of this study.

Researchers involved with Veterans Injury Pain Research (VIPR) are looking to pharmacogenetics, (a branch of pharmacology that studies the interrelation of hereditary constitution and response to drugs) for answers.

Research suggests that people may have what is known as a pain group, a concept very similar to that of a blood type. The theory states that if physicians can identify a patient’s pain group, they will be able to identify not only what kind of drugs individuals will respond most favorably to, but exactly how much of the drug is required to produce the best possible outcome.

An individual’s pain type could be determined by studying genetic predictors, variations in their DNA sequence. This information could easily be obtained through a blood or saliva test. After completing this test, soldiers about to deploy would be armed with something almost as valuable as the armor they wear—the knowledge they need to obtain the best possible treatment should they become injured in the line of duty.

and regeneration, has partnered with colleagues David MacLeod, MB BS, an acute pain specialist, Thomas Buchheit, MD, a chronic pain specialist, and others in the creation of a research project that will enable these individuals to further study this hypothesis. The main goal of their study is to gain an understanding of why some people develop one kind of chronic pain, and others develop another completely different type of pain. If successful, this knowledge will provide them with a better understanding of the biological causes of pain syndromes as they develop, enabling them to raise novel drug targets that focus on personalized medicine. In July 2010, Shaw and his group were awarded a three-year, $1.5M grant from the Department of Defense (DOD) for their research study, “Molecular Signatures of Chronic Pain Subtypes.”

A Personal Mission In studying the transition from acute to chronic pain, Duke physicians are not only helping our military, but humanity in general. Chronic pain can affect anyone. The results of this exciting research will have a widespread impact. To many, however, it is just as important on an individual level. According to Shaw, “the fundamental tenet of medical practice is to cure disease and relieve pain and suffering,” a goal Shaw considers to be far more important than simply, “observing physiological effects.” Work that will impact even just the life of one individual is still a worthy cause. When asked why he deems this study to be of great consequence, Shaw replied, “I believe it’s important to try and give something back. Our soldiers go and put their lives at risk for us. If we can do anything to try to relieve the inevitable pain our wounded heroes face when they come back, then I think that’s a goal worthy of significant effort on our part.”

Andrew Shaw, MB BS, an anesthesiologist employed by the Durham VA Medical Center with an interest in genetics, genomics, response to injury, 25

Duke Anesthesiology BluePrint | BluePrint.duhs.duke.edu

A Stellar Career Behind Him, Reves Sails Into the Sunset

By Jim Rogalski

He helped pioneer modern anesthesiology, co-founded the Duke Heart Center, developed Duke Anesthesiology into one of the best anesthesiology departments in the country, and upped the ante of national respect for the Medical University of South Carolina (MUSC) College of Medicine. So, it was fitting when shortly after Joseph “Jerry” Reves, MD, retired June 30 as vice president for Medical Affairs, dean, and professor at the MUSC College of Medicine, he and his wife Jenny sailed off into the sunset.

Well, actually they motored off into the sunset on July 6, 2010 on their 41-foot motorboat named Sweetgrass. Their destination is the 5,500 mile long Great Loop that will take them from Charleston, S.C. through the Chesapeake, to the Hudson River, the Great Lakes, the Mississippi River, around the tip of Florida, and back to Charleston. They plan to complete the journey in sections.

“Seeing America's earliest states and towns from the water seems like a great way to sail into the next phase of our lives,” he says. “Taking an extended cruise with Jenny and our Labrador is just the next adventure in a life full of them.”

The relaxation Reves will enjoy on the trip is well earned. His career has been a chain of milestone accomplishments, linked, he says, by the robust and enduring influence of his 17 years at Duke.

He first gained international recognition in 1975 26

while associate professor of anesthesiology at the University of Alabama in Birmingham (UAB).

Reves was the first physician in the world to use the sedative midazolam (Versed) on a surgery patient. Today, Versed is one of the most common anesthetics used around the world.

“It was approved by the FDA the year I came to Duke (1984) and I continued to do a lot of research on it,” Reves says. “It became a very important drug, and when I stepped down as the head of the Duke Heart Center in 1997, Roche (the company that makes the drug) endowed the Duke Heart Center Lectureship. I made them a lot of money and they gave Duke a little something in return.”

Reves co-founded the Duke Heart Center in 1987 with then-chairman of the Department of Surgery, David C. Sabiston Jr., MD, and

Alumni Spotlight

27

Top Left: Jerry Reves, MD, his wife Jenny, and their Labrador retriever (Ace) on deck of their 41-foot motor boat Sweetgrass, which they plan to sail around the Great Loop. Bottom left: Jerry Reves relaxing on Sweetgrass on his birthday during their Great Loop adventure. Top right: Jerry and Jenny Reves spending time with their two granddaughters. Bottom right: Jerry Reves with his three daughters: Virginia Hall, Christy Reves, and Betsy Reves.

Joseph C. Greenfield Jr., MD, then-chair of the Department of Medicine. He served as its director for 10 years.

“I remember Joe saying to me, ‘You know, we have a cancer center;\ I don’t know why we don’t have a heart center,’ I said I didn’t know either, so Tom Bashore, MD, (cardiology) and Bob Jones, MD, (cardiac surgery) and I got deputized to figure it out,” Reves says.

Three-days before he retired as chancellor of the Medical Center, William G. Anlyan, MD, appointed Reves as the first director of the Duke Heart Center.

Just two years prior to that in 1985, Reves was instrumental in the success of Duke’s first-ever heart transplant—the first in North Carolina. Reves designed the anesthesia protocol for the delicate operation on the 55-year-old father of five children.

“Heart transplant patients are arguably the sickest patients you’ll take care of,” Reves says, “so you have to be very careful that you don’t give them too much anesthesia, which could kill them, or too little so they might remember.”

28

Reves Sails Into the Sunset

The surgery was successful, and Reves remembers it as a “remarkable demonstration of the close teamwork of the surgeons and anesthesia team.” It also demonstrated how far Reves had taken the Division of Cardiothoracic Anesthesiology after just one year as chief. He was named chairman of the Department of Anesthesiology in 1991, and held that position for 10 years. As chairman, Reves created sub-specialties within the department such as obstetrics, neurology, vascular, and pediatrics. His leadership and foresight made Duke Anesthesiology one of the best programs in the country. He says his favorite time at Duke was helping young careers develop. “It was a special time and special things happened. The great thing is, it’s still happening and that is very gratifying.”

While honoring Reves at a dinner in April, MUSC assembled nearly a dozen of his former associates who had advanced to become department chairs at universities around the country. They included former Duke house staff officers and faculty: Peter S. A. Glass, MD, HS’87-’88, chairman and professor of the Department of Anesthesiology at The

Alumni Spotlight

Jerry Reves, MD, (center with striped tie) is surrounded by some of the grateful physicians he has mentored over the years. From left to right are: Jeffrey Balser, MD, dean of Vanderbilt University School of Medicine; Peter S. A. Glass, MD, HS’87-’88, chair of the Department of Anesthesiology at the State University of New York at Stoney Brook; Scott Reeves, MD, chairman of the Department of Anesthesiology at the Medical University of South Carolina; Reves; Mark Newman, MD, HS’88-’89, chairman of the Department of Anesthesiology at Duke; David Lubarsky, MD, chairman of the Department of Anesthesiology at the University of Miami; Debra Schwinn, MD, HS’86-’89, chairman of the Department of Anesthesiology at the University of Washington; and William Greeley, MD, HS’76-’80, chairman of Anesthesiology at Children’s Hospital of Philadelphia.

State University of New York at Stony Brook; Mark Newman, MD, HS’88-’89, chairman of the Department of Anesthesiology at Duke; David Lubarsky, MD, chairman of the Department of Anesthesiology at the University of Miami; Debra Schwinn, MD, HS’86-’89, chairman of the Department of Anesthesiology at the University of Washington; and William Greeley, MD, HS’76-’80, chairman of the Department of Anesthesiology at Children’s Hospital of Philadelphia.

“Dr. Reves was an unbelievably giving individual— of his time, of his brain and intellect, and of his enthusiasm,” says Glass. “When he felt passionate about something, he would never let go.”

are trying to do at MUSC,” Reves says. “We want to emulate Duke. We won’t catch Duke, but we can be more like Duke.”

Other retirement activities will include serving as an advisor to the Duke DREAM Campaign, and writing a book about staying healthy while cruising. “I want to learn what illnesses and injuries are common for people on boats, get data, and ultimately write an evidence-based book that people will carry on-board to know how to stay healthy.”

Reves and his wife, Jenny, have three grown daughters: Virginia, Christy, and Betsy. You can follow their boating adventure on their blog at sweetgrassadventures.com.

While at MUSC from 2001-10, Reves helped its cancer center achieve National Cancer Center Institute designation, earned MUSC the Clinical Translational Science Award, increased its National Institutes of Health funding, and increased the number of minorities enrolled in the medical college. “Much of what is good about Duke, we 29

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Midazolam Added to Morphine Patient-

Allen B, Demchenko I, Piantadosi C.

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Autonomic Activation Links CNS Oxygen

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Bute, BG, Stafford-Smith M. A Prospective,

Moon RE. Breath-Hold Diving and Cerebral

the Questions and the Answers. J Cardio-

Symptom Distress Scale. Qual Life Res 2009

Double-Blind, Randomized Clinical Feasibil-

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Bennett-Guerrero E, Gan TJ, Roche AM.

Clin Anesth 2010 Mar;22(2):126-9. PubMed James ML. Comparison of Continuous and Intermittent Cerebrospinal Fluid Drainage

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Capillary Barrier Function During Acute

of Body Mass Index, is Associated With a

and Controversies in the Treatment and

Goal-Directed Fluid Management With

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“Higher Success” Rate For Supraclavicular

Prevention of Postoperative Nausea and

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Stafford-Smith M. Invited Commentary.

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Miller TE, Roche AM. Goal-Directed

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Nitric Oxide and Molecular Mechanisms of

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30-Day Mortality in Aortocoronary Bypass

atr Otorhinolaryngol 2009 Jul;73(7):975-

Critical Care, 4th Edition.

