MUSC Catalyst by Cindy Abole

October 14, 2011

MEDICAL UNIVERSITY of SOUTH CAROLINA

Vol. 30, No. 9

endOwed chaiR cOMes with hugs Patient’s story lends ceremony touching moment Editor’s Note: The following is an excerpt from a speech given Sept. 29 by Dana Rothschild celebrating André Hebra becoming the first person to hold the H. Biemann Othersen Jr., M.D., Endowed Chair in Pediatric Surgery.

orty years ago, at the age of 4, I was diagnosed with a neuroblastoma and I was blessed to have the best pediatric surgeon in the country operating on me for almost 21 hours, for the first time. Dr. Bee, as I and others call him, is such an extraordinary human being and physician and has been a consultant and comforter for practically every crisis, procedure and surgery I have had since. I have a story to share with you. It is my story, written by my mother, Faye Seigel, but it is the story of thousands of parents and children who face the journey of hope, fear, recovery and renewal. It begins in her words: “The wide double doors opened. I looked down the aisle framed with unfamiliar faces. Everyone was standing and looking toward us. The applause began as a faint rhythmic sound and then exploded into a thunderous roar. I looked down at my 9-year-old daughter and she gazed up at me. With one hand

Dr. André Hebra with “miracle” patient Khamani Makell.

By Dawn Brazell Public Relations

other Kristella Ham said she didn’t like the news André Hebra, M.D., had to deliver about her premature twin son. The bad news she learned was that one out of three babies wouldn’t last 48 hours with what her son, Khamani Makell, faced. He was premature, had short bowel syndrome, nectrotizing entercolitis and

at one point was close to death in the NICU on a do-not-resuscitate order. But then he started doing better. Hebra, who believes in never giving up when there’s a sign of hope, continued in the fight performing nine of the multiple surgeries that Khamani would need. One of the surgeries removed 90 percent of his intestines. On Oct. 18, Khamani, 3, will be in for a checkup. He has only slight development delays and loves to

$2.8M gRant Children with autism spectrum disorders will receive help thanks to LEND award.

play basketball. “He’s a miracle baby,” she said, adding that Hebra’s an excellent doctor. She’s not the only one to think so. Hebra became the first person to hold the H. Biemann Othersen Jr., M.D. Endowed Chair in Pediatric Surgery Sept. 29 at a ceremony in the historic Rice Mill Building. David Cole, M.D., Rose Professor and chairman of the Department of Surgery,

See Story on page 10

See Chair on page 10

Reaching Out

Meet David

Dr. Thomas Hulsey sees success in global clinical research program.

Medical Center Excellence

Biking To Work

READ THE CATALYST ONLINE - http://www.musc.edu/catalyst

2 the CatalySt, October 14, 2011

Grant to train providers in caring for young children MUSC has been awarded a five-year, $2.8 million grant to create a statewide program called South Carolina Leadership Education in Neurodevelopmental and Related Disabilities (SC LEND). This is the first LEND award for South Carolina, and is unique because it involves three training sites in order to link the state. The grant comes from the U.S. Department of Health and Human Services (Maternal and Child Health). Available South Carolina statistics (2006) suggest that 8.6 per 1,000 children are identified with an autism spectrum disorder (ASD). In this state, boys are 4.5 times more likely to have an ASD than girls, translating to 1 in 70 boys in the state who have an ASD. Despite better awareness, the average age of ASD diagnosis is about 4-years-old in South Carolina, which is beyond the age of early intervention programs. SC LEND is a partnership between MUSC, the University of South Carolina (USC) and Greenville Hospital System (GHS) that aims to establish a statewide interdisciplinary training program to improve

the health of infants, children, and adolescents with ASD and neurodevelopmental disorders (ND). The grant allows for more than 20 faculty members from the institutions to provide training to practitioners who serve children with autism spectrum disorders and neurodevelopmental disorders. The program is a year-long, intense schedule of clinical, classroom research and leadership training. The idea is to bring the level of skill and competence up across the state in caring for these children. “Nationwide, the numbers of children with ASDs and other developmental disabilities are on the rise. Estimates show a 57 percent increase in the prevalence of autism, and the CDC estimates that up to 17 percent of children have special needs,” said Michelle Macias, M.D., pediatrics professor in the MUSC Division of Developmental-Behavioral Pediatrics and the principal investigator for the grant. “One of the biggest problems is the dire lack of professionals to evaluate and treat children with disabilities, and that is specifically what the grant is

