Medical record
INSIDE: Berks County Medical Society Announces New Executive Director and Installation of New Officers
“Lessons Learned,” Sue Perrotty, Retired President and CEO, Tower Health
The Neurobiology of Addiction
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Medical record
A Quarterly Publication
To provide news and opinion to support professional growth and personal connections within the Berks County Medical Society community.
Berks County Medical Society MEDICAL RECORD
D. Michael Baxter, MD, Editor
Editorial Board
D. Michael Baxter, MD
Lucy J. Cairns, MD
Daniel Forman, DO
Shannon Foster, MD
William Santoro, MD, FASAM, DABAM
Raymond Truex, MD, FACS, FAANS
Beth E. Gerber, IOM
Berks County Medical Society Officers
Ankit Shah, MD, FACEP, FAAEM, FAMIA President
Olapeju Simoan, MD, MPH President Elect
Daniel Edwards, DO Treasurer
William Santoro, MD, FASAM, DABAM Immediate Past President
Beth E. Gerber, IOM Executive Director
Berks County Medical Society
2669 Shillington Rd,, Suite 501 Sinking Spring, PA 19608 (610) 375-6555 (610) 375-6535 (FAX) Email: info@berkscms.org www.berkscms.org
The opinions expressed in these pages are those of the individual authors and not necessarily those of the Berks County Medical Society. The ad material is for the information and consideration of the reader. It does not necessarily represent an endorsement or recommendation by the Berks County Medical Society.
Manuscripts offered for publication and other correspondence should be sent to 2669 Shillington Rd, Sinking Spring, PA 19608, Ste 501. The editorial board reserves the right to reject and/or alter submitted material before publication.
The Berks County Medical Record (ISSN #0736-7333) is published four times a year by the Berks County Medical Society, 2669 Shillington Rd, Sinking Spring, PA 19608, Ste 501. Subscription $50.00 per year. Periodicals postage paid at Reading, PA, and at additional mailing offices.
POSTMASTER: Please send address changes to the Berks County Medical Record, 2669 Shillington Rd, Sinking Spring, PA 19608, Ste 501.
10 Guest Editorial: Lessons Learned: Managing Health Care in the 21st Century
17 Reading Berks Science and Engineering Fair, Berks County Medical Society Medicine and Health Science Awards March 13, 2025
18 Installation of Officers/Board Members, Drexel University College of Medicine, West Reading Campus, March 30, 2025
The Neurobiology of Addiction
BCMS News & Events
In Memoriam: Craig H. Johnson, MD, FACS, FAANS
Society –
Content Submission: Medical Record magazine welcomes recommendations for editorial content focusing on medical practice and management issues, and health and wellness topics that impact our community. However, we only accept articles from members of the Berks County Medical Society. Submissions can be photo(s), opinion piece or article. Typed manuscripts should be submitted as Word documents (8.5 x 11) and photos should be high resolution (300dpi at 100% size used in publication). Email your submission to info@berkscms.org for review by the Editorial Board. Thank YOU!
Inaugural Address at the 2025 Officer Installation Ceremony
As I look around this room, I am filled with gratitude and excitement to see so many individuals who have been vital to the past, present, and, most importantly, the future of BCMS. Thank you all for being here today. It is truly an honor to be sworn in as president, especially as we gather for our first formal installation ceremony since before the pandemic!
A few months ago, at our 200th dinner event, I asked each of you to look within and recognize the incredible contributions you’ve made to our county, our society, and our community, especially during the challenges of the pandemic. I hope you took a moment to appreciate all the unseen efforts that were crucial in helping us navigate that difficult time. Your dedication truly made a difference.
As I stand before you today, I am energized by your passion, your energy, and your unwavering commitment. Together, we have an amazing opportunity to shape the future of BCMS over the next two years. While I am confident that BCMS is in great hands for years to come, there are a few key areas I hope to focus on during my term to ensure we continue to grow and thrive. These areas are Membership, Financials, and Community.
Membership
It’s clear to me that our society is incredibly strong, with many of you here having given years of service to both BCMS and our broader community. We are fortunate to have a solid foundation. Yet, as I look around, I also see a
need to better connect with younger practicing physicians and mid-career professionals. Over 200 years ago, BCMS provided physicians in Berks County with a sense of belonging to a larger medical community, a tradition that continues today. However, the healthcare landscape has changed. Physicians now often belong to one of the two major health systems in Berks County or work in smaller private groups. Our challenge—and our opportunity— is to demonstrate the value of being part of this community and to show the many ways BCMS can support not only physicians but their families as well. We have a great deal to offer, and I believe we can make our society even more indispensable.
Financials
As we all know, our membership has been significantly impacted by the pandemic, and, coupled with rising costs, our financial picture has faced some challenges. But I am confident that, together, we can turn this around. Increasing membership is a key piece of this puzzle, but we must also explore new revenue streams and innovative ways to secure our future. This is not something we can accomplish alone—our finance committee will play a vital role along with our treasurer, and we will work together to create sustainable solutions. Beth, our dedicated executive director, is already making tremendous strides in guiding us through this process, and I am confident that, under her leadership, we are heading in the right direction. If any of you have ideas or creative solutions, I encourage you to share
Ankit Shah, MD, FACEP, FAAEM, FAMIA President
them with us. Together, we can strengthen our financial foundation and ensure the long-term success of BCMS.
Community
One of the most fulfilling aspects of BCMS is the impact we have in our community. Whether it’s through our radio show or our Drug Take Back events, we are actively engaging with the people of Berks County. Last year, we worked with the Commissioners to explore the potential benefits of establishing a health department. This partnership is more important than ever, especially with the changing landscape of healthcare and the need for clear, reliable information. Our continued collaboration with local leadership will be key to upholding the high standards of healthcare delivery and education our community deserves.
Additionally, the Alliance, which has historically been a key support network for our society, is something I am excited to strengthen. Many of you may not know about the Doctor’s Grove—a beautiful and poignant site where trees are planted in memory of physicians from our county. This touching tribute is lovingly maintained by the Alliance, and I believe it is a symbol of the deep bond we share. I am committed to fostering stronger ties with the Alliance, and the current President, Gretchen Platt, to not only enrich our society but to further benefit the community as a whole.
Extraordinary
Adam J. Altman, MD
Angela Au Barbera, MD
Helga S. Barrett, OD
Jennifer H. Cho, OD, FAAO
Christine Gieringer, OD
David S. Goldberg, MD, FAAP
Marion J. Haligowski III, OD
Dawn Hornberger, OD, MS
Y. Katherine Hu, MD, MS
Lucinda A. Kauffman, OD, FAAO
Christina M. Lippe, MD
Barry C. Malloy, MD
Michael A. Malstrom, MD
Mehul H. Nagarsheth, MD
Abhishek K. Nemani, MD
Amy M. Olex, OD
Tapan P. Patel, MD, PhD
Jonathan D. Primack, MD
Kevin J. Shah, MD
Michael Smith, MD
Anastasia Traband, MD
Monica Wang, OD
Denis Wenders, OD
Linda A. Whitaker, OD, MS
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Conclusion
We have an exciting journey ahead of us. The road to reinvigorating BCMS will require hard work, but I am inspired by the collective untapped energy in this room. Together, we can meet the challenges of today and rise to the high standards that BCMS has always stood for. The next six
years hold incredible promise, and I am confident that, with all of you, we will accomplish great things.