Gan TJ, Habib AS, Klein SM, Nielsen KC,

Aronson S, Newman MF, Phillips-Bute BG, Shaw AD, Stafford-Smith M. Intraoperative

Roche AM. Does The Choice of Fluid

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on Pediatric Use. Anesth Analg 2010 Feb

Undergoing Outpatient Laparoscopies. Can

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Neurosurgical Anesthesiology 2009; 21(3):

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Mackensen GB. Jugular Bulb Desaturation

Techniques in Cardiothoracic & Vascular

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able Gentamicin-collagen Sponge on

Radical Retropubic Prostatectomy. Anesth

Sternal Wound Infections Following Cardiac

Analg 2009;108:1950-3. PMID: 19448228.

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DS,Yang W. Long-Term Neuroprotection From a Potent Redox-Modulating Metal-

Cherry AD, Freiberger JJ, Moon RE, Pollock NW. Effects of Head and Body Cool-

Piantadosi CA, Suliman HB. Extracellular

Mathew JP, Newman MF, Phillips-Bute BG,

loporphyrin in the Rat. Free Radic Biol Med

ing on Hemodynamics During Immersed

Superoxide Dismutase Regulates Cardiac

Shaw AD, Stafford-Smith M,

2009 Oct 1;47(7):917-23. Epub 2009 Jul 22.

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Function and Fibrosis. J Mol Cell Cardiol

Swaminathan M. Impact of Early Renal

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Kwatra M. Low Expression of Alpha-Adren-

Surg 2010 Apr;89(4):1098-104. PubMed

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J Am Geriatr Soc 2010 Jan;58(1):210-2.

Freiberger JJ, Moon RE, Peacher DF. Effects of Hyperoxia on Ventilation and Pulmonary

Kwtra, M. Flaws in the Serum Anticholin-

Hemodynamics During Immersed Prone

ergic Activity Assay: Implications for the

Exercise at 4.7 ATA: Possible Implications for

Study of Delirium. J Am Geriatr Soc 2009

Habib AS, McCarthy GC. Impact of Intrave-

Immersion Pulmonary Edema. J Appl Physiol

Sep;57(9):1707-8. PMID: 19895433.

nous Lidocaine Infusion on Postoperative

Gan TJ, Miller TE. Managing Postoperative

Analgesia and Recovery From Surgery: A

Nausea and Vomiting. Patient Safety in

Gan TJ, Homi HM. Fospropofol Diso-

Systematic Review of Randomized Con-

Plastic Surgery Edited by V. Leroy Young

Moon RE. Environmental Physiology of the

dium for Sedation. Drugs Today 2009

trolled Trials. Drugs 2010 Jun 18;70(9):1149-

and Richard Botney. Published by Quality

Future. In: Lang MA, Brubakk AO (Eds).

Aug;45(8):567-76. PMID: 19927223.

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Medical Publishing, Inc. St. Louis, Missouri.

and Beyond Washington, DC: Smithsonian

Bennett-Guerrero E. Gentamicin-Collagen

Mathew JP, Phillips-Bute BG, Shaw AD,

Institute Press ; 2009, 11-5.

Sponge for Infection Prophylaxis in

Stafford-Smith M, Swaminathan M.

Mackensen GB. Metabolic Management

Colorectal Surgery. N Engl J Med 2010 Sep

Increasing Healthcare Resource Utilization

During CPB. Chosh et al. (eds). Cardiopul-

9;363(11):1038-49.PMID: 20825316.

After Coronary Artery Bypass Graft Surgery

monary Bypass.

2010;109:68-78.

PMID: 20122076.

2009. 487-510.

Future of Diving: 100 Years of Haldane

Piantadosi CA, Suliman HB. Erythropoi-

in The United States. Circ Cardiovas Qual

etin Activates Mitochondrial Biogenesis and Couples Red Cell Mass to Mitochon-

Mathew JP, Phillips-Bute BG, Stafford-

Outcomes 2009 Jul;2(4):305-12. Epub 2009

Fukuda S, Warner DS. Metalloporphyrin

drial Mass in the Heart. Circ Res 2010 Jun

Smith M, Welsby IJ. Glycosylated Hemo-

Jun 16. PMID: 20031855.

Antioxidants Ameliorate Normal Tissue

11;106(11):1722-30. Epub 2010 Apr 15.

globin Levels and Outcome in Non-Diabet-

PMID: 20395592.

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Karhausen J. Inflammation-Associated

Radiat Biol 2010 Feb;86(2):145-63. PMID:

2010 Jun;57(6):565-72. Epub 2010 Mar 11.

Repression of Vasodilator-Stimulated

20148700.

PMID: 20221858.

Phosphoprotein (VASP) Reduces Alveolar-

Radiation Damage In Rat Brain. Int J

31

Duke Faculty & Alumni Spotlight Highlights from fiscal year 2010 Shaw AD, Swaminathan M. Mitral

Warner DS. Oxygen and Glucose Depriva-

Gradients and Frequency of Recurrence of

tion in an Organotypic Hippocampal Slice

Mitral Regurgitation After Ring

Model of the Developing Rat Brain: The

Annuloplasty For Ischemic Mitral

Effects on N-methyl-D-aspartate Subunit

Regurgitation. Ann Thorac Surg 2009

Composition. Anesth Analg 2009

Oct;88(4):1197-201. PMID: 19766807.

Jul;109(1):205-10. PMID:19535712.

Mackensen GB. Mitral Valve Disease.

Schulman SR. Paraquat Ingestion: A

Nihoyannopoulis and Kisslo (eds.) Echocar-

Challenging Diagnosis. Pediatrics 2010

diography.

Jun;125(6):e1505-9. Epub 2010 May 17.

PMID: 20478935.

Shaw AD, Swaminathan M. Mitral Valve Repair For Degenerative Disease: A 20-Year

Chaney E. Pathophysiology of Fluid

Experience. Ann Thorac Surg 2009; 88:

Retention in Heart Failure. Contrib Nephrol

1828-37. PMID: 19932244.

2010;164:46-53. Epub 2010 Apr 20. Review.

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Nicoara A, Phillips-Bute BG, Shaw AD, Stafford-Smith M, Swaminathan M.

Gan TJ. Peripherally Acting Mu-Opioid

Mortality Trends Associated With Acute

Receptor Antagonists and Postoperative

Renal Failure Requiring Dialysis After CABG

Ileus: Mechanisms of Action and Clinical

Surgery in the United States. Blood Purif

Applicability. Anesth Analg 2009;108:1811-

2009;28(4):359-63. Epub 2009 Sep 1 PMID:

22. PMID: 19448206.

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Allen BW , Demchenko IT, Piantadosi CA, Olufolabi A. Multidisciplinary Team Partner-

Ruehle A, Vann RD. Phosphodiesterase-5

ships to Improve Maternal and Neonatal

Inhibitors Oppose Hyperoxic Vasoconstric-

Outcomes: The Kybele Experience.

tion and Accelerate Seizure Development

International Anesthesiology Clinics

in Rats Exposed to Hyperbaric Oxygen. J

48(2):109-122, Spring 2010.

Appl Physiol 106: 1234-1242, 2009.PMID: 19179645.

Freiberger JJ, Dear GD, Moon RE. Multimodality Surgical and Hyperbaric

Tracey W. Pickpocket is a DEG/ENaC Protein

Management of Mandibular

Required for Mechanical Nociception in

Osteoradionecrosis. Int J Radiat Oncol Biol

Drosophila Larvae. Curr Biol 2010 Mar

Phys 2009 Nov 1;75(3):717-24. Epub 2009

9;20(5):429-34. Epub 2010 Feb 18. PMID:

Mar 26 PMID: 19328634.

20171104.

Piantadosi CA, Suliman HB. Nitric Oxide

Welsby IJ. Plasmapheresis and Heparin

Synthase-2 Induction Optimizes Cardiac

Reexposure as a Management Strategy for

Mitochondrial Biogenesis After Endotox-

Cardiac Surgical Patients with Heparin-

emia. Free Radic Biol Med 46:564-72. PMC

Induced Thrombocytopenia. Anesth Analg

2666005.

2010 Jan 1;110(1):30-5. Epub 2009 Nov 21.PMID: 19933539.

Piantadosi CA, Suliman HB. Nitric Oxide Synthase-2 Regulates Mitochondrial Hsp60

Martin G. Posterior Capsular Injections of

Chaperone Function During Bacterial

Ropivacaine During Total Knee Arthro-

Peritonitis in Mice. Free Radic Biol Med

plasty: A Randomized, Double-Blind,

2010 Mar 1;48(5):736-46. Epub 2010 Jan 4.

Placebo-controlled Study. J Arthroplasty

PMID: 20043987.

2009 Sep;24(6 Suppl):138-43. Epub 2009 Jun 10. PMID: 19520544.

Moretti EW, Shang AB. Noninvasive Monitoring of Tissue Hemoglobin Using

Cherry AD, Frederick HJ, Freiberger JJ,

UV-VIS Diffuse Reflectance Spectroscopy: A

Moon RE, Stolp BW, White WD. Predictors

Pilot Study. Opt Express 2009; 17(26);23396-

of Increased PaCO2 During Immersed

23409 PMID: 20052047.

Prone Exercise at 4.7 ATA. J Appl Physiol 2009;106:316–325. PMID: 18787095.

Grant SA, MacLeod DB. On the Feasibility of Imaging Peripheral Nerves Using

Auyong DB, Gan TJ, Habib AS, Klein SM,

Acoustic Radiation Force Impulse Imaging.

Roche AM. Processed Electroencephalo-

Ultrasound Imaging 2009 Jul;31(3):172-82.

gram During Donation After Cardiac Death.

PMID:19771960.

Anesth Analg 2010 May 1;110(5):1428-32.

Epub 2010 Mar 17. PMID:20237048.

Swaminathan M. Ordinary Images— Extraordinary Stories: Echo Challenges

Mackensen GB, Mathew JP,

and Clinical Decisions. J Cardiothorac Vasc

Swaminathan M. PRO Editorial: Three-

Anesth 2010 Feb;24(1):5-6. PMID: 20123236.

Dimensional Transesophageal Echocardiography is a Major Advance for Intraoperative Clinical Management of Patients Undergoing Cardiac Surgery. Anesth Analg 2010 Jun 1;110(6):157 4-8. PMID: 20501814.

