Medicine on the Midway - Fall 2016

MEDICINE MIDWAY UNIVERSITY OF CHICAGO

on the

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Biological Sciences Division

Unlocking secrets of the microbiome

University of Chicago scientists are forging unexpected collaborations in a quest to understand and harness the capability of microbes

Dean’s Letter

Dear Colleagues,

A Our new Microbiome Center leverages existing affiliations and coalesces talent across disparate fields to advance knowledge on how microorganisms interact with their hosts.

Kenneth S. Polonsky, MD The Richard T. Crane Distinguished Service Professor Dean of the Biological Sciences Division and the Pritzker School of Medicine Executive Vice President for Medical Affairs The University of Chicago

very exciting field of biomedical research is the study of the emerging links between changes in the organisms that inhabit our bodies and effects on normal physiology and predisposition to disease.

The recently established Microbiome Center, a joint effort by the University of Chicago, the Marine Biological Laboratory (MBL) and Argonne National Laboratory, will advance our research efforts in this area. The center supports scientists at all three institutions who are developing new applications and tools to harness the capabilities of microbial systems. Scientists across diverse fields are just beginning to understand how these ecosystems of microbes (bacteria, viruses, fungi and other microorganisms) interact with each other and influence their environments. As you’ll read in this month’s cover story, new technologies such as large-scale genetic sequencing and analysis have become more accessible, thereby increasing the momentum behind microbiome research and the opportunities for unexpected research collaborations.

Members of our faculty were among those who recommended a concerted national effort to coordinate microbiome research. These actions resulted in the White House Office of Science and Technology Policy launching its National Microbiome Initiative earlier this year.

In this issue of Medicine on the Midway, you also will read about how dedicated teamwork can promote our efforts to develop future leaders in biomedical research, education and clinical care. Two of our faculty members provided transformative mentorship to interventional cardiologist J. Raider Estrada, MD. Dr. Estrada, who completed his internal medicine residency and cardiology fellowships at the University of Chicago Medicine, emailed me in June praising the physicians who guided his education here. Roberto Lang, MD, and Atman Shah, MD, he wrote, “molded me and forever shaped my thoughts, perspectives and the medical care I will impart.” Dr. Estrada’s is a compelling story about the will to overcome adversity.

For those of you who have studied gross anatomy, I anticipate that you will marvel at the difference between your experience years ago and the one described in our story about the recent changes to the anatomy course at the Pritzker School of Medicine. Course director Callum Ross, PhD, led the $500,000 renovation project, which included computer system upgrades and the installation of flat-screen monitors and iPads at every dissection station.

Gross anatomy remains a hands-on class, but the introduction of technology for more personalized learning is a welcome addition. Says Dr. Ross, “Gross anatomy is now a more interactive, exciting and fun place to be.”

I also encourage you to read more about team-oriented learning in the story about the MBL boot camp, which emphasizes quantitative analysis in the training given to our aspiring biologists. In the immersive lab on the east coast, students stretch beyond their comfort zones and learn from each other as well.

I hope you’ll enjoy each story in this edition of Medicine on the Midway, and I give you my best wishes for a happy holiday season.

TA B L E O F C O N T E N T S

Beyond the gut MEDICINE MIDWAY UNIVERSITY OF CHICAGO

on the

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As the momentum behind microbiome research builds, so have the opportunities for scientific serendipity. Under the expansive umbrella of the new Microbiome Center, University of Chicago researchers C OV E R S T O R Y

Biological Sciences Division

FA L L 2 01 6

Unlocking secrets of the microbiome

University of Chicago scientists are forging unexpected collaborations in a quest to understand and harness the capability of microbes

Features 4

are forming unlikely collaborations to study the microbiome’s effects outside of the digestive system. Read about recent research on the microbiome’s role in Alzheimer’s disease, organ transplantation and cancer immunology.

Mentor Atman Shah, MD, left, with J. Raider Estrada, MD

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Bold moves Expansion on campus, specialty

care in the suburbs and a hospital merger boost access to University of Chicago Medicine services.

John Benfield, MD ’55, shares memories of medical school and his career as a cardiothoracic surgeon.

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The power of mentors

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How J. Raider Estrada, MD, transformed from a troubled kid on the streets to an interventional cardiologist.

Anatomy reboot Inside the

Pritzker School of Medicine’s renovated gross anatomy lab.

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University of Chicago Medical Center President Sharon O’Keefe addresses guests during the groundbreaking for a new emergency department with Level 1 trauma services.

A lifetime in medicine

Departments Letter from the Dean

BSD News

Pritzker News

Midway News

23 Why asthma is rare among the Amish

34 Back on campus: Reunion 2016

2 The country’s central repository for cancer genomic and clinical data opens at the University of Chicago 7 Alumni profile: Anesthesiologist Bernardo Beker, MD, endows fund for fellowship training, research and education

A publication of the University of Chicago Medicine and Biological Sciences Division. Medicine on the Midway is published for friends, alumni and faculty of the University of Chicago Medicine, Biological Sciences Division and the Pritzker School of Medicine.

Email us at momedit@uchospitals.edu Write us at Editor, Medicine on the Midway The University of Chicago Medicine 950 E. 61st St., WSSC 325 Chicago, IL 60637

uchospitals.edu/midway

38 A white coat welcome

24 Quantitative Approaches retreat at the Marine Biological Laboratory

39 Your News

27 From fin rays to fingers and toes

40 In Memoriam

The University of Chicago Pritzker School of Medicine and Biological Sciences Fall 2016 Volume 69, No. 2

36 Honoring our alumni

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Executive Leadership Kenneth S. Polonsky, MD, the Richard T. Crane Distinguished Service Professor, Dean of the University of Chicago Biological Sciences Division and the Pritzker School of Medicine, and executive vice president for Medical Affairs for the University of Chicago T. Conrad Gilliam, PhD, the Marjorie I. and Bernard A. Mitchell Distinguished Service Professor, dean for basic science, Biological Sciences Division Sharon O’Keefe, president of the University of Chicago Medical Center Holly J. Humphrey, MD ’83, the Ralph W. Gerard Professor in Medicine, dean for medical education, Pritzker School of Medicine

Editorial Committee Chair Chris Albanis, AB ’96, MD ’00 Lampis Anagnostopoulos, SB ’57, MD ’61 Hannah Brechka Arnold Calica, SM ’61, MD ’75 J. Palmer Greene, MS2 Marianna Johnson Matt Present, MS2 Jerrold Seckler, MD ’68 Coleman Seskind, AB ’55, SB ’56, SM/MD ’59 Jack Stockert, AB ’05, MBA ’10, MD ’10 Editor Anna Madrzyk Assistant Editor Gretchen Rubin

Editorial Contributors Steven Ashley Tanya Cochran John Easton Elizabeth Flock Laura Ramos Hegwer Ashley Heher Kristy Hentchel, PhD Kevin Jiang Ruth E. Kott Ellen McGrew Stephen Phillips Gretchen Rubin Rebecca Silverman Stacy Sweat Designs Matt Wood UChicago News

Photo Contributors Cable Risdon Photography David Christopher Daniel Cojanu Megan Costello Megan E. Doherty GradImages Rob Hart Robert Kozloff Jean Lachat Andrew Nelles Eddie Quinones Rebecca Silverman Joe Sterbenc Michael Tropea Joel Wintermantle Nancy Wong

Medical and Biological Sciences Alumni Association Pritzker School of Medicine Special Collections Research Center, University of Chicago Library Design Wilkinson Design

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G E N O M I C DATA C O M M O N S

Midway News

New era of data sharing for cancer research

BY KEVIN JIANG

T Vice President Joe Biden toured the UChicago Genomic Data Commons operations center with Robert Grossman, PhD, in advance of the center’s launch.

PHOTO BY ROBERT KOZLOFF

“Over time, I expect the GDC will play a more and more important role in providing the data required at the scale required so that precision medicine fulfills its promise.”

Robert Grossman, PhD

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he Genomic Data Commons (GDC), a next-generation platform that enables unprecedented data access, analysis and sharing for cancer research, launched at the University of Chicago in June, opening the door to discoveries for this complex set of diseases.

The GDC went live with approximately 4.1 petabytes of data from National Cancer Institutesupported research programs, including some of the largest and most comprehensive cancer genomics datasets in the world — such as The Cancer Genome

Atlas and Therapeutically Applicable Research to Generate Effective Treatments — and more than 14,000 anonymized patient cases. One petabyte equals 1 million gigabytes.

The GDC centralizes, standardizes and harmonizes genomic and clinical data on a unified and interoperable platform. Cancer researchers can access these data for analyses and submit their own datasets to share with the research community. By making high-quality data broadly accessible, the GDC provides much-needed tools to accelerate studies of the biological mechanisms of cancer and the development of personalized treatments for individual patients.

UChicago developed and operates the GDC with NCI funding under a subcontract from Leidos Biomedical Research at the Frederick National Laboratory for Cancer Research, in collaboration with the Ontario Institute for Cancer Research.

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

Development of the GDC began in 2014 at UChicago’s Center for Data Intensive Science (CDIS). Over the past two years, the team has created an innovative suite of tools, software and infrastructure — based on such CDIS open-source projects as the Bionimbus Protected Data Cloud — to curate the massive amounts of data held by the GDC. “Today, making discoveries from cancer genomic data is challenging because diverse research groups analyze different cancer datasets using various methods that are not easily comparable,” said GDC principal investigator Robert Grossman, PhD, professor of medicine and director of CDIS at UChicago. “The Genomic Data Commons brings together genomic datasets and analyzes the data using a common set of methods so that researchers may more easily make discoveries and, in this sense, democratizes the analysis of large cancer genomic datasets.”

The GDC breaks down these barriers by bringing cancer genomics datasets and associated clinical data into one location that any researcher may access. It harmonizes the data with a common set of analytic pipelines to make it easier to study the information, which in the past has typically been available as separate datasets analyzed with separate pipelines. By making these data available using modern computing and network technology, the GDC makes it possible for any researcher to ask new and fundamental questions about cancer.

The Genomic Data Commons ■

Serves as a central unified repository for cancer genomic data and associated clinical data.

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Cleans, standardizes and harmonizes data, as well as provides quality control, so that analyses can be conducted using common algorithms and pipelines.

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Supports basic research and clinical trials by making data easily accessible, findable, interoperable and reusable.

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Provides powerful data transfer, search, application programming interface (API) and analysis tools to researchers at no cost.

SURGERY

Alum returns to lead new Transplantation Institute

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John Fung, PhD ’80, MD ’82

ohn Fung, PhD ’80, MD ’82, has been named director of the new University of Chicago Medicine Transplantation Institute and section chief of transplantation surgery.

Fung is a highly respected surgeon with more than 30 years of experience in kidney, liver, pancreas, islet and intestinal transplantation. He previously served as director of the Cleveland Clinic Health System Center for Transplantation, overseeing transplant services in several states.

As inaugural director of the Transplantation Institute, Fung plans to revitalize the transplantation program at UChicago Medicine, building on its long history of research and advancements. He plans to establish an intestinal transplant program at UChicago Medicine, working closely with specialists in the Digestive Diseases Center. He also wants to expand the use of new technology such as normothermic perfusion, which can rejuvenate donor organs by circulating warm, oxygenated solution through them prior to transplantation, improving their viability and greatly increasing the number of available donor organs.

“The University of Chicago has a long history as a pioneer in organ transplantation, from some of the very first experiments in the 1900s to the first living donor liver transplant in the world in 1989. Dr. Fung brings a wealth of experience that will carry on this tradition by adopting innovative approaches and technologies to care for patients in every stage of the transplant process.”

Jeffrey B. Matthews, MD The Dallas B. Phemister Professor and chair of surgery

Fung has a long-standing research interest in transplantation immunology, immunosuppression therapy and liver-related immunology and has published more than 1,000 articles and book chapters. He is also a longtime teacher, most recently as professor of surgery at the Lerner College of Medicine at Case Western Reserve University. In 2015, he received the Starzl Prize in Surgery and Immunology from the University of Pittsburgh Medical Center, awarded annually to an international leader in organ transplantation.

Fung said the desire of UChicago Medicine hospital and academic leadership to continue as a leader in the field of transplantation drove his decision to return to where he received his first medical training. “The University of Chicago has always had a great tradition of innovation and understanding basic science and discovery,” he said.

ALUMNI U

New alumni website offers free courses and more

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lumni may take free online courses led by University faculty, connect and collaborate with other graduates and find curated content from across UChicago on AlumniU, a new website that launched in September.

A lu m n i U, op e n exclusively to UChicago alumni, offers a highly interactive experience, with opportunities to join and start conversations and weigh in on topics and ideas.

Alumni receive digital badges for completing online courses or through quests — short dives into topics like UChicago’s Nobel laureates and University scholars’ opinions on presidential candidates.

uchospitals.edu/midway

This past spring, AlumniU hosted a six-week class titled “Critical Issues in Urban Education” and also launched the first in a series of shorter discussions with faculty. Titles in the “Connecting the Curious” series included “Gravitational Waves: The Significance of the LIGO Discovery”; “Love, Belonging and Other Surprising Concerns of Science Fiction”; and “Plato’s Meno: On the Possibility of Learning How to Be Good.”

Over the long term, AlumniU could be the first step in a redefinition of what it means to attend a university. “If this really gets traction, it could be something where attending the University is seen as a 65-year value proposition, in which a student can continue learning with University faculty and alumni for a lifetime,” said Mark Nemec, dean of the Graham School of Continuing Liberal and Professional Studies.

Visit alumniu.uchicago.edu to join the online learning community.

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Midway News

In and beyond Hyde Park THROUGH THE GET CARE INITIATIVE, the University of Chicago Medicine

is dramatically increasing access to health care on Chicago’s South Side in specialty, adult trauma, cancer and emergency care.

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MILLION DOLLARS: ESTIMATED TOTAL COST OF GET CARE PLAN

Learn more at uchicagogetcare.org.

Adult emergency and trauma care A state-of-the-art emergency department offering Level 1 trauma services is under construction on the first floor of the new parking facility just north of the Center for Care and Discovery.

The expanded emergency facility is projected to handle an additional 25,000 patient visits a year by 2021. More than 2,000 adult trauma patients are expected in the first full year of trauma center designation.

Adult cancer center The Bernard A. Mitchell Hospital will be transformed into a dedicated adult cancer hospital.