Thank you once again for being here today. Now, let’s enjoy the hors d’oeuvres and drinks, and celebrate the bright future we’re all working toward!
Beth E. Gerber, IOM Executive Director
Berks County Medical Society Announces New Executive Director
BCMS Board Taps Experienced Association Executive to Lead County Medical Society
The Board of Directors of the Berks County Medical Society (BCMS) is pleased to announce the hiring of Beth E. Gerber, IOM, as its new Executive Director. With more than 30 years in nonprofit management and more than 20 years in association management, Beth brings a great deal of experience and knowledge to the position.
“The Berks County Medical Society is pleased to announce the appointment of Beth Gerber as our new Executive Director. Beth brings a wealth of experience to this role, having served in a similar capacity at the Lancaster City & County Medical Society for many years—a role she will continue alongside her work with us. Her extensive knowledge, enthusiasm, and dedication make her a valuable addition to our organization,” shared Dr. Bill Santoro, BCMS Board President. “Beth is highly accessible and eager to engage with our members. We look forward to the leadership and expertise she will bring to the Berks County Medical Society. Please join us in welcoming her to our community.”
Beth has served as the Executive Director of the Lancaster City & County Medical Society (LCCMS) for the past nine years and will continue in that role. Her work at LCCMS focuses on developing programs and initiatives to anticipate and meet the needs of members, create strong relationships among community partners to expand the society’s reach and influence, and coordinate all administrative aspects of the Society as well as that of the Lancaster Medical Society Foundation.
Prior to her role at LCCMS, Beth spent ten years as the Membership Director at the Lancaster Chamber of Commerce and Industry. Here, she developed and managed recruitment efforts to drive membership interest in the organization, its programs, services and initiatives. She also created and coordinated retention initiatives to effectively build relationships with members, and she administered the Chamber’s for-profit entity designed to increase membership value and generate revenue opportunities to be reinvested in operations.
Beth brings with her significant experience in member relations, volunteer management and board governance, event planning, strategic partnerships and financial management.
“I look forward to serving the Berks County physician community, building on the success of the past and advancing the work of BCMS into the future,” said Gerber. “The medical society is focused on promoting and protecting the art and science of the practice of medicine and I am eager to work with the board and our members to develop the resources, events and programs to best support that mission.”
Beth earned her Bachelor of Science in Business Administration, with a concentration in communications, from Elizabethtown College and her IOM credentials through the U.S. Chamber’s Institute of Organizational Management program at Villanova University.
She officially joined BCMS on February 18 and can be reached at bgerber@berkscms.org.
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NO ORDINARY TIME “ “
by D. Michael Baxter, MD, FAAFP
people led by the Franklin D. Roosevelt Administration in the years leading up to and through World War II. This “Greatest Generation” rallied and overcame the double calamities of our worst economic depression and a devastating war of the United States and our allies against ruthless, authoritarian regimes. During this time, much of our nation’s health and safety net as well as our trusted alliances were established which has earned the U.S. the title as world leader in the critical areas of economics, political freedom, social advancements and scientific achievement.
Many would now question whether this “march of progress” will continue. Recent changes at the level of the federal government have caused many distinguished voices in the scientific and medical community to raise the alarm regarding actions that may cause irreparable harm to the health and safety of our nation. In particular, such steps as the U.S. announcement of planned withdrawal from the World Health Organization (WHO); a cancelled meeting of the FDA’s Vaccines and Related Biological
(CDC) Advisory Committee on Immunization Practices (ACIP). In addition, thousands of positions are being eliminated throughout the Department of Health and Human Services including the CDC, Food and Drug Administration (FDA), the Centers for Medicare and Medicaid Services (CMS) and the National Institutes of Health (NIH) including “funding freezes” for hundreds of millions of dollars that support our most advanced scientific medical research in universities and other research facilities which has made the U.S. the world leader in such ground-breaking work.
Perhaps the area of concern which has received the most attention is that of “vaccine hesitancy.” Under the leadership of Robert F. Kennedy, Jr., who has been known as our nation’s most prominent “vaccine denier,” there are reasonable concerns for whether the federal government will support immunization research, development and promotion as it has for generations. In particular, while the U.S. is currently facing the largest number of measles cases in over a decade, Secretary Kennedy has continually raised the same
questions, particularly about the safety of the Measles, Mumps and Rubella (MMR) vaccine that were “debunked” years ago with The Lancet’s retraction (Vol. 363, Issue 9411, P750, Mach 06, 2004) of its earlier article falsely linking the MMR vaccine to autism. In 2024, The Lancet (Vol. 403. Issue 10441, P2307-2316, May 25, 2024) published a study that showed that over the past 50 years, 154 million children’s lives worldwide were saved by aggressive vaccine administration campaigns.
Let us be clear that concerns about these federal government actions transcend Republican or Democratic politics. The Berks County Medical Society (BCMS) has always remained non-partisan. We have many good friends on “both sides of the aisle” who join with us to support the work of physicians and other health care workers to promote the best practice of medicine and the health of our patients and our community. In addition, on March 31st of this year, 1900 scientist/physician members of the National Academies of Sciences, Engineering and Medicine signed a letter to the current Administration stating, “We hold diverse political beliefs, but we are united as researchers to protect independent scientific inquiry…We are sending this SOS to sound a clear warning: the nation’s scientific enterprise is being decimated” (National Academy of Sciences, www.nasonline.org).
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As we learned as we celebrated the 200th anniversary of the founding of the BCMS last year, our physician predecessors brought us out of the earlier days of limited understanding into the modern era of medicine based on scientific discovery and truth. From the earliest vaccines (smallpox-Jenner) to the development of the “germ theory” of disease (Pasteur), the early serendipitous discovery of antibiotics (Fleming) and the countless life-saving advancements since, scientific discovery, rigorously evaluated, has been the hallmark of medical practice. Just as our forefathers did in their “no ordinary time,” now is our time of challenge to rise to the moment, to let our federal representatives know of our informed concerns and to also expect our professional organizations to demonstrate the same courage to speak up that we expect of ourselves. The health and safety of our communities and the very lives of our patients depend on it.
ALESSONS LEARNED: MANAGING HEALTH CARE IN THE 21ST CENTURY
by Sue Perrotty, Retired President and Chief Executive Officer, Tower Health
fter retiring from my decades-long career in banking and finance, I knew I wanted to be of service to our community and support organizations where I could do work that matters.
However, I never thought becoming a Tower Health board member in 2019 would lead me to a multi-year stint in the healthcare industry. In fact, I used to joke that everything I knew about healthcare I learned from watching television shows like ER and Grey’s Anatomy.
Thankfully, I learned quickly. I listened to everyone and learned something new every day. Employees already doing exceptional work, from C-Suite executives to operational experts and frontline clinical staff, shared their insights and innovative ideas. But I must say, some of my best on-the-ground advice came from the talented physicians and caregivers who pride themselves on providing exceptional clinical care, and who never lost their focus, despite the challenges we faced. Their commitment and perseverance will surely allow them to shape healthcare for years to come.
In looking back, the days weren’t always easy. As you know all too well, healthcare is rapidly evolving, and the changes and challenges can feel like an avalanche at times. For example, I had never worked in a business where the “customer” won’t be the one paying, and you don’t know if, when, or how much you will be paid for services that have already been provided. The business model is very complex and
dependent on others, often with conflicting goals and outcomes. Receiving payments in healthcare is hard work, and the process is not well understood by the patients we care for daily.
