Emory Medicine | Summer 2021

Medicine SUMMER 2021

Uncommon Valor, Unwavering Courage OUR YEAR OF COVID-19

W H AT ’ S I N S I D E

GRIEF, JOY, AND PROTON THERAPY PLAGUES THEN AND NOW UNCOMFORTABLE TRUTHS

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EMORY SCHOOL OF MEDICINE

Alumni and faculty sent in PPE selfies from around campus and across the country.

FROM THE DEAN

Adapting in real time This has been a difficult year, one of incredible challenges that were unprecedented and unpredictable. Clearly the pandemic created disruptions, but it also offered oppor-

The Emory Brain Health Center and Georgia Public Broadcasting (GPB) have partnered on an Emmy–award–winning news magazine hosted

by Emory’s Jaye Watson, at pbs.org/show/ your-fantastic-mind/.

tunities for resilience and innovation.

In NIH funding, the School of Medicine ranked 14th in the US with $395 million (the best in our history) and 15 of our departments ranked in the top 25, with pediatrics leading among pediatric Vikas P. Sukhatme, md, s c d

departments at $97.1 million, according to the Blue Ridge Institute for Medical

Emory Medicine Editor Mary Loftus Art Director Peta Westmaas Director of Photography Jack Kearse Contributors Mike Bacha, Don Batisky, Janet Christenbury, Quinn Eastman, Sophia Gorgens, Sheryl Heron, Michelle Hiskey, Chao Ji, Jennifer Johnson, Stacey Jones, Michael Konomos, David Malebranche, Kimberly Manning, Shannon McCaffrey, Naomi Newton, Clyde Partin, Rajee Suri, Cassandra Quave, Zanthia Wiley.

Editorial Intern Deanna Altomara 20C 23MPH

Dean, Emory School of Medicine

Research. We received $91 million from

Chief Academic Officer, Emory Healthcare

the NIH in COVID-19 funding alone, third

Copy Editor Susan Carini

among universities. We’ve developed

Advertising Manager Jarrett Epps

new therapeutics, antivirals, and antibody blood tests for COVID, and

Production Manager Stuart Turner

Web Specialists Wendy Darling, John Mills Associate VP, Health Sciences Communications Vince Dollard

conducted human clinical trials of the first COVID vaccines. Faculty have

Director of Communications, Emory School of Medicine Jen King

served as public scholars, communicating science-based, accurate infor-

Executive Director of Content Jennifer Checkner

mation. And our research wasn’t limited to COVID. We examined repurposing drugs for cancer treatment, made advances in personalized medicine, and deepened our understanding of brain health. We gave out a total of 52 Imagine, Innovate, and Impact awards to catalyze and seed faculty research, and the return on investment has been 4:1, with the supported research generating impressive external funding. More than $9.5 million has already come back to the institution. The Health Sciences Research Building II, expected to open next year, includes labs and collaborative spaces for biomedical researchers. During the pandemic, new methods of

Associate VP, Creative Dave Holston

Emory Medicine is published twice a year for School of Medicine alumni, faculty, and staff, as well as patients, donors, and other friends. © 2021 Emory University

Emory University is an equal opportunity/equal access/affirmative action employer fully committed to achieving a diverse workforce and complies with all applicable federal and Georgia state laws, regulations, and executive orders regarding nondiscrimination and affirmative action in its programs and activities. Emory University does not discriminate on the basis of race, color, religion, ethnic or national origin, gender, genetic information, age, disability, sexual orientation, gender identity, gender expression, or veteran’s status. Inquiries should be directed to the Office of Equity, Diversity, and Inclusion, 201 Dowman Drive, Administration Bldg., Atlanta, GA 30322.

Telephone: 404.727.9867 (V) | 404.712.2049 (TDD).

online teaching were piloted, from virtual surgical electives to digital anatomy labs. It’s amazing how quickly the curricula and our students adapted in real time. Our telehealth services skyrocketed, and faculty clinicians developed ways for patients to stay in touch with their families despite COVID visitor restrictions.

Committing to work for a more just future, Emory medical students organized a White Coats for Black Lives vigil, and Emory and Morehouse medical students worked with metro-Atlanta governments to declare rac-

PHOTO STEVE NOWLAND

ism a public health crisis. SOM faculty and trainees provided frontline care May, Emory faculty and staff had administered more than 170,000 COVID vaccine doses, and students and trainees also helped administer vaccines to the community. I couldn’t be more proud to represent Emory School of Medicine and to recognize and support all of the skill, courage, and dedication it embodies. When our communities—indeed, our world—needed you the most, you were there. To all, my heartfelt gratitude.

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BEHIND THE STORY: In “The Frontlines,” Pulitzer-Prize winning cartoonist Mike Luckovich has emergency workers striking the iconic pose of Marines raising the Stars and Stripes at Iwo Jima. The editorial cartoon ran in the Atlanta Journal-Constitution on March 19, 2020. “I’ve received emails from all over the country from medical professionals and groups who want to use” the cartoon, Luckovich told the Washington Post. “A White Plains, N.Y., firefighter asked to make a leather helmet shield out of it to wear on his helmet.”

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across metro-Atlanta and alumni provided care around the globe. As of

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ILLUSTRATION BY JASON RAISH

FEATURES

Our Year of Living Dangerously 14

School of Medicine community members—from researchers to emergency room doctors, medical illustrators to residents, alumni to students­—reflect on the past year.

While each day we learn more and more about this pandemic, its impact on human health, and its broader impact on global economics and society, we still face a vast void of knowledge—the gray.”

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Reflections YEAR OF COVID-19

The Circle: Grief, Joy, and Proton Therapy 24

When Jacynta Brewton’s twin sons arrived prematurely, she thought that would be the biggest challenge her family would face. But the journey to come brought grief, joy, and a new definition of grace.

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Dinner with a Doctor: Travel Well 30

As we plan vacations, business trips, and family visits again, concerns persist. Henry Wu, director of Emory’s TravelWell Center, answers our panelists’ questions about the best ways to stay safe on planes, trains, and cruise ships.

Pandemics Then and Now 36

Clyde Partin, director of Emory’s Special Diagnostic Services Clinic, shares a historic comparison of pandemics, from the Black Death to COVID-19, and what we’ve learned.

A Crucial Step toward Healing 40

After a rejection from Emory School of Medicine more than 60 years ago because of his race, physician Gerald Hood tells his story of resolve and triumph.

THE BARE BONES Letters 4

By the Numbers 4 Briefs 5

Masking after vaccinations, when chemo isn’t necessary, emergency care in rural counties, staying HIP, heart health for women, heart cells in space, baby blues, new provost, urgent care for cancer patients, children’s vaccines.

AND MORE

Anticipation 47 Hospital chef Mike Bacha switched from sourcing organic vegetables to wondering if he had enough disposable plates for COVID-19 patients. Being a hospital chef during a pandemic is full of unknowns.

What’s Up, Doc? Class Notes 50 Visit us online at emorymedicinemagazine. emory.edu for bonus content. Send letters to the editor to mloftus@emory.edu.

THE BARE BONES

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Letters Nearly two years ago, I checked into Emory

Thanks so much for “Survivor Stories” in the

Hospital and died. I was given a hell-of-a shot, which killed every blood cell in my body. Now if the story stopped then, it would be very sad.

However, two days later, a tiny bag of five million of my pre-harvested stem cells was dripped back into me.

I had a horrible couple of weeks of body and soul-racking exhaustion, nausea, diarrhea, diffuse aches, confusion (I heard organ music all the time), and despair. I was lower than a snake’s belly.

My hair started falling out on the bedsheets.

One of the night nurses smiled and gently said in her lilting voice, “What do you think? Shall we buzz it off?” And she did.

My husband and I can truly say we encountered nothing but compassion, support, good humor, and above and beyond, help, in Cancerland. From the valets that helped us out of the car a gazillion times at Winship Cancer Center to the infusion nurses day in and day out at Piedmont West.

The stakes were so, so high for me. When the people around us treated us with dignity and unfailing decency, we drank it in like a tonic.

Well, more than a year later . . . I’m grateful to God. For so much.

Sometimes almost dying can be a profoundly lifegiving experience. This is true for a person or even a country. Almost dying brings to your mind and heart what you love about living.

Remember that. Look for the helpers. Take heart.

fall issue. Jerry Grillo does a splendid job of capturing the uncertainties of the early days of the pandemic and highlighting the disproportionate impact COVID-19 has on Black Americans.

The individual stories of the heroic patients and their families add human faces to the facts and figures we have all had to become aware of in the last few months.

The combination of an important topic and fine writing is powerful.

The Rev. Martha Sterne Episcopal priest (retired) Atlanta

Susan Percy Decatur, GA

Thank you for your help in making this year’s 17th Annual Hamilton E. Holmes Memorial Lecture, on Feb. 17, such a wonderful success. At our highest point there were more than 170 individuals engaged in the virtual conversation, and since the lecture another 130+ have viewed the video online. The program and the way it came together exemplified some of Emory’s best qualities: Medicine community, academic excellence, and service.

The Two During 2020, we Tr aumas At the collision point weathered the effects of health and social justic e 12 of COVID-19 and heard a “cry for racial justice some 400 years in the making.” Our guest lecturers, Dr. Kevin L. Gilliam II 09MR and Dr. Iesha Galloway-Gilliam 10MR joined us from Minneapolis, where they stood together on the front lines of both. Their story, “The Two Traumas,” was first featured in the Fall 2020 issue of Emory Medicine magazine.

For anyone who missed the event, a video and transcript can be viewed here: https://tinyurl.com/HEHolmes SPECIA L COVID -19 ISSUE FALL 2020

W H AT ’ S I N SIDE:

CHILDR EN AND COVID 22 READY SET PIVOT 28 SURVIV OR STORIE S 36

Associate director, Office of Multicultural Affairs, Emory School of Medicine, Atlanta

We like to hear from you. Send us your comments, questions, suggestions, and castigations.

Address correspondence to Emory Medicine magazine, 1762 Clifton Road, Suite 1000, Atlanta, GA 30322; call 404.727.0161; or email mloftus@emory.edu.

EMORY MEDICINE

$565M

In sponsored research funding in FY20 ($444M in 2019)

Allen Lee

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SOM

BY THE NUMBERS

14th

In NIH dollars (18th in 2019)

15+ hospitals / institutions and dozens of outpatient training sites–for medical students

1,322

residents and fellows in 107 accredited programs

2,967 2,715 FACULT Y &

STAFF

Could we, should we, remove our masks?

IN THE MEDIA 06.08.2021:

Sanjay Gupta interviews Jay Varkey, CNN Health

CNN’s chief medical correspondent Sanjay Gupta, Emory associate professor of neurosurgery, spoke with infectious disease specialist Jay Varkey, Emory associate professor of medicine, about calculating risks when going mask-free:

For more than a year now, many of us have followed the standard drill: wash our hands, stay six feet apart, choose outdoor activities over indoor, and—most of all—wear a mask.

Once vaccines were authorized for emergency use, the rules, as laid out in guidelines from the Centers for Disease Control and Prevention (CDC), slowly started to change as more people got their shots. This incremental loosening accelerated quickly in mid-May, when the CDC announced that fully vaccinated people no longer needed to wear masks outdoors or even indoors, except in a few circumstances.

While the news was certainly a cause for celebration, it also was a cause for confusion. Where we once had one universal, simple rule to follow—wear a mask—we each now have to perform a complicated calculus of risk assessment on a daily, if not hourly, basis as we navigate toward post-pandemic life.

Adding to the confusion is the patchwork of regulations that still exist in different states, cities, and even public spaces like restaurants and stores. And it’s impossible to tell who is vaccinated and who is not.

So, could we, should we, remove our mask? If so, when?

Where? And with whom?

When trying to assess your risk, remember that the CDC is talking about vaccinated people going maskless, not unvaccinated people. COVID-19 cases, especially hospitalizations and deaths, are occurring mostly among this ever-shrinking unvaccinated group, according to an analysis by the Washington Post.

For the most part, unvaccinated people are primarily a risk to other unvaccinated people. They aren’t much of a risk to the vaccinated and the vaccinated aren’t much of a risk to them.

That is why Jay Varkey, an infectious disease expert and associate professor at Emory School of Medicine, can’t stress the importance of vaccines enough. “Number one: get vaccinated.

Number two: get your family and those closest to you vaccinated,” he says. “If you’re vaccinated, if those closest to you, especially those you share a household with, are vaccinated, it makes all these activities easier.”

So how safe is being unmasked? Well, it’s not 100% safe: for people who are vaccinated, there can be what’s termed “breakthrough infections,” which basically mean a person can get infected even after getting vaccinated. But they’re rare.

There are two key points to remember: One is that you (the vaccinated person) are very unlikely to get really sick, even if you do have the rare breakthrough infection. The CDC reports that as of June 1, out of the 135 million Americans who are fully vaccinated, 2,274 either were hospitalized or died due to COVID. And the second point—and this is important for people who live with a child under 12 or with someone who for health-related reasons can’t mount an immune response from a vaccine—is that even if you do get infected, the science is beginning to show that you’re very unlikely to then be contagious enough to spread the virus to somebody else in your family or community.

SILENT INFECTIONS

We don’t know for sure that a vaccinated person can’t ever get silently infected and then infect someone else, even if it is very rare. One large group of people who may choose to be more cautious are parents of kids under 12, who can’t yet get vaccinated. Some parents are confused about when it’s OK to skip the mask. It’s a question that is pressing, especially now that summer is rolling around. Let’s face it: Masks are hard to wear in the heat, even for grown-ups. The good news is that children

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don’t get infected as easily and don’t get as sick as often as adults do. But the bad news is that some do; nearly four million children have tested positive for COVID since the start of the pandemic. Even though it’s tempting to set aside the mask, many medical and public health experts are erring on the side of caution. The American Academy of Pediatrics recommends that children age 2 or older who are not fully vaccinated still wear a mask when out in public, including at camp, when playing with friends, and while playing outdoor sports with close contact and indoor sports. And while the CDC dropped its mask requirement for fully vaccinated campers and counselors, it didn’t for those who are too young to get their shot.

Varkey agrees that continued mask-wearing for the under-12 set is prudent and calls for a little bit more patience. “What I would say, especially for those with children . . . who don’t yet qualify for the currently available vaccines is to sit tight,” he says. “I think it’s the safe, conservative thing to do for kids, for their fellow students, for their teachers, and also for the families they go home to.”

WEAK IMMUNE RESPONSE

Another group that would probably be more risk-averse: people who didn’t mount a strong immune response to the vaccine either because they are immunocompromised or they take certain medications that suppress their immune system, like drugs for rheumatoid arthritis and inflammatory bowel disease. These medically vulnerable people and those who live with them will likely be more cautious about removing their masks. National Institutes of Health Director Francis Collins estimates that 16.7 million Americans fall into that category. And that’s why getting vaccinated, if you’re able to, is so important—because it protects children and the medically fragile among us. That’s the essence of herd immunity. “Think about this as a donation of your own goodwill to those who are more vulnerable,” Collins says. “The only protection those folks are going to have—and they’re 5% of us—is because the rest of us provide this blanket of immunity.”

That’s also why it’s important to remember it’s OK to keep wearing a mask, if that’s what you feel your situation calls for. I carry a mask in my pocket all the time and if somebody is very concerned, out of respect, I’ll put that mask on. And maybe also if I’m on an elevator or someplace similar. Shaming someone who wants to wear a mask serves no advantage. People are nervous and cautious; it’s been a traumatic year for all, and some might take longer to feel safe enough to go mask-free. n

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This is an excerpt from an article on CNN.com.