OPENING 2020

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NUMBER OF DAYS IN ONE YEAR OUR HOSPITAL OCCUPANCY REACHED 90 PERCENT CONCEPTUAL RENDERING; NO ARCHITECT HAS BEEN CHOSEN

OPENING IN 2018 Chicago Mayor Rahm Emanuel spoke at the ED groundbreaking.

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TREATMENT STATIONS

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TRAUMA RESUSCITATION BAYS

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

Center for Care and Discovery floors 3 and 4 When the Center for Care and Discovery opened in 2013, floors three and four were shelled for future expansion of inpatient units. Heart and vascular care, the Burn and Complex Wound Center and multispecialty surgical units are now located on these recently completed floors.

OPENED AUGUST 2016

THE UNIVERSITY OF CHICAGO MEDICINE is expanding the forefront of medicine

in the city and suburbs with three new locations for specialty care and our first-ever merger.

The Center for Advanced Care at Orland Park The four-story ambulatory health care facility in this populous Southwest suburb will offer services in primary care, women’s health, digestive diseases, heart and vascular, and oncology.

OPENING DECEMBER 2016

NUMBER OF EXAM ROOMS

80 Merger with Ingalls Health System in the South Suburbs

Located in a busy retail market in a fast-growing Chicago neighborhood, the ambulatory clinic will provide services in primary care, women’s health, orthopaedics/sports medicine, heart and vascular care and digestive diseases.

Ingalls Memorial Hospital and its five outpatient centers are now part of the University of Chicago Medical Center. The new partnership is an important step in the development of a broader health network. Both organizations will retain their names.

OPENING EARLY 2017

COMPLETED OCTOBER 2016

The Center for Advanced Care at South Loop

14.4

PERCENT INCREASE IN NUMBER OF HOUSEHOLDS SINCE 2010

NUMBER OF BEDS AT INGALLS MEMORIAL HOSPITAL

473

Cancer care at Little Company of Mary Hospital in Evergreen Park The University of Chicago Comprehensive Cancer Center at Little Company of Mary Hospital offers inpatient and outpatient services.

OPENING WINTER/SPRING 2017

uchospitals.edu/midway

Ingalls President and CEO Kurt E. Johnson and Dean Kenneth Polonsky, MD

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T E AC H I N G AWA R D S

Midway News

Professors honored with University awards

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wo faculty members in the Biological Sciences Division were honored with University awards for teaching and mentoring.

Daniel McGehee, PhD, associate professor of anesthesia and critical care, received a 2016 Llewellyn John and Harriet Manchester Quantrell Award for Excellence in Undergraduate Teaching. The prestigious award is believed to be the nation’s oldest prize for undergraduate teaching.

“One thing that has always resonated with me was whether I could instill the same excitement in my students as what I experienced when I was an undergrad taking a course very similar to the one I now teach,” said McGehee, who teaches an undergraduate course in human physiology.

Nicholas Hatsopoulos, PhD, professor of organismal biology and anatomy, received Daniel McGehee, PhD

a 2016 Faculty Award for Excellence in Graduate Teaching and Mentoring.

“I just want students to be passionate about what they’re doing and be creative,” he said. “There are going to be ups and downs.

Just stick with it; it’s going to work out. I try to instill that in my students, which is the same kind of positivity my former mentors instilled in me.”

“We have amazing students. I’m just continually impressed with the challenges they take on by coming here and by their abilities to think through complex problems.”

Daniel McGehee, PhD Nicholas Hatsopoulos, PhD

INTERDISCIPLINARY CENTER

Gift establishes Center for Quantitative Biology and Human Behavior

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he University of Chicago has received a gift of $10 million from Sanford Grossman, AB ’73, AM ’74, PhD ’75, to establish the Center for the Study of Quantitative Biology and Human Behavior.

The center’s objective is to leverage the power of genomics and neuroscience to contribute to understanding about fundamental questions of complex individual and social human behavior.

It will build upon rapidly evolving experimental and analytical approaches in the biological sciences to explore individual and collective behaviors that both drive the emergence of higher-order social structures and are shaped by them. A key feature of this interdisciplinary center will be the interaction of leaders in quantitative biology and neuroscience with researchers

in the social sciences, humanities, Chicago Booth and the Law School.

The new center will work closely with the Grossman Institute for Neuroscience, Quantitative Biology and Human Behavior at the University to expand and enhance neuroscience efforts across the entire University. The Grossman Institute was established in 2011, also with a gift from Sanford Grossman.

M O L E C U L A R G E N E T I C S A N D C E L L B I O LO GY

Rust receives HHMI Faculty Scholar Award

M

ichael Rust, PhD, assistant professor in the Department of Molecular Genetics and Cell Biology and managing director of the Institute for Genomics and Systems Biology, is one of 84 Faculty Scholars named by the Howard Hughes Medical Institute, the Simons Foundation and the Bill & Melinda Gates Foundation.

The organizations joined forces out of concern for the time and energy spent by early-career scientists to secure research funding in the current competitive grant environment. This new program was created to support promising early-career scientists with the potential to perform transformative, original research.

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Rust was selected from more than 1,400 applicants to receive this five-year grant.

His research seeks to understand how and why biological organisms, in particular unicellular cyanobacteria, keep time using circadian clocks. The Faculty Scholar Award will allow him to pursue exciting Michael Rust, PhD new lines of research to understand the biophysical basis of the 24-hour periodicity of the clock and how the circadian clock can control an organism’s metabolism.

To learn more about his work, visit rustlab.uchicago.edu.

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

ALUMNI PROFILE

Celebrating a 35-year romance with the place that shaped his life

BY LAURA RAMOS HEGWER

G PHOTO COURTESY OF BERNARDO E. BEKER, MD

Bernardo and Marti Beker on a recent visit to Machu Picchu in Peru.

rowing up in Uruguay in the 1960s, Bernardo E. Beker, MD, decided to become a doctor after watching the American TV show “Ben Casey.” After graduating from medical school at the Universidad de La República in Montevideo, Beker landed on an icy Chicago runway in 1979 with three invitations to interview for anesthesiology residencies at area hospitals.

Bernardo Beker’s gifts will support the education of anesthesiologists from Uruguay and elsewhere while honoring a beloved mentor.

uchospitals.edu/midway

“I had never been to the United States before, but I thought, what do I have to lose?” Beker said.

His first interview was at the University of Chicago, where he met with attending anesthesiologists and Donald W. Benson, MD, chairman of anesthesiology.

As Beker left the room after an intense interview for the one remaining residency position, he overheard Benson utter two life-changing words to the attendings: “Take him.”

“I still remember that moment,” Beker said. “A week later, I got a letter inviting me to join the program. That is how my romance with the school started.”

During Beker’s residency, another romance was sparked at the University’s Walter G. Zoller Memorial Dental Clinic. Thanks to a toothache, he met a dental hygienist named Marti. One root canal and 33 years of marriage later, the couple is still going strong.

At the University of Chicago, Beker flourished.

One of only a few international residents, he was named chief resident his fourth year. “While I was chief resident, Dr. Benson taught me many clinical pearls of wisdom that I used throughout my 35-year career,” Beker said. “He also told me how to be humble and be a better person — namely, that if I wanted to be happy, I should make someone else happy.”

To that end, the Bekers have allocated part of their estate to endow the Bernardo E. Beker, MD, Clinical Anesthesia Fellowship Fund, which supports anesthesiologists educated or practicing in Uruguay who want to train at the University of Chicago.

To honor his mentor, Beker also established an endowed fund in Benson’s name to support research and education in the Department of Anesthesia and Critical Care. With these gifts, the Bekers will donate more than 90 percent of their estate to the department.

“It never crossed our minds that anywhere besides the University of Chicago and especially the Department of Anesthesia and Critical Care should receive the result of our lives’ work,” said Beker, who became an American citizen in 1986.

After practicing anesthesiology for 35 years, Beker retired in 2014 and plans to move with Marti from Mishawaka, Indiana, to South Florida. In addition to being active in animal welfare causes, the Bekers are avid readers and travelers. In early 2017, they plan to embark on a 30-day cruise along the coast of South America, during which they will visit Beker’s family in Uruguay.

Today, what Beker values most about the gifts that he and Marti have made is how they bring the lessons he learned from Benson full circle. As he put it, “We’re going to help advance the knowledge of anesthesiologists from Uruguay and the United States and pay our respects to Dr. Benson for how transformative he was in my life.”

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Mentors saved his life. Now he saves the lives of patients.

J. Raider Estrada, MD, completed his internship, residency and fellowships in cardiology and interventional cardiology at the University of Chicago Medicine.

PHOTO BY JEAN LACHAT

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THE UNIVERSITY OF CHICAGO

MEDICINE AND BIOLOGICAL SCIENCES DIVISION

J. Raider Estrada grew up on the tough streets of LA. This is the story of how a former gang member became an interventional cardiologist.

BY ELIZABETH FLOCK

O

n a winter day last year, a woman arrived at the University of Chicago Medicine cardiology clinic with elevated blood pressure.

She knew it would be high before she got there, because she hadn’t taken her antihypertensive drug that day. Her interventional cardiologist, Atman Shah, MD, offered that if cost was the problem, help was available. But the woman didn’t reply.

After the team left the room, one of Shah’s cardiology fellows, J. Raider Estrada, MD, asked if he could go back in. Sure, Shah said. “What’s going on?”

Estrada asked the woman, as he took her hand in his own. “Why aren’t you taking your meds? Sweetie, I’m asking you.”

Something about his tone, or his hands on hers, relaxed her. Her husband was abusing her, she confessed to Estrada. She had fled home the night before without her toothbrush, much less her medication.

Though she’d spent the night in a shelter, she still made it to her clinic appointment that day. She wanted to follow doctor’s orders.

Shah was amazed that Estrada found out so much so quickly. It was often difficult to get to the root of the problem with patients who were noncompliant, but this young trainee had done it easily.

“There were so many times when patients would open up to him like that,” Shah said of Estrada, who recently completed seven years of training — internship, internal medicine residency and fellowships in cardiology and interventional cardiology — at UChicago Medicine, and started a job at Maine Medical Center this fall.

There were also many times, according to accounts from his mentors, Estrada walked into patients’ rooms with a giant smile and left with hugs. Many times he’d walk down the hall shaking hands with department chairs and janitors alike. And, when a page came in the middle of the night that Estrada wasn’t required to respond to, the many times he would show up to reassure the patient anyway.

“For him, it’s not just pushing up catheters or using scissor or thread,” Shah said. “He is a rare physician who has this incredible wealth of empathy and experience.”

uchospitals.edu/midway

Two seeds Estrada’s experience, prior to coming to Chicago, wouldn’t be found on the typical medical student’s resume. He grew up in a rough neighborhood in Los Angeles in the 1980s, at the height of the gang wars and a crack epidemic plaguing America’s cities.

When he was 9 years old, Estrada joined a gang.

Three years later, his best friend died in his arms, after a gang-related stabbing. Soon, Estrada was pulled directly into the violence. During his early teen years, he was charged with assault and battery. He bounced in and out of jail. He was stabbed and shot. He seemed destined for a life behind bars or worse.

PHOTO BY JEAN LACHAT

But when a probation officer took a liking to him, Estrada was suddenly diverted out of the juvenile justice system into a wilderness program that would radically change the course of his life. He was 16. The program, called Rite of Passage, included intensive education, physical training and hours spent working with children with disabilities. For the first time, Estrada was told he could do anything he wanted to do with his life. He was regularly in school. And he had mentors.

Estrada catches up with Roberto Lang, MD, left, and Atman Shah, MD, on a recent visit to campus.

These two mentors “have molded me and forever shaped my thoughts, perspectives and the medical care I will impart,” Estrada said.

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“We, as people, aren’t that different from plants and flowers,” Estrada says now. “You take two seeds.

For one seed you provide all of the best nutrients and watering schedule and sunlight schedule. ...You take another seed and you throw it in an empty lot and, when it rains it rains, and when it’s sunny it’s sunny, and it is what it is. I really, really believe that we as people are just like that.”

Estrada’s counselors at Rite of Passage put him on a tight schedule. His coaches were extremely tough on him, but also offered constant positive reinforcement.

After one tutor taught him fractions, he said, it ignited his passion to learn.

PHOTO BY CABLE RISDON PHOTOGRAPHY

J. Raider Estrada as a Georgetown University School of Medicine student.

In spring 2009, his story and photo were featured in the California Wellness Foundation’s magazine, Grantee.

“That mentorship, maybe that was the extra nitrogen or the scheduled sun,” Estrada said. “My story is really a story of mentorship. And of how mentors can mold someone from an angry, aggressive criminal into an interventional cardiologist at the University of Chicago.”

Changing his perspective In 1997, a public service announcement featuring Estrada aired on television across the state of California.

With the homicide problem reaching epidemic levels in the country, violence was being seen as a public health issue for the first time. Estrada was evidence that, with help from the system, a violent person could change. At the start of the video, Estrada, wearing a white sleeveless undershirt, his tattoos visible, speaks of the violence and trouble in his early life. As he puts on a dress shirt and tie, he talks about his progression

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

from an angry kid at Rite of Passage to a community college student body president, with plans to transfer to a university and, someday, become a doctor.

But Estrada’s new path wasn’t straight or easy.

Pepperdine University attracted many wealthy students, with whom Estrada felt he had little in common.

He struggled academically and soon lost confidence in his ability to handle pre-med classes, and so pursued a degree in psychology instead. He began hanging out in the old neighborhood again, and he married young. His wife was soon pregnant. He took a job in the city’s social services unit, where the salary was low.

“I was very insecure. I didn’t feel good about myself,” he said. “I was in a rut.”

But after the birth of his daughter, when Estrada was 22, he says, “It changed my perspective on everything.”

He wanted to earn more money, and give her the best environment he could. This was his motivation not to give up on his medical school dream.

Soon, Estrada was attending classes at night. He applied to programs across the country and was accepted to the post-baccalaureate pre-medical certificate program at Georgetown University in Washington, D.C. As Estrada moved across the country to pursue his career, he promised himself that, this time, he wouldn’t stray off course. And so, even after his wife filed for divorce not long after, Estrada stayed in school. Every night, after hours of intensive classes and studying, he called his daughter back in California and sang “You Are My Sunshine,” as each of them held half a heart on a necklace. He reminded himself that the commitment was for his daughter, not for him. And he decided that when he became a physician, he would talk to his patients about parenting, and ask them about their families, their lives.