But there are many bright spots, too, and I am truly grateful I had the incredible opportunity to lead one of the most significant and impactful “anchor institutions” in Berks County. As I return to my role as a Tower Health board member, I’m excited for the health system’s future with new President and CEO Michael Stern leading the outstanding leadership and clinical teams we assembled during the past few years.
Some lessons and observations I learned:
Importance of Interdependence
Remember K’NEX? It’s a toy that includes dozens of parts and pieces that attach to each other, and you use them to build multifaceted and interconnected structures.
Until I took on the CEO role, I was unaware that it is exactly how healthcare works, in this complicated and interdependent ecosystem where each piece clicks together to provide the best patient care, create an exceptional Tower experience, and move healthcare forward.
For example, look at the pathology department. You often cannot receive a final diagnosis or complete a complex operation until a pathologist reviews and provides results. It’s a major hub that so many depend on but are generally completely unfamiliar with.
Lesson learned: Take time to interact with, understand, and appreciate every function that allows you to provide the care your patients depend on. Be sure to thank them. When we crossed our own boundaries, we found innovative and rewarding new ways to streamline and improve care and lift the value of everyone’s contribution. This is what helped to improve our bottom line.
Hospitals are like cities
In theory, I knew that operating a hospital is a relentless 24/7 job. But again, TV provides a simplistic and glamorous view, much different from reality. Once you’re there, you realize it’s life-or-death every day. It’s complex and urgent, and there are no days off. There is never a minute that a hospital is not open – or busy. It’s all day long, 365 days per year.
Lesson learned: The work we do is for our friends, our families, and our neighbors. It is very personal, and people’s lives depend on us doing our jobs exceptionally well. It is also like running a city within a city, with the expectation that we will always figure things out — like how to be there in the blizzards, making sure that the power is on, systems are up and running, and our patients are being fed as well as healed. I have been awed by people’s commitment and resilience.
Partnerships are powerful
Ironically, there are several parallels between healthcare and banking, including the importance of leveraging partnerships. B2B (Business 2 Business) partnerships in technology, purchasing and operational services will be crucial to the future of healthcare, leveraging their investments and expertise in areas beyond care delivery. This is something the banking and finance industries have done for decades.
Partnerships provide the benefit of scale, specialization, investment and infrastructure, which then allow hospitals to invest in clinical delivery, enabling physicians and providers to deliver the healthcare our communities need.
Lesson learned: With the pace of change and rapid technological advancement that healthcare is seeing, it is imperative that we leverage our learnings, share our advancements, and focus on our mission of providing healthcare for all. Partnering with other B2B companies that are specialists in their areas of expertise allows greater
investment in the local delivery of services our communities need, and we deliver.
We are all in this together
Eliminating the us vs. them attitude that seems to persist all around us is critical. You have to pull it up from the root and throw it away because it is simply not helpful or healthy. Instead, lead with a humanistic approach that includes everyone, inspires hope and holds tight to compassion. It sounds simplistic, but we must first be compassionate to each other to provide compassionate care to our patients, and amazingly, we then create an environment that we enjoy working in.
Lesson learned: We are in complete control of how we treat others, how we react to difficult situations, and ultimately the impact our actions and reactions have on others. When we treat each other as we would like to be treated, we all win.
The mission matters
Tower Health is a nonprofit, mission-driven healthcare provider that researches and responds to the critical health needs of the community. My personal mission was to lift up our human capital, and enable them to create healthier, stronger communities. In the same way the banking industry provides financial literacy, how can we also provide health education that focuses on a holistic approach and compassionate care that addresses the ailment, as well as the patient’s other critical needs.
Lesson learned: I began by referring to Tower as an “Anchor Institution” – one that we depend on always being there to serve us – often in our worst moments. Our healing is paramount when you are in our hospitals or clinical offices, but our economic impact is equally as important. Providing outstanding employment opportunities, living and working in our communities, serving on school boards and educating the future doctors through our partnership with Drexel University’s School of Medicine are just a few examples of our importance to the future of our communities. I am proud to have served Tower Health on your behalf.
Prior to her appointment as leader of Tower Health in 2021, Sue Perrotty had a distinguished 27-year career in banking, culminating as executive vice president and head of Global Operations for First Union Corporation. Following her first retirement from the banking industry, she then went on to serve as chief of staff to Pennsylvania First Lady, Judge Marjorie Rendell.
Domestic Violence: Confronting a Family and Community Tragedy
by Beth Garrigan, Chief Executive Officer, Safe Berks
D. Michael Baxter, MD, Editor, the Medical Record
Domestic violence is defined by the Centers for Disease Control and Prevention (CDC) as “physical violence, sexual violence, stalking and psychological aggression (including coercive acts) by a current or former intimate partner.” It is a widespread issue that affects millions of people each year and impacts all ages, races, and income levels. According to the National Coalition Against Domestic Violence (NCADV), nearly 1 in 4 women and 1 in 7 men experience intimate partner violence in their lifetime. Pennsylvania sees high rates of domestic violence, yet many victims remain silent due to fear, shame, or lack of resources. Approximately 85% of individuals who experience domestic violence are women, most of the ages 18-34. Tragically, domestic violence is one of the major causes of mortality in this age group. In 2020, the United Nations calculated that 47,000 women and girls worldwide were killed by their intimate partner.
What are the Characteristics of an Abuser?
The reasons that a perpetrator may abuse a partner are complex; however, several factors can affect their behavior. Past experiences, especially personal experience with childhood abuse and other forms of family violence or other trauma, can lead to such violent acts. Some studies have shown that a history of substance abuse, which can impair judgment and increase aggression, can contribute to the likelihood of one committing acts of domestic violence. Certain personality traits, e.g. low self-esteem, strongly held beliefs in patriarchal gender roles, oversensitivity to criticism and unrealistic expectations of one’s partner, can also promote abusive behaviors. Certain social and cultural norms can encourage men who feel they are entitled to power and control over their partner. Other factors, e.g. an increase in financial stress and mental health disorders, especially when combined with a lack of social support, can have a
significant impact leading to abusive behaviors. Recognizing such factors can help physicians, other providers and family members identify those at risk of experiencing or perpetrating domestic violence.
On a typical day, there are more than 20,000 phone calls placed to domestic violence hotlines nationwide.
Why do Survivors Stay?
A common question is why doesn’t one who experiences such abuse just leave their partner? On average, a survivor of domestic violence will attempt to leave their abusive relationship seven times. There are many factors that contribute to survivors remaining in and/or returning to an abusive relationship and they differ for each person. Some of these include, but are not limited to:
• Economic Dependence: Many survivors rely financially upon their abuser and/or their abuser does not allow them to be employed and/or have access to funds, making it difficult to leave.
• Isolation: Abusers often cut survivors off from family and friends, limiting their support network.
• Fear: Emotional manipulation and threats of harm can make survivors feel trapped.
• Cultural Pressures: Social norms in some communities discourage survivors from speaking out or leaving.
• Children: Survivors with children may fear losing custody or disrupting their children’s lives.
• Pets: For many, pets are family members, too. In an abusive home, pets can be threatened, harmed, or even killed if the victim leaves.
• Love: The relationship has not always been abusive. There have been periods of peaceful times where the relationship was not volatile. The survivor believes the abuser will change.
Abusive relationships are extremely complex. Domestic violence is a pattern of coercive behavior used by one person to gain power and control over another in an intimate or familial relationship. The most dangerous time for a survivor is when they leave the abusive situation because they threaten the power and control their partner has established over them. For this reason, it is important for survivors to have access to free, confidential help in developing a safety plan.