EMORY MEDICINE

Is Chemo Always Necessary for Breast Cancer?

Not every woman will benefit from chemotherapy for breast cancer. But it’s hard to determine who will and who will not.

Researchers have discovered at least one group that appears not to benefit from chemotherapy: postmenopausal women with a specific, fairly common type of ILLUSTRATION BY GORDON STUDER breast cancer.

Those women with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer that has spread to a limited number of lymph nodes, and whose recurrence risk is relatively low, were shown not to benefit from chemotherapy when it is added to hormone therapy, according to initial results from a clinical trial by an Emory researcher.

Chemotherapy infusions take time and money and can have harmful side effects.

This is the first evidence in a randomized phase III trial that postmenopausal women with HR-positive, HER2-negative breast cancer that has spread to one to three lymph nodes can safely forgo chemotherapy if their recurrence score on a genomic tumor tissue test is 25 or less.

“Every day in clinics around the world, physicians wrestle with the question of how to best treat women with this common form of breast cancer,” says the study’s lead author Kevin Kalinsky, acting associate professor in hematology and medical oncology and director of the Glenn Family Breast Center at Emory’s Winship Cancer Institute.

“These results are practice-changing and demonstrate that some postmenopausal women can be spared unnecessary chemotherapy and receive only hormone therapy. This should bring more clarity to physicians and some relief for patients.”

The trial also demonstrated, after a median of five years, that premenopausal women with the same disease characteristics benefited from chemotherapy. n

Improving Emergency Care in Rural Georgia Emory Assistant Professor of Emergency Medicine Michael Carr, the Emory Rural Tele-EMS network’s project director, is medical director of DeKalb County Fire and Rescue and associate medical director for Air Life Georgia.

In 14 rural counties, Georgians who need emergency medical care will have access to Emory doctors and specialists even before they reach a local hospital through a new telehealth initiative.

The Emory Rural Tele-EMS Network (ER-TEMS) will work with the South Georgia division of Grady EMS in cooperation with local rural hospitals. It is being funded with the help of a four-year, $1.2 million grant from the Health Resources and Services Administration.

“Telehealth hasn’t been used much in the pre-hospital environment. That’s even more true in rural areas, where it has tremendous promise,” says Michael Carr, the network’s project director and an assistant professor of emergency medicine at Emory’s School of Medicine.

“We know that early intervention saves lives. In rural Georgia, the long distances required to reach a hospital contribute to worse medical outcomes in time-sensitive critical conditions like strokes, heart attacks, trauma, and complications during childbirth.”

This network aims to reduce those disparities. “Our vision is to create new models of acute care that are patient focused and provide more equitable access to quality health care through our innovation center, Health DesignED,” says David Wright, chair of Emory’s Department of Emergency Medicine.

Using video technology and high-speed internet connection, the network virtually places Emory emergency medicine professionals “in the ambulance” across remote parts of Georgia.

Residents in rural areas of the state suffer from high rates of chronic health conditions, placing them at increased risk of medical complications. Yet they are often far from the nearest hospital.

The ambulance crew can call the Emory emergency hub physician when a critical patient is identified or if they need other clinical support. Early diagnosis and intervention are key to improving outcomes in most critical conditions. An Emory emergency physician will use a video internet hookup to consult with the ambulance crew, helping to evaluate and manage initial patient care.

EMS personnel can focus their attention on patient care while the Emory emergency provider in Atlanta coordinates with the receiving hospital about the incoming patient’s arrival and treatment plans. The telemedicine interface will allow EKG readings, vital signs, patient charts, and biometric data to be uploaded to the cloud from the inbound ambulance.

Emory is partnering with local hospitals within these rural counties. n

ILLUSTRATION BY MARUMARU

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Stay HIP

“The H is for humility, a willingness to learn from anyone, at any time, in any venue. And to be honest with yourself—what you know and don’t know—as well as with your patients. H is also for leading with heart, finding humor and learning to laugh, especially at yourself, for laughter truly is the best medicine. Remember, you will rarely cure but you can always heal. I is to remind you to imagine, innovate, and impact, to connect the dots. And P is for your passion, what engages you, especially in service to others. Combine passion with compassion. Also, remember to pause. Please take a moment to reflect in the midst of all your activities, to find perspective and respect differences.”—DEAN VIKAS SUKHATME TO 2021 GRADUATES, EMORY SCHOOL OF

MEDICINE COMMENCEMENT, MAY 14, GEORGIA WORLD CONGRESS CENTER, ATLANTA

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A Legacy of Heart Health for Women

“Trailblazing was exciting, and I was fortunate enough to have had spectacular mentors,” says Emory Professor Emeritus Nanette Wenger.

The American Heart Association (AHA) has launched a new annual award honoring cardiologist and researcher Nanette Wenger, professor emeritus in Emory’s Division of Cardiology. The award will recognize the Best Scientific Publication on CVD and Stroke in Women to have run in an AHA publication that year.

Coronary heart disease in women has long been one of Wenger’s major clinical and research interests. She chaired the US National Heart, Lung, and Blood Institute Conference on Cardiovascular Health and Disease in Women. “Dr. Wenger’s name is practically synonymous with women’s cardiovascular research and care—she has been a formidable leader in the field of women’s heart health and a strong ally and advocate for women in cardiology and medicine. This award

recognizes her incredible legacy of paving the way, supporting and mentoring women as scientists and medical professionals, as well as her pioneering efforts in cardiovascular disease research about, for, and by women,” said American Heart Association President Mitchell Elkind. “The new Dr. Nanette K. Wenger Award will serve as an inspiration for continued innovation and discovery in research on cardiovascular disease and stroke in women.”

Wenger received her medical degree from Harvard in 1954 as one of the medical school’s first female graduates. She came to Emory after her residency and was named a full professor in 1971. She is a past president of the Society of Geriatric Cardiology and was editor-in-chief of the American Journal of Geriatric Cardiology. Wenger has authored or coauthored more than 1,600 scientific papers and chapters, and cowrote the medical text Women and Heart Disease. The inaugural award will be presented during the AHA’s Scientific Sessions 2021. n

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3/17/21 12:44 PM

Heart Cells in Space tion—storing cells at minus 80°C—makes it easier to transport these cells to the orbiting lab, providing more flexibility in launch and operations schedules. The process could benefit other biological research in space and on Earth.

The investigation, MVP Cell-03, cultured heart precursor cells on the ISS to study how microgravity affects the number of cells produced and how many of them survive. These precursor cells have the potential for use in disease modelling, drug development, and regenerative medicine, such as using cultured heart cells to replenish those damaged or lost due to cardiac disease.

Previous studies suggest that culturing such cells in simulated microgravity increases the efficiency of their production. But using live cell cultures in space presents some unique challenges. The MVP Cell-03 experiment, for example, must be conducted within a specific timeframe, when the cells are at just the right stage.

“Sometimes a flight is delayed and investigators have to prepare batches and batches of backup cells,” says Chunhui Xu, associate professor of pediatrics at Emory and principal investigator for MVP Cell-03. “Astronauts face an overwhelming amount of work the day investigations arrive, but these cells need fresh medium right away. We thought we had better work out this procedure ahead of time.”

The results, recently published in the journal Biomaterials, show that cryopreservation does not appear to affect the cells

ILLUSTRATION BY JON KRAUSE

Researchers have explored new ways to culture living heart cells for microgravity research aboard the International Space Station (ISS). They found that cryopreserva-

and even offers the added benefit of protecting cells from excess gravity experienced during launch.

The team also compared a new cell culture medium that does not require carbon dioxide with the current standard medium, which does, and found no difference between the two.

Carbon dioxide adds weight and mass—and cost—to a space launch. The research team tested several modifications to culture media to improve cryopreservation procedures as well.

The cryopreserved heart cells flew to the space station in March 2020. Astronauts thawed and successfully cultured them, generating beating heart cells. Those cells were returned to Earth after 22 days of spaceflight. n

A previous version of this article ran on the NASA.gov website.

Baby Blues? Support for New and Expectant Mothers The Emory Brain Health Center recently launched a new program to

support the mental health of Georgia women before and after childbirth.

The PEACE (Perinatal Psychiatry, Education and Community Engagement) for Moms program, is funded by the Georgia Department of Public Health and provides expert consultation and education to physicians, physician assistants, nurse midwives, and nurse practitioners.

“Psychiatric issues, such as depression and anxiety, are the most common adverse events mothers experience during the postpartum period,” says program leader Toby Goldsmith,

assistant professor of psychiatry and behavioral sciences, Emory School of Medicine, and director of the Emory Women’s Mental Health Program. “We are thrilled to help address these issues by offering much-needed support and consultation to those providing care to mothers and mothersto-be throughout the state.”

PEACE for Moms will help fill gaps caused by access to care. Mental health providers such as psychiatrists, psychologists, counselors, and

therapists are in short supply. “Not only do we face a shortage of practitioners in Georgia, most women have minimal health insurance coverage for mental health issues during pregnancy and the postpartum period,” Goldsmith says. “As a result, it is difficult for them to be properly evaluated and cared for during this vulnerable time.”

The program will partner with the Healthy Mothers, Healthy Babies Coalition to provide social services and support. For more, go to the PEACE for Mom’s website (med.emory.edu/departments/psychiatry/programs/peace) n

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Biomedical Scientist Ravi Bellamkonda Returns to Emory as Provost

At Duke, Bellamkonda led a reimagining of the engineering curriculum and helped recruit and retain preeminent faculty members. During his tenure, the number of female and other underrepresented faculty members in the Duke school of engineering nearly doubled.

He also oversaw fundraising efforts to support construction of Duke’s new $115 million Wilkinson Building, designed to advance engineering education, research, and entrepreneurship.

“I believe that Emory has a very special opportunity to define itself at a historic moment—as a socially just university that embraces innoBiomedical scientist Ravi Bellamkonda, previous chair of vation and leads pathbreaking research across disciplines,” the Coulter Department of Biomedical Engineering at says Bellamkonda. “We have the potential to lead in so many Emory and Georgia Tech, became Emory’s provost and areas: from the creative arts and medicine to undergraduate executive vice president for academic affairs on July 1. and graduate education and beyond. We are In addition to serving as Emory’s provost, also poised to make great strides in advoBellamkonda will also be a faculty member cating for racial and social justice, building in Emory College of Arts and Sciences in on the legacy of activism and engagement biology with a joint appointment in biothat has defined our home city of Atlanta for medical engineering. generations. I know that the most significant Bellamkonda returns to Emory after challenges of today are humanistic in nature, serving as dean of the Pratt School of Engiand I am committed to the power of great neering at Duke University for five years. He liberal arts institutions like Emory to address previously held a joint appointment as a them through scholarship that serves comfaculty member at Emory and Georgia Tech, munities around the world.” beginning in 2003.

Bellamkonda received his PhD in medical “Dr. Bellamkonda has an incredible science from Brown University and completenthusiasm for Emory, and he understands ed a postdoctoral fellowship as a Markey what sets our mission apart in delivering Fellow in the Department of Brain and a life-changing undergraduate liberal arts Cognitive Sciences at MIT. education and dynamic graduate and professional programs at our world-class research His lab has contributed to advances Emory Provost university,” says Emory President Gregory in peripheral nerve repair, brain-machine Ravi Bellamkonda L. Fenves. “He is that rare academic leader interfaces, and spinal cord injury repair. whose eminence in his discipline is compleIn recent years, his research has focused mented by a strong dedication to elevating the undergraduon developing innovative treatments for brain tumors. ate student experience and collaborating in research across Bellamkonda has authored more than 130 peer-reviewed many disciplines and fields of study.” articles and holds 10 patents. n

“ I know that the most significant challenges of today are humanistic in nature, and I am committed to the power of great liberal arts institutions like Emory to address them through scholarship that serves communities around the world.”

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Urgent Care for Cancer Patients On average, cancer patients undergoing chemotherapy are more likely than others to visit the emergency room and to need hospitalization. Even so, most report only a small fraction of their symptoms—such as pain, nausea and dehydration—to their care team. Funded by a multimillion-dollar gift from the Ma-Ran Foundation, Emory’s Winship Cancer Institute will establish an immediate care facility to bridge the gap between cancer centers and emergency rooms. The Rollins Immediate Care Center of Winship at Emory University Hospital is set to open in spring 2022.

“Cancer patients need to know that, when they are at their most vulnerable, there is a place where oncology-trained experts can provide urgent and immediate care. That’s an enormous comfort for patients,” says Sagar Lonial, chief medical officer of Winship.

Having a dedicated cancer urgent care center would improve patient care by making cancer treatment plans seamless while also helping patients avoid exposure to infectious diseases in emergency waiting rooms.

Winship piloted the idea in 2020, creating a separate

urgent care area to see and treat cancer patients who had been exposed to COVID-19, or suspected they had been.

The model showed the need for a permanent cancer immediate care center.

The Ma-Ran Foundation has made an investment of $7 million to establish the Rollins Immediate Care Center of Winship, which includes an endowment of $3 million. The endowment’s distribution will provide funding for a variety of research projects and programs for cancer patients.

Examples include outcomes research designed to inform and improve the patient experience and funding for “soft touch” amenities important to patients in stressful situations.

Winship plans to house the urgent care center on the fourth floor of the Emory University Hospital Tower, next to the Phase 1 Clinical Trials Unit and the newly constructed Winship Cellular Therapy Unit.

This space will provide 11 exam rooms, with three dedicated procedure clinics during peak shifts.

The design of the new center will be guided by a multidisciplinary team of patients, nurses, physicians, and research staff. n ILLUSTRATION BY PROSTOCKSTUDIO

Emory, Children’s Healthcare of Atlanta launch COVID-19 Vaccine Trial for Young Children Physicians from Emory and Children’s Healthcare of Atlanta are participating in a clinical trial testing the Moderna COVID-19 vaccine in children ages six months to less than 12 years.

This is the same Moderna mRNA-1273 vaccine that is being

distributed nationwide for adults ages 18 and older following an emergency use authorization from the US Food and Drug Administration in December for that age group.

The initial phase of the KidCOVE study will test different doses of the vaccine to evaluate safety in a younger population. Children enrolled in the trial at the Emory Children’s Center beginning in May. The study is being conducted by the Infectious Diseases Clinical Research

Consortium in collaboration with the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, and the Biomedical Advanced Research and Development Authority.

“This is a critical step for children that could make it possible for them to receive the same type of immune protection now provided to adults,” says Evan Anderson, associate professor of medicine and pediatrics at Emory, attending physician at Children’s, and the study site principal investigator for the trial.

Anderson, who has advocated for COVID vaccine clinical trials to begin in children, was site principal investigator for the phase 1 study of mRNA-1273 last year, which showed that the vaccine was safe and generated an immune response in adults. He also was a site principal investigator for the phase 3 study in adults. n

Summer 2021

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We asked School of Medicine community members to reflect on their past year.

Our writers—doctors and medical illustrators, medical fellows and researchers, alumni and students—wrote of time spent in ERs (both as doctor and patient), working from home while schooling children, facing discrimination and advocating for justice, all while desperately trying to save lives and stay safe.

Our Year of Living Dangerously Illustrations by Jason Raisch

When It Started in Atlanta

By Sophia Gorgens M20 Gorgens is an alumna of the Emory School of Medicine

It’s not like we were unprepared—we’d heard how things were in China and Italy and from New York and Seattle.

They called us every week to tell us what to expect: chaos and all the elder volunteers in the hospital lobby suddenly gone.