Words of wisdom Estrada remembers being “incredibly intimidated” when he first arrived at the University of Chicago Medicine for an internship after graduating from Georgetown University School of Medicine. He was well aware of UChicago’s academic reputation and had his doubts about fitting in. He plowed forward anyway.

Shah, then a new attending physician, took an immediate liking to Estrada. They both knew Los Angeles. Shah had worked in underserved Hispanic communities like the one Estrada grew up in. And as Estrada completed his internship and residency in internal medicine, he discovered that he and Shah also had something else in common: a passion for cardiology.

“Cardiology spoke to me because it just makes sense,” Estrada said. After years of uncertainty, cardiology was reassuring in its logicality. “There are many things in medicine that we just assume, or we accept as is, for example, that the bone marrow produces hematopoietic cells,” he said. But in cardiology, he said, everything that the heart does, its structures and its functions — they all add up.

“You take two seeds. For one seed you provide all of the best nutrients and watering schedule and sunlight schedule. …You take another seed and throw it in an empty lot.”

After Estrada began his interventional cardiology fellowship, Shah became more than just a physician who liked and trained him. Shah, who was now the clinical director for cardiology, along with Roberto Lang, MD, director of cardiac imaging, became Estrada’s two most important mentors. Estrada says both men forever changed his life.

Shah, he said, was like “my drill instructor,” a role Estrada recognized from his days at Rite of Passage.

“There were no compliments, no pats on the back.

There was no recognition if I did a good job. It was just expected.”

Estrada tells a story of doing a percutaneous coronary intervention under Shah’s tutelage. He followed all the steps that were required — gaining access to the artery, putting in a tube, threading the catheter and taking images. He found a blockage, put in a different catheter, put the wire down, ballooned it and stented it. The final step was to close the artery. Before doing so, Estrada went to Shah for approval. But Shah only asked: “Why haven’t you finished the procedure?”

“That is a very different way of teaching someone than saying, ‘Here, watch me do this,’” Estrada said.

“Shah put my hands on the equipment early on.

“Somehow, he had the ability, confidence and teaching skills to observe my work, assess my ability and allow me to push my procedural limits in the context of safety for patients.”

Shah says he mentors people differently, but saw that Estrada responded to being pushed. “From where he was coming from and the path he needed to take, coddling him was not the way to do it,” Shah said.

“Because he had the potential to be great. And so I was especially hard on him.”

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With Lang, Estrada formed a different kind of relationship; he saw Lang as a father figure. “My nickname for Roberto is actually ‘Papa,’” Estrada said, laughing. “It’s because he is so wise. And so caring.

Roberto cared about my academic progress, but just as much about my wife, my brother and my father.

And so, like my own father, I would never, ever want to disappoint him.”

Estrada sees being a clinical fellow under Lang, an internationally renowned cardiologist, as one of the biggest honors of his life. The autonomy Lang gave him early on with patients drove him to work harder.

As Estrada worked hard to do well, Lang worked to fill in the gaps of Estrada’s education: encouraging him to study hard, pursue research and present papers internationally about novel paradigms of treatment.

Under Lang’s guidance, Estrada did all of these.

Lang said it soon became obvious that Estrada was an example of when mentorship and social systems “really, really worked.” “We did the last part here, which was to polish his education,” Lang said.

Estrada, who has since remarried, to a physician who practices family medicine, and is expecting twins with his wife in December, said Lang did much more than that. If they have a boy, he said, they plan to name him Roberto.

But there was one thing neither Shah nor Lang needed to teach Estrada: how to act with patients.

Lang said Estrada “instantly made an unbelievable connection” with people. If Estrada wasn’t there on a given day, his patients always asked when he’d be back.

Really listening to patients, Estrada said, was the most important way to make these connections. “You have unbridled access to people’s lives, to their most intimate details,” he said. “And so people tell you things that they may lie to everyone else about. Associated with that is a huge amount of trust.”

In 1997, Estrada appeared in a public service announcement televised in California. He talked about his progression from an angry teen to a college student with plans to become a physician.

Watch the video: tinyurl.com/estrada-story

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Moving on As Estrada was preparing to leave Chicago for a position as a staff interventional cardiologist at Maine Medical Center, he reflected on the many patients he cared for here.

He remembered, for example, the male patient with dramatic unexplained weight loss who was undergoing a barrage of medical tests to try to determine the cause.

Estrada noticed that the man’s wife always spoke for him, and so he asked to talk to the patient alone. The man revealed that his wife had recently put him on a strict diet. Estrada said he learned from this that “you can be the smartest, most brilliant accomplished doctor in the room,” but “if you don’t listen to patients, you’re going to make the wrong diagnosis.”

Estrada also won’t forget the female preacher from Chicago’s South Side with an incurable disease, whom he helped make decisions about the way she wanted to die. Nor will he forget the mother who was undergoing experimental chemotherapy just so she could live a few more months and attend her daughter’s wedding.

Knowing she wouldn’t survive much longer, Estrada helped make a wedding happen in the mother’s hospital room. As Estrada and the family stood by, a chaplain did the service at the foot of her bed, and everyone shared cake and sparkling cider.

“Mom was able to pass peacefully later that night, after meeting her goal of watching her daughter get married,” said Estrada. What was most important,

On his last day at the University of Chicago, Estrada listened to the Green Day song “Time of Your Life” and thought about how far he’d come. he said, “was that we were able to bring peace to the family in her final hours.”

On his last day at the University of Chicago, Estrada said good-bye to Lang in his office. Lang gave Estrada a copy of a textbook he had authored, which Estrada had been asking for, and signed it “to the best fellow ever.” Then, Estrada walked over to the cardiac cath lab with Shah. The two men hesitated before saying good-bye. “I’ll see you tomorrow,” Shah said finally, though he wouldn’t, and Estrada responded, “See you tomorrow,” and they slapped hands.

Afterward, Estrada sat alone in the lab, looking around at all the equipment he’d used and thinking back on his seven years on the medical campus. As he listened to the Green Day song “Time of Your Life,” he said, “I thought about how far I’d come and, really, about the magnificent growth that had taken place within me.” He thought about the patients he’d see next in Maine. And then, after the song finished, he cleaned out his inbox, and got up to go.

Estrada’s nickname for cardiologist Roberto Lang, MD, is “Papa.” Lang, Estrada said, “has taught me the beauty of academic productivity, but more importantly, he has taught me the incredible power that comes with being great in your field and being a great human being.

I will forever strive to be as humble, kind and as good to patients as he is.”

PHOTO BY JEAN LACHAT

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

Class Notes

“I have a desire to keep learning from and caring for communities with less resources, and my scholarship gives me the freedom to live that dream without the looming burden of debt.”

Sean Gaffney, Pritzker School of Medicine Class of 2017

Sean Gaffney Pritzker Class of 2017 and Margaret Bradley Scholarship recipient

WHAT WILL SEAN’S LEGACY BE? Sean, a former high-school economics and government teacher in a Texas border town, is driven to help answer big questions about medicine—questions like, “How do we ensure that, as a society, we meet everyone’s health care needs?”

The answer starts with protecting the “sacred doctor-patient relationship,” he says. Sean aims to build strong relationships with his own patients and teach future medical students how to do the same, for generations to come.

WHAT WILL YOUR LEGACY BE? The Legacy Challenge is the University of Chicago’s campaign to support scholarships for MD and PhD students. A gift of any amount can help to provide security for students and meet our long-term goal of securing scholarship funding for future students at Pritzker and in the Division of the Biological Sciences. If you’re able to make a leadership-level gift of $25,000 or more, the Legacy Challenge will provide a 50 percent match—$1 for every $2 you contribute.

For more information, visit givetomedicine.uchicago.edu/legacy-challenge.

the LEGACY Challenge

C OV E R S T O R Y

BEYOND THE GUT

University of Chicago scientists are leading efforts to understand the microbiome’s role in disease and translate these scientific insights into therapies. Their work is already yielding unexpected and exciting results.

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

PHOTO BY EDDIE QUINONES

Neurobiologists Myles Minter, PhD, left, and Sangram Sisodia, PhD, are exploring new territory in how the gut influences brain health. They teamed with microbiome researchers to study what effect, if any, changing the bacteria in the digestive system could have on symptoms of Alzheimer’s disease.

A

lzheimer’s disease researcher Myles Minter, PhD, still sounds a little surprised while describing the improbable group of researchers he is collaborating with these days — not just neuroscientists but also colleagues from fields as disparate as gastroenterology and marine biology.

Minter and his advisor, Sangram Sisodia, PhD, the Thomas Reynolds Sr. Family Professor of Neurosciences, wanted to take their Alzheimer’s research in an unexpected direction, exploring the link between bacteria in the digestive system and brain health. The resulting study, published in July in Scientific Reports, broke new ground. It showed that a long-term course of antibiotics in mice weakened some of the telltale symptoms of Alzheimer’s disease in the brain, while at the same time producing marked changes in the makeup of their gut bacteria.

“I’ve been working with marine biologists who go deep-sea diving and take samples,” said Minter, a postdoctoral scholar in neurobiology, shaking his head. “Yes, previously I definitely would laugh at it, but once you put ideas together from different fields that largely have been believed to be segregated from one another, the possibilities are really amazing.”

This research marks one of the first collaborations coming out of the Microbiome Center, a joint effort by the University of Chicago, the Marine Biological

Laboratory (MBL) and Argonne National Laboratory to support scientists at all three institutions who are developing new applications and tools to understand and harness the capabilities of microbial systems across different fields.

BY MATT WOOD

As new technologies such as largescale genetic sequencing and analysis have become more accessible and the momentum behind microbiome research builds, so have the opportunities for scientific serendipity.

The term “microbiome” is shorthand for the vast and still largely unexplored world of bacteria, viruses, fungi and other microorganisms that inhabit every corner of the planet. To put it simply, they’re everywhere.

They’re in the air, water and soil. Commensal bacteria live side by side with our own cells on our skin, in our mouths and along our airways. The bacteria that live in us also colonize all the surfaces we interact with, including our homes, offices and hospitals. Perhaps most important to human health, microbes in the gut constitute what some researchers consider a separate continued on page 16

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Eugene Chang, MD, investigates the role

microbes play in inflammatory bowel disease (IBD) and metabolic disorders like obesity and type 2 diabetes. In 2012, he led a study showing how Western diets — specifically the amount and types of dietary fat — may have contributed to the increase in IBD by disrupting the gut microbiome. His work highlights the delicate balance in the body between the immune system

“I call my work microbiome medicine.”

Eugene Chang, MD’76 The Martin Boyer Professor of Medicine

and our microbial partners, and points to new ways we can harness them for good. In addition, with Vanessa Leone, PhD, he has shown how daily fluctuations in the gut microbiome provide critical metabolic cues to our circadian rhythm to regulate our energy balance. Western diets perturb this relationship, creating an imbalance in energy utilization and promoting obesity.

“The gut microbiome is an ‘organ’ of our body that is essential for immune and metabolic balance,” he said. “And, unlike most other organ systems of the body, its composition and functions can be readily changed and used to our advantage in preventing and treating diseases that have a microbial basis.”

Eugene Chang, MD ’76, works with Noelle Patno, a PhD candidate in the Committee on Molecular Metabolism and Nutrition. Chang is one of the pioneers of microbiome research at the University of Chicago.

PHOTO BY JEAN LACHAT

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

organ that shapes our metabolism, susceptibility to allergies and even responses to medical treatments.

Scientists in fields as diverse as microbiology, physics, chemistry and medicine are just beginning to understand how these ecosystems of microbes interact with each other and influence their environments.

Until recently, researchers largely worked within their own disciplines, but as new technologies such as large-scale genetic sequencing and analysis have become more accessible and the momentum behind microbiome research builds, so have the opportunities for scientific serendipity.

“We’re starting to find that we have a unique ability — through the microbiome — to control how environments work and maybe even use the bacteria as a method of tracking those environmental changes,” said Jack Gilbert, PhD, faculty director of the Microbiome Center, as he and a group of like-minded scientists called for a concerted national effort to coordinate microbiome research across disciplines in the fall of 2015. “So we’re at a point now where if we coordinate our activities as a community, we can go after the really big questions.”

The scientists’ call to action eventually resulted in the White House Office of Science and Technology Policy launching its National Microbiome Initiative in May 2016 to bring together public and private entities to coordinate and fund microbiome research. The new Microbiome Center is one of the first models of how research institutions can leverage existing affiliations and pool intellectual horsepower across disparate fields.

Gilbert’s collection of titles speaks to the scope and ambition of the center: group leader in microbial ecology at Argonne, senior fellow at MBL, and his most unlikely appointment, professor of surgery at UChicago. He started his career as an entomologist studying butterflies before becoming a microbial ecologist (and is a fellow of the Field Museum). His work on the Hospital Microbiome Project, in which he and his team tracked the development of the microbial ecosystem in the University of Chicago Medicine’s new Center for Care and Discovery as it opened in 2013, led to a collaboration with John Alverdy, MD, the Sara and Harold Lincoln Thompson Professor of Surgery, who is working to prevent infections after surgery.

“It’s really bizarre. But here I am sitting in my office in the Department of Surgery, so I guess it is real,” Gilbert said. “I’ve been in environmental microbial ecology my entire life, and then suddenly over the last

five years I’ve started to apply the same approaches to explore the human body as an ecosystem.”

So far, much of the attention on microbiome research, understandably, has centered on the digestive system and its contribution to conditions like inflammatory bowel disease or the onset of food allergies. But researchers across UChicago are already turning up evidence of the microbiome’s effects in new, unexpected places.

The “second brain”

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e’re neurobiologists, so we know very little if anything about what goes on south of the neck,” Sisodia said. He has studied the molecular and cellular biology of Alzheimer’s disease for the past 20 years, but the study in Scientific Reports covered new ground.

One of the hallmark symptoms of Alzheimer’s disease is the accumulation of amyloid beta (Aß) peptides forming plaques in the brain, a process termed amyloidosis. Excessive amyloidosis plays a central role in the onset of Alzheimer’s, and inflammation of the microglia, brain cells that perform immune system functions in the central nervous system, is believed to influence the rate of cognitive decline from the disease.

“We’re exploring very new territory in how the gut influences brain health. This is an area that people who work with neurodegenerative diseases are going to be increasingly interested in, because it could have an influence down the road on treatments.”

Sangram Sisodia, PhD

Scientists sometime call the gut a “second brain.”