What is Being Done?
Organizations like Safe Berks are working to address domestic violence by offering free and confidential support services, legal advocacy, and community education. Safe Berks provides:
• Emergency Hotline: A 24/7 crisis hotline and text line providing immediate access to a trained advocate for resources, referrals, and safety planning.
• Emergency Shelter: Short-term emergency shelter for survivors and their children.
• Counseling: Individual empowerment counseling for survivors and their non-abusive loved ones and survivor support groups.
• Legal Advocacy: Assistance with protection orders, and court and law enforcement accompaniments.
“Every person has the right to live in safety and free from violence. The reality is that not everyone in our community has that freedom. Domestic violence plagues Berks County as it does the rest of our state and country. This year alone we have had two domestic violence homicides in our county. We see dozens of domestic violence victims walk through the courthouse doors and that is only a snippet of the true number. The District Attorney’s Office strives to use a trauma-focused approach to prosecution while seeking to hold these dangerous offenders accountable.”
How Can Members of Our Community Help?
• Raise Awareness: Talk openly about domestic violence and share Safe Berks’ information, highlighting their free and confidential services to make it easier for individuals seeking assistance.
• Community Programs and Education: Raising awareness about domestic violence and providing prevention programming in schools and throughout Berks County Community.
• Collaboration with Agencies: Partnering with law enforcement, healthcare providers, local nonprofit partners, and others to provide trauma-informed and victim-centered support services.
A most important collaboration is the one between those who experience domestic violence, social service programs and our judicial agencies, including local police and the district attorney’s office. According to District Attorney John Adams:
• Support Safe Berks: Volunteer or donate to Safe Berks. This can include donating your time as a family, employer, or community group. Safe Berks is always seeking volunteers to contribute to the organization in a variety of ways.
• Provide Opportunities for Safe Berks Programming: Open your workplace or organization for Safe Berks presentations or workshops. Support Safe Berks programming in your children’s schools or at their other extra-curricular activities/ groups.
• Believe Survivors: When a person shares their story of abuse, listen and believe them. Offer to connect them with Safe Berks resources for when they are ready to change their situation. It is important to empower survivors to make their own decisions. Although at times this may seem frustrating to the person providing the support, the survivor knows their situation best.
Domestic violence is a complex and pervasive issue that requires the attention and involvement of the entire community. While organizations like Safe Berks are crucial in offering support, the fight against domestic violence requires everyone’s participation—from those seeking help to individuals and communities standing up for change. Health care workers who care for those who suffer from domestic violence or who encounter those at high risk, should be vigilant to identify such individuals and readily discuss options for safety and support. By working together, we can create a future where survivors no longer endure abuse in silence, and where safe, healthy relationships are our societal norm. By addressing the root causes of abuse, providing direct assistance to survivors, and fostering a culture of empathy and respect, we can pave the way for a community with zero tolerance for domestic violence.
COMMUNITY ANCHORS: SAFE BERKS
Safe Berks is the leading agency in Berks County that serves all victims and survivors of domestic and sexual violence.
Our survivor support services include an emergency shelter program, 24-hour crisis hotline and text line, short-term empowerment counseling, support groups, legal advocacy and representation, medical advocacy, and educational programming to increase awareness and promote the prevention of domestic violence, sexual assault, and all forms of oppression.
Where Our Journey Began
In 1976, twelve dedicated Berks Countians met at the YWCA in Reading to begin the monumental task of providing support services to survivors of domestic and sexual violence. They met to discuss the details of providing a crisis hotline, counseling services, and temporary housing options. These individuals were pioneers both locally and statewide, as they sought to find solutions to end family violence and to help all survivors.
On November 12, 1976, they attended the first meeting of the Pennsylvania Coalition Against Domestic Violence (PCADV) held in Lancaster, Pennsylvania. Being some of the Coalition’s first members, these changemakers worked tirelessly to put together the framework to assist families seeking safety. They pooled their resources and pursued the support of the greater Reading community. They did not give up and the community responded. They even courageously provided shelter to survivors of domestic violence in their own homes.
Originally founded as Berks Women in Crisis (BWIC), we celebrated our 40th anniversary in 2016 with a significant transformation which included a name change to Safe Berks. This new name better reflects our mission and the diverse individuals we serve—all survivors, not just women and not just in crisis, but whenever a survivor needs support. As outlined in our vision statement, Safe Berks is committed to our work until there is a zero tolerance for abuse in Berks County.
Who We Serve and Our Impact Across Berks County
According to the National Domestic Violence Hotline, more than 1 in 3 women and 1 in 4 men in the United States have endured rape, physical violence, and/or stalking by an intimate partner at
some point in their lives. These staggering statistics highlight a harsh reality—abuse can affect anyone, regardless of their age, race, gender, ethnicity, religion, geographic location, physical ability, appearance, sexual orientation, or gender identity. Abuse does not discriminate. It knows no boundaries, impacting individuals across all walks of life. Given the widespread prevalence of domestic and sexual violence, it is nearly certain that everyone knows someone who has experienced abuse. This widespread impact underscores the urgent need for awareness programming, support for survivors, and action within our community.
For nearly 50 years, Safe Berks has been dedicated to serving survivors of domestic and sexual violence. We have expanded our support services and educational programming to address the evolving needs of the Berks County community. Additionally, we have increased our community partnerships to assist in removing barriers for individuals seeking our free lifesaving services. With the increase in community partnerships, Safe Berks has experienced a consistent increase in the number of requests for survivor support services, proving these wrap-around efforts to be invaluable for those we serve.
Educating our Community
Safe Berks offers educational programs designed to prevent domestic and sexual violence, raise awareness, and promote healthy relationships. Our outreach initiatives reach local schools, businesses, and organizations, helping to cultivate a deeper understanding of these critical issues throughout the community. Each year, our education team collaborates with local school districts to ensure that Berks County youth, at all grade levels, learn about healthy relationships. By using age-appropriate curricula tailored to different student age groups, we aim to empower young people with the knowledge and skills to foster respectful and positive relationships.
Safe Berks actively advocates for meaningful policy changes and collaborates with various community agencies to ensure that survivors receive a holistic and coordinated approach to care, addressing all aspects of their physical, emotional, and legal needs. By supporting Safe Berks, the community plays an essential role in breaking the cycle of abuse while working toward a future where every person lives a life free from domestic and sexual violence.
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Community Anchors: Safe Berks
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Raising Awareness and Supporting Change
Each year, Safe Berks organizes a variety of community-based events designed to raise awareness about the impact of domestic and sexual violence. The Celebration of Peace, which was held on January 21, 2025, is our largest fundraising event of the year and is crucial to the ongoing support of unrestricted funding for the organization. This event is traditionally held in winter and is an impactful evening for all attendees.
The Walk For NO MORE, being held on June 21, 2025, is a free public event aimed at sending a strong message to our community that we will no longer tolerate domestic and sexual violence. This event is held in tandem with Arts on the Avenue in West Reading. In October, Domestic Violence Awareness Month, Safe Berks partners with Reading Area Community College to hold the Silent Witness March and Dedication, an event to honor and recognize those lost to domestic violence homicide in Berks County while also providing support to their families and loved ones. This event will be held October 14, 2025.