32

Faculty & Alumni Spotlight

Cherry AD, Moon RE, Stolp BW. Pulmonary

Borel CO, Lombard FW, Sheng H, Warner

Gas Exchange in Diving. J Appl Physiol

DS. Simvastatin Treatment Duration and

2009;106:668-677.

Cognitive Preservation in Experimental Subarachnoid Hemorrhage. J Neurosurg

Huh BK, Pulsed Radiofrequency for Reliev-

Anesthesiol 2009 Oct;21(4):326-33. PMID:

ing Neuropathic Bone Pain in Cancer

19955895.

Patients—An Alternative Strategy. Pain

Ross AK. Society for Pediatric Anesthesia/

Practice 2009: 33 (9): Suppl 1, 102-103.

American Academy of Pediatrics/Congenital Cardiac Anesthesia Society: Winter

Taekman J. Recognizing and Treating

Meeting Review. Anesth Analg 2010 Jan

Malignant Hyperthermia. Simul Healthc

1;110(1):266-71. PMID:20023193.

2010 Jun;5(3):169-72. PMID: 20651479.

Wright DR. Sodium, Potassium and Glucose Aeschlimann N. Recombinant Activated

Management in Organ Transplanta-

Factor VII for Perioperative Bleeding.

tion. Curr Opin Organ Transplant 2010

Rev Med Chil 2009 Jun;137(6):837-43.

Jun;15(3):383-9. PMID:20308896.

Epub 2009 Sep 4. Review. Spanish. PMID: 19746288.

Huh BK. Spinal Cord Stimulation for Chronic Pain. Ann Med Singapore 2009 Nov, 38(11):

Gan TJ. Reduction in Opioid-related Ad-

998-1003. PMID: 19956823.

verse Events and Improvement in Function with Parecoxib Followed by Valdecoxib

Piantadosi CA, Suliman HB. Staphylococcus

Treatment After Non-Cardiac Surgery: A

Aureus Sepsis and Mitochondrial Accrual

Randomized, Double-Blind, Placebo-Con-

of OGG1 DNA Repair Enzyme in Mice. Am

trolled, Parallel-Group trial. Clinical Drug

J Respir Crit Care Med 2010 Aug 23. PMID:

Investigation 2009; 29: 577-90.

20732986.

Gan TJ, Malinzak EB. Regional Anesthesia

Mathew JP, Newman MF, Phillips-Bute BG,

for Vascular Access Surgery. Anesth Analg

Stafford-Smith M, Welsby IJ. Storage Age

2009 Sep;109(3):976-80. Review. PMID:

of Transfused Platelets and Outcomes After

19690276.

Cardiac Surgery. Transfusion 2010 Jun 21.

[Epub ahead of print] PMID:20573071.

Winchester JB. Regional Anesthesia Live Web Video Education. ASRA Newsletter

Funk D, Gan TJ, Moretti EW. Stroke Volume

2010 Aug.

Calculation by Esophageal Doppler Integrates Velocity Over Time and Multiplies

Stafford-Smith M. Renal Functioning

This “Area Under the Curve” By the Cross

Monitoring. Chapter in Miller RD, Miller’s

Sectional Area of the Aorta. Anesth Analg

Anesthesia 7th ed.

2009 Sep;109(3):996. PMID: 19690286.

Johnson CE. Restraint of Apoptosis During

Maxwell CD. Surgically Placed Left Ven-

Mitosis Through Interdomain Phosphory-

tricular Leads Provide Similar Outcomes to

lation of Caspase-2. EMBO J 2009 Oct

Percutaneous Leads in Patients With Failed

21;28(20):3216-27. Epub 2009 Sep 3. PMID:

Coronary Sinus Lead Placement. Heart

19730412.

Rhythm 2010 May;7(5):619-25. Epub 2010 Jan 20. PMID: 20156615.

Huh BK. Retrospective Analysis of Lowdose Methadone and QTc Prolongation in

Piantadosi CA, Suliman HB. Survival in Criti-

Chronic Pain Patients. Korean J Anesthesiol

cal Illness is Associated with Early Activation

2010 Apr; 58(4): 338-343.

of Mitochondrial Biogenesis. Am J Respir Crit Care Med 2010 Sep 15;182(6):745-51.

Martin G. Reversal of Profound Vecuroni-

Epub 2010 Jun 10. PMID: 20538956.

um-Induced Neuromuscular Block Under Sevoflurane Anesthesia: Sugammadex

Roberson RS. Survivin and Escaping in

Versus Neostigmine. BMC Anesthesiol 2010

Therapy-induced Cellular Senescence. Int J

Sep 1;10(1):15. [Epub ahead of print] PMID:

Cancer. 2010 May 25. [Epub ahead of print].

20809967.

PMID: 20503268.

McDermott WJ. Running-Specific Prosthe-

Taekman JM, Wright MC. Teamwork Train-

ses Limit Ground-Force During Sprinting.

ing With Nursing and Medical Students:

Biol Lett 2010 Apr 23;6(2):201-4. Epub 2009

Does the Method Matter? Results of an

Nov 4. PMID: 19889694.

Interinstitutional, Interdisciplinary Collaboration. Qual Saf Health Care 2010 Apr 27.

Gan TJ. Safety Evaluation of Fospropofol

[Epub ahead of print]. PMID: 20427311.

for Sedation During Minor Surgical Procedures. J Clin Anesth 2010; 22:260-7. PMID:

Bennett-Guerrero E. Temporal Changes in

20522356.

the Use of Blood Products for Coronary Artery Bypass Graft Surgery in North

McQueen-Shadfar L, Taekman J. Say What

America: An Analysis of the Society of

You Mean to Say: Improving Patient Hand-

Thoracic Surgeons Adult Cardiac Database.

offs in the Operating Room and Beyond.

J Cardiothorac Vasc Anesth 2010 Aug 13.

Simulation in Healthcare. 2010.

PMID: 20709572.

Grant SA, The ASRA Evidence-Based

Gan TJ. Update on the Management of

Medicine Assessment of Ultrasound-Guided

Postoperative Nausea and Vomiting and

Regional Anesthesia and Pain Medicine:

Postdischarge Nausea and Vomiting in

Executive Summary. Reg Anesth Pain Med

Ambulatory Surgery. Anesthesiology Clin

2010 Mar-Apr;35(2 Suppl):S1-9. Review.

2010;28:225-249.

PMID:20216019.

Clarke C. Using Perfusion MRI to Measure Gan TJ. The Effect of Cultural Background

the Dynamic Changes in Neural Activation

on the Usage of Complementary and

Associated With Tonic Muscular Pain. Pain

Alternative Medicine for Chronic Pain Man-

2010 Mar;148(3):375-86. Epub 2009 Nov 14.

agement. Pain Physician 2009;12:685-688.

PMID: 19914778.

PMID: 19461837.

Shelley K, Taekman JM. Virtual EnvironPaschen W, Yang W. The Endoplasmic

ments in Healthcare: Immersion, Disruption,

Reticulum and Neurological Diseases. Exp

and Flow. Int Anesthesiol Clin 2010;48:101-

Neurol 2009 Oct;219(2):376-81. Epub 2009

121. PMID: 20616640.

Professional Growth Anesthesiology, Duke University Winston C. V. Parris , MD—Awarded the St. Lucia Cross (St. Lucia's second highest

Barry W. Allen, PhD, "Apparatus for Non-

honor) by the Prime Minister and Governor-

invasive Estimation of Arterial Carbon-

General of St. Lucia for contributions to

Dioxide Content for Ventilation of Combat

Pain Medicine in February 2010

Casualties" (research award), sponsored by Polestar Technologies, Inc. $17,428

Mihai Podgoreanu, MD—ASA 2009 Presidential Scholar Award

Mackensen GB. The Impact of Cardiopul-

Time Ultrasound Guidance for Facet Joint

monary Bypass on Systemic Interleukin-6

Injection: A Proof of Concept. Anesth Analg

Release, Cerebral Nuclear Factor-Kappa B

2010 May 1;110(5):1461-3.PMID: 20418305.

Expression, and Neurocognitive Outcome in Rats. Anesth Analg 2010 Feb 1;110(2):31220. Epub 2009 Oct 27. PMID: 19861361.

General Awards & Recognition

Kuhn CM. The Innovative Anesthesiol-

Solomon Aronson, MD—2010 listed in Best

ogy Curriculum: A Challenge and Hope

Doctors in America, "Intraoperative Systolic

For The Future. Anesthesiology 2010

Blood Pressure Variability Predicts 30-Day

Feb;112(2):267-8. PMID: 20098121.

Mortality in Aortocoronary Bypass Surgery Patients" Anesthesiology 2010 Aug

Huh BK, The Kerman Air Product (KAP) Method for the Effective Dose Estimation

article selected for Faculty of 1000 Medicine

in Lumbar Epidural Steroid Injection Procedure: Phantom Study. Am. J Roent 2009

Guy de Lisle Dear, MB—2009 Craig Hoff-

June; 192(6): 1726-1730.

man Memorial / Charles Shilling Award (International Award)

Mathew JP, Phillips-Bute BG, Stafford-Smith M, Welsby IJ. The Relationship of Plasma

John J. Freiberger, MD— Board Certification

Transfusion From Female and Male Donors

in Public Health by the National Board of

With Outcome After Cardiac Surgery. J

Public Health Examiners

Thorac Cardiovasc Surg 2010 Feb 5. [Epub ahead of print]. PMID: 20138634.

Tong Joo (TJ) Gan, MD—Chair, Department Appointments, Promotion and Tenure

Stafford-Smith M. The Renal System and

Committee

Anesthesia for Urologic Surgery. Chapter in Clinical Anesthesia 6th ed, Barash et al.