Gastrointestinal distress can trigger mood changes, not just because the physical symptoms, pain or discomfort put you in a bad mood, but because the enteric nervous system, or millions of nerve cells that line the digestive tract, communicates directly with neurotransmitters in the central nervous system and brain. Microbes in the gut can influence this communication through the various chemical signals and byproducts they produce in their everyday activity. These products

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can directly influence brain chemistry, but can also indirectly affect the central nervous system by either charging up or calming down the immune system.

Several recent studies have suggested, at least in mouse models, that the activity and makeup of the gut microbiome can influence neurodegenerative diseases such as multiple sclerosis by limiting inflammation that damages the nervous system. So Sisodia and Minter wanted to see what, if any, effects changing the microbiome could have on symptoms of Alzheimer’s disease.

For the study, they administered high doses of broad-spectrum antibiotics to mice over five to six months. At the end of this period, genetic analysis of gut bacteria from the antibiotic-treated mice showed that while the total mass of microbes present was roughly the same as in controls, the diversity of the community changed dramatically. The antibiotic-treated mice also showed more than a two-fold decrease in Aß plaques compared to controls and a reduction in the number of brain cells that perform immune system functions surrounding the plaques. Levels of important signaling chemicals circulating in the blood were elevated in the treated mice, though, meaning that the immune response may be more effective at clearing the plaques after antibiotic treatment.

So far it’s just a correlation — the study doesn’t prove that the changes in the gut microbiome caused the changes in the brain. But it opens up an exciting line of research that links two seemingly unrelated fields.

“We’re exploring very new territory in how the gut influences brain health,” Sisodia said. “This is an area that people who work with neurodegenerative diseases are going to be increasingly interested in, because it could have an influence down the road on treatments.”

The study is one of the first research projects to benefit, at least informally, from the creation of the Microbiome Center. Sisodia is one of several dozen faculty members associated with the center at its launch. Through initial conversations, he began working with Eugene Chang, MD ’76, the Martin Boyer Professor of Medicine and one of the pioneers of microbiome research at UChicago. Chang’s work focuses on the communication between a host organism and microbes in the digestive tract, particularly on how an imbalance in the natural state of these microbes can lead to digestive diseases. Chang and postdoctoral scholar Vanessa Leone, PhD, worked with Sisodia and Minter to analyze the gut microbiome of the mice before and after antibiotic treatments, continued on page 18

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showing what a game changer it can be to have some of the world’s leading experts in one field, ready to collaborate, right across campus.

“If it wasn’t for Gene and his group, Vanessa particularly, we couldn’t have gotten this thing off the ground,” Sisodia said. “Jack Gilbert and Gene and the others are providing us all kinds of services and technologies to do this stuff, like deep gene sequencing. It’s something we wouldn’t know how to do, and they have all the capacity to do all the computational work for us.”

PHOTO BY NANCY WONG

to organ transplants. Transplantation is a critical, lifesaving procedure — the body needs a new organ to survive — but the immune system does everything it can to reject it as a foreign invader, just as it would a bacterial infection or virus. Even with an organ donated from a close, genetically matched relative, transplant recipients usually have to take medication the rest of their lives to suppress the immune system response and prevent rejection.

Success rates for transplants of skin, lungs and intestines — organs exposed to the outside world — are much lower than for transplants of internal organs such as kidneys and hearts. That’s true in both clinical settings for humans and in laboratory models. One hypothesis to explain this difference is that skin, lungs and intestines are colonized by microbiota whereas sterile internal organs are not.

A better understanding of the role microbes play to prime or suppress the immune response could lead toward new strategies to improve transplant outcomes in humans.

Marisa Alegre, MD, PhD ’93, and her team are studying the role microbiota play in the body’s ability to accept transplanted skin and other organs. In a recent study, the researchers demonstrated that skin grafts in mice treated with antibiotics prior to transplantation survive longer.

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Community matters

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ccess to in-house microbiome expertise and technical facilities at UChicago is helping researchers explore the impact of the microbiome on other unlikely areas. Maria-Luisa Alegre, MD, PhD’93, is a professor in the Department of Medicine who studies how the immune system behaves in response to infections, autoimmune diseases and cancer. Her lab’s main focus now, though, is organ transplantation, specifically the body’s mechanisms that either help tolerate or reject a new organ.

As with autoimmune diseases, the immune system can be the body’s own worst enemy when it comes

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

Earlier this year, Alegre and her team tested this hypothesis with the help of special “germ-free” mice from the Gnotobiotic Mouse Facility. The germ-free facility is a resource within the Animal Resources Center at UChicago, in partnership with the Digestive Disease Research Core Center, directed by Chang and Bana Jabri, MD, PhD, a professor in the Department of Medicine who focuses on celiac disease. Gnotobiotic or germ-free mice are born and raised in a tightly controlled, sterile environment so that they have no bacteria or viruses living on their skin or in their guts.

This makes them excellent models for microbiome research, because scientists can track physiological changes after introducing different strains of bacteria, changing their diet or introducing non-sterile companions.

In a study published in June, Alegre and her team showed that skin grafts between mice treated with antibiotics prior to transplantation survive roughly twice as long as mice that didn’t receive the medications. Grafts between mice raised in a sterile, germ-free environment also survived longer.

Meanwhile, the team found that if germ-free mice were dosed with microbes from conventional, untreated mice, they rejected the skin grafts more

quickly. But if they were dosed with the microbes that survived the antibiotic treatment of conventional mice, they retained the skin grafts similarly to sterile mice. Changing the microbiota also affected the fate of other organ transplants — hearts transplanted into conventional mice pre-treated with antibiotics survived longer as well. This suggests the composition of the microbiota influences the fate of the graft.

“The species that form the community of microbes colonizing the mice — and supposedly humans too — have different effects,” said Alegre. “One community of bacteria from the normal mice is capable of inducing accelerated rejection of a transplant, but another community of bacteria, those that are left after antibiotics, doesn’t have that capacity.”

Genetic analysis of bacteria present on the intestine and skin of the animals that were treated with antibiotics showed that the overall amount of bacteria was the same as in untreated mice, but with significantly fewer distinct species.

“In terms of the total number of bacteria that are present, it’s the same before and after antibiotics. But instead of 1,000 species, let’s say you have just 500 after treatment,” Alegre said. “So it’s not the bacterial load that makes the difference, it’s the composition of the bacterial community.”

One can imagine how studies like this can lead toward more research on ways to recruit the microbiome to improve health. For transplants, Alegre said a better understanding of the role microbes play to prime or suppress the immune response could lead toward new strategies to improve transplant outcomes in humans. One could be the development of more narrow-spectrum antibiotics that target specific bacteria that trigger a rejection response or, conversely, using probiotics with bacteria known to suppress the immune response.

However, as with many studies so far, scientists know the microbiome influences a particular health condition, but the specific species that cause those effects, and just how they do it, remain a mystery.

Alegre warns that altering the balance of microbes in the body can have unintended consequences — as we’re now seeing in the spread of drug-resistant superbugs as a result of widespread, indiscriminate use of antibiotics.

But in some cases, scientists have identified the specific strain of bacteria making a difference, and it’s leading to exciting advances against one of medicine’s oldest enemies. continued on page 21

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“We think there is going to be a way to create what I call molecular diplomacy.”

John Alverdy, MD Sara and Harold Lincoln Thompson Professor of Surgery

PHOTO BY MEGAN E. DOHERTY

Gastrointestinal surgeon John Alverdy, MD, collaborates with scientists from Argonne National Laboratory and the University of Chicago Institute for Molecular Engineering on research aimed at harnessing the body’s microbiome to prevent surgical infections.

John Alverdy, MD, a gastrointestinal surgeon,

has a keen interest in bacteria that can cause dangerous, even deadly, infections after otherwise successful surgeries. In 2015, he and Jack Gilbert, PhD, collaborated on a study that identified a strain of a normal intestinal bacteria, Enterococcus faecalis, that can “go rogue” and undo the surgeon’s handiwork by causing a leak in newly constructed anastomosis, the area in which a segment of intestine has been removed and reconnected. This complication can cause a life-threatening infection.

He is currently working with Matthew Tirrell, PhD, dean and founding Pritzker director of the University of Chicago Institute for Molecular Engineering, to develop polymers that can deliver nutrients to the right place after surgery to keep friendly bacteria happy and well-fed, and stop bad guys like E. faecalis from taking over. It’s the kind of creative, outside-the-box thinking he says comes naturally at UChicago.

“We challenge ourselves here to tackle the most elusive, most complicated problems, because we feel empowered to do so, we feel resourced to do so and we feel encouraged to do so,” he said.

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The ClostraBio team — Project Manager John Colson, PhD, left; Cathryn Nagler, PhD, the Bunning Food Allergy Professor; and Jeffrey Hubbell, PhD, the Barry L. MacLean Professor of Molecular Engineering Innovation and Enterprise — at the Polsky Exchange, the University of Chicago’s co-working space to help faculty, students, staff and alumni launch new ventures.

PHOTO COURTESY OF THE POLSKY CENTER FOR ENTREPRENEURSHIP AND INNOVATION

“The microbiome is the next revolution in science.”

Cathryn Nagler, PhD The Bunning Food Allergy Professor

Food allergy rates have risen by as much as

therapeutics inspired by the microbiome to

50 percent in the past 20 years, with frustratingly

prevent or treat food allergies. In less than one year,

few treatments. Cathryn Nagler, PhD, studies how

ClostraBio has incorporated, received $800,000 in

the commensal microbiota, the bugs that usually

funding, and hired its first employee — John Colson,

live happily inside us, regulate allergic responses

PhD, formerly a postdoctoral fellow at the Institute

to food. In 2014, she and her team found that

for Molecular Engineering. ClostraBio is currently

the presence of Clostridia, a common class of

participating in the Polsky Center’s Innovation Corps

gut bacteria, protects against food allergies by

program, where Nagler and Colson are receiving

minimizing the immune system’s exposure to

entrepreneurship education and training to

allergens. In 2015, the researchers identified

evaluate market opportunities for the business. This

differences in the gut bacteria of infants who had

experience will help them further refine ClostraBio’s

cow’s milk allergies when compared to healthy,

business strategy as the company continues to get

age-matched controls.

ready for pre-clinical trials.

With this discovery, Nagler received a technology

This research was supported by the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH) under Award Number 4 UL1 TR 000430 through the University of Chicago Institute for Translational Medicine (ITM).

20

For Nagler, a research scientist for more than 30

pilot award from the Institute for Translational

years, starting a company was not originally part of

Medicine. When a new pre-clinical model of food

her career plans. “I’m passionate about my research

allergy was established, she and bioengineer

and now I am excited to see how my research can

Jeffrey Hubbell, PhD, received guidance from the

make a greater impact in the world,” she said.

Polsky Center for Entrepreneurship and Innovation

“Being able to form this company with the support

at the University of Chicago to start a company

of all of these different parts of the University is

called ClostraBio. ClostraBio is developing

pretty amazing.”

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

PHOTO BY NANCY WONG

An unexpected ally

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n March 2016, President Jimmy Carter announced that his cancer was in remission, just four months after learning that he had metastatic melanoma that had spread to his liver and brain. His doctors said that his remarkable recovery was largely due to a new type of treatment that recruits the immune system to fight tumors.

This may be the first time many Americans had heard of immunotherapy for cancer, but by that time it had already become one of the most exciting developments in cancer research. It uses drugs called “checkpoint inhibitors� to make slight tweaks to the way the immune system works so it will attack cancerous tumor cells the same way it would a virus.

Such drugs have had a dramatic impact on treatment of several tumor types, including melanoma, lung cancer, head and neck cancers and others. But only a minority of patients — one-third or less — have a vigorous response. Cancer researchers have wondered why so few benefit.

“Our results clearly demonstrate a significant, although unexpected, role for specific gut bacteria in enhancing the immune system’s response to melanoma and possibly many other tumor types.�

Thomas Gajewski, AB ’84, PhD ’89, MD ’91

Thomas Gajewski, AB’84, PhD’89, MD’91, a professor of pathology and medicine at UChicago, saw a similar pattern in the mice he and his colleagues used for research. They noticed that mice purchased from Jackson Laboratory (JAX) tended to have a robust spontaneous immune response to small melanoma tumors implanted under their skin. Mice from another lab, Taconic Biosciences (TAC), showed only a weak immune response.

But when they put the mice from both sources in cages together for three weeks, the differences in tumor growth disappeared. This made them suspect that by sharing exposure to various types of bacteria, the TAC mice had acquired microbes from JAX mice that somehow enhanced their immunity to tumors.

They confirmed their suspicion by collecting fecal matter from JAX mice and transferring it into the uchospitals.edu/midway

stomachs of TAC mice. It worked. Treated TAC mice were then able to mount a strong immune response and delay tumor growth. The reverse process, transferring fecal bacteria from TAC to JAX mice had no effect.

Next, they combined bacterial transfer with a checkpoint inhibitor antibody. They found that introducing the bacteria alone had comparable efficacy to the checkpoint inhibitor antibody, but that the combination dramatically improved tumor control.

Gajewski and his team published their findings in Science in November 2015, one of the first studies to show how differences in the gut microbiome could impact the effectiveness of a cancer treatment. “Our results clearly demonstrate a significant, although unexpected, role for specific gut bacteria in enhancing the immune system’s response to melanoma and possibly many other tumor types,� Gajewski said at the time. He used the word “specific� because when they looked deeper, it was actually a handful of bacteria that made a difference.

They identified microbes from the digestive tracts of JAX and TAC mice by large-scale genetic sequencing. Although there were significant differences in hundreds of families of bacteria from the two sets of mice, three groups were prominent.

When they tested the effects of each group on the mice’s immune systems, one group, the Bifidobacterium, stood out. Within two weeks of oral administration, TAC mice that received just Bifidobacterium species, rather than the full fecal transfer, had a marked increase in the anti-tumor

Thomas Gajewski, AB ’84, PhD ’89, MD ’91, talks with a patient. Gajewski and his team produced one of the first studies to show how differences in the gut microbiome could impact the effectiveness of cancer treatment.

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“ Microbiome research can change the way we practice

T cell responses. These mice displayed tumor control comparable to those who received the full mixture. The effect was long-lasting. TAC mice exposed to tumors as late as six weeks after the Bifidobacterium transfer were still able to mount a robust immune response.

In essence, Gajewski and his team had discovered a way to improve an already promising treatment by recruiting an unexpected ally into the fight.

“The field has recently recognized close connections between the gut microbiome and the immune system,” Gajewski said. “This finding provides a novel way to exploit that connection, to improve immunotherapy by selectively modulating intestinal bacteria.”