In July, Safe Berks holds two fun, free, and interactive day camps for youth. These camps provide the opportunity to learn about social justice and how to collaborate to create positive change. Campers meet new friends and positive adult role models, and enjoy games, art projects and guest speakers. After Camp ends, Meetups are held throughout the year, offering the youth an opportunity to stay connected, develop friendships, and continue to work on positive initiatives in their schools and communities. Camp Safe Berks Jr. will be held July 7-11, 2025 and Camp Safe Berks will be held July 21-25, 2025.
In addition to the events mentioned above, Safe Berks organizes other activities throughout the year including awareness activities during April for Sexual Assault Awareness Month (SAAM), webinars, presentations, workshops, and community outreach efforts, all focused on further educating the public, ending stigma, and fostering a deeper understanding of the critical issues surrounding domestic and sexual violence.
The Impact of Funding on Survivors’ Services
Despite the increase in the number of victims/survivors requesting services, and the ongoing health crisis created by domestic and sexual abuse, Safe Berks faces level and/or reduced federal and state funding. The largest source of funding for our direct service staff has already been reduced, with an even larger, potentially devastating, cut expected in the year ahead. Unrestricted funding is vital for organizations like Safe Berks, but now more than ever, securing other revenue streams is crucial to the baseline of our organization. In response, Safe Berks has launched a variety of exciting initiatives to support unrestricted funding, including the sponsorship of birdies, a personal safety alarm for survivors, a Shop Safe Berks platform, and a fee-based Sexual Harassment in the Workplace training designed for local businesses and organizations, to name a few.
Domestic violence and sexual assault are not isolated issues—they happen county-wide and are public health crises. Safe Berks calls on every member of our community to stand together in ending abuse, saving lives, and breaking the stigma surrounding domestic and sexual violence. Together, we can make a powerful difference. Together we can create a Safe Berks.
To learn more about the impact of Safe Berks or how to get involved, visit www.SafeBerks.org or reach out via email to: MindyM@SafeBerks.org.
Reading Berks Science and Engineering Fair
Berks County Medical Society Medicine and Health Science Awards
March 13, 2025
The Reading Berks Science and Engineering Fair (RBSEF), held annually at Albright College, is a great Berks County tradition featuring the best and brightest projects from middle school and high school students throughout Berks County. The Berks County Medical Society (BCMS) is proud to be a featured sponsor of awards in the categories of Medical and Health Science. This year, local physicians Dr. Olapeju Simoyan, Dr. Ivan Bub, Dr. Samuel Bub, and Dr. Michael Baxter served as judges. BCMS President Dr. William Santoro presented the awards at a ceremony honoring all participants. BCMS awards included:
Senior Division:
First: Brady Edmund Robinson, Advancements in Cancer Therapy: Exploring Nanoparticles and Chemo Drugs for Targeted Cell Toxicity, MH004, 9th-12th Grades Medicine and Health, Conrad Weiser HS (District: Conrad Weiser)
Second: Allie Noel Horack, Managing Lactose Intolerant Symptoms Using a Galacto-Oligasaccharide, MH001, 9th-12th Grades Medicine and Health, Conrad Weiser HS (District: Conrad Weiser)
Third: Anika Sinha, Applications of Synthesized Gold Nanoparticles with BSA and Tryptophan as Capping Agents, MH003, 9th-12th Grades Medicine and Health, Wilson HS (District: Wilson)
Junior Division:
Alyssa Merie Reali, What’s in a Puff?, 7N007, 7th Grade Natural Science, LaSalle Academy
The judges were extremely impressed by the thoughtfulness and quality of every project and congratulate all participants, teachers, and staff who promote this outstanding event each year.
Installation of Officers/Board Members Drexel University College of Medicine, West Reading Campus
March 30, 2025
The Berks County Medical Society (BCMS) installed new Officers and Board members at an Installation brunch Sunday, March 30th, at the Drexel University College of Medicine, West Reading Campus. President Willaim Santoro, MD, welcomed the assembled group and introduced special guest Wendy Braund, MD, MPH, of the Pennsylvania Department of Health, and our 5th District Representative to the Pennsylvania Medical Society (PAMED) Board of Trustees. Dr. Braund provided an update on PAMED priorities and performed the installation ceremony. In addition, Dr. Santoro introduced Richard Long, Esq., General Counsel for PAMED; Michael Rivera, Berks County Commissioner; and Beth Gerber, the new Executive Director for the BCMS. Eve Kimball, MD, started the program with an inspiring quote from a 1923 publication from the Berks County Medical Society, reminding us of the great legacy which we carry forward.
Dr. Ankit Shah delivering his Presidential Address
Dr. Ankit Shah reciting his oath of office from Wendy Braund, MD, MPH, PAMED, District 5 Trustee
Officers, Board Members and PAMED representatives
Specializing in the diagnosis and treatment of ALL neck and back disorders.
Officers installed and serving two-year terms are:
Ankit Shah, MD, FACEP, FAAEM, FAMIA, President
Olapeju Simoan, MD, MPH, President-elect
Daniel Edwards, DO, Treasurer
Board Members include:
William Santoro, MD, FASAM, DABAM –PAMED Delegation Chair
Lucy Cairns, MD – Education Chair
D. Michael Baxter, MD, FAAFP – Advocacy Chair and Editor, the Medical Record
Caitlyn Moss, MD – Early Career Physician Chair
Gretchen Platt – BCMS Alliance President
Resident Chair – Fatima Khalid, MD, PGY-1, Reading Hospital Internal Medicine
Resident Member – Osadebamwen Osaghae, MD, PGY-1, RH Internal Medicine
Medical Student Chair – Peter Azia, Drexel University College of Medicine, W. Reading
Medical Student Member – Amogh Nagol, Drexel University College of Medicine, W. Reading
(There are a few open Board Member positions. If you’re interested in joining, please contact Bgerber@berkscms.org.)
Dr. Shah’s Inaugural Address is included this month as his “President’s Message.” (see page 4)
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ALL SURGERY PERFORMED IN BERKS COUNTY
Pain Management
Physical Therapy • Epidural Injections
Spinal Surgery
Edward M. DelSole, MD Fellowship-Trained Spinal Surgeon
Stephen P. Banco, MD Fellowship-Trained Spinal Surgeon
Steven M. Evans, DO Director of Non-operative Spinal Care
Attendees enjoying brunch
Installation of Officers/Board Members
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Dr. Santoro’s Farewell Address:
Good afternoon, everyone,
It has been an incredible honor to serve as President of the Berks County Medical Society for the past two years. This role has been especially meaningful because it coincided with the Society’s 200th anniversary—a milestone that allowed us to reflect on our rich history while also envisioning an even brighter future.
Anniversaries like this provide a rare opportunity to look back at the extraordinary achievements of both our Society and the field of medicine as a whole. Over two centuries, we have witnessed remarkable advancements, from the earliest days of medical practice to the cutting-edge innovations of today. But just as importantly, anniversaries push us to look forward—to ask what comes next, to consider how we, as physicians, can continue to shape the future of medicine in our community and beyond.
At the Berks County Medical Society, we have always been guided by our four core pillars: Practice Professionalism, Patient and Physician Advocacy, Educational Advancement, and Collegiality among our peers. These principles serve as the foundation of our work, shaping our efforts to support both our members and the broader community. Over the past two years, we have remained steadfast in upholding these values, ensuring that our initiatives not only enrich the lives of our physicians but also enhance patient care and strengthen the future of medicine.
It is often said that small changes, made with purpose and persistence, lead to profound transformations. Over the past two years, I have seen firsthand how this principle holds true. As a Society, we have taken important steps—some large, some small—that have strengthened our foundation and positioned us for continued growth.