Challenge yourself at 2-mile run Nov. 19

Runners and walkers can lace up their shoes for the MUSC Healthy Charleston Challenge 2-Miler Run and Walk held Nov. 19 at 8 a.m. at MUSC. Participants can compete for several prize awards, which include top three finishers; top three by age groups; top master; and top MUSC student finishers. MUSC’s challenge is Charleston’s version of the Biggest Loser competition, a weight loss and healthy living program. So far almost 700 Lowcountry adults have participated in this program since it began in 2008 where participants have lost more than 16,418 pounds. Participants can save $5 if they pre-

Editorial of fice MUSC Office of Public Relations 135 Cannon Street, Suite 403C, Charleston, SC 29425. 843-792-4107 Fax: 843-792-6723 Editor: Kim Draughn catalyst@musc.edu Catalyst staff: Cindy Abole, aboleca@musc.edu Dawn Brazell, brazell@musc.edu

register online or at the MUSC Wellness Center before Nov. 1 ($25 per person). After Nov. 1, registration is $30 per person. Register early to guarantee an event T-shirt and other goodies including a free one-month membership (for nonmembers only) at the MUSC Wellness Center. Guest membership must be completed by Dec. 31. Early race packet pick-up is from 11 a.m. to 6 p.m., Friday, Nov. 18 and from 6:30 to 7:30 a.m., Nov. 19 (race day). This year’s event sponsors are TrySports, Action Carolina, Harris Teeter, Carolina Acoustical & Drywall Inc. and Sun Sign Co. Visit http://www. musc.edu/hsc or call 792-5757. The Catalyst is published once a week. Paid adver tisements, which do not represent an endorsement by MUSC or the State of South Carolina, are handled by Island Publications Inc., Moultrie News, 134 Columbus St., Charleston, S.C., 843-849-1778 or 843-958-7490. E-mail: sales@moultrienews.com.

designed to provide—including educational efforts for all health care professionals who care for children and their families.” SC LEND long-term trainees may be drawn from a range of professional disciplines including pediatrics, psychology, speech pathology, social work, occupational therapy, physical therapy, pediatric dentistry, psychiatry, neurology, genetics and special education. SC LEND also will provide technical assistance and continuing education to community agencies, providers and consumers. With assistance from MUSC's Center for Academic Research and Computing and from the South Carolina Area Health Education Consortium, many of SC LEND's activities will be widely disseminated using internet-based learning methods. There are 43 LEND programs in 37 states nationwide, allowing for a collaborative approach to improve the care of children. In 2007, LEND programs were expanded to include the additional focus on autism and related developmental disabilities.

the CatalySt, October 14, 2011 3

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4 the CatalySt, October 14, 2011

Scientist encourages faculty to seek opportunities

By CinDy aBole Public Relations World-renowned biochemist Cynthia Kenyon, Ph.D., shared her insights on aging and inspired female colleagues as the guest presenter of the MUSC Women Scholars Initiative’s (WSI) annual Eminent Scholar program Sept. 15. Kenyon met with female faculty and spoke about the molecular biology of aging as part of her talk, “Cells and Pathways that Control of Aging of C. elegans,” held at Gazes Cardiac Research Institute auditorium. Her ongoing research studies show how genetic control circuits are involved in the aging process. At the talk, Kenyon was presented with the WSI award. Kenyon and her colleague’s discoveries have led to a better understanding of the aging process by more focused study on simple organisms such as the microscopic roundworm, C. elegans, to study gene regulation and changes in its lifespan