One role of the Microbiome Center is to help scientists quickly translate their findings to private and clinical sectors. Gajewski serves as a model for how to translate early-stage research. He worked closely with the Technology Commercialization and Licensing group (formerly UChicagoTech) at the Polsky Center for Entrepreneurship and Innovation to develop his intellectual property and execute a license with Evelo Biosciences, which will work with him to further develop microbiome-based cancer immunotherapy approaches toward patient benefit.

medicine, improve

An ecosystem of research

our productivity

T

and even restore the health of damaged ecosystems.”

Jack Gilbert, PhD

o microbiologists, the idea that there is a vast world of microbes out there, living in just about any nook and cranny you can think of, isn’t all that earth-shattering.

“If there is a carbon source out there, there is an organism that’s going to figure out a way to make a

living off it,” said Dionysios Antonopoulos, PhD, a microbial systems biologist at Argonne and assistant professor of medicine at UChicago. He started his career studying the microbiology of ruminant digestive systems — i.e., cow guts — and has since moved on to studying the broader ecosystems these microbes inhabit and the give and take with resources that makes those communities stable.

To him, the interesting leap is when scientists start to take what they’ve learned about those other systems, from cow guts to waterways to man-made buildings, and apply it to human health.

“We’re not really in complete control of our bodies; these millions and millions of other entities are influencing the way our bodies function,” he said. “It’s that sort of work that’s sort of captured the imagination.”

For Gilbert, the secret to maintaining that momentum lies in breaking down barriers between different disciplines to create an ecosystem of shared research, so that a postdoc studying Alzheimer’s disease — such as Minter — may find himself learning sampling techniques from a marine biologist.

“We want to be able to break down boundaries between disciplines and institutions so that they are essentially nonexistent,” Gilbert said. “Yes, individual institutes have their own research agendas. But when people talk about the Microbiome Center, they won’t say the Microbiome Center at UChicago or the Microbiome Center at Argonne. They will just say the Microbiome Center.”

John Easton and Stephen Phillips contributed to this story.

2

Faculty director of the Microbiome Center, a joint effort by the University of Chicago, the Marine Biological Laboratory and Argonne National Laboratory

PHOTO BY NANCY WONG

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

I M M U N O LO G Y

Amish farm life protects children from asthma

In Amish farming communities, barns are close to homes and children run in and out all day.

PHOTO BY CAROLE OBER, PHD

“You can’t put a cow in every family’s house, but we may be able to protect children from asthma by finding a way to recreate the time-tested Amish experience.”

Carole Ober, PhD Chair of the Department of Human Genetics

communities — the Amish of Indiana and the Hutterites of South Dakota — a team of researchers found that specific aspects of the Amish environment are associated with changes to immune cells that appear to protect children from developing asthma.

Substances in the house dust from Amish, but not Hutterite, homes were able to engage and shape the innate immune system in young Amish children in ways that may suppress pathologic responses leading to allergic asthma, the researchers showed. The study was published in August in the New England Journal of Medicine.

“It shows that the source of protection is not simply farming and has narrowed in on what the specific protection might be,” said study co-author Carole Ober, PhD, Blum-Riese Professor in the Departments of Human Genetics and Obstetrics and Gynecology, and chair of the Department of Human Genetics at the University of Chicago.

The Amish and Hutterite farming communities in the U.S. provide textbook opportunities for comparative studies. The two groups have similar genetic ancestry. They share similar lifestyles and customs, including a Germanic farming diet. They have large families, get childhood vaccinations, breastfeed their children, drink raw milk and don’t allow indoor pets.

The communities, however, are distinct in two important ways. Although both groups depend on agriculture, their farming practices differ. The Amish have retained traditional methods, living on single-family dairy farms and relying on horses for fieldwork and transportation. In contrast, the Hutterites live on large communal farms and use modern, industrialized farm machinery. This

distances young Hutterite children from the constant daily exposure to farm animals.

The other striking difference is what Ober calls a “whopping disparity in asthma.” About 5 percent of Amish schoolchildren aged 6 to 14 have asthma.

This is about half the U.S. average (10.3 percent) for children aged 5 to 14, and one-fourth of the prevalence (21.3 percent) among Hutterite children.

To understand this disparity, the researchers studied 30 Amish children 7 to 14 years old and 30 age-matched Hutterite children. They scrutinized the children’s genetic profiles, which confirmed the remarkable similarities between Amish and Hutterite children.

They compared the types of immune cells in the children’s blood, collected airborne dust from Amish and Hutterite homes and measured the microbial load in homes in both communities.

“The Amish had more and younger neutrophils and fewer eosinophils,” said study co-author, immunologist Anne Sperling, PhD, associate professor of medicine at UChicago.

Gene expression profiles in blood cells also revealed enhanced activation of key innate immunity genes in Amish children.

Dust collected from Amish homes was “much richer in microbial products,” the authors note, than dust from Hutterite homes.

“Neither the Amish nor the Hutterites have dirty homes,” Ober explained. “The Amish barns, however, are much closer to their homes. Their children run in and out of them, often barefoot, all day long. There’s no obvious dirt in the Amish homes, no lapse of cleanliness. It’s just in the air, and in the dust.”

To better understand how asthma protection was achieved, the researchers used animal models that lack MyD88 and Trif, genes crucial for innate immune responses. In these models, the protective effect of the Amish dust was completely lost.

The researchers hope their findings will allow the identification of relevant substances that will lead to novel strategies to prevent asthma and allergy.

BSD News

By probing the differences between two farming

— John Easton

uchospitals.edu/midway

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BSD News

M A R I N E B I O LO G I C A L L A B O R AT O R Y

Biology meets big data at the MBL

BY STEVEN ASHLEY

T Boot camp introduces BSD graduate students to quantitative approaches — and each other

PHOTO BY DANIEL COJANU

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oday’s biologists must have the computational, statistical and analytical skills to handle large data sets. Incoming BSD graduate students got a jumpstart on the future of the field at a one-week boot camp at the Marine Biological Laboratory in Woods Hole, Massachusetts.

The 98 students who participated in the second annual Quantitative Approaches in Biological Research (qBIO) in September also learned about research and education opportunities at the MBL, an affiliate of the University of Chicago.

“Even though some biologists still hope to avoid doing much math, statistics and programming in their careers, these quantitative methods are now unavoidable in biology,” said Stephanie Palmer, PhD, assistant prof e s s or of organismal biology and anatomy, and co-director of the course. “The qBIO boot camp gives our graduate students experience with the analytic approaches and their applications as they’re used in biology today.”

Added co-director Stefano Allesina, PhD, professor of ecology and evolution: “It also allows them to meet others in different areas of biology right from the start, before they get siloed into their own specialties.”

In workshops during the retreat, students learned quantitative skills by manipulating real-world experimental data sets derived

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

PHOTO BY MEGAN COSTELLO FOR THE MARINE BIOLOGICAL LABORATORY

“There’s a lot of tradition in biology, where observation and qualitative approaches are customary. As a result, biology has been the last of the fundamental sciences to fully modernize.

We’re trying to exploit students’ familiarity with digital technology, data and programming and to build on that knowledge.”

Michael Rust, PhD, assistant professor of molecular genetics and cell biology

from neuroscience, disease and cancer research, and other areas of biology. “In these intensive workshops, students are likely to learn something new that will aid them in the future,” said Michael Rust, PhD, assistant professor of molecular genetics and cell biology. “And the fact that they’re learning it together will help them to connect to each other to better tackle interdisciplinary issues.”

Eric Gauchat, a graduate student in biophysical sciences, participated in the workshop “Unraveling Dynamics from Time Series,” led by Sarah Cobey, PhD, assistant professor of ecology and evolution.

“Dr. Cobey brought in an epidemiological data set that tracked measles cases over more than 100 years — through various

The 3-year-old affiliation between UChicago and the MBL is opening the door to new collaborations and generating useful new synergies for both institutions, faculty members say. For the qBIO boot camp, UChicago faculty members conceptualized and led the classes, while the MBL supplied its top-notch facilities and equipment. In the process, the course exposes incoming UChicago students to the invigorating scientific environment at the MBL, while simultaneously giving MBL researchers opportunities to recruit students from this talented pool to their own research projects — a happy outcome that has already occurred a few times.

For Eric Gauchat, a highlight was a visit to the MBLWHOI Library in the iconic

uchospitals.edu/midway

PHOTO COURTESY OF BROOKE WEIGEL

The MBL's David Remsen discusses the history of the Gemma collecting boat, below left. First-year graduate students, from left, Dave Klawon, Hannah Whitehurst, Brooke Weigel, Gayani Senevirathne, Can Dong and Jimmy Lee aboard the vessel. Boot camp participants Jennie Ayling, left, Evan Kiefl, Ryan Fuller and Alexandra Cabanov, bottom.

PHOTO BY MEGAN COSTELLO FOR THE MARINE BIOLOGICAL LABORATORY

epidemics, the onset of other diseases etc.,” he said. “We started out with a simple model, then altered various factors and added more complexity, all the time monitoring the results. We learned how to infer valid conclusions from the models, what makes them good or bad, how to be appropriately skeptical of models. The best thing was to do it, see the result and then try to understand what it means.”

Immersion into topics in a retreat-type atmosphere is an MBL tradition for which the lab is well-known. “We’ve found that this intensive hands-on learning, combined with more traditional lectures, is highly effective,” said Rae Nishi, PhD, Burroughs Wellcome Fund Director of Education at the MBL. “And bringing students out to the MBL means that they are effectively isolated from other distractions that might exist at their home institution. For example, at UChicago, the students would have courses, labs, friends, outside faculty, and entertainment in the big city to divert them from their study goals.”

Lillie Building. The library, run jointly with the nearby Woods Hole Oceanographic Institution, houses one of the world’s foremost print and electronic literature collections in the biological, biomedical, ecological and oceanographic sciences.

“Probably the most inspiring experience, at least to those who went, was the library tour,” Gauchat said. “Holding Thomas Hunt Morgan’s Nobel Prize medal was absolutely awesome. It had all of us there thinking: ‘Maybe we can also get there someday.’”

“To be successful as a biologist today, you have to be able to do your own data analysis, your own modeling, as well as the math and computer programming that you need.”

Eric Gauchat, BSD graduate student

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Suiting up BSD News

A look inside the world of doing research in a biocontainment facility

BY KRISTY HENTCHEL

PHOTO BY JULIEN HERROU, PHD

P

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ostdoctoral researcher Jonathan Willett, PhD, go into an anteroom where they change into full designs every experiment on the human and body Tyvek suits and put on their personal proteccow pathogen Brucella abortus in exact detail. tion equipment (PPE): a high-efficiency particulate “Working in containment makes you think about (HEPA) filtered respirator, gloves, special shoes, shoe covers and an additional outer layer of protective and meticulously plan out your day,” he said.

Research done in biocontainment facilities across clothing. the country requires additional safety oversight and “We all are glad we have our own respirators and regulatory guidelines from the Centers for Disease PPE because after wearing them for hours on end, Control and Prevention (CDC), the U.S. government they can develop a specific funk that I wouldn’t and the academic institution or national lab where wish on anybody,” said Willett, a member of the the work is performed. Willett and his colleagues Crosson lab in the Department of Biochemistry and conduct their Brucella research in the Howard T. Molecular Biology.

Ricketts Regional Biocontainment Laboratory at Argonne National Laboratory. The Ricketts Lab is “Investigators working in the University of Chicago’s biocontainment facility biocontainment have a high degree for conducting biodefense-related and emerging of respect for their bug, infectious disease research.

Before scientists can begin working in a contain- their research and for each other.” ment facility, they are fingerprinted and undergo a Kanabrocki, PhD, associate vice president for background check. After this clearance stage, they Joseph research safety go through hours of classroom instruction to pass Because of the cost and time incurred each time written exams, followed by hands-on training by a they go into the lab, the scientists try to do everything certified biological safety professional. in one entry. “You’ve got to develop a pretty good control of your bladder,” Willett said. “A real rookie mistake is finishing a big cup of coffee right before you enter for several hours. You don’t want to have to exit after 20 minutes to go to the bathroom.”

Before leaving the containment lab, scientists spray themselves down with a special disinfectant and then repeat the steps in reverse.

“In containment, we pretty much assume everything is coated with the infectious Brucella,” said Willett, “so we are insanely careful to make sure that everything is disinfected routinely.”

Jonathan Willett, PhD, examines growth of Brucella, a Willett says that while there is risk related to human and cow pathogen, on plates while working in working on a pathogen like Brucella, it is actually containment. quite safe. Kanabrocki agrees. “With appropriate “It is critical that our investigators be fully pre- education, equipment, training and experience, risks pared to work in this hazardous environment,” said associated with high biocontainment research can Joseph Kanabrocki, PhD, associate vice president be effectively mitigated,” Kanabrocki said. for research safety. “In addition to science-based Writer Kristy Hentchel, PhD, a postdoctoral scholar in knowledge about the host and its interaction with biochemistry and molecular biology, is a science the pathogen in question, it is important that each communications intern through myCHOICE, a BSD program that helps broaden experiences in scientific scientist be technically competent.”

The process of entering or exiting containment training at the University of Chicago. typically takes around 15 minutes. First, researchers Read more at sciencelife.uchospitals.edu.

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

PHOTOS BY JONATHAN WILLETT, PHD

Entry into containment requires special safety gear, including layers of protective clothing and a respirator. While working in containment, researchers continuously spray themselves and the work area down with disinfectant.

O R G A N I S M A L B I O L O G Y A N D A N AT O M Y

How fish fins became fingers

O

ne of the great transformations required for the descendants of fish to become creatures that could walk on land was the replacement of long, elegant fin rays by fingers and toes. In research published in Nature in August, scientists from the University of Chicago showed that the same cells that make fin rays in fish play a central role in forming the fingers and toes of four-legged creatures.

PHOTO COURTESY OF THE SHUBIN LAB

Markers of the wrists and digits in the limb of a mouse, left, are present in fish and demarcate the fin rays, right. The wrist and digits of tetrapods are the cellular and genetic equivalents of the fin rays of fish.

After three years of painstaking experiments using novel gene-editing techniques and sensitive fate mapping to label and track developing cells in fish, the researchers describe how the small flexible bones found at the ends of fins are related to fingers and toes, which are more suitable for life on land.