Among our key initiatives, we continued our Drug Take-Back Day, a program that plays a crucial role in combatting prescription drug misuse in our community. We also furthered our commitment to education by expanding our scholarship efforts through the Pat Sharma Scholarship in our collaboration with the Reading
Hospital–Tower Health Summer Internship Program. These initiatives provide opportunities for the next generation of physicians and reinforce our dedication to the future of medicine.
Another significant step forward has been the realignment of our Society’s leadership structure to be more inclusive of medical students and residents. By creating a more welcoming and supportive environment for early-career physicians, we are ensuring that the next generation of medical leaders is actively engaged in shaping the direction of organized medicine.
Additionally, we made great strides in fostering relationships with all of the health systems in our county, encouraging collaboration and strengthening our collective voice in advocating for physicians and patients alike.
Of course, we also took time to celebrate our 200th anniversary with a wonderful gathering that brought together our members in the spirit of camaraderie and appreciation for our shared history. Beyond that, we embraced the joy of being together in a variety of ways—from a night at the Reading Phillies baseball game to a series of smaller, more intimate events that allowed us to connect on a personal level.
From initiatives like our Journal Club, where we met at various venues to explore both contemporary and historical medical literature, to lighter moments such as
gathering to watch the Army-Navy football game, taking a nature walk through the Wyomissing Park system with expert moderator Dr. Lucy Carins, enjoying an ice cream social at a member’s home, and even participating in a baking class at a local restaurant, we created spaces for meaningful connections. These gatherings were more than just social events—they strengthened the bonds that unite us as physicians and reinforced the importance of community, not only in our professional lives but in our personal lives as well. They reminded us that as physicians, we are more than just providers; we are individuals with unique interests and passions that make us human.
While these efforts may seem small on their own, together they form the backbone of something much larger: a Society that is thriving, growing, and evolving to meet the needs of both its members and the community we serve. Through each of these initiatives, we have worked to expand membership, increase engagement, and ensure that the Berks County Medical Society remains a vital force for good in the years to come.
As my tenure comes to a close, I do so with deep gratitude and great confidence in the future of our Society. I am thrilled to pass the torch to my esteemed colleague and friend, Dr. Ankit Shah, who I know will lead with vision, dedication, and integrity. Alongside him, Dr. Peju Simoyan and Dr. Dan Edwards will bring their passion and expertise to guide the Society forward.
Leadership is never about one person—it is about collaboration, shared purpose, and a commitment to something greater than ourselves. I have no doubt that under this new leadership team, the Berks County Medical Society will continue to flourish, making a lasting impact on both our profession and our community.
Though my time as President has come to an end, my commitment to this Society remains steadfast. I look forward to supporting our new leaders, working alongside all of you, and continuing to contribute in any way I can to the bright future that lies ahead.
Thank you all for your trust, your dedication, and your unwavering commitment to the field of medicine. It has been an honor to serve you.
Resident Rounds: A Shared Hometown –On Medicine and Vulnerability
by Fatima Khalid, MD
When we enter medicine, especially Internal Medicine, many of us talk about the “human connection” aspect of things. We talk about the longevity of the relationships we build, but as I sit in silence at the end of a long workday, I realize there are many other fields of work that involve human interaction—perhaps even more than medicine. It struck me that it is not merely about the connections we have, but about the nature of those connections—the conversations held in silence, in vulnerability, beyond all insecurities and walls.
When we meet our patients, we become privy to the most sensitive and personal information. We hold their secrets, tucking them into the millions of crevices in our hearts, protected beneath MRN numbers, HIPAA regulations, and a thousand different folds. Yet, as we sit at their bedside, we must remain composed, hiding ourselves beneath empathetic smiles, a comforting hand, and a gentle touch. Vulnerability takes up a lot of space, and sometimes there is only room and time enough to hold one person’s.
However, occasionally, in this dance of connection and vulnerability, the curtains fall, and rare crossovers happen. Sometimes, the room holds just enough space for both the doctor’s and the patient’s emotions to be acknowledged.
I want to preface this piece by saying that I arrived in this foreign land nine months ago, from a small town 11,000 km away. Adjusting to a different country and culture has been challenging, and residency is demanding. Needless to say, free time has been rare, and these months have raced past in a whirlwind cycle of rapidly passing days and nights. However, on that beautiful day, time stood still for a moment.
Miss A. was one of my colleague’s patients. I was informed that she was born and raised in the U.S. but had spent up to 15 years in my home country. I was told she really misses the food there and believes it is the best she has ever had. Naturally, I wanted to meet this person who
clearly had the best culinary taste in the world.
The next day, we met after rounds. As I introduced myself, I said my name, and she seemed enthralled to hear the most common name from my home country. When she asked where I was from, I told her the name of my hometown—a small, lesser-known town in the south of the country. To make it more relatable, I began to describe its proximity to a larger, more familiar city. She stopped me mid-sentence.
She held my hand and told me I didn’t need to explain—because it was the town she had gotten married in, the town she had lived in, the town she had spent so much of her life in.
After nine long months in this foreign land, I had found someone from my hometown. Time stopped. And for a moment, I think my heart did too.
She said she had never met anyone from there before, and interestingly, I told her neither had I. Conversation flowed effortlessly. We shared stories about that town, the country, and the food. She told me about her life there and how much she misses it. I told her the same. Her story was 15 years old; mine was fresh and raw.
In the silence that followed, she asked if I missed home. I told her yes, and in the momentary pause that followed, I knew she understood exactly what I meant.
Medicine demands a lot from us—it takes emotions, physical resilience, and mental strength. But in return, it gives us these moments of connection, raw emotion, and human experience.
So, as I sit here after a long workday, I feel somehow both empty and full, exhausted and rejuvenated. Yes, I give this profession my all, but in return, it gives me back so much more. And that, I believe, is a unique aspect of human interaction that I cannot find in any other field of work.
Student Vital Signs
AEmbracing the Challenge: From Classroom to Clinic
by Amogh Nagol MS ll, Drexel University College of Medicine West Reading Campus
s I look back to finishing my second year of medical school at Drexel University, I find myself standing at the crossroads between two distinct phases of medical education. The shift from preclinical coursework to clinical clerkships is not just a transition—it’s a transformation.
For the past two years, my learning has largely taken place in classrooms, small group discussions, and simulated patient encounters. We’ve spent countless hours dissecting complex disease mechanisms, memorizing intricate pharmacologic pathways, and honing our diagnostic reasoning skills. The rigor has been relentless, and yet, the deeper I delve, the more I appreciate the vastness of medicine.
Now, with Step 1 looming behind us and clerkships just ahead, a new kind of challenge begins—one that moves beyond textbooks and into the lives of real patients. There’s an undeniable excitement in finally stepping into the clinical world, applying what we’ve studied to real cases, and learning directly from seasoned physicians. But with that excitement also comes uncertainty.
How will I adapt to the fast-paced environment of the clinical sites? Will I be able to make meaningful contributions to my team? How will I navigate the inevitable moments of self-doubt and feelings of imposter syndrome? These questions echo in my mind, but they are met with an equally powerful sense of purpose.
What excites me most about this next stage is the opportunity to connect with patients. Medicine, at its core, is a human experience, and I am eager to build those relationships, listen to their stories, and be part of their care. I look forward to applying everything I have learned thus far. There are a lot of answers that I do not have. As such, the transition from student to clinician-in-training is a humbling one, but it’s also a privilege—one that reminds me why I chose this path in the first place.