Katherine P. Gricknik, MD—Director for the Center for Educational Excellence at

Huh BK, Thermogram in Spinal Cord

the DCRI

ment of Nonin 7600 NIRS Tissue Oximetry during Cardiovascular Surgery" (Clinical

gist of the Year for Duke School Of Nursing

Trial), sponsored by Nonin Medical, Inc.;

SRNA program; America’s Best Doctors

Regional PI – FOCUS stage III -Broadly Disseminate Self Assessment Tool and Safety

Jeffrey M. Taekman, MD—2010 Chancellor’s

Program—The FOCUS Initiative “Flawless

Clinical Leadership in Academic Medicine

Operative Cardiovascular Unified Systems”;

Program (C-ChAMP), Duke University

"Safety and Efficacy of Esmolol for the

Health System; Co-Director for the Center

Treatment of Peri-operative Tachycardia in

for Educational Excellence at the DCRI

Patients at Risk for Post Operative Adverse Ischemic Outcomes" (Grant) $168,216

Melanie C. Wright, PhD—selected as an Associate Editor for IEEE Systems, Man, and

Raquel Bartz, MD, "Mitochondrial DNA

Cybernetics, Part A Journal

Repair and Biogenesis" (Mentored Clinical

Alumni Class Notes

Steven E. Hill, MD—elected as Secretary/

Neuromodulation 2009 April; 13 (2): 14-116.

Treasurer of SABM

Stafford-Smith M. The Role of Biomark-

Michael L James, MD—2009 American

ers in Cardiac Surgery Associated Acute

Society of Critical Care Anesthesiologists/

Kidney Injury. Chapter in Vincent JL, 2009

Hospira Physician Scientist Award; 2009

Yearbook of Intensive Care and Emergency

Society of Neurosurgical Anesthesia and

Medicine.

Critical Care/Integra Foundation Award; 2009 Society of Neurosurgical Anesthesia

Phillips-Bute BG, Shaw AD, Stafford-Smith

and Critical Care John D. Michenfelder New

M, Swaminathan M. Trends In Cardiac

Investigator Award; 2010 Society of Critical

Surgery-Associated Acute Renal Failure

Care Medicine Annual Scientific Award

in the United States: A Disproportionate Increase After Heart Transplantation. Ren

David L. McDonagh, MD—2006 United

Fail 2009;31(8):633-40. PMID: 19814629.

Council of Neurologic Subspecialties Accreditation for the Duke Neurocritical

Freiberger JJ. Triage and Emergency Evacu-

Care Fellowship; 2010 Chancellor’s Clinical

ation of Recreational Divers: A Case Series

Leadership in Academic Medicine Program

Analysis. Undersea Hyperb Med 2010 Mar-

(C-ChAMP); Duke University Health System

Apr;37(2):133-9. PMID: 20462146.

2010 promotion to Division Chief of Neuroanesthesiology

Allen BW, Demchenko IT, Piantadosi CA. Two Faces of Nitric Oxide: Implications For

Richard E. Moon, MD—DAN Asia-Pacific

Cellular Mechanisms of Oxygen Toxicity. J

Contributions to Dive Safety Award, 2010;

Appl Physiol 106, 2009. PMID: 18845774.

2009 Teacher of the Year, Department of

Scientist Development Award [K08]) sponsored by National Institutes of Health

Peter DeBalli, MD (residency 2001) is in

Elliott Bennett-Guerrero, MD, "Impact of

private practice in Florida, and was recently

Blood Storage Duration on Physiologic

selected as an ABA New Examiner for the

Measures: RECESS Ancillary Study" (Clinical

Part 2 (oral) examination.

Trial), sponsored by National Institutes of Health $1,605,021

Daniel DeMeyts, MD (residency 2003, CT Fellowship 2004) is in practice in Roanoke,

Tong Joo (TJ) Gan, MD, "PALO-08-11:

VA. He does a variety of clinical work

Study to Assess Palonosetron vs. Ondan-

including OB, regional, cardiac, and

setron for PONV in PACU" (Clinical Trial),

pediatrics.

sponsored by Helsinn Healthcare S.A. $7,563; "Triple Low Confirmation Col-

John Morreale, MD (residency 2004) is in

laboration" (Research Award) sponsored

practice in Bloomfield, MI. Over the years,

by Covidien Ltd. $99,335; "Assessment of

John has improved care at his hospital in

NICOM vs.Esophageal Doppler Monitor

several ways: incorporating peripheral

Guided Goal Directed Fluid Therapy in

nerve blocks in total joint patients, provid-

the Perioperative Period" (Clinical Trial),

ing paravertebral blocks for breast surgery

sponsored by Cheetah Medical $187,700;

patients, and using regional anesthesia in

"Durect BESST" (Clinical Trial), sponsored by

carotid surgery.

the DURECT Corporation $2,786,600

George Lappas, MD (residency 2005, CT

Brian Ginsberg, MB ChB, "C803-025: Bupi-

Fellowship 2006) is in practice in St. Louis,

vacaine Effectiveness and Safety in SABER

MO. He and a former partner started their

Trial" (BESST, Clinical Trial), sponsored by

own practice, which is rapidly expanding.

the DURECT Corporation $108,395

Stimulation with Complex Regional Pain Syndrome and a Review of the Literature.

Solomon Aronson, MD, "Clinical Assess-

Bryant W. Stolp, MD, PhD—Anesthesiolo-

Jul 17.

Clarke C. Virtual Reality Imaging With Real-

Grants, Clinical Trials, & Research Awards

He spearheaded an effort in his first group to incorporate ultrasound for regional

Ashraf S. Habib, MB BCh, "Computerized

anesthesia into the practice, making it one

Surveillance of Opioid Related Adverse

of the first programs in the state to utilize

Drug Events in the Periopeartive Period"

this technology.

(Research), sponsored by The Anesthesia Patient Safety Foundation $149,999

Christina Reiter, MD (residency 2007) is in Bethlehem, PA. She has just started a

Billy K. Huh, MD, PhD, "Partnership for

peripheral nerve catheter program in her

Advancement In Neuromodulation (PAIN):

hospital and is planning to learn TEE for

A Prospective Clinical Outcomes Registry"

non-cardiac use with others in her group.

(Clinical Trial), sponsored by Advanced Neuromodulation Systems $24,008

Todd Stevens, MD (residency 2005, Regional Fellowship 2006) is in practice in Richmond,

M. Luke James, MD, "Pharmacogenomic

VA. He is a partner in his group.

Influences of ApoE and Mimetic Peptides on Neurological Outcomes as a Paradigm for Targeted Therapeutic" (Research), sponsored by the Foundation for Anesthesia Education and Research $175,000; "Microglial-Mediated Inflammation in a

33

Duke Faculty & Alumni Spotlight Highlights from fiscal year 2010

Selected National/International Involvement & Leadership Solomon Aronson, MD, President Elect,

Murine Model of Intracerebral Hemorrhage

Mihai V. Podgoreanu, MD, "Cross-Species

as a Paradigm for Targeted Pharmacoge-

Analysis of Myocardial Susceptibility to

nomic Intervention" (Research), sponsored

Perioperative Stress" (Research), sponsored

by The American Heart Association

by National Institutes of Health $455,027

$308,000; "Clot Lysis: Evaluating Accelerated Resolution of IVH Phase III"(CLEAR III

Scott R. Schulman, MD, "DEX-08-05:

Clinical Trial), sponsored by Johns Hopkins

Safety and Efficacy of Dexmedetomidine

University $69,388; "FAER Mentored

in Intubated and Mechanically Ventilated

Research Training Grant" (Translational

PICU Subjects"(Clinical Trial), sponsored by

Science [PI: James; Mentor: Laskowitz/

Hospira, Inc. $80,547

Warner]) Andrew D. Shaw, MD, "Molecular Qing Ma, PhD, "PPAR Gamma as a Novel

Signatures of Chronic Pain Subtypes"

Therapeutic Target in Perioperative

(Grant), sponsored by the Department of

Cerebral Injury Following Deep Hypo-

Defense (DOD) $1,500,000

thermic Circulatory Arrest" (Research), sponsored by the Society of Cardiovascular

Huaxin Sheng, MD, "Novel Restorative

Anesthesiologists $80,000

Therapy for Spinal Cord Injury" (Research), sponsored by Cognosci, Inc. $164,544

David B. MacLeod, MB BS, "Phase 1B Dose Escalation Study of PMX-60056 with

William (Dan) D. Tracey, PhD, "Genetic

Heparin" (Clinical Trial), sponsored by

Analysis of Nociception in Drosophila"

PolyMedix Inc. $322,559; "Calibration &

(Research), sponsored by National Insti-

Validation of the 4 Wavelength Nonin

tutes of Health; $662,683"Genome-Wide

Non-Invasive Cerebral Oxygen Saturation

Analysis of Ion Channels Required For

Oximeter & Cerebral Sensor" (Clinical Trial),

Mechanosensation"(Research), sponsored

sponsored by Nonin Medical, Inc. $494,997;

by National Institutes of Health $429,000

"CAS Medical: Lidocaine for Neuroportection During Cardiac Surgery" (Clinical

Richard Vann, MD, "Evaluation on Perfor-

Trial), sponsored by CAS Medical Systems,

mance of Equipment at High Altitude"

Inc. $375,210; "Introduction of ExtendAir

(Research), sponsored by General Dynamics

CO2 Absorbent into Anesthesia Breathing

Advanced Information Systems, Inc. $2,200

Circuits" (Clinical Trial), sponsored by Micropore Inc $144,266.

David S. Warner, MD,"S-Nitrosylated Hemoglobin and Ischemic Brain Injury" (Re-

Joseph P. Mathew, MD, "Lidocaine for

search), sponsored by National Institutes of

Neuroprotection During Cardiac Surgery"

Health $195,000; "Novel Neuroprotective/

(Clinical Trial), sponsored by National Insti-

Anti-inflammatory Therapy for Ischemic

tutes of Health $717,303

Stroke" (Research), sponsored by Angion Biomedica Corp. $534,657; "Integrated

Richard E. Moon, MD, "Screening Tests for

Training in Anesthesiology Research"(Inst.

Susceptibility to IPE" (Research), sponsored

Training Prgm.), sponsored by National

by Naval Sea Systems Command $969,962

Institutes of Health $183,987

Eugene W. Moretti, MD, "ACCESS: A Con-

Ian J. Welsby MB BS, "Open Label Use of

trolled Comparison of Eritoran Tetrasodium

Riastap During Aortic Reconstruction"

and Placebo in Patients with Severe Sepsis"

(Clinical Trial), sponsored by CSL Behring

(Clinical Trial), sponsored by Eisai, Inc.