“When I first saw these results you could have knocked me over with a feather,” said the study’s

Postdoctoral researcher Cara Froyd (UChicago), left, graduate student Dana Gilmore (UChicago), postdoctoral researcher Yasaman Ghadar (Argonne) and graduate student Chris Quintanilla (UChicago) at the NIH.

PHOTO BY H. DARR BEISER FOR MYCHOICE

uchospitals.edu/midway

senior author, Neil Shubin, PhD, the Robert R. Bensley Distinguished Service Professor in the Department of Organismal Biology and Anatomy. Shubin is an authority on the transition from fins to limbs.

“For years,” he said, “scientists have thought that fin rays were completely unrelated to fingers and toes, utterly dissimilar because one kind of bone is initially formed out of cartilage and the other is formed in simple connective tissue. Our results change that whole idea.”

To unravel how fins might have transformed into wrists and fingers, the researchers worked mostly with a standard fish model: the zebrafish.

Tetsuya Nakamura, PhD, a postdoctoral scholar in Shubin’s lab, used a gene-editing technique, CRISPR/ Cas, in zebrafish to delete important genes linked to limb building and then selectively bred zebrafish with multiple targeted deletions. He spent more than two years building and crossbreeding the fish mutants, a project that began at the Marine Biological Laboratory in Woods Hole, Massachusetts, an affiliate of the University of Chicago.

At the same time, Andrew Gehrke, PhD, formerly a graduate student in Shubin’s lab, refined cell-labeling techniques to map when and where specific embryonic cells migrated as the animals grew and developed. “It was one of those eureka moments,” Gehrke said. “We found that the cells that mark the wrists and fingers of mice and people were exclusively in the fin rays of fish.”

— John Easton

G R A D U AT E E D U C AT I O N

C A N C E R B I O LO G Y

Learning about science policy

Student awarded bridge grant

University of Chicago graduate students and

Payal Tiwari, a fourth-year Committee on Cancer Biology student, was awarded a new and prestigious NIH National Cancer Institute F99/K00 Predoctoral to Postdoctoral Fellow Transition Award. The award identifies and encourages graduate students to commit to pursuing careers as independent cancer researchers.

Tiwari is investigating the link between obesity and triple negative breast Payal Tiwari cancer.

postdoctoral researchers met with leading scientific policy agencies in Washington, D.C., as part of career development programming orchestrated by myCHOICE and UChicagoGRAD. Participants met with governmental agencies, nonprofits and scientific societies as well as PhDs from diverse scientific backgrounds who shared their stories of moving from research to science policy.

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Pritzker News

A look back John Benfield, MD’55, reminisces about his life and 61 years in medicine

PHOTO BY JOE STERBENC

John R. Benfield, MD ’55, returns to campus each year for the John and Joyce Benfield Lecture, presented by the Section of Cardiac and Thoracic Surgery. The 12th annual lecture was held in September.

John R. Benfield is professor of surgery emeritus in the David Geffen School of Medicine at the University of California, Los Angeles, where he still teaches. During his six-decade career in academic surgery, Benfield served as director of the American Board of Thoracic Surgery and president of five organizations, including the Society of Thoracic Surgeons and the Thoracic Surgery Foundation for Research and Education.

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

J

ohn Benfield arrived at the courtyard in front of Snell-Hitchcock Halls in a dusty 1949 Chevrolet, tired after the long drive from New York City. Jack Robertson, from Oklahoma, pulled up around the same time in a pickup truck.

The classmates came from very different backgrounds but shared the same excitement about the University of Chicago. It was the beginning of a lifelong friendship, one of many in the Class of 1955.

The next four years would bring an academic experience at once “wrenching, incessant and rewarding,” Benfield recalled.

His courses were taught by leading professors, including physiology professor John Forbes Perkins, Jr., MD, who guided Benfield to the thoracic surgery research laboratory that inspired his choice of specialty.

HISTORICAL PHOTOS COURTESY OF THE SPECIAL COLLECTIONS RESOURCE CENTER, UNIVERSITY OF CHICAGO LIBRARY

For recreation, Benfield and his medical school buddies played tennis and dated the Kahler School of Nursing students from Rochester, Minnesota, who lived in Hitchcock Hall. Occasionally they could afford the Great Lakes perch special that cost 85 cents at the Tropical Hut on 57th Street.

Benfield has written his memoirs, entitled Vienna Roots — Refuge and Adaptation.

Writer Ruth E. Kott compiled the following highlights: First medical role model When other boys were dreaming of becoming superstar athletes, firemen, police officers or soldiers, I dreamed of becoming a doctor. My father — an ophthalmologist in Vienna — was my role model.

I had completed most of first grade in March 1938 when Hitler annexed Austria.

My parents courageously fled the country immediately because we were Jewish, and we headed for New York. It had been 14 years since my father had graduated from the uchospitals.edu/midway

University of Vienna. He knew little English, but he passed the New York State medical licensing examination in April 1939, nine months after our arrival. His drive and his ability to learn inspired me.

In 2011, I returned to Vienna to swim in the 13th European Maccabi Games (Jewish Olympics) on the U.S. team to honor the memory of my parents. I had reclaimed my Austrian citizenship to be able to vote, but I declined an invitation to swim on the Austrian team, noting that I am alive because I am an American.

The plasticity of the viscera?

During my first day of gross anatomy, Professor Isidore Gersh, PhD’32, who had originated the frozen section method for studying tissues, asked me to explain “the plasticity of the viscera.”

I knew neither what he meant by plasticity nor the word viscera. The cadaver we were starting to dissect was preserved in formaldehyde, and there was nothing plastic — pliable — about it. Gersh wanted me to know that living humans’ parts were very different from those of a cadaver.

My basic science professors were truly outstanding. Konrad Bloch, PhD, was awarded a Nobel Prize. William Bloom, MD, was co-author of the definitive histology text of its day. And we had direct contact with all of them.

‘Call me Joe’ The dean of students, Joseph Ceithaml, SB ’37, PhD’41, welcomed us to medical school. It was his first year in what would become a long tenure in the dean’s office. Timing had required Ceithaml and F. Howell Wright, MD, professor of pediatrics, to choose the students for the Class of 1955 without the benefit of the usual admissions committee, and so Ceithaml felt a special sense of responsibility about our class. He spoke of this on several occasions in years to come, including our 55th class reunion, during which he asked me to call him Joe. He stood tall and straight, and he had a crew cut, and we found him intimidating because he tolerated no nonsense. In reality

A C L A S S G I V E S B AC K

The Class of 1955 Endowed Scholarship A gift from Richard Katzman, MD ’55, initiated the scholarship that now totals more than $192,000, thanks to generous gifts from members of the Class of 1955 and their families. The Legacy Challenge provided a match for gifts of $25,000 or more.

Louis Cohen, SB ’48, MD ’53, painted this watercolor of Joseph Ceithaml, dean of students.

Many students found Ceithaml intimidating at first, but came to see him as a friend and advocate.

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T O G E T H E R AG A I N

In June 2010, members of the Class of 1955 and their families celebrated their 55th reunion on classmate Herb Greenlee’s McEachran Homestead in Caledonia, Illinois.

Snell-Hitchcock alumni: Richard Katzman, MD ’55, left, Herbert Greenlee, MD ’55, Ronald Wemple, MD ’55, and John Benfield, MD ’55.

60th Diamond Jubilee Twelve of the 72 members of the Class of 1955 attended their 60th reunion in 2015. The classmates reminisced about their medical school days and honored those classmates who had died. Lou Cohen, SB ’48, MD ’53, and a friend of Dean Joseph Ceithaml, joined the group for breakfast at the Quadrangle Club.

“The evening was a bit of an adventure. We tried Jimmy’s Woodlawn Tap but it was too loud for us, and so the evening ended at the Erie Café, where we had concluded our 55th reunion,” Benfield wrote.

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he was deeply and genuinely our friend and an advocate for each of us. For example, when he found out that my classmate Lloyd Brandborg, MD’55, had driven a beer truck to support his family during our first off quarter, Ceithaml concluded that driving a beer truck was not appropriate for a University of Chicago medical student. He called Lloyd in and told him that he had found him a position as a technician in Cy Rubin’s pioneering G.I. cytopathology laboratory. Lloyd later became an acclaimed leader in gastroenterology with special knowledge in cytopathology.

From research to practice Every first-year medical student worked full time in a research laboratory during the final quarter.

For a number of us, including me, that was the entrée to a career in academic medicine. I worked in the lab of William Elias Adams, MD, a pioneering thoracic surgeon and head of thoracic surgery. I studied oxygen concentration in patients’

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

blood during operations using an oximeter.

It was a brand-new instrument, and Perkins and Adams had the only ones except for Earl Wood, the inventor at the Mayo Clinic.

I was fortunate to use the oximeter in the operating room to study Adams’ patients. I was hooked!

Later, while I was a resident in surgery, we affectionately called Adams “Uncle Willie.”

He guided me in studying how chronically collapsed lungs function when they are reinflated. We created an animal model in which we collapsed one normal lung by occluding its bronchus for periods of time, ranging from a few weeks to 5 years. Then we operated to remove the blockage that had caused the collapse and measured the function of the reinflated lung. Almost 40 years later, I applied this research when I cared for Bobby Hurley, a superstar professional basketball player who is now the head coach of the Arizona State University basketball team. His left lung was collapsed because it had been torn from his windpipe in a 1993 car accident. We reconnected his lung to his windpipe. Hurley returned to the NBA for the 1994-95 season and played four more years. When a newspaper reporter asked about his health, he said, “My lung is not my problem.”

The rewards of teaching Nothing has approached the extraordinary privilege of teaching young people to become good doctors. I am humbled by the success of the students and residents I have mentored.

About six years ago, I received an email from Michael Sinclair, MD, one of my former residents, who had become a cardiac surgeon and who wrote: “It was you who taught me how to be a surgeon. I hope I carried with me some of the integrity, professionalism and intellectual honesty that I learned — sometimes with difficulty.” Sinclair is now on his 15th mission for Doctors Without Borders. He is serving with distinction as a faculty member in Rwanda’s leading medical school. His alma mater, the University of California, San Francisco School of Medicine recently named him as its 2016 alumnus of the year. Nothing has rewarded me more than the success of those whom I have had the privilege of teaching.

Interactive anatomy

I

t’s the first day of the third module — the abdomen — and there’s only one Netter’s and one Gray’s open in the gross anatomy lab.

“I looked at them to prepare for today’s class,” lab manager Richard Madden, PhD, says with a laugh.

“I use the textbooks. The students don’t.”

Instead of referencing the venerable manuals used for generations, members of the Pritzker Class of 2020 can quickly access a customized dissector, an atlas of anatomy, lectures, histology slides and medical imaging, all on wall-mounted screens and tablets.

“Today’s students search the universe for anything to help them learn,” Madden said. “And what’s remarkable is how fully engaged they still are.”

Course director Callum Ross, PhD, led a recent $500,000 gross anatomy lab renovation project, which included computer system upgrades and the installation of two flat-screen monitors and two iPads at each of the 24 dissection stations in the lab’s four bays. Initially, Ross had concerns about adding new technology to his hands-on class.

“I was worried the students wouldn’t be looking at the cadavers,” he said. “But they are. There’s plenty to do around the cadaver. We’re offering lots of ways

for the students to learn the way they want to learn.

Gross anatomy is now a more interactive, exciting and fun place to be.”

Ross has never been one to control all that goes on in his gross anatomy lab. In his 10 years of running the course at Pritzker, he has always let the student teams self-organize.

“We create the environment,” he said. “Then we put really smart students, peer educators and postdocs in the lab and watch what they do. We nudge them a bit, help them and answer questions.”

Throughout this year’s 10-week course, Ross and Madden will observe the MS1s as they navigate, and guide the future use of, the lab’s new technology.

Ross has seen students take photos and movies, label them and then share with each other. “They are interacting in ways they are used to and are comfortable with,” he said.

Peer educator Yuan Liu, MS4, agrees. “It’s all so familiar to this generation,” said Liu, who also assisted with the course in her second year, before the new computer systems were added. “If this year’s students have questions about a vessel or a nerve, they can search online and get answers immediately. It’s great.”

Pritzker News

BY GRETCHEN RUBIN

continued on page 32

Postdoctoral fellow Michael Granatosky, PhD, gives medical students a lesson in radiological imaging and anatomy in the updated gross anatomy lab at the Pritzker School of Medicine.

PHOTO BY JOEL WINTERMANTLE

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“ We’re offering lots of ways for the students to learn the way they want to learn. Gross anatomy is now a more interactive, exciting and fun place to be.”

Callum Ross, PhD

When researching what improvements to make to the lab, Ross consulted with other medical schools around the country as well as with physicians at the University of Chicago Medicine.

“Our clinicians recommended the integration of medical imaging at the stations so that students would see scans in real time, while they are looking at the organ or structure,” Ross said.

Amber Pincavage, MD ’07, co-director of the medicine clerkship, thinks it’s a great correlation.

“Unless you’re a surgeon, most of us do not look inside the body in our practice,” she said. “We use imaging.”

PHOTOS BY JOEL WINTERMANTLE

Course director Callum Ross, PhD

First-year students Natalia Khosla, left, and Sabrina Lichon study an image on an iPad. Tablets enable students to zoom in on the same image shown on flat-screen monitors overhead.

Memories of gross anatomy Pritzker students and alumni share some of their gross anatomy remembrances with Medicine on the Midway.

MANAS NIGAM, MD ’15 Resident, Georgetown University Hospital I remember, on day one in the first hour, the

The Joseph B. Kirsner Professor of Medicine, University of Chicago

first cut to assess the muscles of the back. I

Eric Lombard was famous for using different

didn’t expect it to happen so soon. But then our

colored chalk to draw the different layers of

teams were there, intrigued yet curious, as we

embryonic development. All of the students

evaluated the swimmer’s, or latissimus, muscle

would pick up multi-colored click pens to

that very morning. I’ll never forget it, because

take notes. We would hear the entire room of

that’s been my experience since the beginning

students “click” to a different color each time

of medical school: constantly surprised, but

he picked up another piece of chalk!

acquiring new tools quickly to meet the unknown head on.

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DAVID T. RUBIN, MD ’94

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

Among other improvements to the lab were the addition of surgical lights over each table and new dissecting microscopes. Chalkboards and small whiteboards were replaced with stretches of lab walls covered in whiteboard paint.

For today’s class, an MS2 peer educator has drawn a typical body segment on one of the walls.

The large multi-colored illustration will remain there for reference for the duration of the module.