2011 Women Scholars Initiative Eminent Scholar Dr. Cynthia Kenyon, center, met with WSI members Drs. Sudie Black, Bonnie Dumas, Ashli Sheidow, Amy Bradshaw, Samar Hammad and Barb Rohrer on Sept. 15. and other biological processes. Earlier, Kenyon met with graduate students, research colleagues who specialize in aging and women campus leaders. She answered questions, shared career advice and addressed the benefits of mentorship and professionalism in research and science. “The opportunities for junior faculty

and women scientists are incredible today. I encourage new faculty and women to seek out and respond to those opportunities and get involved,” she said. Kenyon earned a dual graduate degree (chemistry and biochemistry) from the University of Georgia in 1976. She earned her doctorate at the Massachusetts Institute of Technology

in 1981 and later worked with Nobel laureate Sydney Brenner at the MRC Laboratory of Molecular Biology in Cambridge, UK. She is the Herbert Boyer Distinguished Professor and American Cancer Society Professor at the University of California, San Francisco (UCSF), and Department of Biochemistry. She is director of the Hillblom Center for the Biology of Aging at UCSF. Kenyon is a member of the U.S. National Academy of Sciences, the American Academy of Arts and Sciences and the Institute of Medicine and has received numerous honors and recognition for her research work. Kenyon is MUSC’s fifth named Eminent Scholar. Last year, Kristi Anseth, Ph.D., Howard Hughes Medical Institute Investigator and Distinguished Professor of the University of ColoradoBoulder was the event’s speaker. The award is sponsored by the WSI and the College of Graduate Studies’ Molecular & Cellular Biology and Pathobiology external seminar series.

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Research master’s program casts global appeal By Dawn Brazell Public Relations

t 7 a.m. here, it’s noon in England, 4:30 p.m. in India and 7 p.m. in Singapore. Thomas Hulsey, Sc.D., rattles off the times. Arranging a Skype session among the different locales is a feat, but one he’s adept in handling as assistant dean for global educational programs in the College of Graduate Studies. “Everybody is able to visit at the same time. It’s a challenge. They can all see the questions and hear the answers, and they get to benefit from what’s going on in other campuses.” Hulsey, who has come a long way from his Colleton County farming roots, travels globally as he guides the success of MUSC’s Master of Science in Clinical Research (MSCR) global program. The program now boasts four locations of study in addition to MUSC and has an 85-student enrollment this fall. Students in the Institute of Clinical Research India (ICRI) may choose London, Singapore, Deharadun and Hyderabad in India or MUSC as their main campus for study. There’s also a collaboration with the Drum Tower Hospital in Nanjing, China, that sends students to MUSC, and the MSCR program is negotiating with a sixth location: the Zhejiang Hospital in Hangzhou, China. “The exciting thing is we’ve done this with no advertising, no Web page and no brochure. We wanted to go with this very carefully and make sure we had all the right approvals and that we were geared for this kind of global delivery.” For Hulsey that meant making sure the technology team was on board; the curriculum content was modified for distance delivery; and the Skype system adapted for all locations just to name a few of the logistic hurdles. The faculty was challenged to come up with new ways to deliver curriculum, test students and give exams. Students are required to speak English. Of the 85 students accepted, there will be 10 to 15 students who will be coming to MUSC to study, he said. “As we start to advertise and start to build momentum, I think the demand for

Above is faculty at the Institute of Clinical Research India in Hyderabad. Dr. Thomas Hulsey, left, with a wall hanging that was a gift from Chinese students signifying good luck and blessings. He’s holding an image of Ganesha, the Hindu God of Success, a gift from an Indian student.

this is limitless at this point. We live in an ever shrinking world. I can be in Delhi in 14 hours by plane. The world marketplace for health care is getting incredibly close. We don’t live in a vacuum anymore.” Medical trends including medical tourism and drug development encourage cross-fertilization across diverse cultures and specialties, he said. Beyond the possibilities for advancing medicine, more diversity in medical education encourages cultural sensitivity,

an added benefit in delivering quality health care. Hulsey said the MSCR program was originally developed around the needs of the MUSC family to enhance the ability of clinical researchers. The 38-hour credit program has since expanded to be more than just that. “It challenges us to think of new ways and new materials to make our content fresh — to make our content not only match what's needed in the domestic marketplace from what our NIH guidelines are but what's going to be in the global marketplace as we look to pharmaceutical industries and publicprivate partnerships with everybody else who’s involved in this whole health arena.” Impressed by what students bring to the table during discussions, Hulsey said the classes benefit not only from the diversity of students’ cultural perspectives but also from the wide range of medical specialty areas that are represented. He has no doubt the program will continue to grow, given the enthusiastic support of central administration and faculty, who have opportunities to travel to other countries and collaborate in campus environments that they are not used to, he said.