LLC $200,000; "NN1810-3540: Trial of FXIII

$193,250

Replenishment With Two Different Doses of Recombinant Factor XIII Following CPB"

Mark F. Newman, MD, "#4935 - Phase 1

(Clinical Trial), sponsored by Novo Nordisk

Periop"(Clinical Trial), sponsored by Astra-

A/S $204,742

Zeneca Pharmaceuticals, LP $50,000 David R. Wright, MD, "Study to Evaulate Wulf Paschen, PhD, "Conditional Gene

the Safety and Efficacy of LUSEDRA as a

Silencing in Ischemia/Stroke Research"

Sedative for Colonoscopy in Adult Special

(Research), sponsored by National Institutes

Populations"(Clinical Trial), sponsored by

of Health $78,000; "SUMO Conjugation and

Eisai, Inc. $85,915

Deep Hypothermia-Induced Organ Protection" (Research), sponsored by National

Melanie C. Wright, PhD, "Information

Institutes of Health $1,170,000; "Shutdown

Management in the Perioperative Environ-

of Translation and Ischemia/Stroke-Induced

ment" (Research), sponsored by Agency for

Cell Death" (Research), sponsored by Na-

Health Care Policy and Research $93,552

tional Institutes of Health $170,625 Claude A. Piantadosi, MD, "Impact of PFC Emulsions on CNS O2 Toxicity," sponsored by the Henry M. Jackson Foundation, $300,001

34

Faculty & Alumni Spotlight

Board of Trustees the Society of Cardiovascular Anesthesiology; Board of Trustees the Society of Cardiovascular Anesthesiology Foundation; Steering Committee for FOCUSThe FOCUS Initiative “Flawless Operative Cardiovascular Unified Systems� - Human Error Reduction in Cardiovascular Surgery; 2010 Refresher Course Lecturer, Anesthesia Subspecialties Committee, Cardiovascular and Thoracic Anesthesia Committee, Practice Management Committee, American Society of Anesthesiologists (ASA) Guy de Lisle Dear, MB, Assistant Medical Director, Divers' Alert Network Tong Joo (TJ) Gan, MD, member of multiple committees for the American Society of Anesthesiologists (ASA); immediate Past President and involvement in multiple committees for the Society for Ambulatory Anesthesia (SAMBA); Past President, International Society for Anesthetic Pharmacology; Education Committee, American University of Anesthesiologists Katherine P. Gricknik, MD, CME Consultant and Ad Hoc committee member, CME Committee, American Society for Echocardiography; Vice Chair, CME Committee, Society of Cardiovascular Anesthesia, Education Liaison Committee, Society for Cardiovascular Anesthesia Steven E. Hill, MD, Board of Directors, Society for Advancement in Blood Management Allison Kinder Ross, MD, Newsletter Editor, Society for Pediatric Anesthesia Catherine M. Kuhn, MD, Past President and Teaching Workshop faculty, Society for Education in Anesthesia; President-Elect, Association of Anesthesiology Core Program Directors; Specialist Site Visitor and Anesthesiology Consultant to Surgery Milestones Advisory Group, Accreditation Council for Graduate Medical Education (ACGME); Examiner, American Board of Anesthesiology, Senior Editor, American Board of Anesthesiology/American Society of Anesthesiologists Joint Council on Intraining Examinations; Scientific Advisory Committee member, Occupational Health Committee member, PBLD Committee Chair, American Society of Anesthesiologists (ASA); Interhospital Study Group for Anesthesia Education.

Jonathan B. Mark, MD, Examiner, American Board of Anesthesiology Terri G. Monk, MD, Board of Directors, Anesthesia Patient Safety Foundation Richard E. Moon, MD, Foundation Chair, Decompression Illness Adjunctive Therapy Committee Chair, Undersea and Hyperbaric

Medicine Society; Vice President and Medical Director, Divers' Alert Network Mark Newman, MD, member of the Society of Academic Anesthesia Associations Association of Academic Anesthesia Chairs Cathleen Peterson-Layne, MD, PhD, examiner, American Board of Anesthesiology Andrew D. Shaw, MD, Program Committee Workshop and PBLD Chair, Society of Cardiovascular Anesthesiologists; Basic PTEeXAm committee, NBE; Editorial Board, Reviews in Cardiovascular Medicine Mark Stafford-Smith, MD, Associate Editorial Board, Anesthesia and Analgesia; Cardiothoracic Fellowship Directors Committee, Cardiothoracic Fellowship Directors Executive Committee, and Acute Kidney Injury Network Representative, Society of Cardiovascular Anesthesiologists Bret W. Stolp, MD, PhD, Immediate Past President, Undersea and Hyperbaric Medicine Society; Assistant Medical Director, Divers' Alert Network Madhav Swaminathan, MD, Board of Directors, Intraoperative Council, Vice Chair-Elect, Intraoperative Council, Industry Roundtable, American Society of Echocardiography (ASE); Echo Course Planning Committee, Annual Meeting Program Committee, Educational Liaison Committee, Society of Cardiovascular Anesthesiologists (SCA); Examination Committee for the NBE Advanced Perioperative TEE Examination, National Board of Echocardiography, USA (NBE); Committee on Outreach Education, Co-Director iTEE Course, American Society of Anesthesiologists (ASA); membership in the Association of University Anesthesiologists (AUA), Membership in the International Anesthesia Research Society (IARS) Jeffrey M. Taekman, MD, Founding Board Member, Former Inaugural Secretary, Founder and Chair of the Society for Simulation in Healthcare Group on Serious Games / Virtual Environments, and Founding Editorial Board Member/ Current Editorial Board Member of the Journal of Simulation in Healthcare, Society for Simulation in Healthcare (this involvement enables Duke to be considered one of only five "Founding Supporters" for this rapidly growing international society); Inaugural Member of the Committee on Simulation Education, Committee on Electronic Media and Information Technology, American Society of Anesthesiologists (ASA) David S. Warner, MD, Editorial Board: Anesthesiology, Journal of Neurosurgical Anesthesiology, Neurocritical Care, Journal of Anaesthesia, Frontiers in Neurology, Therapeutic Hypothermia and Temperature Management

INTRODUCING the 2010 DREAM Innovation Grant applicants. Applicants are encouraged to submit unique, high-

risk ideas with the potential for immeasurable impact on the field of anesthesia and pain management. The grant will provide investigators with one-year pilot funding, enabling them to develop their hypotheses and collect data that will be submitted for long-term funding from other prestigious agencies. Winners of the DIG will be announced at this year's annual ASA Duke Anesthesia Alumni Reception in San Diego, California.

Terrence K. Allen, MB BS

Ashraf S. Habib, MB BCh

Mihai V. Podgoreanu, MD

J. Brandon Winchester, MD

The Effect of Labor Epidural Analgesia on

A Pilot Study Assessing the Correlation of

Elucidating Adaptive Mechanisms of

Paying it Forward: A Pilot Study of the Effects

Maternal and Fetal Inflammation

Preoperative Sensory Testing and Genetic

Perioperative Organ Protection Following

of Videoconferencing on Participation in an

and Oxidative Stress

Polymorphisms With Acute and Persistent

Ischemia-Reperfusion in Hibernating Arctic

Anesthesiology Clinical Research Study

Postoperative Pain

Ground Squirrels

Randomized Pilot Study of Preoperative

M. Luke James, MD

Srinivas Pyati, MD

Role of SUMO2/3 Conjugation Pathway in

Normobaric Oxygen Breathing vs. Standard of

Gender-Based Differences in Genetic

A Randomized Controlled Clincial Trial of

Cerebral Ischemia/Stroke

Care in Surgical Patients at Higher Risk for

Expression After Acute Brain Injury in Mice

Conventional Versus Fluoroscopically Guided

Elliott Bennett-Guerrero, MD

Wei Yang, PhD

Postoperative Anemia David R. Lindsay, MD

Thoracic Epidural Catheter Placement in

Zhiquan Zhang, PhD

Elective Thoracotomy Patients

Mechanism-Based Amelioration of Myocardial

Heather J. Frederick, MD

Development of a Postamputation Pain

Exploring Error and Validating Tests of

Classification System, Relational Database,

Madhav Swaminathan, MD

Data Quality in the Electronic Preoperative

and Establishment of a Postamputation Pain

Curcumin to Prevent Perioperative

Assessment

Biorepository

Complications after Elective Abdominal Aortic

Ischemia-Reperfusion Injury

Aneurysm Repair: A Phase 1 Randomized Joseph P. Mathew, MD Functional Neuroimaging to Assess Cognitive Function after Cardiac Surgery

Controlled Trial

Duke Anesthesiology BluePrint | BluePrint.duhs.duke.edu

Joining Forces To Meet A Global Need How YOU can help Duke Anesthesiology achieve its global mission

This year began with a tragedy in Haiti with such profound ramifications that it remains at the forefront of our minds, even as 2010 draws to a close. The entire Duke family was touched by this devastation, and responded with fierce generosity. Duke Anesthesiology is proud to have played a significant role in this effort.

Anesthesiologist, David B. MacLeod, MB BS, was one of the first to respond to the mass devastation in Haiti, and played a critical role in organizing the first Duke response team. His quick thinking inspired several other department members to follow suit over the course of the next several months. His selfless generosity serves as an inspiration to many.

Anesthesia plays a critical role in global health care, not only in times of crisis, but in day-to-day events, such as childbirth. Things that we consider routine or trivial in the U.S., such as hernia repair, can be life-threatening in third world countries lacking adequate supplies or medical education. There is a great need for the skills possessed by the anesthesiologist abroad. In response, Duke University has taken several large steps to encourage its global presence in countries that need it the most.

36

Joining Forces to Meet A Global Need

In recent months, Duke Anesthesiology has begun to formalize its relationship with the Duke Global Health Institute (DGHI). With the support of chairman, Mark F. Newman, MD, the department has opened a pathway for career opportunities in anesthesia and global health in response to an increasing interest in global philanthropy expressed

by Duke personnel. Duke Anesthesiology has collaborated with DGHI in the development of a twoyear fellowship program that will allow candidates to spend approximately half of their time in the field, and the remainder in the classroom at Duke earning their masters in global health. Adeyemi “Yemi�

Olufolabi, MB BS, from the Division of Women’s Anesthesia, will serve as the program director for this fellowship, which is slated to be in place by July 2011.

Anesthesia residents will also have the opportunity to gain early exposure to international work and the various challenges associated with it.