Even so, just as class ends, several students walk up to the board with a phone or an iPad and snap a picture.

National Geographic visited the Pritzker School of Medicine gross anatomy lab for its story, “The Secret Life of Cadavers.” Read the story and see photos on nationalgeographic.com.

COURSE

The Human B

ody

90 students 1 course direct or 1 lecturer/man ager 6 faculty gues t lecturers 3 postdocs 16 peer educat ors (MS2s an d MS4s) 52 iPads 52 flat-screen monitors 2 textbooks

Gross anatomy lab manager and lecturer, Richard Madden, PhD, quickly accesses text and images using new technology in the lab.

AMBER PINCAVAGE, MD ’07 Co-director, Medicine Clerkship, Pritzker School of Medicine

MATT PRESENT, MS2 Pritzker School of Medicine The abiding lesson of anatomy was the great

Putting on our scrubs for the lab became an

gift our donors enabled. Anatomy was the

important ritual for us. After spending hours

best first course in medical school because it

sitting quietly in a lecture hall, we could

accelerated the process of feeling conflicted.

socialize and have some fun in the locker room.

We became better prepared to deal with the

It was a time of transition before we walked

stew of emotions that medicine engenders

into the lab, quiet and focused. Anatomy lab

because our donors thought about what lasted

really bonded the class. It was an emotional

beyond them and decided a future they’d

and poignant experience. It was an important

never see still mattered.

part of becoming a doctor before seeing our first real patient.

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Pritzker News

REUNION WEEKEND 2016

Back to school

Alumni of the Pritzker School of Medicine were welcomed PHOTOS BY ROB HART AND JEAN LACHAT

back to Hyde Park last spring to catch up with classmates, engage with faculty and students, and explore the campus during Reunion Weekend 2016.

Steven Bhutra, MD ’16, center, and Adam Weiner, MD ’16, talk with David Whitney, MBA ’78, MD ’80, left, at the Legacy Challenge Leadership Brunch.

t, Kenneth rshall Urist, MD, lef Class of 1971 are Ma the m , and Gordon fro MD ts u, or W sp e Smile! Left: Good Trace, MD, Georg ter Pe , MD , an and rm omas Kloste ckwell, MD ’11, left, Begelman, MD, Th 2011 are Brandy Bla of ss Cla the ing le: Repp Lin, MD ’91.

Telford, MD. Midd MD ’92, left, and Jim ’11. Right: James Li, MD ll, we Do ine Jasm

Samuel Volchenboum, MD, PhD, MS, director of the Center for Research Informatics at the University of Chicago, left, talks with Miles Ellenby, MD ’91, center, and other attendees after Volchenboum’s presentation, “Could Critical Illness Be Contagious?”

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

Alumni and their families learn about old and new architecture during a guided tour of the campus. Left: John Kurnick, MD ’66, and Laura Kurnick, left, and Robert Gillespie, MD ’86, and Lisa Gillespie aboard the trolley. Below, middle: Juliann Williams, MD ’91, greets a classmate. Bottom: William Leong, MD ’61, leaves the Donnelley Biological Sciences Learning Center.

Robert Keller, MD’66, right, and fellow alumni tour the Pritzker School of Medicine’s Clinical Performance Center to learn how today’s medical students practice their clinical skills in an environment that combines encounters with both standardized and simulated patients.

Freeze frame Fun in the Reunion photo booth

Left: MBSAA staffe rs get in the Reun ion spirit. Middle: his partner, KK An Edward Kolner, MD derson. Right: Jo ’56, and se ph Cooper, MD ’06 their family celeb , Pilar Ortega, MD rate Reunion. ’06, and

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Pritzker News

Honoring alumni for outstanding achievements and service The Medical and Biological Sciences

Alumni Association’s (MBSAA) tradition of honoring outstanding achievement and service began in 1951. This year’s recipients join a notable group of 139 faculty honorees of the Gold Key Award and 286 alumni honorees of the Distinguished Service Award.

Gold Key Award

PHOTO BY ROBERT KOZLOFF

Jesse Russell Hall, MD ’77 Professor Emeritus of Medicine University of Chicago Christopher J. Rhodes, PhD Kovler Family Professor Emeritus of Medicine Endocrinology, Diabetes and Metabolism University of Chicago

2016 award winners join alumni leaders and deans at the Alumni Awards reception on June 4. Front row, from left, Ernest Mhoon, MD ’73, chair of the Alumni Awards Committee; William A. McDade, PhD ’88, MD ’90; Eve Van Cauter, PhD; and Oluwaseun “Seun” Adelanke Adetayo, MD ’06. Back row, from left, Holly J. Humphrey, the Ralph W. Gerald Professor in Medicine and dean for medical education; Timothy Billiar, MD ’83; Michael Silverman, MD ’73, president of the Medical and Biological Sciences Alumni Association; Jesse Russell Hall, MD ’77; Eugene Chang, MD ’76; and Kenneth S. Polonsky, MD, the Richard T. Crane Distinguished Service Professor and Dean of the Biological Sciences Division and the Pritzker School of Medicine.

2017 Distinguished Service Award Nominations Now Open The Distinguished Service Award and the Distinguished Service Award for Early Achievement recognize alumni who have shown leadership in their professional lives or through public service. These individuals have brought honor and distinction to the Division of the Biological Sciences and to the University of Chicago through the significant contributions they have made to the fields of the biological sciences and medicine.

Nominate a fellow alumnus for this honor. Submit your nomination online

by December 31, 2016: tinyurl.com/MBSAA-DSA-Nominations

Visit the MBSAA website to learn more about the Gold Key and Distinguished Service Award recipients: medbsd.uchicago.edu/alumni/awards

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THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

Eve Van Cauter, PhD Frederick H. Rawson Professor Emeritus of Medicine Endocrinology University of Chicago

Distinguished Service Award Timothy R. Billiar, MD ’83 Distinguished Professor of Surgery Chair, Department of Surgery George Vance Foster Endowed Professor University of Pittsburgh Eugene B. Chang, MD ’76 The Martin Boyer Professor of Medicine Associate Section Chief for Research Gastroenterology, Hepatology and Nutrition Director, Digestive Disease Research Core Center University of Chicago William A. McDade, PhD ’88, MD ’90 Executive Vice President and Chief Academic Officer Ochsner Health System (Formerly Professor of Anesthesia and Critical Care and Deputy Provost for Research and Minority Issues University of Chicago) David Steven Pellman, AB ’81, MD ’86 Margaret M. Dyson Professor of Pediatric Oncology Dana-Farber Cancer Institute and Boston Children’s Hospital Professor of Cell Biology, Harvard Medical School Investigator, Howard Hughes Medical Institute

Distinguished Service Award for Early Achievement Oluwaseun “Seun” Adelanke Adetayo, MD ’06 Section Chief, Pediatric Plastic Surgery Director, Cleft-Craniofacial Center Albany Medical Center

Medical Reunion June 2016

CLASS OF 1966

CLASS OF 1971

CLASS OF 1976

CLASS OF 1986

CLASS OF 1991

CLASS OF 2001

CLASS OF 2006

PHOTOS BY ROBERT KOZLOFF

CLASS OF 2011

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ALUMNI EMERITI

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Pritzker News

W H I T E C OAT C E R E M O N Y

Welcoming the Class of 2020 with a clear vision Keynote speaker Kathryn Colby, MD, PhD, addresses students and guests during the White Coat Ceremony.

A

fter three days of orientation — filled with seminars, service trips and fun — members of the Pritzker School of Medicine Class of 2020 filed into Rockefeller Memorial Chapel for the annual White Coat Ceremony in early August.

In the keynote speech, Kathryn Colby, MD, PhD, Louis Block Professor and chair of the Department of Ophthalmology and Visual Science, shared the five keys to her success: passion, focus, persistence, integration and gratitude. “You will heal when you can and comfort when you cannot,” Colby said. “How fortunate we all are to have found such a meaningful calling.”

PHOTO BY GRADIMAGES

Students face family and friends as they take the Physician’s Oath.

PHOTO BY GRADIMAGES

COMMUNITY SERVICE

D I V I S I O N A L AC A D E M I C C E R E M O N Y

Pritzker dean, students honored

Congratulations, Class of 2016

The University Community Service Center recognized James Woodruff, MD;

Phillip Hsu, MSTP; and Victoria Wang, MS3, at an event honoring outstanding volunteers across the UChicago campus last spring.

Woodruff, associate dean of students for the Pritzker School of Medicine, received the Faculty Service Award for his career-long commitment to ensuring that underserved communities receive quality health care. He oversees Pritzker’s student-run free clinics as well as five community clinics that treat uninsured patients.

Hsu and Wang were recognized with the President’s Volunteer Service Award for their efforts in founding the Bridgeport Free Clinic. Noting a need to address health disparities among Chicago’s large and growing Asian American population, the two students recruited faculty supervisors, conducted needs assessments, partnered with a local church, recruited classmate volunteers and collaborated with two nearby federally qualified Victoria Wang, MS3 health centers to open the clinic. Phillip Hsu, MSTP 38

PHOTO BY REBECCA SILVERMAN

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

PHOTO BY GRADIMAGES

Students and their families gathered in

Rockefeller Memorial Chapel in May for the Divisional Academic Ceremony. The Pritzker School of Medicine graduated 83 students who went on to pursue residencies across the country. Lisa Sanders, MD, associate professor of medicine at the Yale School of Medicine and author of the “Think Like a Doctor” column in the New York Times, gave the keynote address.

James Woodruff, MD, associate dean of students, hoods Ndang AzangNjaah, MD ’16, MPH, during the Divisional Academic Ceremony.

1970s

Glenn R. Hodges, MD’67, MS, received the 2016 Community Service Award at the annual meeting of the Kansas City Medical Society (KCMS) in Kansas City, Missouri. The Community Service Award is given to a KCMS member or physician group practice that has served in community leadership or made a significant contribution to the community.

Gary Slutkin, MD’75, was named a Chicago Humanitarian of the Year by UNICEF in September. He is the founder and CEO of Cure Violence, currently ranked 14th on the list of best NGOs in the world. Slutkin, a professor of epidemiology and international health at the University of Illinois at Chicago School of Public Health, was recognized for his pioneering efforts in changing the national and international conversation and approach to stopping violence. “Violence is one of the most pressing public health crises of our time,” he said. “Violence has now been determined to behave like a contagious disease, and has been shown to be able to be successfully treated as such. Most epidemics are managed by the health and public health sector, which is now being activated to better change the course of violence epidemics in the U.S. and around the world.” The Cure Violence model is being applied across the U.S., Latin America and the Middle East, as well as in Africa.

2016 -2017 ALUMNI COUNCIL Executive Committee Michael H. Silverman, MD ’73 President Rene Mora, PhD ’88, MD ’89 Immediate Past President Paul R. Rockey, MPH, MD ’70 Vice President Ernest Mhoon, MD ’73 Alumni Awards Chair Douglass B. Given, PhD ’79, MD ’80 Chicago Partners Chair Chris Albanis, AB ’96, MD ’00 Editorial Committee Chair Dean Rider, MD ’78 Regional Programs Chair Andrew Aronson, MD ’69 Mark Aschliman, MD ’80 Juliana Basko-Plluska, AB ’04, MD Oliver G. Cameron, PhD ’72, MD ’74 Amy Derick, MD ’02 Jeanne Farnan, AB ’98, MD ’02 Stanley E. Friedell, MD ’85 Sanford A. Garfield, PhD ’74 Susan Glick, MD ’90 Keith Horvath, AB ’83, MD ’87 Joel E. Kleinman, SB ’66, MD ’73, PhD ’74 Karyl Kopaskie, AB ’07, PhD ’14 Dennis Lee, MD ’91 Howard Liang, PhD ’92, MBA ’01 Doriane C. Miller, MD ’83 Christian W. Sikorski, AB ’94, MD ’00 Jack Stockert, AB ’05, MBA ’10, MD ’10 Baruch Solomon Ticho, PhD ’87, MD ’88 William Weese, MD ’69 Lifetime Members L.D. Anagnostopoulos, SB ’57, MD ’61 Arnold B. Calica, SM ’61, MD ’75 Coleman Seskind, AB ’55, SB ’56, MD ’59, SM ’59 Russ Zajtchuk, SB ’60, MD ’63 Student Representatives Olufemi E. Adams, MS2 Ava Ferguson, MS4 Pritzker School of Medicine Ittai Eres Alyssa J. Harker Biological Sciences Division Resident Representatives Noura J. Choudhury, MD ’16 Robert J. Sanchez, MD ’15 University of Chicago Medicine

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Wai-Kwan Alfred Yung, MD’75, stepped down from his role as chair of the neuro-oncology department at the University of Texas MD Anderson Cancer Center and joined the National Brain Tumor Society (NBTS) as special advisor to the CEO. He will play an important role in guiding and informing new and ongoing research and science-policy related efforts at the organization. “Dr. Yung has been a friend and advisor to the National Brain Tumor Society for a number of years and is a true giant in the field of neuro-oncology,” said David F. Arons, JD, the organization’s CEO. “Dr. Yung’s new engagement with NBTS will help us gain momentum during this historic period of progress in brain tumor research and drug development to ensure we fully capitalize on the era of precision medicine.”

1980s Lorraine Fitzpatrick, MD’80, is chief medical officer of Radius Health, working to develop innovative therapeutics in the areas of

Your News

1960s

PHOTO BY ROB HART

Your News

Reunion is moving to May Attention medical alumni who graduated in the following years: 1962, 1967, 1972, 1977, 1982, 1987, 1992, 1997, 2002, 2007, 2012.

Due to the ASCO conference and limited hotel availability, reunion is moving to May. Mark your calendar for your reunion: May 4-6, 2017. See you on campus next spring! osteoporosis, oncology and endocrine diseases. Previously, she was at GlaxoSmithKline, where she headed an international multidisciplinary team as the medicine development leader for the osteoporosis drug denosumab and led the clinical development of novel agents to treat musculoskeletal diseases and women’s health. She has held many national and international positions, including member of the advisory committee for the Office of Research on Women’s Health at the National Institutes of Health (NIH); chair of the general clinical research center study section of the National Center for Research Resources, NIH; and advocacy committee of the American Society of Bone and Mineral Research (ASBMR). She served on the National Committee for Quality Assurance technical subgroup on osteoporosis; the clinical guidelines committee of the Endocrine Society; and as associate editor for Mayo Clinic Proceedings and the American Medical Association Scientific Advisory Board osteoporosis guidelines. Her honors include the Boy Frame Award of the ASBMR, the Glenn Foundation Award in Endocrinology and Aging from the Endocrine Society and election to the American Society of Clinical Investigation. She has published extensively in the field of mineral metabolism. Fitzpatrick completed her internal medicine residency at Columbia-Presbyterian Medical Center in New York and trained in mineral metabolism and endocrinology at the NIH. Previously, she was a professor of medicine at the Mayo Clinic, where she served as director of bone histomorphometry and founding director of the Women’s Health Fellowship.