Then they disappeared from the streets and stores, gone, and handguns sold out right after toilet paper, chlorine, and yeast.

There wasn’t a mask mandate and then there was and then it really depended where you were. Wear it under your chin.

We practiced our screams. The club downtown didn’t close until curfew was called. The National Guard. Really, curfew was called only because of the protests. The whole city couldn’t breathe.

At the hospital, we looked at bodies and counted these victims in one part, COVID in the other, until we realized they were the same.

How many names, we said as we resuscitated and took the pulse of our strangled city, can you give death?

Ventilators rasped, surgical masks slashed our mouths blue, a patient coded, and a doctor was found on the tiled bathroom floor, fast asleep. Outside, signs for Heroes suffered from the summer rains.

Someone suggested a roll call, but halfway through night had fallen and we gave up.

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UNCOMMON VALOR

‘I Hope They All Made It Through’

By Michael Konomos Konomos leads the Visual Medical Education (VME) team for Emory School of Medicine.

These are strange but important times for medical illustrators. When I chose to become an artist-scientist who depicts the intricate workings of the human body, I knew my work would be important in the training and teaching of medical teams and in communicating important information to the public.

We were used to tight deadlines on projects.

But illustrating urgent health messages in real time during a pandemic to communicate to healthcare workers and the public how best to survive—the stakes were higher than ever before.

I was at Emory during the time we cared for the country’s first Ebola patients and remember that once the news vans showed up, the physicians were too busy caring for patients to work with our VME team. In February I started to think COVID-19 might come to the US in a small, contained way, much like Ebola.

Not wanting to miss being part of Emory’s critical response, I built a 3D model of SARS-CoV-2, the virus that causes COVID, on the night of February 11, 2020. That whole week I had researched journal articles and contacted labs who were mapping this new virus. This was the first of many weeks in which I would work 70 to 80 hours.

I remember listening to the song “Don’t Fear the Reaper” while I was working alone in the office late one night as my wife and children slept at home, wondering what was about to happen.

After connecting with Emory’s Serious Communicable Diseases Program in the first week of March, our team’s work took a very different turn. We focused less on depicting the virus itself, and more on showing—in photos, videos, and

illustrations—the proper way for people to wear personal protective equipment (PPE).

In particular, we drew training materials that showed people putting on and taking off PPE like masks and gowns.

General PPE guidance was widely available prior to the pandemic, and staff were welltrained in its use as it related to routine duties.

But COVID presented some new challenges, such as PPE shortages, which require a different process to safely reuse pieces of equipment.

Emory Healthcare was among the first to adapt procedures to preserve supplies. We did our first educational handout in a single day, something that normally would have taken weeks. We also started directing PPE training videos.

We would film a video, edit, and post it in a day. The pace was insane.

Our team was invited to work with the Emory Center for Digital Scholarship to film the putting on and taking off of PPE (“donning and doffing”).

We filmed at the isolation unit at Emory University Hospital so we could provide the proper context. This is where the Ebola patients had been cared for a few years before. It was surreal. In the midst of filming, we had to stop and scramble to relocate the shoot because Emory’s first COVID patient was being admitted to the unit.

A few days later, in mid-March, we were filming a PPE fitting and training session. By then, we understood the gravity of what was coming. I looked around at these brave young health care workers. We knew global PPE supplies would be limited. It felt like we were preparing for war. My eyes welled up as I wondered if each of the young people practicing donning and doffing would make it through this.

It was a deeply moving scene to bear witness to, that these health care workers would be willing to show up and risk so much for others.

The work kept coming. We ramped up our efforts and brought in more medical illustrators to help with the overflow. The graphics and videos we posted to Emory’s Serious Communicable Diseases Program site were viewed by people from around the world. Providers wrote from rural US hospitals, US military bases, hospitals in Puerto Rico, the Philippines, and Tanzania to thank us or give feedback.

Our analytics showed the materials also being used in Brazil, Russia, Malaysia, Columbia, Pakistan, South Africa, and many other nations. It was meaningful work.

Since April 2020, I have been continuing COVID-related work from home. I can’t help being overcome as I think about the health care workers at Emory, and around the world, who put on PPE and go to work each day in a COVID unit.

I hope they all made it through. n

Summer 2021

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Minding My P’s . . .

By Sheryl Heron Heron is professor of emergency medicine and associate dean for community engagement, equity, and inclusion.

I call it the peril of the p’s: pandemic, police brutality, protests, and politics—and they collided to make 2020, for me, a painful year yet one that fostered deep reflection.

Here are the hats I wear. I am a professor and an associate dean; a vice chair of faculty equity, engagement, and empowerment for emergency medicine; and associate director of education at Emory’s Injury Prevention Research Center. I am a healer and stand for fairness. That’s what those long titles of mine come down to in the end.

March 2020. More than a year in now, we all are choosing what to remember. The most startling recollection I have from that month, perhaps one that is universally shared, was that life would never be the same.

One irony is that, as the country was beginning to shut down, I and colleagues from the School of Medicine and Emory’s Center for Contemplative Science and Compassion-based Ethics had returned from a charrette on cognitively based compassion training.

With the entire world at a reckoning based on those four p’s, small steps such as compassion training seemed both desperately needed and wholly inadequate.

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As an emergency medicine physician who works clinically at Grady, I saw firsthand the trauma, tragedy, and fear associated with putting ourselves on the front lines. We were caring for patients with a still-mysterious illness that could be deadly to them, to their loved ones and associates, and to us—their doctors.

Patients were arriving in increasing numbers with the red flags tied to COVID-19: fever, cough, and shortness of breath. These patients were appropriately placed in an isolation room. But others came with abdominal pain and diarrhea and were not isolated; we hadn’t yet learned that these too were symptoms of COVID. I vividly remember a patient presenting with diarrhea and abdominal pain. She was being seen in our fast-track area, which meant there was a good chance she would be discharged. Because she had reported no respite from her symptoms, a CT scan of her abdomen was ordered. It captured the bottom part of her lungs and immediately elicited everyone’s concern. She, too, was suspected of having COVID. I saw the fear in my colleague’s eyes as the patient was rushed to an isolation room but not before potentially exposing my colleague and other health care workers, as well as other patients, to the virus.

As the days advanced, it was a further blow to learn that Black and Brown people bore a higher risk of hospitalization and death.

So, I took a list I’d always used in my care for patients and published it, the “Heron 8.”

We all need these three things: *something to do *someone to love *something to look forward to (in a word, hope).

And we all need five communities that carry us through life: community of origin, community of creation, community of neighbors, community of workers, and community of faith.

Many of my patients are more vulnerable, lacking some of these elements.

While we, as their doctors, cannot create these essentials out of whole cloth, we can recommit ourselves to combating racial disparities and pushing toward health equity.

We committed our energies, in the School of Med-

UNCOMMON VALOR

icine’s wellness working group, to sharing our pain. We explored art, in all its forms, as a balm. As the chair of that group, I recognized the urgency to be vulnerable, to bring forth the realities of the pain we all were feeling.

So, I shared a spoken word with the wellness working group; it was published in the fall 2020 issue of The Styloid Process, the School of Medicine’s literary magazine created by students. Bringing these words to the forefront of my consciousness helped me regain some of my strength, the strength I needed to keep moving.

I also participated in the Good Listening Project, which partnered with the American Association of Medical Colleges. Its goal is to cultivate resilience and well-being in health care communities and to showcase the value of the arts in health care. One personal joy in that experience was that a poem was created for me. I’ll share the lines that haunt and galvanize me: She knows that we must unmake the things that are destroying us.

She knows which anchors can bear the weight of that unmaking.

As the year rolled mercilessly on, trapping us in Zoom, isolating us from our family, I wasn’t sure where to look to find hope.

COVID-19 accelerated and so did political divisiveness and senseless acts of hate. My husband and I, my colleagues and I, hunkered down, fearful that someone in our family might be the next to die—perhaps us.

No amount of PPE could protect me from the stress, pain, and suffering of patients, colleagues, and staff.

November 2020. I fell to my knees with severe right-side chest pain, not sure what was happening to me. There was no fever, no cough, no shortness of breath, no funny taste. I had the benefit of thoughtful, concerned, expert colleagues in the emergency department and yet initially none of us was thinking COVID. But it was. I immediately worried for my parents and my mother-in-law, residents in the same long-term-care facility, whom my husband and I had just seen the day before. We were afraid.

My time with COVID was rough but short, and my parents and mother-in-law were thankfully spared. I was one of the lucky ones, left whole only through God’s grace: friends and colleagues have succumbed or lost people close to them.

I also am abundantly, sadly conscious of the many people

who are unable to shake off COVID, who continue to battle it for weeks, months, even a year after the initial symptoms.

A year later, I know what I have always known, but I am more secure in this knowledge after seeing it validated by rocky days of uncertainty during a pandemic.

I know that I must care for myself—doing so is part and parcel of being a committed physician.

I know that a focus on wellness and well-being for faculty, learners, and staff—though it seemed like battling Goliath with David’s rocks back in March—is right for me to pursue, and I accept the help of others in so doing. It doesn’t sweep away all pain, but it helps.

I know that there is an art to medicine that cannot be dispensed with, even in the midst of all the other imperatives the crisis puts before us. I must model that art for my colleagues and students, and I must bring it daily to my patients’ bedsides.

I know that my voice and yours matter.

The p’s haven’t receded; they are still with us. But I tolerate their presence by magnifying the value of two other words: grace and time. n

THE MASKS WE WEAR

I knew I was not alone in my articulation of the 4 p’s when I saw what the editors of The Styloid Process did with the theme of masking.

“For more than a century, healthcare workers have worn masks to protect themselves and their patients. What narratives have hidden, and continue to hide, behind those masks?”

“Now, in the midst of the COVID-19 pandemic, masks are being worn not just by healthcare workers but by everyone. What does it mean for us, as a society, to interact with each other in this way?”

“While masking us physically, the pandemic has unmasked issues that lie at the heart of society, bringing matters of social justice to the fore. . . .

Where are we, and where must we go next?”

“What identities, issues, or themes do you grapple with behind your mask?”

Tough questions, all, and stubborn—demanding answers for us to move forward.

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Getting Back to ‘Normal’

By David Malebranche M96 Malebranche is an alumnus of Emory School of Medicine and an Atlanta-based internal medicine physician.

I am a physician. A scientist. A researcher. I understand the inner workings and rationale behind clinical trials, study analyses, and the development of public health guidelines.

I am also a Black man, a same-gender-loving man, and a person living with HIV who is trying to get by during the COVID-19 era, just like everyone else. This pandemic has affected me much more than I would care to admit, which makes me, above all things, human.

So while many have celebrated the latest CDC guidelines on the fully vaccinated being able to go maskless as a shortterm victory, my feelings are more mixed. The start of the pandemic seemed surreal to me. My father had just passed away in upstate New York. I had taken an unpaid leave of absence from work to be with my mother and help her handle my father’s possessions, sell their home of 20-plus years, and facilitate her safe pilgrimage to California to live with my sister.

It was mid-January 2020, and the rumblings in the US of a new, fatal virus were faint.

They quickly became louder. By March, hospitals began overflowing with COVID patients.

Medical staff were becoming burnt out and systems were overwhelmed.

Then came the shutdowns of public spaces and events. Mask mandates. Travel restrictions.

Physical distancing requirements that became thinly veiled experiments in human tolerance of social isolation.

It hit closer to home when friends who were feeling ill or had tested positive for the coronavirus started calling me for medical advice. Some were hospitalized; others fought through their symptoms at home. One friend died on an early spring day only months after celebrating his 40th birthday. Daily social media postings from friends and colleagues detailed how loved ones had succumbed to the disease.

It has felt like one hazy, protracted nightmare that I sometimes thought I would never awake from. Some days I found it hard to get out of bed and function. Fortunately, we began getting some good news. Vaccines were quickly developed, tested, and distributed in record time. I got mine as soon as I knew I would be going back to seeing patients. Now, as rates of new

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infections, hospitalizations, and deaths have been dropping, restrictions are being lifted.

CDC’s new guidelines inform me that, as someone who is fully vaccinated, I can “resume activities that I did prior to the pandemic.” That means I can often go maskless. The physician and scientist in me leapt for joy upon hearing these evidence-based recommendations. The human in me, however, isn’t as enthusiastic.

Nothing for me is “normal” anymore. While I feel somewhat safer after being vaccinated, I still cringe knowing the element of narcissistic American culture that hijacked the pandemic narrative for the past year is still out there in droves. Too many Americans don’t care about anyone’s health but their own, and that frightens me. I find myself longing for scientists to develop a vaccination to protect me from their particular brand of self-centered recklessness and stupidity that could injure me or someone I love.

Despite being a fully vaccinated physician, researcher, and scientist, I’m a human being who is afraid of this virus.

During the pandemic, we all had to grow increasingly comfortable with uncertainty, especially about what the future holds. COVID, and the subsequent public health measures deployed to fight it, have taken a toll on mental health for many people , who are experiencing depression, feelings of isolation, anxiety, insomnia, and more. Much has been said about this generation of youth and the negative emotional impact this has had on schoolchildren.

COVID has presented us—children and adults alike—with a particularly insidious form of trauma for more than a year now. A microscopic organism few had ever heard of before 2020 has forced us to rely on Zoom calls, FaceTime, elbow bumps, and head nods when really all we long for are in-person conversations, handshakes, and long hugs.

The COVID pandemic has left a scar on me that will take some time to heal, and I don’t know whether I’m quite ready to fully ditch the mask and place my trust in a country that has yet to earn it. n

This is an excerpt from an article that ran in STATnews.com.

UNCOMMON VALOR

Shades of Gray

By Don Batisky Batisky is a professor of pediatrics at Emory School of Medicine and a pediatric nephrologist at Children’s Healthcare of Atlanta.

Being a small group adviser to medical students in the Osler Society is the best job I’ve ever had. It’s not only interesting, motivating, and humbling, but also so very rewarding. I’ve read up on Sir William Osler, our historic namesake, who is credited with bringing medical students to the bedside, saying, “I desire no other epitaph than the statement that I taught medical students in the wards, as I regard this as by far the most useful and important work I have been called upon to do.”

While I agree with Dr. Osler, the COVID-19 pandemic has led to rapid change in every aspect of our lives. Because of concerns for their safety, medical students were pulled out of clinical rotations, teaching was done remotely, and we adapted quickly as we figured out ways to best prepare students for all that lies ahead. In the beginning of the pandemic, I reached out to my former students to offer words of support. The Emory School of Medicine Class of 2018 included my very first group that I took from M-1 through M-4, and most of them had scattered across the country for residency.

One young physician’s return message was especially poignant: “Thank you for reaching out. I’ve been thinking a lot recently about your teachings during our time in medical school. Especially during these uncertain times, your adage that life is shades of gray rings truer and truer. While each day we learn more and more about this pandemic, its impact on human health, and its broader impact on global economics and society, we still face a vast void of knowledge—the gray. And as we stare into this abyss, scared for our own safety and well-being in addition to that of our loved ones, I am comforted by your wisdom. That chasm, that gray, is where we are called as physicians. It is where we will make the hard decisions and push ourselves to grow beyond what we think possible of ourselves. If ever there was a place to make a real impact, to save lives and shape life, it is here in the gray. This is what you prepared us to do. And I can never thank you enough.”