There also is a domestic marketplace for the MSCR program from smaller universities not able to provide this kind of training on site. The technology and abilities of distance learning changes how and what students can learn in the comfort of their own small communities, he said. One advantage of the MSCR program is that academically it is a part of CGS and administratively it is part of the South Carolina Clinical and Translational Institute, so it has access to the resources of both groups. The program specifically was designed to avoid a one-person-at-a-time degree. “We’re heading to closer collaboration. We’re building partnerships. Every place we go is building a partnership with the campus, or the hospital or another university so we can build with them using the MCSR. We have great collaborations that have taken place with our physician researchers now that we have individuals going to these hospitals and universities spending time doing research. It’s opening the door to entire global collaboration.” For information, email Hulsey at hulseytc@musc.edu or visit the MSCR website at http://tinyurl.com/3uc68zu.

The Catalyst, October 14, 2011 7

Medical Center

‘Making a difference every day’ DAISY winners helped in healing process

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Toschua Thomas and Jessica Stout Johnson, 10W, were September’s DAISY winners. To see past winners, visit http://tinyurl.com/3apnmdn.

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Toschua Thomas and Jessica Stout Johnson, 10W Nominated by nurse manager Mike Sawin after he received a letter of thanks from the patient. “We had a young female patient on 10W, who was scalped in an ATV and had to have all of her hair removed. Toschua purchased a basket of lotions and oils as well as a real wig that she could wear over the dressing. The patient left a card for Toschua and Jessica that said, ‘It helped so much to know that I would look normal with the wig. You are both amazing nurses that I count as an honor to have met.’ The patient is a nurse at another hospital. Their kindness to a young female patient helped her cope with a traumatic life changing event and to be able to begin the healing process.” The MUSC DAISY (Diseases Attacking the Immune System) Award for Nurses is a monthly award and is part of the DAISY Foundation’s program to recognize the super-human efforts nurses perform every day. The foundation was formed in 2000 by the family of J. Patrick Barnes. Barnes died of complications of idiopathic thrombocytopenic purpura.

8 the CatalySt, October 14, 2011

Diabetes board, council approve care guidelines The Diabetes Initiative of South Carolina (DSC) and the statewide Diabetes Advisory Council (DAC) have approved the “South Carolina Guidelines for Diabetes Care - 2011.” The guidelines were announced by MUSC President Ray Greenberg, M.D., Ph.D., at the Diabetes Fall Symposium for Primary Health Care Professionals held at the Embassy Suites in the North Charleston Convention Center. Daniel Lackland, DrPH, chairman of the DSC and MUSC Neurosciences professor, said the guidelines serve as a reference tool for diabetes care providers looking for the current, accepted clinical standards for the care of people with diabetes. The guidelines help to improve patients’ care experience by establishing and reviewing patients’ self-management goals and increasing involvement in patients’ care. The health of populations is improved by consistently using evidence-based diabetes care guidelines,

and per capita health care costs will be reduced as the guidelines are implemented and care is coordinated across settings. Greenberg said the guidelines come at a good time. “With the growing epidemic of obesity in our state and country, we anticipate a surge in the incidence of diabetes,” he said. “To the extent that we can standardize and optimize care for patients with diabetes, we can help them better cope with this illness and avoid many of the complications that occur.” Consistent with recommendations endorsed by the American Diabetes Association and the American Association of Clinical Endocrinologists, the concise document provides reliable, evidence-based care for diabetic patients. The guidelines also help providers meet the requirements of the Hospital Outpatient Quality Reporting Program, Hospital Inpatient Quality Reporting Program and Meaningful Use Criteria for Electronic Health Records.

Nominations being accepted for honorary degrees Nominations are being accepted by the Office of the Vice President for Academic Affairs and Provost for honorary degree recipients from MUSC. The honorary degrees will be awarded at the May 2012 Commencement. In general, honorary degrees go to individuals in the following broad categories: Contributions to the nation, contributions to science or contributions to the state or MUSC.