As we prepare to don our short white coats and step into the real world, we do so with a mixture of anticipation and resolve. The next chapter of our journey will test us in ways we cannot yet fully grasp, but it will also shape us into the physicians we aspire to be. And that, more than anything, is what makes this moment so exciting.
IFrom The Boards to The Wards
by Peter Aziz MS ll, Drexel University College of Medicine West Reading Campus
t’s fascinating to think about moments of transition in one’s life. As I approach the end of my dedicated study period for my first-ever “board” exam—one in a series of many to come throughout my career—I pause to reflect. The path up to this point has not been entirely straightforward, with some bumps and a few turns, and the road beyond remains uncertain. One thing I do know, however, is that it is in these moments of transition that I feel most alive, turning the page to start a new chapter of growth and grit.
The pre-clinical phase of my medical education is almost complete. As I tie up the last few loose ends, I have come to realize—unsurprisingly—that most of my medical knowledge has been applied either to hypothetical cases or standardized patients. The latter are paid actors trained to present with a constellation of symptoms and life events, facilitating practice and assessment of our clinical reasoning, primarily through the physical exam. Notably, I have spent most of my time in this phase with the hypothetical patients—whom I will call the “vignette” patients. They have helped me, and many others, build the clinical foundations of our medical careers.
Vignette patients present like this:
“A 45-year-old man comes to the physician for evaluation of worsening heartburn, which has been present for the past 15 months. The pain has become more frequent and severe in the past month and is no longer relieved by antacids. He also has occasional trouble swallowing. Endoscopic examination shows erythema of the lower third of the esophagus. Microscopic biopsies of this area reveal basal hyperplasia and an eosinophilic infiltrate of the squamous mucosa.”
One thing that instantly stands out to me is that vignette patients always seem to exist in a perfectly efficient healthcare system, where biopsies and endoscopies are performed and interpreted without any delays. Medical students everywhere have saved countless lives in these board-style practice questions simply
by choosing the correct answer. By that same logic, many vignette patients have also been misdiagnosed—and even lost their lives— when the correct answer was unknown, a common experience for anyone undergoing medical education, me included.
There are obvious differences between patients on board examinations and real patients in hospital wards. The clearest difference, as one would expect, is that healthcare providers rarely have access to such neatly packaged details of a patient’s suffering and illness. This is due, in large part, to the complexity of the human experience—how each individual copes with illness—as well as external factors that influence health, such as social determinants, language barriers, and healthcare access. Healthcare providers must actively listen to their patients and piece together the full picture behind their illness.
As I prepare to begin my clinical rotations in a few weeks, I am both excited and eager to witness this process unfold in real life. At the same time, I can’t help but feel a bit nervous about stepping into the role of the provider myself.
The Neurobiology of Addiction
by William Santoro, MD, FASAM, DABAM
Addiction, now often referred to as “substance use disorder,” is a primary, treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences. The brain circuitry addiction effects are those of reward, motivation, learning, judgment, and memory. The dysfunction of addiction leads to characteristic biological, psychological, sociological and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use. Addiction can be defined as a chronically relapsing disorder, characterized by compulsion to use a substance, loss of control in limiting the use of a substance, and emergence of a negative emotional state, withdrawal, when access to the substance is prevented. DSM-5 combined two separate disorders, substance abuse and substance dependence, into substance use disorder (Addiction) with a range of mild, moderate, to severe.
Addiction is characterized by the inability to consistently abstain from use, impairment in behavioral control, craving, diminished recognition of problems with behaviors, and diminished recognition of problems with interpersonal relationships. To separate addiction from other neurological disorders, four factors must be present. These four factors, compulsion, craving, consequences and control, are simply referred to as the 4 Cs. Although no other chronic disease has the 4 Cs, addiction does have a lot in common with other chronic diseases. Like other chronic diseases, addiction involves cycles of relapse and remission. Like any other chronic disease, including diabetes, cancer, and heart disease, addiction is caused by a combination of behavioral, psychological, environmental, and biological factors. While genetics play a key role, it is estimated that they are responsible for only about half of a person’s risk of developing a substance use disorder. Without treatment or engagement in recovery activities, addiction is very often progressive and can result in disability or premature death. Addiction is considered a disease by most medical associations, including the American Medical Association and the American Society of Addiction Medicine.
People feel pleasure when basic needs, such as hunger and thirst, are satisfied. In most cases, these feelings of satisfaction are caused by the release of certain chemicals in the brain. Dopamine is believed to be the neurotransmitter (hormone) responsible for addiction, due to its role in producing euphoria. The difference between normal activity, other neurological disorders, and addiction is that substance use disorder causes the brain to release high levels of dopamine that cause extreme feelings of pleasure. Continued substance use causes the brain to release more dopamine, which ultimately results in changes in the brain’s reward and motivation systems as well as memory. Dopamine rewards the individual and as the individual commits the experience to memory, it sets the individual up to repeat the behaviors that produce those feelings. This is no different than how healthy habits are formed. In this sense, humans are no different than Pavolvian dogs or Skinner pigeons.
The normal developmental changes might result in higher risk for drug use at some stages of a person’s life than other stages. Experimentation, and a path toward addiction, often begins in adolescence, a time when the brain undergoes important developmental changes. Beginning in preadolescence and continuing into the mid-20s, cortical grey matter volume decreases, part of the normal pruning process, and white matter volume increases, resulting in increasing connectivity. Drug exposure during adolescence is associated with more chronic and intensive use and greater risk of a substance use disorder than when the use is started at a later age. Normal adolescent-specific behaviors, such as risk-taking, novelty-seeking, and sensitivity to peer pressure, increase the liklihood to experiment with legal and illegal drugs. These activities may be due to incomplete development of brain regions that are involved in executive control and motivation. Heavy alcohol use during
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The Neurobiology of Addiction
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adolescence is associated with a range of neurobehavioral problems, including impairments in visuospatial processing, attention, and memory. Adolescents who drink heavily have had faster declines in the grey matter and smaller increases in white matter volumes than adolescents who were not heavy drinkers.
Certain environmental factors such as low socioeconomic status, weak social support systems, parental drug use, parental depression, general poor parenting, and drug availability due to poor neighborhoods have been associated with increased risk of drug use. Stress is also a common feature that increases the risk for drug abuse. The mechanisms responsible for increased risk of drug use due to stress are not yet well understood but are likely due to the stress-responsive neuropeptide, corticotropin releasing factor (CRF) through its effects in the amygdala and hypothalamic-pituitaryadrenal axis, part of the pleasure center of the brain.
As a person continues to use substances, the brain tries to get back to a balanced state by reacting less to those rewarding chemicals. This is called adaptation. As a result, a person may need to use more of the substance just to feel the same way they felt with lower amounts. This is called tolerance. Neuroadaptation refers to the processes by which initial drug effects are either enhanced (sensitization) or attenuated (counteradaptation) by repeated drug exposure. Drug-related responses (reinforcement) are modulated by the neuroadaptive changes that occur with repeated drug exposure. Addiction alters the brain’s mesolimbic dopamine pathway, also known as the reward circuit, which begins in the ventral tegmental area (VTA) above the brain stem. Dopaminergic neurons arise in the VTA, and their axons extend to the nucleus accumbens. Disruptions in these three areas of the brain, the prefrontal cortex, the VTA, and the nucleus accumbens, are particularly important in the onset, development, and maintenance of substance use disorders.