We’re learning a lot these days about a virus, its effects on our human bodies, PPE, social distancing, and flattening curves. And we are learning how to teach innovatively. I look forward to the day when I can again see my students together in a classroom or clinic or at the bedside. I look forward to teaching them not just renal pathophysiology and electrolyte balance, but those nuances, those shades of gray. To paraphrase Osler, I desire no other epitaph than that I taught medical students in the classroom, in the clinic, on the wards, and via Zoom. This by far is the most useful and important work I have been called upon to do. n

Hubris

By Naomi Newton M20 Newton is an Emory School of Medicine alumna and a medical resident at the University of Miami.

I’m on the cusp of something so important, yet I’m relegated to the sidelines.

Medical students were banned from hospital rotations, although the school held out until the very end.

Students are like dutiful postal workers: for “neither snow, nor rain, nor heat,

nor gloom of night stays these couriers

from the swift completion of their appointed rounds.”

We always show up to the hospital— that is, until they run out of PPE and remember that we’re non-essential workers who are always in the way yet trying ever so hard to be useful.

I know it’s not about me, and I’m all too happy to surrender a mask to a clinician or staff member who needs it to do their hero’s work.

I don’t care about missed Match Days and

doctoral hooding ceremonies—

How could I, when so many are suffering?

In fact, I’m proud of the ways that my classmates have banded together to do our duty remotely and provide hope and relief to our wearied leaders.

But a small part of me— the part that can’t wait to shove my short, white coat

into the back of my closet

and embrace the title of “Emergency Room Doctor”

in early June—

wishes that I, too, could answer the call to arms and join my colleagues in this worldwide virologic battle.

At the moment, I feel useless and far-removed— as I Zoom into classes and scroll through viewing options on Netflix.

Totally isolated from the war zone that’s not five miles from my apartment.

Summer 2021

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Whatever I Can Do to Save Another Life

By Zanthia Wiley Wiley is an assistant professor of medicine at Emory and an infectious disease physician.

As a hospital-based, infectious diseases doctor, I became interested in the patients being admitted with COVID-19. What zip codes are they living in? What factors increase the likelihood of their contracting the virus? And which of these patients end up returning to the hospital? My primary research now is trying to describe factors that increase the likelihood of Blacks and Hispanics contracting COVID. I’m working with more than 30 colleagues from Emory hospitals, the VA Medical Center, and Grady to address these disparities. We are looking at what we can do to meet people where they are.

We recognize there are barriers for certain communities to get the vaccine: Internet access, transportation, a language barrier.

It’s great to have central vaccine sites, but I’m looking forward to the day we have mobile vaccine units at neighborhood hubs like churches, libraries, and community centers.

On Friday, March 13, 2020, I took care of my first COVID patient. She was Black, in her 70s, churchgoing, married, lived with several family members, and had adopted two younger children as well.

The second patient I took care of with the coronavirus was Black. The third patient was Black.

Very early on, I noticed that these patients look like me. They look like my grandmother; they look like my aunt. The disparities in COVID are very personal for me. Fighting against this disease is equivalent to fighting for my family.

A few months ago, I saw a healthy Black patient in his 30s come in with COVID and die within hours. He had no history of medical problems and worked every day. Then I saw that two people admitted after this young man had his same last name. Turns out they were his parents. Just imagine both parents in the hospital, sick with this virus, having to figure out burial arrangements for their healthy child. My heart is heavy right now thinking about it and telling their story.

My research on health disparities is also personal because COVID has struck my own family. But to witness this tragedy

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and travesty daily has forever changed me as a physician, magnifying what I already knew was out there. To see how this ravaged our community and our world has been life changing. I can no longer stay in the safety net of taking care of individuals; I have to think about the big picture—populations, structural racism, and inequities. What can I, as a Black woman from rural Alabama, do to help my people? What can we all do?

It’s time that academic communities, many of which are sitting right in these neighborhoods, engage our neighbors, even when things are going well. We need to engage faith-based organizations and schools so that when we’re in a tough situation like a pandemic, they know and trust us. Do I understand the seeds of mistrust?

Absolutely.

What can I do and what have I done? I got my vaccine. I made sure my mother got her vaccine. I make sure my family members are getting their vaccines.

I tell my patients that.

And not just my patients.

Sometimes it’s the lady at the grocery check-out. Or to groups organized by my pastor or other community leaders, via Zoom. People feel more comfortable after knowing that I took the vaccine and trusted it for my loved ones.

When I’m speaking to someone, I start off with an open-ended question. I ask them what they think about the vaccine, and then address each of their concerns and questions, one by one. Am I having the same conversation over and over, all day, every day? Yes. But if that’s what I have to do to change one person’s mind, I’ll do that.

Think of it as “community immunity”. The more of us who get vaccinated, the better for all of us. I’m grateful that my grandparents survived COVID, but there are more than 600,000 humans in the US alone who did not. That’s what motivates me, what keeps me up after midnight and wakes me at 5 a.m. Whatever I can do directly or indirectly to save another life, I’ll do it until this pandemic is over. n

This is an excerpt from the video series “I Am an Emory Researcher”.

UNCOMMON VALOR

Perspective in the Time of COVID

By Kimberly Manning Manning is a professor of medicine at Emory who sees patients and teaches residents at Grady Memorial Hospital in Atlanta.

I’m squatting in a corner with my hands over my ears.

Noise. It is too much noise. About us, about me.

Because us is me.

It is inescapable. So much noise. Make it stop.

Your people are dying. They’re dying from a virus.

No, not that virus. Oh wait, that virus too. I mean, yeah.

They’re dying from heart disease, cancer, violence, and this.

More. Most. Just fill in the blank. We win. But really, we lose.

We lose. The baggage was left on front lawns in piles.

Centuries worth.

Maybe push it to the backyard? Not yours though.

Out of sight out of mind, right?

Wrong. Get A’s, become a doctor, right? Wrong.

The same baggage spills out front. Blocks the entrance and exit. We lose.

The words. They’re so awful, so hurtful. A reference to a whale.

Another so bad I can’t even find a metaphor.

Those words weren’t directed at me. But they were really.

Because us is me.

So they hit my jaw like a fist, hard. And that was just this week. Yeah. Running, chased, pursued, shot.

Which reminds me, the other day our neighbors told us that before we moved in they came into our home. Looked around, checked it out.

Furniture, photos, and all.

I drag in a breath of air and lean my head against the wall, swallowing hard.

Then I wait for my ears to acclimate. Like always.

They always do.

But I don’t unhear. I do not. This. This is what it was like to be black this week.

At least for me.

A cacophony of noises clattering all around me in a pitch that I hear in Dolby stereo all day long.

Plus, an expectation for me to hold my head up, do my job, represent, and not startle. Yeah.

But thank God for the other sounds. The clapping hands and snapping fingers the throaty laughs. And that special interdental fricative in our vernacular that I recognize even by phone. We are connected.

We have handled louder, worse noises and kept on singing.

Do I want to be someone else? Not for one day. But still.

Sometimes I do wish that I could, if only for a minute, turn down the noise.

Or turn it up so loud that everyone else hears it the same as me or will at least startle sometimes. Yeah, that.

My sons are upstairs, laughing and yelling at their video games.

My husband has the TV up way too loud, watching the news.

No human was shot. No character assassinated.

Not that time at least.

He calls out to me.

A woman frantically calls 911. “An African American man is threatening my life.” A bird-watching one no less.

Me: Silence. He shows me, more, most. I can’t see. I can’t unsee. Or unhear. We lose, again.

When my dad had a heart attack I said, dad, say you’re having chest pressure

My loved one was discharged against medical advice but is home now and OK.

To create urgency and to not get him overlooked. I guess people say what they know will work.

Dad is less worried. Good. And with all of this noise, life is still happening.

A beloved elder in my family got hospitalized. My dad calls me, worried.

What will our kids do this summer? Son, why’d you get a B? Text me as soon as you get there. And, sorry for the delay in replying to your email.

Dad: He’s trying to leave the hospital, Kimberly. Me: Why? Dad: He’s scared he might die there. He doesn’t trust them.

He doesn’t want to be alone.

What do you say to that? I try to call. Straight to voice mail.

More noise. Heated exchanges. It’s all too much.

Especially now.

All of it is so loud. I try to press my hands tighter to my ears to drown it out. I can’t.

I slowly peel my fingers away. I stand up. The noise is still there. It’s always there.

Him: Babe, did you see this, in Minneapolis?

This is what goes on, between revising rejected manuscripts, thinking about my patients, and clearing my epic in-box. Between figuring out summer plans, washing dishes, folding laundry and wondering what will happen with school next year. For me. For us.

So right now, I’m just sitting at my kitchen table, listening to some Earth, Wind, and Fire.

Being Black. Writing down my feelings. And doing my best to just keep on singing.

Summer 2021

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My Pandemic Zoo

By Cassandra Quave Quave is an ethnobotanist, herbarium curator, and associate professor at Emory.

Headphones in place, I’m in yet another Zoom meeting, taking notes and wondering when I’ll be able to get back to writing my next grant. A loud series of squeals pierced the barrier of the headphones. It had begun to rain, and Frankie, our pet mini-pig, wanted inside. My youngest child opened the back door, and in they raced: the pig, followed by our dog, Togo, a large American Staffordshire. I set my microphone to mute.

The melee of hooves and paws racing across the tile was followed by high-pitched squeals from the pig and barking from the dog, and then shouting and laughter from the kids as they chased the animals through the house with towels to dry them off, creating quite the cacophony. At least our colony of silkworms isn’t loud.

Our pets have been a source of comfort and entertainment during the pandemic. I got up to intervene; half a banana in hand for Frankie and Togo was enough to lure them for a rest in their dog beds. “I live in a zoo,” I thought, as I wiped mud from the kitchen floor.

I returned to my desk in my home office, aka the sunroom just off of our kitchen. I’ve made the room as comfortable as possible, filling my bookcases with a mixture of tomes ranging from science texts to memoirs to cookbooks.

Tear-drop shaped leaves cascade from the shelves; philodendrons keep my books company.

Plants make me happy, and in a year where an awareness of the vulnerability of life has been ever present and stressors are running high, I grasp on to any source of joy I can find. I’ve planted a hulking monstera, wispy parlor palms, hanging pots of ferns, a peace lily.

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My once bare transitional office has slowly transformed into a mix between a quirky library and greenhouse. There is no door or privacy to this new office.

Each day I balance running a drug discovery research group and the Emory Herbarium, teaching an undergraduate course, mentoring graduate students, and supervising remote learning for my four children, ranging in age from 8 to 17.

It’s hard to believe more than a year has passed since they last attended school in person.

Each day comes with a constant stream of disruptions no amount of careful planning can prepare for.

When the World Health Organization declared COVID-19 a pandemic, I canceled all of my upcoming travel for talks and a field research season to collect medicinal plants in the Mediterranean. I temporarily closed my research lab and canceled countless experiments to transition the team to remote work. Despite the pandemonium that had begun to encircle our lives, we were productive during this early phase of the pandemic, secure in the safety of our homes.

This level of productivity, though, is an accomplishment I know won’t be possible in 2021.

Although my team is back in the lab now, things are slow. Shipments of basic supplies are chronically delayed and, for most of the past year, we had to work in limited shifts due to occupancy restrictions. In a normal year, the research group gets as large as 30 members spread across the herbarium and labs. Many are undergraduate interns and international visiting scientists. These additional members haven’t been able to join us; we’ve been operating with six core staff for most

of the year, drastically decreasing the number of experiments we can take on.

Complicating things even further, I’ve largely been unable to return to in-person work with a household full of kids, only recently squeezing in Fridays to work in the lab.

Like many others during the pandemic, I’ve had to come to grips with my deep grief after losing three loved ones. The stress has been overwhelming at times. As a principal investigator (PI), I am responsible for ensuring the lab meets contractual deadlines, stays on track with projects, and most important, secures funding to keep team members employed.

When I fail, we all lose, and that is an incredible burden to carry in a normal year, much less this one.

As a mom, I’m the glue that holds our family together and my mom duties have vastly expanded.

I’ve had to become the chief motivator, P.E. coach, counselor, teacher, cook, maid, and chore supervisor.

We’ve shared special times at home, such as growing and tending

UNCOMMON VALOR

Xenophobia in Our Time

By Chao Ji 21M to the vegetables and herbs in our backyard garden. But, like a sponge, I’ve also absorbed my children’s anxieties, and I hurt for the loneliness and fear they’ve battled over the past year.

I worry about their ability to reenter the “new normal,” postvaccination, and how this period will affect their academic and athletic trajectories, and their social relationships.

Likewise, each member of my lab team has struggled with individual difficulties during this challenging period. I’ve offered what support and counsel I can. We’ve developed individual goals that address both work and well-being, emphasizing the need to dedicate time for sleep, exercise, and wellness.

Not many of us are emerging unscathed from the pandemic, which continues to flare around the world.

We are survivors of a historic event, one that impacted our families, our work, and our psyches. But I’ve been reminded that, in dark and anxious times, it can be helpful to find solace in the growth and renewal that is all around us. n

Ji is an alumna of Emory School of Medicine and is a medical resident at Brown University.

When I think of COVID-19, the first things that come to mind are dyspnea and xenophobia. While I am sure a talented writer can string together an extended metaphor for the two, I will just focus on the rampant xenophobia that is happening all across the world.

It’s disgusting and disturbing. Every day, my newsfeed is flooded with videos of Asians getting verbally and physically abused.

Months ago, when the outbreak was largely confined to Wuhan, a video surfaced on the internet showing an East Asian tourist frantically running across a busy highway after his taxi driver kicked him out. He was mocked and filmed as people on mopeds sped past him, holding shirts and scarves across their faces. Not long ago, a Burmese family was stabbed at a local grocery store for being Asian.

Recently, NYPD started investigating a mass shooting threat against Asians. Apparently, an Instagram user had posted their intentions of shooting every Asian they come across in NYC Chinatown. The user believes that is the only way to rid NYC of COVID. I have never been more aware of my ethnicity and appearance than now.

Should I wear a hood when I go outside? I now feel myself profiling people who walk past me in grocery stores. Will they say something racist? What if they attack me? Should I kick them where it hurts?

Maybe this is what my relatives in China meant when they told me I will always be considered a foreigner in the states. I had brushed aside their comment, thinking they were overly proud of their heritage, and reminded them that I am also considered a foreigner in China. However, maybe deep down, I share their sentiment. Maybe that is why I have always been reluctant to give up my Singapore citizenship. At least in Singapore, my race and ethnicity are not regarded as viruses. n

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Jacynta and Greg Brewton play with their children in a park near their home.

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SURVIVING THE UNSURVIVABLE

the Circle

G R I E F, J O Y, & P R O T O N T H E R A P Y

By Michelle Hiskey

n

Photos by Jack Kearse

AS HIGH SCHOOL SWEETHEARTS IN FLORIDA, Jacynta Williams and Greg Brew-

ton wrote letters to each other describing their dreams of raising a family together, down to possible names for their future kids.

After they married, their work planted them in Atlanta, and their first child, Jacqueline-Denise, was born. “We always believed children are gifts from God,” Jacynta says.

In mid-April 2018, Jacynta was in her fifth month of carrying twins. She wasn’t feeling well. A shower usually helped ease her pregnancy pains, but this time as she stood under the water, a sharp pain shot through her.

The 911 operator told her and Greg not to resist labor and, as their 2-year-old daughter watched, Greg delivered the first twin—his PHOTO COURTESY JACYNTA AND GREG BREWTON

namesake—before the paramedics arrived.

In the ambulance, the second twin entered the world: Graceson, a name created the night before by his parents to celebrate God’s grace. He and his brother were gifts that had arrived early.

Jacynta Brewton holds son, Graceson, who was born prematurely along with his twin, Gregory.