Nominations may be submitted of candidates, along with supporting materials such as letters, articles, curriculum vitaes, etc., in the above mentioned categories. The nominations should be forwarded to Marcia Higaki, Office of the Provost, Colcock Hall, 179 Ashley Avenue, MSC 002, higakimc@musc.edu, no later than Nov. 4. Nominations of MUSC alumni are generally discouraged.

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Employee shares experience on biking to work

Why do you bike to work? The fantastic views and smells that I'd miss in a car, especially along the marsh and river, the changing colors of marsh grass with the seasons; scurrying crabs; heron, egret, ibis intent on fishing; pelicans flying in formation; occasional otter or dolphin playing in the river... The fresh air and exercise, sometimes the only opportunity of my mostly sedentary work days. The minimal expense — maintaining a bike is so cheap compared to even just the gas and parking costs of driving, not to mention other car-related

Do you have any concerns about biking to work? Both the design of many Charleston roads as well as the awareness of many drivers are not conducive to bicycles safely sharing roads with cars. Minor concern — limited availability of bike parking spaces that are safe, convenient, and sheltered from the rain. My bike chain gets rusty. What is available to address those concerns? A number of bike advocacy groups are

Dr. Amy Horwitz bikes to work Monday through Friday. working on the first concern. Perhaps as driving cars becomes more expensive, more people will find alternatives such as car-pooling, public transport, biking, etc. Regarding minor concern of parking: Including more sheltered bike parking where feasible around campus would be great.

In May, a survey was conducted to investigate commuting issues at MUSC. The majority of respondents, 82.2 percent, travel five or more miles to work, with 75.2 percent driving and 9 percent taking a bus. Most respondents would not consider riding a bike to work because of lack of changing facilities, inadequate parking, lack of bike lanes, crossing the Ashley River, the distance being too great and the need for more flexibility. Providng additional comments, the majority of the 380 respondents offered suggestions related to CARTA, parking challenges and biking issues.Respondents included safety as a barrier to biking to work. The MUSC Mobility Task Force is working to create a community that has bike accessibility, both at MUSC and in the surrounding areas to increase commuting options and promote active lifestyles to employees and the community. To become involved, contact Susan Johnson at johnsusa@musc.edu.

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Amy Horwitz, Ph.D., assistant professor in the Department of Otolaryngology, rides her bike to work and shares her thoughts about the bike accessibility issue at MUSC: How far is the commute? Three-plus miles each way, from Magnolia Road in West Ashley to Walton Research Building (Sabin Street). I ride Highway 17 to 61 over the Ashley River on the southbound bridge because it has wider sidewalks. Then Lockwood Boulevard to Calhoun Street to Jonathan Lucas to Sabin.

10 the CatalySt, October 14, 2011

Biography: André Hebra

Chair Continued from Page One

said it is a fitting tribute that Hebra is the one to first hold the Othersen Chair. Their paths first intersected 25 years ago when Hebra was a medical student at MUSC and subsequently conducted his residency training in general surgery. Othersen then was a member of the faculty in pediatric surgery and guided Hebra through his internship in pediatric surgery and beyond. “The Othersen Chair was created three years ago in honor of South Carolina’s first pediatric surgeon and one of the state’s most revered physicians and gentleman,” Cole said. “Biemann Othersen has touched the lives of literally thousands of children and their families. In his more than 50-year association with MUSC, few have made a more significant impact on patients, faculty, staff and students.” Cole said the endowed chair serves as a permanent tribute to Othersen’s compassion and skill as a surgeon, along with his many contributions to his profession and community. Hebra took the occasion to share some of the giants in his life, including the “super giant” Othersen. “If it wasn’t for him, this endowed chair would not exist and I would not be standing here today. Probably everyone in this room knows of the numerous and amazing accomplishments of his professional life. What you should also know is that his hard work and dedication has allowed the Department of Surgery and the Division of Pediatric Surgery to pull together financial resources that made this endowed chair a reality.” Hebra went on to name other giants that made this moment possible, including his patients and their families. “I have always admired the courage of parents that must deal with sick children who undergo surgery, and I am amazed at the resilience of children when it comes to surgery and disease. “The most important lessons I have learned from my patients are: To appreciate how lucky my family and I are and to never give up. I am not sure that I could endure the emotional stress that comes with having a sick child. The patients and their parents are the giants of my daily life in the operating room and in the hospital.”