Through its growing relationship with DGHI, Duke Anesthesiology will have access to new resources allowing for multidisciplinary collaborative projects appealing to both medical and non-medical personnel,

Outreach & Philanthropy

I DREAM...that our students, our leaders of tomorrow, will partner with their students, their leaders of tomorrow, to remove health disparities that have caused much pain and suffering in low resource areas.

-Adeyemi "Yemi" Olufolabi, MB BS

as well as ambitious students. There are multiple opportunities for those willing to travel with a team to a project site. Duke is establishing post-disaster medical relief teams to aid local and national teams with direct medical relief after both natural and allhazard disasters, in addition to partnerships already in place, such as those established with Kybele and Makerere University in Uganda.

Kampala, Uganda An ever-growing departmental global health project is provided by collaboration with Makerere University and Mulago Hospital in Kampala, Uganda. It was observed on repeated visits to Uganda made by a team headed by Michael Haglund, MD, PhD, from Duke Surgery, that there was a dire need for further anesthetic and critical care teaching and training assistance in this region.

In 2007, Duke Anesthesiology responded with the creation of a program specifically designed to address this need. Thanks to the leadership and passion of Tony Roche, MB ChB, a member of Duke Anesthesiology's General, Vascular, High-Risk Transplant and Critical Care Medicine Division, combined with the tireless devotion of Rebecca Schroeder, MD, an anesthesiologist

employed with the Durham VA Medical Center, Duke Anesthesiology currently undertakes two trips to Kampala per year, in addition to staffing two annual surgical camps. Teams consist of anesthesiologists and CRNAs alike.

The key objectives of this mission are the creation of new partnerships with the Emergency Medicine Department at Mulago Hospital and the development of Biomedical Engineering support with training and research collaborations at Duke. Local Ugandan residents and faculty lead research support teams.

Multidisciplinary teaching support has been provided though the establishment of an anesthesia officer training program and various perioperative safety programs at Mulago Hospital. In addition, a safe motherhood program with Women’s Health Services in Kampala and Mbarara has been formed.

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Duke Anesthesiology BluePrint | BluePrint.duhs.duke.edu

Collaboration with other academic institutions is key to the development of these programs. Duke Anesthesiology is currently working closely with Global Partners in Anesthesia and Surgery (a nongovernmental organization based at the University of California, San Francisco), on the development of multiple joint efforts, including a curriculum for Mulago Hospital’s Scholars Program that will be instituted by Health Volunteers Overseas. This major development will open the program to residents from multiple institutions. There is a strong need to expand the alumni and faculty presence in these programs.

Volunteers are welcome.

Kybele Non-Profit Organization Locations: Ghana, Turkey, Croatia, Republic of Georgia, Egypt, Romania, Brazil, and Mongolia Kybele (Key-bell-a) is a non-profit organization founded by an anesthesiologist at Wake Forest University. The name is derived from an ancient Turkish fertility goddess. Kybele, the non-profit organization, improves birthing conditions and outcomes for mothers and babies worldwide by providing training and resources to host countries.

The emphasis of Kybele’s work is on local capacity building. Kybele uses health care professionals from the U.S., Canada, Australia, and Europe. These professionals work alongside doctors, midwives, and nurses in countries with high birth mortality rates to help make system changes that improve health care safety. For more information on Kybele, visit: www.kybeleworldwide.org.

Duke University faculty, alumni, and CRNAs have participated in maternal care improvement projects in Turkey, Croatia, Republic of Georgia, Egypt, and Ghana. Duke Anesthesiology's presence has been particularly strong in Ghana. Under the leadership of Olufolabi, Duke Anesthesiology has returned to Ghana the past four consecutive years. This enthusiastic team has seen dramatic improvements.

Earlier in the year, the department celebrated their 2009 successes, including: a 35 percent reduction in maternal death rate, a 36 percent reduction in stillbirths, and the opening of a CRNA training program in their principle medical center, Ridge Hospital, in Accra, Ghana.

Wanted: Helping Hands & Open Hearts Individuals who participate in these teams invariably describe these experiences as rewarding, but warn that they are not for the faint of heart. Veterans caution 38

Joining Forces to Meet A Global Need

that as a member of such a small team, those in need of care will vastly outnumber you. Consequently, you will be forced out of your comfort zone. It is impossible to meet such a great need, and at times, the sense of helplessness this engenders can be devastating. When asked if they would do it again, however, volunteers uniformly reply, “in a heartbeat.”

The stories of the tragedy and triumphs they return to tell have touched the hearts of many at Duke.

Those who remain behind to cover shifts, organize supply and equipment donations, and provide funding, are just as paramount to the success of these teams as the individuals who venture abroad. Over the course of the next year, volunteers involved in Duke Anesthesiology’s global health efforts will be working to develop a base fund for projects, clinical research, and teaching which will have an international impact.

Support from many will be required for the overall success of this campaign. To learn more about how to contribute to global efforts at Duke, contact the individuals listed below, or visit the Duke Anesthesiology web site (anesthesia.duhs.duke.edu), which is being updated to include a global health contact link. This will enable dialogue with project leaders for information on future trip participation, avenues for donation, and opportunities to share your ideas concerning project development. Duke Anesthesiology requests your participation in this cause as we combine forces to answer a global call.

Special contributor: Sarah L. Stogner

Who To Contact: Uganda Dr. Tony Roche p: 919.681.9660 e: tony.roche@duke.edu

Haiti Dr. Ian Greenwald p: 919.684.5537 e: ian.greenwald@duke.edu

Uganda Dr. Rebecca Schroeder p: 919.286.6938 e: rebecca.schroeder@duke.edu

Ghana Dr. Yemi Olufolabi p: 919.668.6266 e: olufo001@mc.duke.edu

DUKE ANESTHESIOLOGY HAS TWO CHAIRS AVAILABLE WITH MATCHING FUND OPPORTUNITIES. SECURE YOURS TODAY!

Anything YOU can do...

I can do BETTER. We ANwould ENDOWEDtend CHAIR,to alsoagree. referred to as a professorship, or a "chair," is a preserved legacy that honors both past and current faculty by providing researchers at Duke with the necessary funding to make important medical breakthroughs. Take advantage of this once in a lifetime opportunity to double your investment while securing a $2.5M level professorship. To learn more, contact Elizabeth Perez at elizabeth.perez@duke.edu, or call 919.681.2849.

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Duke Anesthesiology BluePrint | BluePrint.duhs.duke.edu

Outreach & Philanthropy

DUKE DREAM CAMPAIGN "When we are dreaming alone it's only a dream. When we are dreaming with others, it's the beginning of reality."

-Dom Helder Camara

Anesthesiologists are sometimes referred to as the unsung heroes of the medical community. The average patient knows very little about what an anesthesiologist actually does. If all goes well during the procedure, the patient does not remember him. To the average person, the a nesthesiologist is a vague, mysterious benefactor, with an u n c l e ar job description that is notoriously difficult to pronounce, a n d n early impossible to spell. This obscurity presents the field of a n e s t hesiology with a special challenge when attempting to raise p h i l a nthropic support for important medical research. Yet with eve r y c h a l l e nge comes even greater opportunity.

41

About the DREAM Campaign The Developing Research Excellence in Anesthesia Management, better known as the DREAM Campaign, is unique in that it is the only philanthropic campaign at Duke devoted to supporting anesthesia research. The overall goal of the DREAM Campaign is to improve patient care and quality of life, impacting the lives of patients both at Duke and abroad. The DREAM Campaign works not only with Duke Anesthesiology, but also with every facet of Duke Medicine in an attempt to continuously improve our research program.

A New Approach to an Old Problem This year, the DREAM Campaign has joined forces with Lifeline to Modern Medicine, a PR effort sponsored by the American Society of Anesthesiologists (ASA), in an attempt to educate the public about the role of the anesthesiologist in the overall health and long-term well-being of patients. This concept has been broadcasted though their recent Vital 2 Health Campaign, which was created in response to the discovery that most Americans associate good health with 42

Duke DREAM Campaign

lifestyle behaviors at the expense of key vital health measures, such as body mass index (BMI), blood pressure, and cholesterol. This campaign seeks to inform individuals about the importance of their vital health, and position the anesthesiologist as the guardian of vital health throughout the challenging perioperative period.

DREAM Campaign Goals/Projects Endowed Professorships: Goal $2.5M With Matching Funds

Creating professorships, also known as endowed chairs, honors both past and current faculty, and raises funds to support investigator salaries, benefiting our research program, and assisting in the procurement of funding from National Institutes of Health (NIH). This provides distinguished faculty with the impetus to discover unprecedented breakthroughs, adding to the thriving academic environment at Duke, while simultaneously attracting new world-class faculty. Professorships are unique naming opportunities that are ideal for donors who would like to leave a legacy at Duke. Donors who generously endow professorships are not only ensuring academic and research excellence—they are giving a gift for future generations. We currently have two professorships available with matching fund opportunities at the $2.5M level.

Outreach & Philanthropy Learning Center—A Unique Naming Opportunity: Goal $175K

We are currently in the planning phase of a new initiative to improve our learning environment through the conversion of our current office suite into a learning center.

The learning center would be equipped with our TEE simulator, and interactive learning materials for students (specifically, what is known as 3D iTeams simulation). Both of the aforementioned are currently housed separately from our main facility, making access for students and faculty difficult.

This new learning space, which is estimated to cost $175K, provides donors who would like to make a significant contribution to our academic mission with a unique naming opportunity.

DREAM Innovation Grant (DIG): Goal $2M

This internal research grant was established with the goal of raising $2M to support highly innovative research with the potential for immeasurable impact on the field of anesthesia and pain management. Funding will be provided to individuals whose ideas not only have high potential for success in solving a current issue within our field, but also display a unique creative ability or insight. Duke Anesthesiology seeks to attain this funding over the course of two-and-ahalf years. At the time of the printing of this publication, there is approximately $1.56M left to raise.

The DIG Grant was created with two primary goals in mind: 1) To foster ideas within the department with the potential to lead to growth in extramurally funded research from major funding agencies such as the NIH. Using this model for DIG increases the chance that applicants will pursue the R21 (or similar awards) since the application will already be near to completion at the time that these submissions are due. An important criterion in the selection of the recipients of this grant will hinge upon their ability to provide a clear definition of how this work will support future grant submissions.