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Above: Cardiothoracic surgeon Seth Force and radiation oncologist Kristin Higgins, of Winship.

Mansour Professor in Thoracic Surgery Seth Force (above, far left) of Emory’s Winship Cancer Institute surgically removed Jacynta’s rare tumor, called a thymoma, prior to her having proton therapy.

Like many preemies, Gregory III and Graceson stayed in the NICU for monitoring. Each weighed around two pounds at birth, and they were at risk for infections. Not even their parents could hold them.

At five weeks, Gregory III was beginning to thrive. His dad, Big Greg, had been born early and grown into a college football lineman. Graceson was struggling a bit more, but the Brewtons tried not to worry.

Then the call from the hospital came in the middle of the night. Graceson was worsening.

Necrotizing enterocolitis, a bacterium, was attacking his intestinal wall. He was taken into exploratory surgery.

The Brewtons told the pediatric surgeon not to sugarcoat the results. As people of faith as well as planners, they needed facts to make their best decision.

Graceson’s small intestines are not salvageable, the Brewtons were told. He can’t fight this.

He’s too small.

Jacynta knew she had to hold him for the first

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time in his 38 days of life, and for the last time.

She and Greg gently sponged his tiny body and sang the hymn, “It Is Well with My Soul” as Graceson passed away in her arms.

JACYNTA AND GREG took Gregory home,

and Jacynta’s aunts from Florida, both neonatal nurses, came to lend a hand.

One aunt was concerned about Jacynta’s persistent cough. Had she gone to a doctor for herself? No, she had been too busy. But she listened to her auntie.

The pulmonologist discovered the thymoma—a mass between Jacynta’s lungs and sternum—and told her it was benign. The thymus is an organ that nurtures T cells, a type of white blood cell that acts like a soldier for the immune system. The thymus is usually only active until puberty, at which point it shrinks and is replaced by fat. A thymoma is a tumor originating from the epithelial (surface) cells of the thymus.

Jacynta planned to have the thymoma removed at a later date. She wanted to get her fam-

SURVIVING THE UNSURVIVABLE

While the twins were growing inside Jacynta, so had the thymoma. And it was malignant.

“WE KNOW that pregnancy is not a good

environment for cancer because there are a lot of different growth factors, like hormones, in your system that can promote the growth of cancers,” says Kristin Higgins, a radiation oncologist at Winship.

While the twins were growing inside Jacynta, so had the thymoma. And it was malignant.

“It’s a rare tumor and patients tend not to be symptomatic until the thymoma is very large,” says Seth Force, a Winship cardiothoracic surgeon. “There’s a little bit of misunderstanding of these tumors, and some physicians think they are benign when that’s not the case. They will grow and metastasize and spread.”

Jacynta’s mass was bigger than a business card, about 4 inches by 2 inches, and she was coughing because it was pressing on nerves to her diaphragm.

Worse, the Stage 3 thymoma rested near her heart. Jacynta needed chemotherapy to try to shrink the tumor before surgery.

COWORKERS AND FRIENDS who know Jacynta say that if anyone had the gumption for this battle, she did.

“Her faith is beyond measure,” says Courtney Stombock, Jacynta’s friend and former manager at Emory Law. “She kept saying, ‘This is to show me something that I may have never known otherwise, and I have to trust it.’ ” “This would have just defeated any normal person,” says John Jordak, an Emory Law alumnus who met Jacynta when he chaired the Emory Law Alumni Board. “Somehow she kept her chin up and fought through it in a really impressive way.

Her natural personality made it hard for cancer to take her down.”

As they faced this next crisis, Jacynta and Greg realized what the twins’ journey had revealed. If the pregnancy had gone to term, her thymoma would not have been operable. Without the auntnurse who had provided care after Graceson’s death, Jacynta may not have sought a diagnosis for her cough.

“If we would’ve waited three more months, four more months, Jacynta’s tumor probably would have grown to the point where it could not have been removed,” Higgins says.

Jacynta Brewton during chemotherapy.

Graceson’s death, the Brewtons believe, saved Jacynta’s life.

BY DECEMBER 2018, chemotherapy

had barely shrunk Jacynta’s tumor. In surgery, Force had to take part of her left lung to ensure the thymoma was gone. While recuperating, she developed pneumonia, and her hospital stay doubled.

Radiation to her chest was next, but this could scar her heart, lungs, or coronary arteries—what Force calls “innocent bystanders.”

That was unacceptable

PHOTO COURTESY JACYNTA AND GREG BREWTON

ily in a routine first, and return to work without distraction at Emory University, where she was building a network for the law school as its first Black director of alumni engagement.

Too much had happened too quickly—she had expected to be near the end of her pregnancy in July 2018, not grieving the death of a child and rushing her own surgery.

To be certain of her plan, she sought a second opinion at Winship Cancer Institute.

Winship is at the forefront of research to develop the most effective treatments that target the cancer cells yet leave healthy tissue and vital organs untouched. Advances in precision medicine are allowing oncologists to determine the genetic and molecular factors of each patient’s specific cancer. Diagnosis, treatment, and survival are improving through clinical trials and new technologies, such as proton therapy.

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ILLUSTRATION BY DAMIEN SCOGIN

n

n

T he Emory Proton Therapy Center cyclotron, which weighs 90 tons, gets the subatomic protons whirling, gaining the energy they need to destroy cancer cells.

Clinical trials at the center have focused on proton therapy treatment for patients with brain, lung, esophageal, breast, liver, prostate, pediatric, and head and neck cancers.

preparing them for future careers treating patients with proton therapy. n

Proton therapy has been used to treat more than 108 pediatric patients since the opening of the center.

Radiation oncology residents and students train at the center,

PHOTO COURTESY JACYNTA AND GREG BREWTON

n

The Emory Proton Therapy Center (above) occupies a full city block in downtown Atlanta.

The center observed its second anniversary in December 2020 and reached an important milestone: treating its 1,000th patient.

at Winship, which is designated by the National Cancer Institute as a comprehensive cancer center.

“Chemotherapy, surgery, radiation—it’s a long road,” Higgins says. “We as a care team were concerned with everything she had been through.”

Thankfully, there was another option

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close to home. The Emory Proton Therapy Center had just opened for patients who needed targeted, precise doses of radiation. It’s the only proton therapy center in Georgia and among just a few in the Southeast. Jacynta was one of the first patients to receive treatment there.

For specific cancers—like brain tumors, lung cancers, head and neck cancers, and prostate cancers—proton therapy represents the most effective and advanced treatment available. It uses accelerated subatomic particles to concentrate radiation on the targeted area.

Just down the street from Emory Hospital Midtown, the proton center is no small oper-

ation. The cyclotron that gets the subatomic protons whirling, gaining the energy they need to destroy cancerous cells, weighs 90 tons, equivalent to a loaded 757 jet. And the vacuum tube that transports the accelerated protons from the cyclotron through the facility—at nearly twothirds the speed of light, guided by magnets—is about 100 yards long and runs the length of Juniper Street.

Other advantages to proton therapy include

SURVIVING THE UNSURVIVABLE

that it’s relatively painless and can be administered on an outpatient basis, requiring no hospital stay. Patients often experience faster recovery, improved quality of life during treatment and after, and reduced risk for possible longer-term effects. “Proton is a particle form of radiation and there is no exit dose as that particle leaves the body,” Higgins says. “New data show that patients have less acute side effects with proton therapy, and any way I could reduce Jacynta’s side effects during treatment and after would be a plus.”

Winship also serves one of the largest African American communities in the United States and leads in research and advancing an

understanding of how cancers affect African Americans: what biological and genetic markers might give greater insights into risk, preemption, prediction, and prevention. Winship researcher clinicians also focus on developing and delivering more effective targeted treatments to achieve better outcomes.

In spring 2019, Jacynta completed her course of proton therapy. Like other Winship patients who finish treatment, Jacynta rang a bell at the Proton Therapy Center. She took note of the date: May 22, 2019, the first anniversary of her son’s death.

“That was another way to celebrate the life of

baby Graceson,” she says.

As Jacynta and Greg laugh with their son and daughter in a park by their home on a clear, bright day, the grief and joy seem to have come full circle.

“This has been, and continues to be, the journey of our lives,” she says. n

“This has been, and continues to be, the journey of our lives,” says Jacynta Brewton.

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DINNER WITH A DOCTOR

travel well Hosted by Mary Loftus and Peta Westmaas

n

Illustrations by Sandra Dionisi

folks are ready to go.”

MANY OF US ARE STARTING

By being an informed

TO IMAGINE—AND PERHAPS EVEN TO PLAN—OUR NEXT

traveler, you can minimize

BIG TRIP BY AIR, LAND,

your risks. “Travel is im-

OR SEA.

portant,” Wu says, “wheth-

So Emory Medicine

er it’s to visit someone you

magazine decided to

haven’t seen in a while, for

invite medical epidemiol-

important business that

ogist Henry Wu, associ-

needs to be done face to

ate professor at Emory

face, or just for your own

School of Medicine and

mental health.”

director of Emory’s

Still, you don’t want to

TravelWell clinic, to host our first virtual Dinner with a

go on a trip and be worried the whole time about infect-

Doctor on travel safety.

ing your family or getting sick. “The fantastic power of

On a calm evening in April, with food-delivery gift

some of the simple things has been underappreciated,

cards at the ready, our seven intrepid panelists sat down

such as hand washing, distancing, and masking,” Wu says.

to Zoom with Dr. Wu, as thoughts of pleasure cruis-

“They were valuable tools for not getting sick even before

es, cross-country train trips, and international flights

the pandemic.”

zoomed through their minds.

Wu, who during COVID-19 has been director of Emory’s

L AYER UP

Acute Respiratory Clinic, an outpatient COVID clinic and

“For more than a year now, at my clinic, we’ve been seeing

infusion center, was ready to kick back and talk travel after

COVID patients daily, some more infectious than you see in

a year of being grounded himself.

an ICU,” Wu says. “I’ve had more than 150 staff working with

“In normal times,” he told the panel, “I do mostly

me and no one has gotten sick with COVID. We know how

travel medicine, which is multidisciplinary, involving

to prevent it. Most of that time was without vaccine. That

infectious disease, emergency medicine, preventive care,

has really informed the way that I inform travelers.”

and vaccinology. I enjoy exploring risks with travelers.

A layered approach is key, he says, especially since not

Wherever you’re going, whatever you’re doing, be sure

everyone has gotten the vaccine yet. “The vaccine is a huge

you do it safely.”

jump as far as another layer of protection. For those of you

The COVID pandemic has made travel complicated

who are vaccinated, the Centers for Disease Control and

on a lot of levels, says Wu: “There was a period where we

Prevention (CDC) has started to relax a lot of the precau-

couldn’t travel. We’re at a tipping point now that we have

tions, which is an acknowledgment of how effective the

vaccines and a better understanding of the virus. Certainly,

vaccines in the US are,” he says. “Definitely get the vaccine if

Summer 2021

31

you can. For most folks, it’s a huge advantage.”

But Wu doesn’t believe people who are vaccinated should immediately jump back in as if everything were back to normal. “The good news is, everything is that much

why, if somebody is jogging by you on the street without a mask, you don’t need to panic,” Wu says.

As COVID spreads primarily through the air, there’s

safer for you if you are vaccinated. But my goal is to keep

only a small potential for spread through touching con-

you out of the hospital in every way possible. And that

taminated surfaces, he adds. “A lot of the larger droplets

means being vaccinated AND taking the usual precautions.

fall out of the air pretty quickly and are caught by masks,

Masking is not the most comfortable thing, but we’re

even the cheap paper ones,” he says. “More insidious are

getting used to it. In many situations, with masking plus

the small aerosols that hang out in the air a little longer

the vaccine, plus extra distancing, honestly, I can’t imagine

and potentially travel even farther than six feet. They tend

people getting sick.”

to build up in a crowded environment, which is why we

Infectious disease is not just about exposure, it’s about

Jennifer: About air flight and being on a plane, I can see staying masked for a short flight, but for a long transcontinental flight, to the African continent, that’s a long flight. I am likely going to want to have something to eat or drink. Is it a concern to take off my mask and have a meal on the plane?

Wu: The good news is, on an aircraft, the air exchange and recirculation rates are fantastic. The air in the cabin is replaced every few minutes. That’s better than anything you will find indoors in your day-to-day life. And the air is filtered through HEPA filtration, very high efficiency. The only thing I can imagine that is better is a hospital operating room. It’s already very protective, and when you put everyone in masks, that makes it even better. All evidence we have suggests the transmission risk on airplanes is extremely low. If you want to eat or drink for limited periods of time, I wouldn’t think too hard about it. But try not to have your mask off for prolonged periods. This is not the time to have a leisurely dinner or sip a glass of wine for a long time. Be quicker about it than usual. If the person next to me is not be-

32

inoculum dose: the amount and time of exposure. “That’s

EMORY MEDICINE

have superspreader events.”

ing great with masking, or looks sick, the less likely I will be to take my mask off.

I am constantly assessing my situation.

For shorter flights, I’d take meals and bathroom breaks before and after.

Are there documented transmissions on aircrafts? The science is a little hazy; it’s hard to prove that someone got it on a plane rather than at the hotel, the wedding, or the cab ride home. But, rarely, you can prove it through molecular sequencing, using isolates from different passengers. There have been cases of transmission on airplanes, but they have been rare. And it tends to be on long-haul flights, with no masking. If it were a major risk, we’d be seeing a lot more of it.

Think about all the superspreader events we know about, in restaurants, at weddings and funerals, choir practice, etc. Flying itself is not zero risk but it’s probably very low risk compared to other things we’re doing in indoor areas. Overall, the airplane is one of the safest places to be sitting, assuming everyone is masked.

Being on an eight-hour flight, assuming

everyone is masked, is much safer than spending an hour in a crowded bar.

Sonia: I have a question about trains.

A couple of friends are encouraging a trip from Chicago to Seattle, stopping along the way, and sharing two per person to a sleeper car. We have all been vaccinated.

Wu: A lot of the new trains are very well ventilated. How well, I don’t know offhand, it may depend on the type of car. If you’re talking about a sleeper car, sharing a space with people you know who are vaccinated, that’s much safer.

Having read Amtrak’s COVID statement, the reported air changes per hour on the trains should be excellent. Furthermore, they do have a masking policy. Considering all that, I think riding Amtrak should be fairly safe, and even more so if you are vaccinated. As always, the less crowded the better.

Sonia: What about sharing a hotel room, all four of us? That also had me a little concerned.

DINNER WITH A DOCTOR

Henry Wu

Deanna and Barbara Altomara

Donovan Roper

Gang Wang

Sonia Bacchus

Jennifer Joe

Raven Badger

Peta Westmaas

Mary Loftus

Wu: It should be fine. The CDC has said if you’re all vaccinated you can be indoors without a mask. Is it safer if you all had separate rooms? Sure. Is it worth the expense? Probably not. If everyone is going to sleep better, maybe split up your group into a couple of rooms. These COVID vaccines are really good, effectiveness can be above 90 percent, but they aren’t 100 percent. Even if it’s a breakthrough case and you get sick after the vaccine, the chance that you would have to go to the hospital or that you might die has become fantastically unlikely.

But that said, no COVID at all is still best.

You don’t want to risk a mild infection that you could pass to someone else. My

nuanced answer is, for a near-zero risk trip, split up a bit.

Jennifer: What should you be asking your friends to do?

Wu: That depends, what’s your acceptable personal risk level? As a personal example, I have elderly parents I haven’t seen in over a year because they live in Hawaii. I chose not to visit them last year because they’re both about 80 and my dad has severe lung disease, so even a cold could kill him. And yet, I am actually planning a trip to go see them soon. They aren’t getting any younger.