Dr. H. Biemann Othersen applauds as Dr. André Hebra, center, receives his award from Dr. David Cole. André Hebra, M.D., began his medical education with a pre-med and Doctor of Medicine at FUABC University in Sao Paulo, Brazil. He obtained a second medical degree in 1987 from MUSC where he also completed his residency in general surgery. It was during this time

Story

he formed an interest in minimal access surgery and given an opportunity to be a part of the early development of laparoscopic surgical techniques. During his residency he completed a twoyear research fellowship at the University of Pennsylvania and completed a fellowship in pediatric surgery at the

Children’s Hospital of Philadelphia. He became board certified in general surgery, surgical critical care and pediatric surgery. In 1995, he returned to MUSC as assistant professor in the Department of Surgery and in 1999 was promoted to associate professor. In 2002, Hebra was recruited to director of the Minimally Invasive Pediatric Surgery Program and chief of surgery at All Children’s Hospital in St. Petersburg, Fla. Hebra returned to MUSC in 2007 as the chief of the Division of Pediatric Surgery and chief of surgery of MUSC Children’s Hospital. Hebra has been responsible

Continued from Page One

in mine and the other in her father’s, we began walking down the aisle and with each step forward, my mind took me back—back to the months and years that had brought us to this moment of triumph. When you hear the words, ‘Your daughter has cancer’ the life you had a few days ago is transformed into a nightmare. Radiation and chemotherapy began immediately in hopes the tumor would shrink before surgery. It had engulfed her kidneys, aorta and intestines. We were referred to Dr. Bee who became the invaluable source for information and expertise and provided the constant reassurance and patience when we asked over and over, ‘Will she be OK? Will she survive?’ Dana’s operation was scheduled for Feb. 18, 1972. Her father, Jerry Rothschild and I held her hands as she was wheeled down the corridor. She looked up at us with the trust of a 4-yearold. We had been told that the operation would prolong her life, but there were no guarantees of long-term survival. The elevator doors closed and we were left to endure 21 hours of endless waiting. At last it was over and she was taken to

Dr. H. Biemann Othersen with Dana Rothschild. intensive care where she would remain for six weeks, and we would endure another five months of life-and-death complications and many more surgeries. Her tiny frame was emaciated because she wasn’t allowed to eat or drink, and tubes entered every orifice. When she was able, we put her in a big red wagon with all her machines and took her out into the corridors. Her father would take the night shift. I would be by her side during the day. Finally, Dr. Bee encouraged us to get some help for the evening and we were blessed to have a dear woman named Peggy. She made little hospital gowns for her with her name embroidered on the front and crocheted colorful afghans for her. One night, she appeared with a small brown paper bag,

for the restructuring of the pediatric surgical services and development of the pediatric surgical and anesthesia specialty group. His expertise in minimally invasive surgery has brought MUSC Children’s Hospital to a new level of recognition. His study of pectus excavatum and carinatum was a critical contribution to the hospital’s designation as a center of excellence. Because of his experience with laparoscopic and robotic surgery, he was also responsible for initiating the da Vinci robotic surgical program at MUSC. Hebra and his wife, Jennifer, have two children, Alex (13) and André (11), and live on Johns Island.

and inside was a black bundle of curly fur, a poodle that weighed less than a pound. For the first time in months, we saw life come back into Dana’s eyes and she smiled and reached out to touch him. After weaning Dana off the machines and letting her wounds heal, Dr. Bee gave us the news we had waited six months long to hear, ‘Dana, you can go home today and take all your toys with you.’ The sound of our names brought me back to the crowded room we had entered. We reached the podium and learned that her miraculous story had just been told to the audience who were participating in an American Cancer Society conference on childhood cancer. That night, we attended a football game. The announcer said ‘This football game is dedicated to all the children who have waged the war against cancer.’ As he spoke, our eyes turned toward the scoreboard. In flashing lights it read: The Winner: Dana Rothschild.” Yes, I am so grateful to be a winner with a wonderful husband, two beautiful children and a career I love as a pediatric occupational therapist. Dr. Bee because of your skill, relentless commitment as well as the other physicians and nurses at MUSC, I thank you from the bottom of my heart.

the CatalySt, October 14, 2011 11

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