2) To provide future DREAM fund-raising efforts with tangible evidence that donor dollars have been amplified. Recipients of the grant will be expected to provide frequent reports on their progress, which will in turn be reported by the DREAM Campaign to its supporters.

DIG, the first grant of its kind at Duke Anesthesiology, is to become an annual competition. Funds will be awarded to different investigators each year. The opportunity for critical discovery, as well as the potential for positive national, or global attention to be achieved is maximized through the establishment of new principle investigators annually.

We Need Your Help!

You're invited to become our partners in advancing perioperative medicine and pain management. The DREAM Campaign is designed to give ownership back where it belongs—to our community. Your support will give us the power to dream.

If you are interested in supporting the DREAM Campaign initiatives, please contact Elizabeth Perez at: elizabeth.perez@duke.edu or call 919.681.2849.

ADVISORS By giving of their time, talents, and treasures, our advisors are helping us achieve our mission of improving patient care. DREAM advisors serve as mentors who provide advice and feedback, ambassadors who represent Duke Anesthesiology to the community, and supporters who give and inspire others to give to the Duke DREAM Campaign.

Elizabeth Allardice Jim Anthony Alice Chou Joanne Doberstein Bud Doughton Janeen Drinkard Jeff Drinkard Ernestine Friedl, PhD Merel Harmel, MD Mary Pat Heath Peter Heath Rebecca Hinshaw Angela Hodges Rochelle "Shelli" Lieberman Anne Lloyd, CFP Jerry Maccioli, MD Asun Mathew Kit McConnell Catherine Miller Chuck Musciano Jerry Reves, MD Jon Stewart Mary "Sidney" Troidl Ed Vinson Jeaninne Wagner

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Duke Anesthesiology BluePrint | BluePrint.duhs.duke.edu

BUILT FOR

BATTLE A Survivor's Inspiring Journey

Health care professionals work in an extremely challenging environment—one that is not only highly stressful, but also both physically and mentally demanding. Working in such challenging conditions makes it easy to become overwhelmed and disheartened. If you keep your head up, your eyes, ears, and heart open, sometimes you stumble upon someone like Jeff Drinkard who can put things back into perspective and remind you of your original source of inspiration.

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Outreach & Philanthropy

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A Grim Diagnosis Jeff’s life was changed forever in January of 2006 when Jeff and his wife, Janeen, were visiting a wellness clinic. Jeff, the picture of good health at that time, was told that his life was about to take a dramatic turn for the worse. The doctor told Jeff that he exhibited signs of Interstitial Pulmonary Fibrosis (IPF), a deadly disease of the lung for which there is no cure. IPF causes scarring of the lung tissue that will cause a gradual thickening of the lungs, eventually destroying them.

The average lifespan of an individual suffering from IPF is two to five years after the onset of symptoms.

In August of 2006, the prediction of the doctor at the wellness clinic was verified—Jeff was diagnosed with Familial Pulmonary Fibrosis (FPF).

The term familial indicates that this form of IPF runs in the family. That same year, Jeff’s brother, Mark, was diagnosed with the same disease—a disease which had already taken the lives of their mother, aunt, uncle, and presumably their grandmother as well. Three of his mother’s five sons inherited FPF. When asked to recall one of the greatest challenges of this time, Jeff described the following situation: he was out in the yard in the late afternoon, having a quiet moment to himself shortly after his diagnosis.

His youngest son, Jack, was outside with him. Both father and son were silent—lost in thought. Jack was staring off into the distance and had his favorite dog, a corgi, in his lap.

After a long time, Jack turned and looked his father in the eye. “Dad," he said inquiringly, "you have this disease, Mark has this disease...is this something I could get?”

It was a situation that a parent would never want to face. Jeff knew 46

Built For Battle

Jeff Drinkard (far right) living life with his wife, Janeen, and their four children.

From left to right: Sam, Ben, Grace, Jack, Janeen and Jeff.

that he had to be strong—his son needed to hear the truth. Jeff paused a moment to regain control of the flood of emotions threatening to overwhelm him, then replied evenly, “Well, you could. I hope you don't, but you could.” Jack looked at his father for another long moment, and then slowly turned to face the vast landscape ahead of him. After a moment, he resumed petting his dog.

“Okay,” he replied.

The Battle For Survival After his diagnosis, Jeff was constantly in and out of the hospital, repeatedly suffering from debilitating cases of pneumonia.

Jeff is unique in that he is able to see the positive side of every situation. He remained confident in his ability to overcome this disease—even when his local doctor in Texas blatantly told him that the situation was out of his hands and that Jeff and his family should start saying their good-byes.

Jeff, who is a fighter, refused to accept defeat. Instead, he found a new doctor who told him about Duke University. Duke is known internationally for its expertise in

transplant procedures—specifically lung transplants. Not only are waiting times substantially shorter, Duke's one and three-year posttransplant survival rates are significantly greater than national averages. Furthermore, Duke has no absolute upper age limit, and is known for evaluating potential transplant candidates who, like Jeff, other centers have chosen not to transplant due to their complex medical conditions. Duke performed 94 lung transplants last year—a number expected to increase dramatically in the near future with the opening of the Duke Medicine Pavilion.

Sacrificial Giving When Jeff learned that Paul Noble, MD, the Division Chief of Pulmonary, Allergy, and Critical Care Medicine at Duke was conducting a familial study on FPF that he and Mark were the perfect subjects for, he knew they had to participate. In offering themselves up as research subjects, Jeff and Mark were giving up some of their most precious asset: time. Although this sacrifice couldn’t save them, it could provide doctors at Duke

Outreach & Philanthropy with valuable information that could lead to improved treatment methods or an eventual cure. According to Jeff, giving is a “heart condition.” When you find something that is bigger than you, “something worth dying, at least in part for…you have to participate," Jeff says. "Otherwise, my question is, what’s the point?

Why are you here?” In the face of death, Jeff and Mark found purpose and meaning for their lives again through sacrificial giving.

in October of that year, when, Jeff's brother, Mark, succumbed to lung cancer.

As time passed, Jeff's health improved, and he began to realize the importance of making the transition from “surviving” to “survivor.” Although it may sound easy, this transformation is incredibly challenging.

“It’s important to get to a place where you’re not just surviving,” Jeff states. “I know when that happened to

New Challenges & Opportunities Before long, however, Noble and his team discovered a new challenge the two brothers had to face: lung cancer—a complication commonly associated with IPF. Tests revealed that the two brothers had developed different types of cancer. Jeff was diagnosed with bronchioalveolar carcinoma, a small problem in relation to his IPF, while Mark was diagnosed with an aggressive form of adenocarcinoma that would soon become his primary concern. Although the prospects for Mark were looking grim, the team at Duke decided that Jeff was a good candidate for an experimental lung transplant.

Realizing that this was his only chance, Jeff prepared himself for the worst—he said good-bye to his wife, found substitute fathers for his three boys, and mournfully considered who would walk his little girl down the aisle on her wedding day. “You realize that you don’t have the right to hold on to any of them,” Jeff says of his loved ones. “God is the one who gets to hold them. He just lets you use them and enjoy them for as long as he sees fit.”

Number of Transplants At Duke

Jeff came in immediately for testing, which was completed in a shocking three days as opposed to the three weeks typically devoted to this period. In February of 2008, Jeff underwent a double lung transplant.

From Surviving to Survivor “The good news,” Jeff states confidently, “is I’m built for battle. I do very well under very intense, difficult circumstances.” When he refers to doing “battle,” Jeff is not just speaking of the immense physical pain associated with a lung transplant, but of the emotional challenges one must face. When Jeff returned home, he was fortunate to have a strong support system of family and friends. His wife and children were especially brave throughout this period of uncertainty.

Without their support, Jeff doesn't know how he could have dealt with the next devastating blow 47

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me, the opportunity to have "For all of us who work through the night a future became real to me to care for these patients, it is not just again…the cancer, the fibrosis, a “lung” that we care for, but a person and the death…at some point such as Jeff, who can once again dream in time you have to let go of that stuff. You have to say, of walking his daughter down the aisle I’m moving forward.” on her wedding day. Is this not the reason Jeff is extremely grateful to Noble, Scott Palmer, MD, medical director of the Lung Transplant Program, and the team of experts at Duke willing to take a chance on his transplant.

Over time, he has established a close relationship with several Duke faculty members, including chief of Cardiothoracic Anesthesiology, Joseph Mathew, MD, and Elizabeth Perez, RN, BSN. “When Jeff was

we chose medicine as a career?"

- Joseph P. Mathew, MD

hospitalized, I made a point to visit him regularly,” recalled Perez. “My intention was to encourage him during the tough times—especially since he was away from his family.

However, each time I left his room, he encouraged me more. He has truly transformed my thinking and stretched my faith. His generosity and positive outlook are an inspiration to others.”

“Meeting with Jeff is both humbling and inspirational,” Mathew states. “Despite all of the struggles of surviving a lung transplant, he is genuinely focused on those around him, constantly encouraging nurses, patients, and visitors. By example, he teaches about the importance of living out your faith and of the value of a 'foxhole buddy' during life crises.”

As a result of these close relationships, Jeff has become very involved with Duke Medicine, and serves as an advisor for the Duke DREAM Campaign. The DREAM Campaign raises funds for crucial research that have the potential to save, or prolong the lives of patients like Jeff.

“It’s important to get to a place where you’re not just surviving…I know when that happened to me, the opportunity to have a future Jeff stresses the value of giving became real to me again.“ back and the concept that no -Jeff Drinkard gift is too small. Making a huge

impact in the lives of others can be as simple as agreeing to be an organ donor the next time you renew your driver’s license. If it

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Built For Battle

Jeff and Grace at the Father Daughter Dance

were not for the generosity of a stranger, Jeff would not be here today. “Everyone has the ability to provide a miracle,” Jeff states matter-of-factly.

A New Perspective Jeff doesn’t know how much time he has left—but then again, who does? For now, he lives each day with a greater sense of purpose in the knowledge that many of the things that he placed a lot of emphasis upon in the past, such as money, power, and the accumulation of wealth, are simply, “window dressing.” He is focused on building meaningful relationships and on being a good husband and father.