I’m vaccinated; they’re vaccinated. I may still wear a mask when I’m close to my

dad. There’s no data that says you have to do that, but it will make me more comfortable. A .001 percent risk is too big for me when dealing with my dad, I want to make it zero and I know how to make it zero. I’m very proactive as a traveler. I’m going to take those extra precautions.

Don: When the pandemic hit, we had a couple of staggered cruises that have been rescheduled twice, both of them.

One is to Portugal, the second is in Asia—Bangkok to Singapore. Should I hold out any hope?

Wu: Cruises are an interesting topic; they are unique. I once did a travel panel and one of the other speakers was the

Summer 2021

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Deanna Altomara: Rising

graduate student at Emory’s Rollins School of Public Health with an interest in infectious diseases. “My parents are coming down from New Jersey to visit me in Atlanta, and I want to keep them safe.”

Sonia Bacchus: Recently

retired attorney, Washington, D.C. “I had a lot of travel planned for my retirement and COVID wasn’t part of my plan.”

Barbara Altomara: Bank teller, Mahwah, New Jersey. “We are planning a cruise and I am wondering about port visits.”

former medical director of a major cruise line; he gave a couple of talks on cruise medicine that I was blown away by. The good news is that the cruise industry is very regulated. They have learned their lesson: the last thing they need is another outbreak. And if you’re going to have a heart attack, the best place to be is on a cruise ship—there is actually an ER on the ship, they can do person-to-person blood transfusions and are fantastically well equipped. The bad news is, outbreaks have happened on cruises: foodborne, normal viruses, Legionella. COVID did a number on a few cruises. COVID was and remains a big challenge, but they are gearing up. Some lines require that everyone on the ship is vaccinated: staff, crew, and all passengers. If you’re not vaccinated, you’re not coming on board.

Don: My wife and I are both fully vaccinated.

Wu: That’s great, and even better if you get on a cruise line where everyone is vaccinated. If you are a cruise kind of person, vaccines are your best friend. In reality, there are a bunch of common

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Raven Badger: Former academic now doing equine therapy in Arkansas. “My mom has been traveling and recently came to stay with me, and I’m very interested in what risks we should or should not take.”

Jennifer Joe: Professor, University of Delaware, chief diversity officer for Lerner College of Business. “I have been on sabbatical and am wanting to meet up with friends to travel around the country, and also perhaps a safari in Africa in early 2022?”

areas. It’s probably going to be less crowded, though, since many cruises are limiting capacity/passenger numbers.

There are going to be some intrinsic risks but that doesn’t mean not to go by any means.

Gang: I’m fully vaccinated, so I’m not worried about myself, I’m more worried about my parents in China.

Are there any guidelines you could give me about visiting them?

Wu: The COVID vaccines have been shown to be fantastically effective in preventing you from getting sick, especially very sick, but still there might be the possibility you could get a mild COVID infection and transmit it. Although CDC Although CDC guidance now allows most vaccinated persons to do most activities without a mask, I think it is still prudent to wear one in higher risk situations or

Donovan Roper: Trial lawyer, Apopka, Florida.

“My wife and I have quite a bit of planned travel coming up that was delayed, and I have questions about traveling to Mexico and Jamaica and cruising in other parts of the world.”

Gang Wang: Assistant professor, University of Delaware. “My first air travel was last week to Nashville. I plan to go back to China this summer, to visit my parents.”

when around those at risk of complications, which would be the case if you’re visiting elderly parents. China will test you for COVID when you arrive. That helps. So, to be super careful, you can quarantine before the trip, and you can mask when you are around your parents, especially if they are frail or at risk of complications.

If they can get vaccinated, even better.

Barbara: I have another cruise question. My concern is getting off in ports. What activities will we be allowed to do?

Will there be opportunities to explore? If you do have symptoms, will you be quarantined or isolated?

Wu: That depends on where the port is, and what’s happening there. You don’t want to spend all this money to go somewhere that is basically closed. Just because a country is letting in travelers doesn’t mean it’s fully opened to tourists. The cruise industry is aware of that and will probably

DINNER WITH A DOCTOR be avoiding cities that are having lockdowns.

Off-ship activities may be less than usual. Outdoor activities are much safer, such as visiting beaches instead of cities. Definitely do your research. Few places around the world are “normal” right now.

Cruise ships are very strict about quarantines, even prepandemic. If you have a GI illness and are throwing up, they are going to make you stay in your room. The last thing they want would be you going to the buffet and causing a small outbreak. COVID rules will probably be pretty strict: maybe fever checks around the boat, maybe COVID testing. You should be prepared for that level of getting checked.

Raven: I live very rurally, two acres on the side of a mountain, so quarantining is pretty much normal behavior. I limit trips, stock up on supplies. It takes half an hour to get out to the pavement. I get concerned when I go out, or have a friend flying to see me. What communication should you have with people…have you been vaccinated? Do you mask?

Wu: Prevaccine it was a little trickier. If you are vaccinated, that is your insurance policy. I still suggest a layered protective approach, but the vaccine is a pretty thick layer. It’s not quite good enough that I would say drop everything else, but pretty darn good.

I use the analogy that the pandemic is like a rainstorm.

When it’s pouring rain and you go outside, and want to stay dry, up until now you’ve only had an umbrella and a pair of boots.

Now that the vaccine is here, you’ve got a really good raincoat.

Now, if it’s pouring, you still want to be holding an umbrella, layering up. But when the rain starts to slow (i.e., COVID cases are low in your area) you can put the umbrella away. The raincoat is plenty. The variants are a concern and should be watched, but we’re getting there.

And I suggest, instead of following the six-foot rule, just redefine your personal space.

Make it automatic. It takes retraining your mind; personal space is a cultural norm. But it’s also just common courtesy, during a pandemic, to respect other people’s space.

Deanna: What about riding mass transit, like subways, or using ride-share services?

Wu: Air-exchange rates on subways are quite high, so I think it should be pretty safe if some distancing is observed and everyone is masked.

As for buses, MARTA (here in Atlanta) did recently announce they are still limiting capacity and have installed “antimicrobial” air filters. In short, I would think either should be pretty safe if people are masked and not shoulder to shoulder, and even safer if you are vaccinated.

On the other hand, if I saw a train or bus coming that looked too crowded for comfort, I’d wait for the next one or call a ride share, if possible.

I think ride shares (e.g., Uber, Lyft) should be pretty safe if everyone is masked and the windows are open.

PL AN AHEAD Wu encouraged everyone to think about their trip in its entirety, not just the part on the boat, train, or plane. “Your biggest risks during travel are not infectious diseases but accidents and car crashes,” he says. “The reality is, we deal with risk every day.

“That being said, when you travel, you do stuff you don’t normally do, such as stay at hotels, go out to eat in crowded restaurants and bars, and meet up with different groups of people from different places,” Wu says.

He recommends thinking a bit more about your choices: “Give yourself a second more to assess situations and actions that used to be second nature: That elevator’s crowded, I’m going to take the next one; that restaurant is packed, I’m going to eat outside.”

Also, it’s more important than ever to plan ahead when you travel.

Have multiple masks. Bring your vaccine card and/or your COVID test results. Do your homework to find out requirements in advance.

Prepare for a possible quarantine, even if you’ve had the vaccine, on the off chance that you still get a mild case of COVID. “We are getting reports from travelers of lots of unexpected situations,” Wu says. “If you only have five days off work, it could be risky to say to yourself, I am going to do A, B, and C, and be back to work on day six. You may potentially have to call and say you’re stuck for another day or two. Build in flexibility.

The rules are changing quickly.” n

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‘What Happened to the World We Knew?’

The Plague Then and Now “Plagues are like imponderable dangers that surprise people. They seem to have a quality of destiny.”– Gabriel García Márquez, Love in the Time of Cholera (1985)

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A PLAGUE ON OUR HOUSES

By Clyde Partin

APPLYING

THE LESSONS OF HISTORY TO THE

PRESENT HAS LONG

BEEN A SCHOLARLY AND PRACTICAL ENDEAVOR. THIS PRACTICE IS ALSO

EXCEEDINGLY APPLICABLE TO THE CURRENT COVID-19 PANDEMIC. One

revelation worth revisiting is that stemming the spread of contagion requires the timely recognition and acknowledgment of public health officials and their prompting immediate action by government officials. Albert Camus’s 1947 novel The Plague depicts this behavior as literary testimony to the pestilent indifference of authority.

Social distancing may be the current moniker, but this concept is nothing innovative. Of the 541-549 Plague of Justinian, DePaul History Professor T. Mockaitis noted the recognition and ILLUSTRATION BY JOHN FRANKLIN (FL 1800-61)

importance of limiting closeness when he wrote:

“People had no real understanding of how to fight it other than trying to avoid sick people.”

Early civilizations already knew that proximity was to be

Clyde Partin is Gary W. Rollins Professor, a master clinician, and director of Emory’s Special Diagnostic Clinic.

avoided—like the plague. The Black Death of 1347 spawned quarantines of 40 days, initially 30 days. Think of the commercial cruise ships that in the early days of COVID were circling ports of call around the world, especially Florida, desperately trying to unload their human cargo. Yes, history is repeating itself.

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LEGISLATIVE

EFFORTS IN 16TH-CENTURY

LONDON ENACTED LAWS REGARDING SECLUSION OF THE AFFLICTED: “HOMES STRICKEN BY PLAGUE WERE MARKED WITH A BALE OF HAY STRUNG TO A POLE OUTSIDE. IF YOU HAD INFECTED FAMILY MEMBERS YOU HAD TO CARRY A WHITE POLE WHEN YOU WENT OUT IN PUBLIC. ALL PUBLIC ENTERTAINMENT WAS BANNED.” MORE RECENTLY, AMERICAN MAJOR LEAGUE SPORTS PAUSED THEIR SEASONS, THE 2020 OLYMPICS WERE POSTPONED, AND THE VAUNTED

In the 17th century, some plague doctors wore long coats, gloves, and bird-like masks filled with fragrant herbs to “purify the air” and fend off disease.

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NCAA BASKETBALL TOURNAMENTS WERE CANCELED. YES, HISTORY HAS REEMERGED.

As sad and devastating as it seems, New York City officials in the COVID-19 pandemic’s surge made the decision to carry out a mass burial. Ancient precedence also exists for this practice. Two sites in northeastern China— Hamin Mangha and Miaozigou—are preserved communal burial sites from 3000 BC that reflect the human toll from an epidemic of unknown etiology. If we were to include this pandemic in science writer Owen Janus’s list of the previous top-20 plagues experienced by humankind, we would see that viruses were the culprit in 52%.

One-third were bacterial, and 14% have resisted definitive explanation.

If beacons of illumination are possible in the wake of pandemics, one result has been technological progress. Following the Black Death of 1346-1353, according to Janus: “Lack of cheap labor may have contributed to technological innovation.”

Such innovation is similarly occuring today, due to COVID. Take the meteoric rise of Zoom technology in teaching and telehealth. Telemedicine likely will remain an integral part of routine health care delivery, since that service is billable and enhances care for those whose access to clinics is logistically difficult. In a New Yorker piece

about Zoom, Naomi Fry wryly observed that Zoom’s mute function is one “option many will likely come to miss once face-to-face meetings resume.” Others finally installed the Starbucks app on their cell phone to effect a contamination-free, no-touch financial transaction for their coffee.

Idle manufacturing plants quickly retooled and began to mass-produce personal protective gear and hand sanitizer. As for ventilators, physicians and bioengineers reconfigured the current supply of life-support equipment.

Leading medical journals have made available promptly, without charge, updated COVID articles. Sophisticated mathematical computer-tracking programs have helped epidemiologists quickly identify hot spots.

Even climate change began to self-correct.

The background hum of commercial airline traffic diminished and cars stayed parked in driveways, the shoe size of the carbon footprint grew smaller in the face of the pandemic. Rivers ran cleaner and air pollution diminished.

Depictions in Art and Literature Google “novels about plagues,” and instantly 20 titles depicting epidemics are an Amazon trip away. In a 1988 interview with a reporter from the New York Times, Gabriel García Márquez, author of Love in the Time of Cholera, revealed that Daniel Defoe’s 1722 historical novel, A Journal of the Plague Year, was the inspiration for Marquez’s novel.

The Renaissance artists depicted plague scenes in their masterpieces, which hung in the finest but unattended (closed for pandemic) art museums. “The Plague at Ashdod,” for example, is a complicated artwork that possesses its own perverse history. Rendered in 1631 by the French painter Nicholas Poussin, at the behest of a Sicilian merchant, this painting emerged through multiple variations, some of which were involved in a money-laundering scheme.

Though the scene in this painting invokes biblical lore and is set in front of the Temple of Dagon, in the now-Israeli port of Ashdod, the inspiration derives more from the Italian bubonic plague of 1619-1630. The foreground depicts a baby snatched from a dead mother’s breast and a lifeless infant nearby. Rats dot the canvas.

Though Poussin left an unfinished manuscript that explains the work and demonstrates his prescient knowledge of plagues, the interpre-

A PLAGUE ON OUR HOUSES tation of the painting continues to foster much debate among art historians.

The focus of pandemic art today does not include such village scenes and town plazas with their decimated humanity, but spotlights the coronavirus itself, as colorful and imaginative renditions of the virus impart a paradoxical beauty to this microscopic, unseen foe. Even the ubiquitous masks, many homemade, have become an art form.

Satyen Tripathi, an Emory medical illustrator, created a colorful coronavirus image.

Tripathi said his group began their work on this design “before the full scope and repercussions of the pandemic were apparent. We wanted to strike a balance between something that was not too menacing and not too fluffy. Deep hues and cooler colors with a background that mimicked the respiratory environment seemed appropriate. But we tried to avoid an appearance of earthy, organic tones that might bring to mind the Death Star. The end result has to support the story that is being communicated.”

Tripathi has a high regard for the CDC likeness of the virion, created by Alissa Eckert and Dan Higgins, and praised how it supports their scientific and didactic missions.” The prominent red spike S-protein, dotted with the smaller yellow E-protein and orange M-protein, is in stark contrast to the muted gray sphere, and suggests that the spike protein is the attacking tool of the virus that leads the charge, attaching and burrowing into healthy cells.

According to New York Times reporter Cara Giaimo, the CDC illustrators were asked, on January 21, to “create a beauty shot of the coronavirus, give it an identity, something to grab the public’s attention.” A week was required to complete their task, and just like the novel coronavirus, quickly spread around the world, only faster, thanks to its popularity with the news media. “It might even show up in your dreams,” the reporter warns.

The World We Knew Stressful times are the petri dish of odd but predictable behavior. Take the hoarding of toilet paper--which is something the denizens of the 17th century did not, one might wager, partake in.

The pandemic-induced purchasing of hand sanitizer also may make one wonder what humans previously did along these lines.

A Google Doodle on March 21 featured Ignaz

Semmelweis as “the father of infection control, who first discovered the lifesaving power of clean hands” in the 1850s. Semmelweis deserves much credit for effectively advancing this knowledge, but two others had already successfully promoted this concept: Scottish physician Alexander Gordon who, in 1795, published his observations regarding handwashing, as did the American physician Oliver Wendell Holmes Sr., in 1843.

Two centuries later, the pandemic has sparked a reprise, in the form of videos with dance routines, catchy tunes, and coronavirus cartoons, all advocating for proper handwashing technique.