Mark E. Brecher, MD’82, chief medical officer of Laboratory Corporation of America and an adjunct professor of pathology and laboratory medicine at the University of North Carolina, received the annual Francis S. Morrison, MD, Memorial Lecture Award by the American Society for Apheresis. The award recognizes individuals who have made major contributions to the field of apheresis medicine and apheresis professionals who have made a lasting difference in the field at the national level.

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In Memoriam

In Memoriam 1940s Harry Oberhelman Jr., SB’46, MD’46, died peacefully at his home on February 10, 2016. He was 92.

Oberhelman was a professor emeritus of surgery at Stanford University School of Medicine, and he was untiringly committed to his patients for more than 50 years. He trained more than 160 general surgery residents during his career.

He retired from active surgical practice in 2001, but continued to consult and teach until 2006, when he joined Stanford Health Care’s International Medical Services as its medical director. Oberhelman was born in Chicago, the eldest son of a surgeon. He married his high school sweetheart, Betty Jane Porter. After graduating from medical school, he served with the U.S. Air Force Medical Corps before returning to the University of Chicago to complete his surgical training. In 1960, he joined the faculty of Stanford’s medical school. He was an avid Stanford football fan, attending nearly every game. He tended to his cymbidium orchids and enjoyed relaxing at the family cabin in Wisconsin. In addition to his wife, Oberhelman is survived by his brother, John; sister, Barbara Uecker; cousin, Joline Oberhelman; sons, Harry, James and Robert; daughter, Nancy; daughters-in-law, Leslie Oberhelman and Pamela Brands; and nine grandchildren.

1950s Kingsbury G. Heiple, MD’53, died on March 13, 2016, of a cerebral aneurysm at the University Hospitals Case Medical Center in Cleveland. He was 88 years old. Heiple, former chair of the Department of Orthopaedics at Case Western Reserve University (CWRU) School of Medicine and University Hospitals and an internationally known researcher and clinician, achieved excellence in clinical care, teaching and research. He was deeply involved in the training of more than 200 orthopaedic residents at CWRU/ UH. His research, funded by the National Institutes of Health from 1959 to 1985, resulted in many research papers and book chapters. The

40

American Academy of Orthopaedic Surgeons awarded Heiple the Kappa Delta Award, the most prestigious award for orthopaedic research, in 1985. The University of Chicago Pritzker School of Medicine honored Heiple with the Distinguished Service Award in 1993. Heiple was a revered artisan in orthopaedics and woodworking. He enjoyed tennis and golf and played both sports until a month before his death. He and his first wife, Helen Ilo Haberle, had four children: Kingsbury G. Heiple II; Jeanne Heiple, MD; Holly Heiple; and Caroline D. H. Sokol, MD. They were married for 39 years until her death in 1989.

Heiple is survived by his second wife, Nancy Wallace Gaddis; his children; daughter-in-law, Holly Frazier Heiple; son-in-law, Joseph Sokol; and four grandchildren. He also leaves three stepchildren and their wives: David and Kathy Gaddis; William and Jenny Gaddis; and Robert and Mary Gaddis; and six stepgrandchildren.

Henry C. Maguire Jr., MD’54, died on June 11, 2016, at his home in Merion, Pennsylvania. He was 88 years old. After completing medical school, Maguire was stationed at Fort Hood, serving two years as a captain in the U.S. Army Medical Corps. He completed his medical training in dermatology at the University of Pennsylvania. His main professional interest, in addition to caring for patients, was cancer immunology research. He was introduced to immunology as a fellow at Rockefeller University under Merrill Chase, PhD, who first demonstrated the phenomenon of cell-mediated immunity. Maguire went on to help establish the nascent field of immunotherapy for the treatment of cancer. He was the author of numerous research papers and, during his career, held appointments and worked at Fox Chase Cancer Center, Thomas Jefferson University Hospital, the Rockefeller University, and the University of Pennsylvania. He was a past president of the Philadelphia Dermatological Society and chairman of the Department of Dermatology at Hahnemann University Hospital. He enjoyed classical music, bridge, sailing and tennis. Charity, giving and love of family were part of his being. Maguire is survived by Elise, his wife of 63 years; children, Henry Maguire III, MD; Jean Maguire van Seventer, DVM; and Albert Maguire, MD; and eight grandchildren.

1960s Frederick Seymore Mishkin, MD’62, died on March 5, 2016, after a decade-long battle with Alzheimer’s disease. He was 78.

Mishkin was born in Elkhart, Indiana. From a young age he was inspired by his father, a small town doctor who provided both medical and spiritual guidance, sometimes taking payment in the form of fresh corn or plumbing repairs. While in Greece on an American Field Service scholarship, Mishkin contracted polio, which gave him insight into the difficulties of living with an affliction. He completed his medical internship and residency at Indiana University (IU) Medical Center, and a fellowship in nuclear medicine at Johns Hopkins University.

He returned to IU Medical Center and took over as chief of nuclear medicine, a title he would hold at several institutions over his lifetime. Along with his friend, radiation physicist Isaac Reese, PhD, he moved to Southern California to help found the nuclear medicine department at Martin Luther King Jr. Community Hospital and the Charles R. Drew University of Medicine and Science in 1971, remaining until 1986. He spent nine years in private practice at Long Beach Memorial Medical Center before returning to public practice — and his true love, teaching medical students and technologists — at Harbor-UCLA Medical Center. Mishkin was preceded in death by his elder brother, Marvin Mishkin, MD. He is survived by his wife, Judith; children, Cindi Mishkin, Jeffrey Klain, Karen Mishkin, and Eben Mishkin; and four grandchildren.

1970s Geoffrey Heron, AB’66, MD’71, died on August 20, 2016, following a brief battle with an aggressive form of lymphoma. He was 72. Heron was born in Pittsburgh. He completed his psychiatric residency at the University of Colorado Health Sciences Center in 1976. He graduated from the Denver Institute of Psychoanalysis in 1987.

Heron practiced psychiatry and psychoanalysis for many years in Denver and Boulder, and was

THE UNIVERSITY OF CHICAGO MEDICINE AND BIOLOGICAL SCIENCES DIVISION

committed to both inpatient and outpatient psychiatry. He served as president of the medical staff of Mount Airy Psychiatric Center in 1982 and as medical director of the North Valley Hospital medical staff from 2005 to 2006. He was named a distinguished fellow of the American Psychiatric Association in 2003. At the time of his death, he was president of the Denver Psychoanalytic Society.

Heron taught at the University of Colorado Health Sciences Center and the Denver Institute for Psychoanalysis. He was the assistant medical director for medical education at Centennial Peaks Hospital from 2007 to 2013. Heron had a lifelong passion for family, sports and the outdoors.

He was an accomplished skier and avid basketball player, and enjoyed biking, fishing and hiking. He reached the summit of many of the 14,000-foot peaks of Colorado. He was also an excellent snowboarder and tennis player. He remained active in many of these sports until his death. Heron is survived by his wife, Joan; his son, Ted; his stepsons, Sam and Harrison; and his sister, Cathy.

Resident Alumni Donald Harvey Gilden, MD, passed away in Denver on August 22, 2016, of cancer. He was 78. Gilden was born Baltimore in 1937 to Jewish immigrants. He played a season of semi-pro baseball before attending Dartmouth College in 1955. He graduated, with honors, from the University of Maryland School of Medicine in 1963. Gilden completed his neurology residency in 1967 at the University of Chicago, where he met his future wife, Audrey. He then served two years as a U.S. Army physician at Walter Reed National Military Medical Center. In 1985, Gilden became chairman of the Department of Neurology at the University of Colorado School of Medicine. Under his leadership, the department expanded from fewer than 10 full-time faculty members to a staff of nearly 50. Gilden published more than 420 scientific papers and book chapters and edited several books on viral infections of the central nervous system. A musician, he played violin every morning and was known to give musical performances at scientific conferences. Gilden is survived by his wife; three sons, Daniel, Adam and Paul; a sister, Devera; and six grandchildren.

Faculty

Gary Toback, MD, PhD

G

ary Toback, MD, PhD, professor of medicine and former interim section chief of nephrology, died July 20, 2016, when he was struck by a vehicle while jogging before work. A loyal, productive and popular member of the faculty for 42 years, he was devoted to the care of patients with kidney disease and the education of medical students.

Toback was a highly respected authority on kidney disease, especially the use of renal growth factors to treat acute kidney injury and hasten repair. He was also a highly respected clinical scientist. His earliest studies focused on potassium and the kidney, and on the development of kidney stones. Later in his career he concentrated on proteins associated with regeneration of kidney tissues. More recently, in collaboration with colleagues in gastroenterology, he searched for proteins that could prevent damage or speed recovery for gastric epithelial tissues. His research led to multiple patents and the formation in 1995 of a biotechnology company based in Kalamazoo, Michigan.

Colleagues also remember Toback as a remarkably friendly, kind, level-headed and well-liked professor, readily available to faculty and students, and consistently able to provide solid, sensible advice.

Frederick Gary Toback was born October 23, 1941, in Brooklyn, New York. He graduated cum laude in biochemistry from Columbia University, earned his medical degree at the New York

“Gary was a true role model for

University School of Medicine and completed his residency at the Cleveland Metropolitan General Hospital, part of the Case Western Reserve system. After serving a year in the U.S. Navy Medical Corps, he returned to school to earn his PhD in biochemistry at Boston University. He came to the University of Chicago in 1974 as an assistant professor of medicine and — except for one sabbatical year at the Salk Institute in San Diego — stayed for the rest of his career. He was promoted to associate professor in 1980 and professor in 1985. He served as interim section chief of nephrology from late 2008 to 2015. He published 100 research papers during his four decades at the University of Chicago. He also took on dozens of administrative and committee roles, within the University and on the national level. Toback was elected to the Association of American Physicians and the American Society for Clinical Investigation. The Biological Sciences Division honored him last year with a symposium in his name about the biology of kidney disease and its treatment.

He was devoted to his family. He married his childhood friend Phyllis Brooks, PhD, DMin, and the couple raised three children: David Andrew, PhD, a professor of physics and astronomy at Texas A&M; Alison Rachel, a psychotherapist; and Jonathan Daniel, a mechanical engineer at Baxter. There are seven grandchildren. A memorial service was held on campus in September at the Quadrangle Club.

physician scientists, deeply committed to scholarship, education and the care of patients with renal disease. He always conducted himself with the highest level of dignity and professionalism.”

Kenneth S. Polonsky, MD The Richard T. Crane Distinguished Service Professor Dean of the Biological Sciences Division and the Pritzker School of Medicine

Faculty

Robert L. Replogle, MD

R

obert L. Replogle, MD, a nationally recognized specialist in congenital and adult open-heart surgery, died at the University of Chicago Medicine on May 9, 2016, surrounded by his family. The longtime Hyde Park resident was 84 years old. Replogle spent most of his career in Chicago, beginning in 1967 at the University of Chicago, followed by leadership positions at three other Chicagoarea hospitals.

His impact, however, was international.

Replogle lectured all over the world. He was one of the first members of the Society of Thoracic Surgeons (STS), in which he held multiple leadership roles, including president from 1996 to 1997. He was also a key player in developing a national database managed by STS that includes detailed records of millions of cases, which can be used to track variations in surgical mortality and to negotiate reimbursement from government and private payers. One of his first scholarly papers, published in 1963 when he was a resident at what is now known as Boston Children’s Hospital, described the “Replogle tube,” a two-channel suction device inserted into the throat of a newborn with a malformed esophagus to prevent aspiration pneumonia. It is still in use.

Robert Lee Replogle was born September 30, 1931, in rural Iowa. He studied biology at Cornell College. He served in the U.S. Navy during the Korean War, working at the Naval Research uchospitals.edu/midway

“Bob Replogle was at the core of visionary

Institute in Bethesda, Maryland. He graduated cum laude from Harvard Medical School in 1960, also completing his residency in the Harvard hospital system, specializing in pediatric surgery at Boston Children’s Hospital. He came to the University of Chicago in 1967 to direct the congenital heart surgery program and rose quickly through the ranks, becoming section chief of pediatric surgery in 1970 and chief of cardiac surgery in 1973. In 1978, his team garnered national attention when they performed a triple cardiac bypass for entertainer Jackie Gleason, who was on tour in Chicago. Although he retained his connections to the University of Chicago, Replogle went on to head cardiac surgery programs at Michael Reese, Ingalls Memorial and Columbus Cabrini hospitals. He retired in 1998 after having built strong surgical teams, mentoring many outstanding academic surgeons and publishing more than 100 scientific papers and book chapters.

Outside the office, Replogle enjoyed cars, scuba diving, underwater photography and wine collecting. But the project that seemed to mean the most to him was Opportunity Village, a home in Iowa for adults with disabilities, including Replogle’s brother Ralph, who suffered from cerebral palsy. Replogle is survived by his wife, Carol; three children: Jennifer (Mark) Bremer, Edith (Scott) Sheffer and Robert E. (Michelle) Replogle; and nine grandchildren.

changes that have had a lasting impact on cardiothoracic surgery worldwide.

He had the personality, foresight and intelligence to make lasting connections among various disciplines.”

Mark Ferguson, MD ’77 Professor of Surgery

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L A S T LO O K

Mixed media mold An art quilt, titled Penicillium, depicts the medicinal mold as seen in a petri dish and through a microscope. Artist Cynthia Fowler, MD, created the textile for Natural Healing, an exhibit of contemporary fiber art representing animals and plants that contribute to human wellness. The exhibition, a project of the Studio Art Quilt Associates of New Mexico, came to the University of Chicago Medicine after a showing at the National Institutes of Health. It can be viewed on the Center for Care and Discovery’s newly opened fourth floor until mid-December.

PHOTO BY MICHAEL TROPEA

The University of Chicago does not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national or ethnic origin, age, status as an individual with a disability, protected veteran status, genetic information, or other protected classes under the law. For additional information, please see uchicago.edu/about/non_discrimination_statement.