Rather than fixating on past tragedies, Jeff is hopeful for the future and feels blessed by the lessons that he has learned through this process. “This is my life,” he states, “this is my adventure. You can’t have it. I wouldn’t trade seats on the bus with anybody. This is my experience. Granted, it’s a little more extreme…that’s okay. It’s real. It’s mine.”

To Sleep: Perchance to Dream.

AN INTERVIEW WITH REBECCA HINSHAW, RN Meet Rebecca Hinshaw, RN, Interim Chair for the Duke DREAM Campaign. In addition to her involvement with the DREAM Campaign, Rebecca (a former nurse) and her husband, Eric, are long-time supporters of Duke Hospital. She now works as a designer with Sleep To Live Inc. (a Kingsdown Company). Are you sensing a theme yet?

Don't be fooled—despite the ironically similar names of her two most prominent pastimes, Rebecca is anything but lethargic. As a key player in Duke Anesthesiology's philanthropic efforts, she's making big things happen.

How did you get involved with the DREAM Campaign?

My friend, Mary Pat Heath, invited me to attend a special event called Inside Duke Anesthesiology. The program was wellorganized, including several presentations from expert physicians, who spoke about their areas of specialty, research, medical advancements, and personal connections to Duke Anesthesiology.

Wow! I was strongly impacted by the broad spectrum of influence this one department maintains.

How are you supporting the DREAM Campaign?

Hopefully, I am able to contribute some prosperous effort and ideas to help reach the much needed goals set forth by the campaign.

What inspires you?

Within Duke Anesthesiology, the research and the ongoing effort to improve the patients' quality of life seem endless. The average person does not have the chance to become educated on the broad spectrum of benefits made possible through the achievements of Duke Anesthesiology. I am inspired by the possibility of contributing even a small fraction to a very exciting and important purpose.

What have you learned through your experience with the DREAM Campaign?

As mentioned before, I have learned to appreciate the realm of responsibilities involved within the field of anesthesia. Aside from influencing a patient's comfort levels during surgery, there are many other areas outside the OR where anesthesiologists are key in managing optimal care. The purpose of the DREAM Campaign is to support research, professorships, and provide exceptional patient care.

What has been your favorite experience with the DREAM Campaign?

My absolute favorite experience was the first time I heard that a large sum of money had been pledged! My second favorite was hearing about an area of research that is delivering progressive, positive results. And, last but not least, the "bunny suit tour" through the OR that I was able to partake in. I was amazed when I saw a team preparing for a complicated double lung transplant and delighted to get an inside look into the new "hybrid" OR, which has revolutionized the operating room as we know it.

What is one of your personal dreams?

The belief that my aspirations are possibilities, and that I may in some way help bring a better quality of life to those in need.

Please describe Duke Anesthesiology in three words.

Sleep, comfort, life.

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DONORS & SUPPORTERS Founders $100,000 or more Anthony & Co. Ms. Margaret Cathcart* Dr. Nicolas Gilliard Dr. and Mrs. Joannes Karis* Dr. and Mrs. Mark Newman* Dr. and Mrs. Jerry Reves*

Sustainers $75,000 to $99,999 Dr. and Mrs. Mike Alvis The Alvis Foundation*

We are delighted by this opportunity to recognize and thank the supporters of the Duke DREAM Campaign. This list represents those who have made a donation during the 2010 fiscal year in addition to those individuals who provided unwavering support in the earliest days of our campaign. Our supporters serve as an inspiration to us all. As a part of Duke University, Duke Anesthesiology benefits from grants and the contributions of several outstanding organizations. For the sake of clarity, however, this list represents only those who have given to the DREAM Campaign. Every effort has been made to make this list as accurate as possible. We apologize for any errors or omissions that may have occurred and welcome any corrections for future reference.

For corrections, please contact us at blueprint@mc.duke.edu.

Friends

Up to $4,999 given during fiscal year 2010 (July 1, 2009 through June 31, 2010) Dr. Nathaniel P. Nonoy and Dr. Julie L. Adams*

Dr. Paul Jaklitsch and Mrs. Alki Burdett Mr. Timothy L. Kearby Mr. and Mrs. Percival King

Ms. Jeanne M. Aufiero

Dr. and Mrs. Stephen M. Klein

Dr. David Scott Bacon and

Dr. George D. Lappas

Mrs. Victoria E.Taub

Dr. and Mrs. Bruce J. Leone*

Ms. Charlotte E. Banks

Dr. Labrini C. Liakonis

Dr. Elliott Bennett-Guerrero and

Ms. Rochelle “Shelli” P. Lieberman*

Mrs. Karin Bagin

Dr. Steve F. Lipson*

Ms. Sharon P. Bode

Dr. Andrew G. Lutz

Ms. Laura B. Bromhal

Dr. and Mrs. Darryl Evan Malak

Mrs. Parker N. Call

Drs. David L. McDonagh and Anne Tuveson*

Mrs. Laura M. Cann

Dr. and Mrs. Steven Morozowich

Drs. James Chien and Michelle Lau

Dr. James F. O’Neill Jr.

Dr. James Michael Chimiak

Dr. John V. Parham Jr. *

Dr. Donat R. Spahn

Dr. Andrea C. Clark*

Mr. and Mrs. Philip and Elizabeth Perez

Mrs. Anne Lloyd

Dr. Thomas H. Collawn*

Mr. and Mrs. Francis T. Quinn Jr.

Dr. George W. Crane Jr.

Mrs. Anne M. Ray

Ms. Sabrina S. Deaver

Dr. Teodulo Remandaban

Sponsors

Mr. and Mrs. James "Bud" Doughton*

Mr. Joseph A. Rybicki*

$10,000 to $24,999

Mrs. Catherine D. Ellington

Dr. Randall M. Schell*

Dr. and Mrs. Jonathan Mark*

Ms. Janis Ernst

Dr. Adam J. Schow

Dr. and Mrs. Joseph Mathew*

Ms. Virginia D. Finley

Mr. and Mrs. Lawrence B. Shuping Jr.

Mr. and Mrs. Steven and Catherine Miller

Dr. William J. Greeley and

Ms. Sarah L. Stogner

Ambassadors $50,000 to $74,999 Clancy & Theys*

Grantors $25,000 to $49,999 Dr. Randall P. Brewer

SunTrust Investment Services, Inc.*

Dr. Eugene Moretti*

Ms. Cece M. Fortune-Greeley

Dr. Gijsbertus F. Van-Staveren and

Drs. Debra Schwinn and Robert Gerstmyer

Dr. Elisabeth J. Fox*

Mr. and Mrs. Shelton Zuckerman

Dr. Mark Alan Frankel

Mrs. Leila T. Veasey

Dr. Angelo V. Gagliano

Associates

Dr. and Mrs. Anil M. Vyas*

Dr. and Mrs. Peter S. Glass*

$5,000 to $9,999

Dr. and Mrs. David S. Warner*

Dr. Alina M. Grigore*

Dr. Deryl Hart Warner

Dr. Tong Joo (TJ) Gan

Halifax Anesthesiology Associates

Dr. Gregory J. Waters*

Dr. and Mrs. Steven Hill*

Drs. Merel Harmel and

Dr. and Mrs. Stanley W. Weitzner

Mr. and Mrs. Sam Mathan Mr. Warren Newman and Mrs. Warren Newman Peters Family Charitable Trust Dr. Ralph Snyderman Dr. Mark Stafford-Smith

Ernestine Friedl*

Ms. Cindi J. Edwards*

Dr. and Mrs. Andrew R. Wiksten

Mr. and Mrs. Cecil W. Harrison Jr.

Mr. and Mrs. John D. Wolfe*

Dr. Albert Michael Hasson

Dr. Richard Lee Wolman

Mr. and Mrs. Peter R. and

Dr. Matthew Wood

Mary Pat Heath Dr. and Mrs. David M. Hendricks

Dr. David Wright

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Individuals who have given three or more years are honored as members of the Chairman's Circle indicated by an asterisk (*). The names of those who are now deceased are seen in italics.

Outreach & Philanthropy

We make a living by what we get, we make a life by what we give.

-Sir Winston Churchill

WAYS TO GIVE TO DUKE ANESTHESIOLOGY Duke University can accept donations in many different ways. For more information, please contact Elizabeth Perez (919.681.2849 or elizabeth.perez@duke.edu) or visit: http://dreamcampaign.duhs.duke.edu.

You can make a gift online by visiting www.gifts.duke.edu/daa. When giving to the DREAM Campaign, please designate your gift to "anesthesiology."

Cash

The most popular and easiest way to make a donation to Duke is by cash or check. Please make checks payable to Duke University.

Matching Gifts

Double, or even triple your gift to Duke by having your employer match your donation!

Payroll Deduction

Duke employees are eligible to make charitable contributions to Duke via payroll deduction. The deductions occur monthly or biweekly depending on your payroll status.

Personal Property/Real Estate

Duke University gladly accepts gifts of tangible, personal property that the university would otherwise need to purchase, or that further the endeavors of Duke's educational and/or medical communities.

Stock/Securities

There are several ways to transfer securities to Duke: electronic transfer, mailing certificates, or hand delivery.

Electronic Transfer

Duke University offers you the opportunity to make your gift without writing a check through electronic transfer. W ith your authorization, we will automatically debit your checking account in the amount you designate on the same day each month (usually on or about the 10th).

Bequests

As the most common and simplest form of planned giving, a bequest is a gift that is made through a donor's will.

Gift Annuities

The gift annuity agreement provides older donors who give cash, securities, real estate, or personal property with fixed annual payments for a specified period of time.

Life Insurance

A gift of whole life insurance can be made to Duke by naming Duke University as the irrevocable owner and beneficiary of the policy.

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Duke Anesthesiology

40

th

Anniversary

A Distinguished Past, an Exciting Future

Duke's History, Your Stories.

In 2011, the Department of Anesthesiology at Duke will celebrate its 40th anniversary.

We invite you to share your stories and photos for the 2011 special commemorative edition of BluePrint. Stay posted for upcoming special events, including the 2011 Duke Alumni Reception at the 2011 ASA conference in Chicago, IL, where we will celebrate our distinguished past and look forward to an exciting future. Stories, photos, and questions can be emailed to: blueprint@mc.duke.edu.

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