All plagues have their peculiarities and similarities as they create chaos, wreak economic destruction, and spread a miasma of misery, death, and hopelessness (and paranoia, as the enemy is, indeed, invisible and could be anywhere or everywhere.)

Some unique pathological idiosyncrasies of COVID that have vexed physicians and public health authorities have included the asymptomatic virus shedding, the difficulty in recognizing who had the disease and didn’t know it, and understanding novel pulmonary pathophysiology.

Philosophical theologian and psychoanalyst David Pacini suggests that what has been lost is our “assumptive” world. “Patterns and rhythms of behavior, resonances of gestures, and relationships in communities, institutions, and organizations make up our assumptive world. It is as if we went on vacation from the world and on returning, the world had disappeared,” Pacini says. “As with trauma victims who lose their assumptive worlds, a searing scar has now been visited upon the human psyche.”

Or, to quote another master of his craft, in his song “Yester-Me, Yester-You, Yesterday,” musician Stevie Wonder asks poignantly and presciently: “What happened to the world we knew?” n

Top: A music video by Vietnam’s health department about fighting the coronavirus went “viral” on social media.

Center: CDC depiction of the coronavirus, with red spike (S) proteins providing contrast.

Bottom: The more ethereal Emory School of Medicine coronavirus image.

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39

AFTER A REJECTION FROM EMORY SCHOOL OF MEDICINE MORE THAN 60 YEARS AGO BECAUSE OF HIS RACE, PHYSICIAN M. GERALD HOOD TELLS HIS STORY OF RESOLVE AND TRIUMPH.

A CRUCIAL STEP TOWARD

Healing

By Stacey Jones

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EMORY MEDICINE

UNCOMFORTABLE TRUTHS

Hood with his mother, Jessie Lee Hood Trice, at his 1959 A successful Atlanta OB-GYN, Hood went into the field because his OB-GYN professor was Clark College graduation. A practical nurse, she reared the only one of his Loyola University instructors to ask him questions in class. him and his two siblings in Griffin, Georgia.

Marion Gerald Hood’s last Founders’ Day as a student at Clark College coincided with the school’s 90th anniversary. The event was the culmination of a days-long celebration, and the college awarded four honorary degrees that evening in 1959.

Five years after Brown v. Board of Education, it riled him that Clark, a historically Black college, had honored a man from still-segregated Emory.

“They gave an Emory University professor an honorary degree. He can come over here and get a degree with my class,” Hood remembers. “So, I said, ‘if he can do that, I should be able to go to his university.’ So, I sent in an application and wrote him a letter that said, as a classmate of mine, perhaps he could help me get into Emory University medical school.”

Hood’s “honorary classmate” was more influ-

Dear Mr. Hood: Acknowledgement is made of your letter of July 30, enclosing your application for admission to our School of Medicine.

I am sorry I must write you that we are not authorized to consider for admission a member of the Negro race.

I regret that we cannot help you.

ential at Emory than he realized. He was none

P.S. I am returning herewith your $5.00 application fee.

other than Goodrich C. White, Emory’s president

L. L. Clegg, director of admissions

from 1942 to 1957 and at the time its chancellor.

White did not write back, but Hood did receive a swift and pointed reply from L. L. Clegg, Emory’s director of admissions.

A CHANCE TO LISTEN AND BE HEARD

On June 17, nearly 62 years after its rejection of his application, the Emory School of Medicine formally apologized to Hood and invited him to share with the Emory community his story of tenacity and resilience. “Giving Voice: The Rest of His Story with Dr. Marion Hood” was held to commemorate Juneteenth, the newest federal holiday.

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“I was a doctor. I wanted to take care of people, and sometimes you have to take care of people that you don’t really like or that you don’t really want to.

You can’t be disrepectful.

You always have to respect the patient.”

Gerald Hood, above, at the “Giving Voice” event June 17 at Emory’s Convocation Hall.

Right page: Hood shakes hands with Emory President Gregory Fenves, as moderator Sheryl Heron looks on (top left); Hood with plaque presented to him by second-year medical student Sydni Williams (bottom left); the “Giving Voice” event in Convocation Hall (far right.)

“Advancing the School of Medicine’s lens to a climate and culture of inclusion and belonging cannot be done without restorative justice. As a university, acknowledging our past is a necessary step toward an empowered future,” says Carolyn Meltzer, the School of Medicine’s chief diversity officer and executive associate dean for faculty academic advancement, leadership, and inclusion and co-moderator of the event.

“Giving Voice” is one of several initiatives undertaken broadly by the university and by the School of Medicine in particular to look at the institution’s history in a candid and unflinching manner.

A small group was on hand at Convocation Hall to honor Hood at the largely virtual program, including Emory President Gregory L. Fenves. “Throughout American history and Emory’s history, Dr. Hood and so many other talented students were denied access to achieve their dreams and realize their potential,” Fenves said in his opening remarks. “This one individual and this one letter vividly show the systematic injustice of that time and the legacy that Emory is still reckoning with.”

Also present were Executive Vice President for Health Affairs Jonathan Lewin; Chief Diversity Officer Carol E. Henderson; School of Medicine Dean Vikas Sukhatme; William Eley, executive associate dean for medical education and student affairs; and second-year medical student Sydni Williams, president of the Emory Student National Medical Association. Sheryl Heron, associate dean for community engagement, equity, and inclusion at the School of Medicine, served as co-moderator and interviewer.

After the event, Lewin noted that, “While diversity, equity, and inclusion are core values and a critical focus for us, this event reminds us that ensuring racial equality and eliminating social injustice are works in progress that require our constant effort and attention.”

‘BOOKISH’ AND DRIVEN TO SUCCEED

A product of Griffin, Georgia, 21-year-old Hood was thoroughly versed in the customs of the Jim Crow South when he applied to Emory and was not really expecting to be admitted. But in that fearless way of youth, he was trying to make a point. After all, he had the drive and fortitude to attend college when his circumstances as one of three children of a single mother and his race had closed that door for so many others.

Hood’s mother, a practical nurse, was the impetus for so much of what he achieved—and not just because of her unwavering support. “I went to the doctor once with my mother, and we went through the back door and they put us in a little room like a closet and she sat on a Coca-Cola crate,” he remembers. “We had to wait until they saw everybody else and then the doctor came back and took care of her.” He decided then that he wanted to become a physician.

Before attending medical school at Loyola University Chicago, Hood was in the process of obtain-

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EMORY MEDICINE

UNCOMFORTABLE TRUTHS ing a master’s degree in biochemistry at Howard University. While there, his longtime friend, retired dentist Lewin Manly, recalled Hood as bookish and hard-working. He held down several jobs to make ends meet.

“He was a country boy in class, so nobody paid any attention to him,” Manly says. “After the first midterm, the professor in the class said, ‘There’s only one person in the class who made an A on this test. Mr. Hood, would you stand up?’” Hood became very popular in class and at Howard after that, Manly says.

At Loyola, Hood was the only Black student in his class and one of only two Black students in the school. The atmosphere was decidedly unwelcoming. “People ignored me because they didn’t want to embarrass me, and people ignored me because of what I was. That was everyday living,” Hood says. He still struggled financially but did find a small number of advocates and mentors at Loyola willing to help. Together, they made a difference.

In the fraternity house where Hood lived, the house cooks were a Black couple who made sure Hood had a plate of food after his shifts. Two of Hood’s female classmates introduced him to a Catholic priest. One day, the priest took

Hood out to dinner and told him, “My church has a ministry and we’re going to give you $30 a month—a dollar a day.

This is for you to go out on the weekends and have a beer with the guys.”

In one of the peculiarities of the segregation era, the state of Georgia paid Black students the difference in cost to attend school out of state. “If it cost $500 a year to go to school in Georgia, and it cost $1,000 to go up there, they would pay the extra $500 so I would pay the same thing,” Hood explains. “And I would come home each semester, go down to the capitol, and reluctantly they would give me this check to take back to Loyola University.”

In 1962, when Hood was in his second year of medical school, Emory officially desegregated, after the Georgia Supreme Court sided with the university in its challenge to state laws that denied tax-exempt status to racially integrated schools. The university admitted its first Black medical student, Hamilton E. Holmes, in 1963.

Hood went on to an internship in Orange County, California, and returned to Chicago for his obstetrics/gynecology residency. He served in Vietnam as a doctor after completing his education and came back to Atlanta to start his

own practice of 45 years, retiring in 2008.

Not only did Hood experience racism in the pursuit of his education, but it also followed him into practice as well.

During the program he told of an encounter with an emergency room patient. “He woke up and looked at me and spit in my face,” Hood recalled, his voice breaking. “I was a doctor. I wanted to take care of people, and sometimes you have to take care of people that you don’t really like or that you don’t really want to. You can’t be disrespectful. You have to always respect the patient.”

Hood married relatively late in life.

He and his wife, Julie, adopted two girls, five years apart in age. Despite Hood being on-call and busy with his practice, both daughters say their dad rarely missed a sports match, recital, or school program while they were growing up.

At age 83, Hood, along with his wife, are about to become first-time grandparents by their younger daughter, Kira Hood-Knott. “I still learn stuff about my dad’s story and how he really did come from little to nothing,” she says. “Just the fact that he didn’t have books to make it through school and there were people in school who purposely tried to hold him back—they didn’t want to study with him, they didn’t want to let him borrow

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Hood with daughter Kira Hood-Knott and her husband, Robert Knott, after the event.

Emory School of Medicine Dean Vikas Sukhatme (above, left) presents Hood a framed copy of the apology letter (right).

books—he literally ground his way to learn. He was facing so much adversity just to get through medical school.”

audience. Because he goes by his middle name, Gerald, rather than his first name, few at the event realized he was the Marion Hood connected to the letter so many of them had seen and heard about, says Simpson.

Hood’s older daughter, Zoë HoodBrown, said she found out about the letter about the time the rest of the world did. “My dad never has been the type of person to dwell on anything that has happened to him where he was wronged,” she says. Rather, he used those experiences for motivation, she contends.

“I was proud of him for sticking up for what he believed was an injustice, and something he felt was wrong,” Hood-Brown adds. “It’s amazing to see that he’s not upset with the institution at all. He was just making a point of the injustice.”

Her sister agrees. “My dad was really not looking for anything from the school. I think the letter was a reminder for him of what he’s accomplished and what he’s overcome. And that’s why he framed it—and it wasn’t even in the main part of the house, it was literally in the basement.”

As Emory sought to acknowledge its role in Hood’s racially motivated rejection, representatives asked what he wanted the institution to do. Hood was not sure at first about receiving an apology, as he wasn’t looking for one, says Carol Henderson, vice provost for

THE STORY GETS OUT

Hood’s mother kept the rejection letter from Emory, which his sister returned to him after their mother’s death. Hood shared the letter with a longtime group of friends he meets with regularly, who asked for copies of it. One of the friends, Herman Reese, former director of financial aid at Emory College from 1971 to 1988, dropped his briefcase after their get together and the contents, including the letter, fell out. A young man helped pick up his papers, read the letter, and took a picture of it, Hood says.

The picture of the letter found its way to social media, where it has cropped up intermittently for several years. Hood was interviewed by the local Fox television affiliate and honored by the city of Atlanta as well as his alma mater, now Clark Atlanta University, after the letter and his story were made public. This year, the photo of the letter was retweeted some 330,000 times.

Many of those dismayed by the contents of the letter included Black alumni of Emory and the School of Medicine, says Marché Simpson, director of diversity and inclusion for Emory’s Office of Advancement and Alumni Engagement. She recalls Hood’s presence at an alumni event that honored his friend Reese, where he was introduced to the

44

EMORY MEDICINE

diversity and inclusion and Emory’s chief diversity officer.

But Emory’s past transgressions regarding race are hidden in plain sight. Going forward, it’s important to understand this, Henderson says. “That means not only celebrating the wonderful things that make Emory the great institution it is but rediscovering some uncomfortable truths about ourselves as an institution,” she said in her remarks at the program. “1959 has come and gone, but the work of diversity, equity, and inclusion—of justice—cannot be done without remembering this history and the resilience of the people who lived it and experienced it.”

Gerald Hood is still practicing medicine, retraining after his retirement to work two days a week as a primary care physician at YourTown Health, a network of six nonprofit community health centers south of Atlanta.

“The realities of Dr. Hood’s rejection for admission to Emory School of Medicine, notably during the time of segregation, will not and should not diminish Dr. Hood’s accomplishments,” says Heron. “He continues to work to this day, exemplifying his commitment to the field of medicine and dedication to the many patients who have benefitted from his care.”

The apology demonstrates Emory’s work to clearly assess and overcome its past racial transgressions. And while Hood’s rejection from the School of Medicine was directed personally at him, he also stands as a proxy for the many people over the years who were denied entry to Emory or suffered discrimination due to their race, religion, disability, background, or identity. Perhaps his story and Emory’s efforts to atone can serve as an inspiration to those once denied, and to future generations of students, that it’s never too late to right a historic wrong. n

UNCOMFORTABLE TRUTHS

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We ns, aged y, are Blac stud activ k ents ely stud work to ents purs ing com whe ue to increase the number ofprise our ther care Docat 16ers Emo tor perc inent ryMed heal ofoffe ofth elsew theprof icine here stud essio prog unde (MD . We ents ns, rams r-rep )prov in are and prog resen activ ram. ted ely rormen stud work We torin ents inve ing g in to st to our incre in mult ase ide continued support once they iplethe num pipe berprog line of prog unde undepast rams rams r-rep rreprfew andyear to resen esen offe enco enro ted s,rgrou men ll. urag Whi torin ents eprog le we histo the g to inover and our are prov socio prou ly ide -eco d ofted contfocu nom ourstud inueysed weps icall d supp know ressrical disad ort we once vant mus aged they t stay enro stud ll.to entsvalu Whi le on the purs we livin whepast are ue ther g care prou few up at ers to deofheal year Emo our in ourth s, ry we prog or es elsew know ress prof to inclu buil herewe over essio sive community. d . We mus ns, a mor t stay are activfocu equi ely table sed work , on just ing livin and to incre g upase to the ournum valuber es of to unde inclu buildr-rep programs sive com a mor and mun resen e equi offeity. ted table r mentoring to provide continued supp students , justinand our ort once they enroll. While we are prou the past few d of our progress over year s, we Thank you for agreeing know weusmus t stay focu sed to join on for a webinar or disculivin g up to our es Emo Than to buil inclurksive ssion youcom d aceleb to coin foran morratio agre cidevalu e equi mun eing with ity. table You , just ry’s story is webinar insp n of iratioton join or discu June teenand to ususallfor ssion th. to our anda will coinobse cidervati add with new Emo mea Your story is an inspiratio ry’simpo ning celeb to ratioday. n of Juneteenth. on of this n to us all and will add new meaning rtant to our obse rvati on of this Than important day. yourefor agre eing With ksince grati tude , to join us for a webinar or discussion to coincide with Emo With Your since ry’s celebration of Juneteenth. storyreisgrati an insp tudeiratio , n to us all and will add new mea ning to our observation of this impo rtant day.

With sincere gratitude, Vikas P. Sukhatme, MD, ScD Vika P. Sukh ScDr, Deans and Wooatme druf,f MD, Professo Dean Woo druf f Prof esso Emoryand r, icine University Scho ol of Med Emo Vikary Univ P. ersit Sukh yOffi atme Scho , MD, olEmo of Med Chie ScD fs Acad icinethca emic cer, ry Heal re Chie Deanctor, f and Acad emic Woo Offi druf cer, f Prof Emo Dire esso Heal r,ry thca Mor ree and ning side Cent er for Inno vativ Affordable Medicine Dire Emoctor, ry Univ Morersit ning y side SchoCent ol oferMed for icine Innovative and Affordab le Medicine Chief Academic Officer, Emory Heal thcare Director, Morningside Center for Inno vative and Affordable Medicine

Summer 2021

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Resilience & Resolve USING TECHNOLOGY TO TOUCH

“One of the most important things you can do for someone at the end of life is help them connect to things that are most important to them, and that is always the people they love,” says Joanne Kuntz, medical director of palliative and supportive care for Emory University Hospital Midtown, and associate professor of emergency medicine. Kuntz developed telemedicine protocols for Zoom and other video technologies so patients quarantined in hospital ICUs due to COVID-19 could talk with their families.

Check out Joanne Kuntz’ story and the entire Resilience and Resolve video series by scanning this QR code with your smartphone.

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EMORY MEDICINE

THE LAST WORD

Anticipation

“

Do we have enough disposable plate ware for the COVID patients so our dishwashers and servers are kept safe from contact? Do we have enough tube-feeding for patients too sick to eat? Can I keep my staff and myself healthy enough to keep the kitchen running? Will our café business return to normal at some point?

MARCH 20, 2020: ATLANTA, GEORGIA

The anticipation brings me back to similar feelings that would come rushing through me on a Friday or Saturday night before a large reservation dinner service. Cooks and chefs all over the world feel the adrenaline coming right before the reservations start rolling in: Does my station have enough mise en place, sauté pans, or bar towels to get through service? Will I sell more specials than à la carte items? How many cancellations will we receive? These questions are common thoughts among chefs on a nightly basis and I too felt and handled these questions with confidence for 15 years as I worked in the restaurant business. I also had feelings of adrenaline up until the economy crashed in 2008 and I was forced to leave the fine dining industry for something different. That something different ended up being a hospital.

I have spent the past 10 years as an executive chef, transforming an institutional kitchen for a large academic medical center into a kitchen that prides itself on purchasing and preparing local and sustainable products that nourish the sick. We no longer cook with foods that come out of cans and boxes, but instead focus on fresh vegetables, stocks, and even heirloom beans and grains. All this aside, we now sit and wait in anticipation, as business has slowed and all but stalled.

We have experienced a large decrease in patient volume due to the hospital canceling elective procedures to make room for the increasing number of COVID-19 patients we expected in the coming weeks. No more local organic lettuce

here for a while; we have shuttered our doors to visitors, closing salad bars and all self-service operations. We have cleaned shelves and floors, organized coolers, and prepared emergency menus, all for the sake of being ready to take on the rush. But, while I am experiencing a similar adrenaline rush to that from my memory of the restaurant business on a busy weekend, my worries now revolve around different types of mise en place.

Do we have enough disposable plateware for the COVID patients so our dishwashers and servers are kept safe from contact? Do we have enough tube-feeding for patients too sick to eat? Can I keep my staff and myself healthy enough to keep the kitchen running? Will our café business return to normal at some point? In the same way that I felt confident many years ago each and every Saturday night before the rush, I feel confident now that we are ready for service.

So, while I am again ready for this, I unfortunately do not know how many reservations I have, nor do I want to know, because a hospital is not a dining destination. As my anticipation grows, my uncertainty of what the future holds grows even stronger. What will the situation be, not only for my foodservice operation, but for all restaurants around the world? When will it be safe to open? What does good and safe service look like for the future of dining? For now, I work patiently and anticipate the uncertainty.

Mike Bacha is the executive chef at Emory University Hospital. n

The original version of this article ran in Gastronomica.

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News and views from Emory School of Medicine alumni SUMMER 2021

A Different Role

Richard J. Kim 03MD 03MBA had a driven approach to his studies at Emory, becoming one of three students who were part of a pilot program to get MBA and MD degrees simultaneously As vice president and chief medical officer at American Express, he was going to need to keep that focused philosophy, as the company would look to him in a way he couldn’t have expected when he joined in November 2019.

“This road for me actually first began at Emory when I was an assistant professor [of medicine],” he says. “There I had my first opportunity to enter the corporate world as the global medical director for the Coca- Cola Company in 2013.”

Keeping his professorship while he took the reins at perhaps the most famous company in Atlanta, Kim realized he had a chance to truly change employees’ lives, designing programs to inspire health and

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EMORY MEDICINE

wellness while also having the business acumen to look out for The Coca-Cola Company’s bottom line.

From there he became executive director of corporate health at New York-Presbyterian, where he served more than 50 Manhattan-based clients in their health needs. In 2017, he moved to Goldman Sachs as its associate medical director, managing the firm’s wellness programs, which ranged from onsite health centers to disability management. “One example was dealing with employees’ musculoskeletal conditions like lower back pain,” he says.

“We had onsite physical therapy and partnered with the Hospital for Special Surgery to design unique benefits for employees to go to a physical therapist without a doctor’s prescription. We had an onsite podiatrist and orthopedic surgeon who would come once a week to schedule appointments. Reducing the barriers to care was the largest driver in reducing health care cost.”

5 THINGS TO KNOW ABOUT Richard J. Kim

1.

2.

3.

4.

THE CORONAVIRUS

Kim had developed a unique skill set to lead a global organization from his prior roles. By January 2020, COVID-19 was emerging as a regional threat and Kim was called on by the CEO and the executive committee to help manage the growing risk. By March, he helped pivot the company to 100% virtual, a key decision to keep the employees of American Express safe.

5.

Kim grew up in Centerville, Ohio.

Kim met his wife, Sonia, at Emory when she was a graduate student and he was in business school. They have two sons, ages 11 and 8.

Kim is a Standards Committee member of the National Committee for Quality Assurance (since 2018) and serves on the Medical Advisory Board for Eden Health.

Kim continues to play ice hockey to maintain his physical and emotional wellbeing. He believes exercise is a main tenet of wellness and encourages his team and colleagues to prioritize it as part of a balanced lifestyle.

While Kim doesn’t have as much time these days between work and family, he still loves to play the guitar.

(But he hasn’t expanded his song list much beyond the Dave Matthews Band.)

The pandemic would quickly change the dynamics of his job, but he had experiences that prepared him. “When I was working for CocaCola, in 2014 there was an Ebola outbreak and the company had three bottling plants in West Africa where the disease was prominent,” he says.

“I remember consulting with Dr. Phyllis Kozarsky, an infectious disease expert and then-director of Emory’s TravelWell Clinic, in writing safety and business-continuity protocols on how to mitigate and manage risk of infection among employees and in product distribution. At Goldman Sachs, I dealt with workplace communicable diseases like tuberculosis and mumps. This on-the-job training is priceless. You glean best practices from peers and mentors on how to manage health risk and make data-driven decisions in relation to occupational health and safety.”

Kim would become a key partner at American Express, participating in town hall meetings and offering guidance to the CEO and other executives. There was no playbook on COVID and much of the risk-mitigation strategies had to be created. “I immediately worked with others in the company who were strong in analytics and started building, for example, COVID metrics and dashboards to monitor case trends, how many people were impacted, and how to adapt protocols based on local government requirements at each location. This work became the foundation in how we managed our business operations and the health of our people around the world.” As the company started to think about opening offices back up, Kim remained at the forefront. “This involved designing policies for workplace social distancing and facial coverings, COVID surveillance testing, and collaborating with government entities to offer COVID vaccines to our people,” he says. “I was tasked with the responsibility of overseeing the health and welfare of more than 60,000 employees and their family members around the world.”

Although the situation is improving in the US, he says, the status is less certain in other countries. “There are parts of the world where the vaccine isn’t available or only slowly becoming available,” he says. “I have to go about my job country by country, where there are different challenges and the pandemic is very fluid. To do this job, it’s partly about becoming comfortable with uncertainty.”—Eric Butterman

Advocacy in Action “I was helping military families face Lee Savio Beers 96M is president of the American Academy of Pediatrics a lot of stress,” she says. “I realized I gravitated toward supporting fami(AAP), helping families and her fellies in challenging situations and low doctors I learned a lot by being the only Beers may have been destined for pediatrician.” the US Navy—growing up near Annapolis definitely “My dad is increased the odds. But PRESIDENT AND her willingness to learn to PRESENT TO HELP a nuclear lead did as well. Today, as Beers is still supporting engineer and families as president of president of the AAP, she’s had a long track record in my mom is the AAP, founded in 1930. leadership.

She holds this position at a teacher. In a time when pediatricians Beers, medical director, community health and many ways often are being asked to advocacy, at Children’s weigh in on current topics, what I do National Hospital in such as school reopenings.

Washington, D.C., looks “Our primary goal is blends these back at her decision to be to help child health by professions.” promoting what we know a doctor and can see how her parents’ about eviprofessions set dence and scithe stage for ence and how her own. children can “My dad thrive,” she is a nuclear says. “It can be engineer and challenging my mom is to have these a teacher. In collaborative many ways conversations, what I do but it’s our blends these goal and my professions,” goal. We know she says. “The for kids and science-based adults only part seems about 10% of a obvious, but many don’t consider the child’s or a patient’s health is actually teaching element because you’re tryaddressed within the medical setting. ing to impart knowledge on healthier So much is impacted by their comliving. A doctor who can explain that munity and their nutrition and the part well may get through to a child education they’re getting. We need more than someone who can’t.” to think about how we can play After the Navy paid her way our part.” through medical school, she served She relishes the chance to serve as a pediatric resident at Naval and represent pediatricians, as well Medical Center Portsmouth from as their mission of healing. “I thought 1996 to 1999. She would gain more I’d throw my name in the hat and lessons through serving as a doctor in see what happened,” she says. “I feel Guantanamo Bay from 1999 to 2001. humbled that I was chosen.”

Summer 2021

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Class Notes MEDICINE ALUMNI

When she can, she still sees patients at Children’s National Hospital’s community pediatric health center. But much of her energy is spent on research and pilot programs to increase access to services. “One pilot we’re doing involves brief autism evaluations in the primary care center,” she says. “Another examines policy and advocacy. We have a small policy team I oversee. We look at systems, laws, regulations, and more … factors that influence the ability of children to access mental health care.”

Beers co-directs the Early Childhood Innovation Network, a collaborative of health and mental health providers, community-based advocates, parents, and early childhood education centers and groups. “We use a two-generation approach, working with both the parent and the child to help provide them with support to promote good mental health and social-emotional development, as well as decreasing the impact of adversities and challenges they may face,” she says.

Beers is passionate about advocacy and looks forward to making real changes while leading AAP. “As physicians, we really have to be non-partisan,” she says. “We need to talk to policymakers or others who are in positions to make decisions and to be able to share with them the real-life—not just theoretical—situations that patients are experiencing.”

This year has been difficult, she acknowledges, saying, “Together, we all have held both grief and gratitude in our hands. Sometimes we’ve felt strong, and sometimes it’s been really hard. We have dipped into our wells of resilience, and while they may feel shallow now, in the words of Eleanor Roosevelt, ‘With the new day comes new strength and new thoughts.’ ”—Eric Butterman

Who do you know?

In Memoriam

1960s

FACULTY

Mark J. Holzberg 83M

EMORY MEDICINE

S

87MR (dermatology) ofEuropean Atlanta isMolecular co-chair Biology Laboratory in Heidelberg. Warren ofwas thethe United Way RESIDENTS/FELLOWS Charles Howard Candler Chair of Emory’s Department ofofGreater Sarah Y. Vinson 13MR HumanAtlanta’s Genetics and the William Patterson Timmie Professor Regional Commission of Human Genetics. He joined the(forensic School ofpsychiatry) Medicine asofan on Homelessness. He Atlanta was selected assistant professor in biochemistry and pediatrics (medical organized and volunteers to the Atlanta Business genetics) and became a full professor in 1993. His research of at the Mercy Care Chronicle’s 2020 Class of 40 five decades focused on the mechanistic understanding of dermatology clinic, serves Under 40.

Vinson is founder fragile X syndrome.

In the first major human triumph of the on the board of directors of the Lorio Psych Group, Genome Project in 1991, he led an international effort atHuman the Gateway Center, a mental health practice, thatisidentified theofgene responsible for fragilewhich X. He and co-founder its mutationand Lorio Forensics, Advisory Council. consultation in led clinical trials ofHolzberg, drugs to treat provides the condition.

Warren was who servesofasthe a clinical civil, and family president American Societycriminal, of Human Genetics, won assistant professor of cases. of She an the William Allan Award, and wascourt an inductee theisNational dermatology at Emory adjunct faculty member Institute of Child Health and Human Development’s Hall ofat University, is founder Emory School of Medicine Honor for the identification of triplet repeat expansion as the of Avail Dermatology in and associate clinical cause of fragile X. He was elected to the National Academy of Newnan. professor of psychiatry and Medicine, the National Academy of Sciences,atand the American pediatrics Morehouse Academy of Arts and Sciences. Survivors his wife, Karen Schoolinclude of Medicine, where 1980-1990s Warren, son, Thomas Warren.she was named Psychiatry Mark S. and Soberman and Faculty of the Year in 83M 90MR (surgery) of 2015. Vinson is treasurer McLean, Va., is a senior of the Georgia Psychiatric safety officer at Johnson & Physicians Association and Johnson’s Ethicon Global an advisor for the Judges Surgery Group where he Psychiatry Leadership is responsible for device Initiative. safety of new products Dan Dunaway 61M sent in this from development through photo to honor his Emory medical to Eric “Our M. Hamm post-market surveillance. class’s 60thBorn: anniversary.

08PHto17MR (emergency Soberman also worksclass with is devoted promoting medicine) and Heidi M. the Johnson & Johnson scholarships, which we have 06C 09PH says. of Lung Cancer InitiativesuccessfullySoeters done,” Dunaway Atlanta, their second child, and serves as an in-house a son, Ansel Willem Hammsubject matter expert for Soeters, on Aug. 22, 2020. thoracic surgery-related products and issues at Ethicon.

Matthew W. Wilson 90M 91MR (internal medicine) 94MR (ophthalmology) 95FM (ocular pathology) of Memphis, Tenn., a professor of ophthalmology who also serves as vice chair

50

of academic affairs at the University of Tennessee Health Science Center and chief of ophthalmology at St. Jude’s Children’s Research Hospital, made a planned gift of $4 million to tephen T. Warren, Furman University’s PhD, died Institute for theon June 6, 2021.

Advancement of Community Health.

Warren was born in The gift will fund 1953 and was raised an endowment and in East Detroit, Mich. scholarships as well He began his studies as provide students at Michigan State, at his undergraduate graduating with a BS in alma mater with zoology and a PhD in experiential human genetics, education and with postgraduatethey training internships at the to University need pursue health care careers. of Illinois and the

Deaths ALUMNI

1940s

Charles P. Yarn Jr. 43C 45M of Huntsville, Ala., on Sept. 5, 2020. Yarn served as a naval surgeon

Emory University Alumni Records Office 1762 Clifton Road Atlanta, Georgia 30322

Plan big.

As a patch of bulbs planted at Emory’s HaygoodHopkins Gate blooms into a bed of beautiful tulips each year, your legacy gift will flower into a sustainer of Emory’s eminence.

Your planned gift will not only establish your legacy, it will allow Emory to Robert Taylor, director of cardiology, captured this fiery sunset and a slice of the Atlanta skyline from the physicians’ parking continue to do remarkable deck of Emory University Hospital. things for years to come.

Red Sky at Night

Everything starts with a plan, made possible with a gift from someone with the imagination and wisdom to visualize the blossom in the bulb.

Contact the Emory Office of Gift Planning and let’s discuss your plan.

giftplanning.emory.edu 404.727.8875

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