Adaptation and tolerance result in a person having strong desires or urges to continue to use a substance to revisit the sensation the release of dopamine will give, even if there are harmful or dangerous consequences. Furthermore, with many substances a person may continue to use simply to avoid feeling sick (withdrawal). As the pattern of use causes more dopamine to be released and used, the result is a lower baseline of dopamine. When the use stops, the deficit of dopamine causes the reverse sensation that the substance use caused. This is called withdrawal. Once this damage has occurred, the brain can heal, but it takes time. Normal, healthy dopamine production depends on a wide variety of factors, but many medical professionals believe that the brain’s dopamine production will return to pre-substance misuse levels over a period of about 90 days. Because of the time needed, those with a substance use disorder are at risk of returning to use due to triggers. A common term to describe triggers used by those in recovery is “people, places and things.” A trigger can be meeting
up with a person who the patient has used with in the past, going to a restaurant or bar the patient used to frequent, or simply seeing a glycine envelope from a package. Many people can be triggered to use by seeing substance use in a movie or hearing a song associated with their previous drug use.
The goal for someone with an SUD may be to stop them from using substances entirely. However, it is important to take whatever steps needed to reduce the risks associated with substance use. In the case of opioid use disorder, these strategies include the use of fentanyl test strips, needle exchange programs, expanding the access to naloxone, and even the creation of safe injection sites along with medication such as naltrexone, buprenorphine, or methadone.
Some people think addiction is not a disease because it is caused by the individual’s choice to use substances. While it is true that a person’s first use, and even into a person’s early use, there may be a choice; however, once the brain has been changed by addiction, the person loses control of their behavior. Choice does not determine whether something is a disease. Heart disease, diabetes and certain skin cancers involve personal choices like diet, exercise, and sun exposure. A disease is what happens as a result of those choices. Others argue that addiction is not a disease because some people with addiction get better without treatment. Most people who engage in substance use do not develop addiction, and many young people tend to reduce their use once they take on more adult responsibilities. People with a mild SUD may recover with little or no treatment. People with the most serious form of SUD usually need intensive treatment followed by lifelong management of the disease. However, some people experiencing addiction stop drinking or using other substances without treatment. Others achieve recovery by attending self-help meetings without receiving much, if any, professional treatment. Still, about 25-50% of people with a substance use problem develop a severe, chronic disorder. A chronic disease is a long-lasting condition that can be controlled but not cured.
In all cases, professional treatment and recovery supports should be made available to anybody who develops a substance use disorder. Addiction is a brain disease resulting in long-lasting changes in brain structure and function, specifically in the reward system. Advances in neurobiology have provided crucial insights into how addiction works, leading to the development of effective treatments. A combination of pharmacological and behavioral approaches offers the best chance for individuals to overcome addiction and lead fulfilling lives in remission or recovery. Remission is when a person decreases their use to a level that they no longer reach the criteria for substance use disorder. Recovery includes an improvement in the social determinants such as employment and a reconnection to family. Recovery occurs after remission. Bottomline… addiction is a treatable disease.
At MADJ, we specialize in helping medical practices and health systems of all sizes thrive in competitive landscapes. From small beginnings to significant success, our tailored strategies have transformed healthcare providers into community cornerstones.
IAdvocacy PAMED Advocacy in Action:
t’s been a busy start to the year for PAMED’s advocacy efforts! Earlier this year, a group of 20 dedicated PAMED members made their way to Washington, D.C., for the AMA’s annual National Advocacy Conference. One of the highlights? Productive meetings with legislators—or their staff—from 12 different offices in Pennsylvania’s congressional delegation, including conversations with Congressman Glenn Thompson and Congressman Dwight Evans.
The big topic of discussion was the 2.8% Medicare physician payment cuts that took effect on January 1. This marks the fifth year in a row of payment reductions. PAMED physicians stressed the importance of reversing these cuts, which are straining medical practices and jeopardizing patient access to care. Reversing this trend is critical to stabilize health care practices across the country.
Governor Shapiro’s Budget Address: Wins and Concerns
Switching gears to Harrisburg, Governor Shapiro’s recent budget address caught our attention with several health care-related proposals. PAMED was thrilled to hear the governor tackle private equity’s growing influence in health care. Private equity takeovers are putting profit over patient care, creating unnecessary pressure for physicians and eroding patient trust. PAMED couldn’t agree more with the governor’s call for action here—we must protect the integrity of health care.
Another win? The governor’s proposal to increase incentives for the Primary Care Loan Repayment Program, which will help bring more physicians and health care professionals to rural areas in
Pennsylvania. We also strongly support his focus on expanding mental health services statewide, ensuring all Pennsylvanians have access to the care and support they need. Breaking the stigma surrounding mental health is a mission we fully endorse.
However, there was one major disappointment in the governor’s address: his position supporting independent practice for nurse practitioners without physician supervision. While we respect the vital role nurse practitioners play, independent practice introduces significant risks, and we urge the governor to reconsider this stance. As PAMED President Dr. Lynn Lucas-Fehm so perfectly put it, “Patient safety should always be our top priority.”
Your Voice Matters: New Legislative Priorities
Looking ahead, PAMED has set its legislative priorities for the next two years, based on feedback from our December 2024 survey. Here’s what’s on the agenda:
• Medicare and Medicaid Reimbursement
• Scope of Practice
• Noncompete Clauses
• Mental Health Services Access
• Reproductive Rights
With these priorities in focus, 2025 promises to be a pivotal year for advancing health care legislation and protecting the interests of physicians and patients alike.
Thank you to our new, rejoining, and renewing members!
JAN 1 - APRIL 1
Muhammad Zain Ali
Badri Aryal
Bidisha Baral
Brett Bentkowski
Meha Bilkhu
Raesham Bukhari
Patrick Colarusso
Scot Depue
Rohan Dhamsania
Drug Take-Back Event
Saturday, May 3, from 8:00 a.m. to 11:00 a.m.
Reading Fightin’ Phils, FirstEnergy Stadium parking lot
1950 Centre Avenue, Reading Volunteers encouraged!
Amin Muhammad Dharani
Justice Dove
Khaled Elsokary
Michael Kakareka
Madhavi Devi Kakarlapudi
Eric Kantner
Jade Kerr
Fatima Khalid
Jacob Lucas
Amogh Nagol
Osadebamwen Osaghae
Prakash Patel
Bailey Pechner
Pablo Sisiruca
Shandelle Sookdar
Taylor Standiford
Jessica Vasanthan
Berks County Medical Society:
Upcoming Events
BCMS Night at the Reading Fightin’ Phils
Thursday, August 14, 6:00 p.m., FirstEnergy Stadium
1824 Journal Club Fall 2025
(Date to be announced)
The Highlands at Wyomissing 2000 Cambridge Avenue, Wyomissing
In Memoriam
Craig H. Johnson, MD, FACS, FAANS
November 11, 1947-January 29, 2025
by Richard A. Close, MD, and Raymond C. Truex, Jr., MD
Fifty years ago, the “3094 Club” was one of the most exclusive organizations in Philadelphia. It was so select, in fact, that it had only five members; among the five were both authors of this obituary. In July of 1974, those members eagerly awaited the incoming new sixth member of the club, one whose prodigious reputation preceded him. On the appointed day, the initiate arrived, leaving his Corvette in the parking lot.
To explain, “3094” was the telephone extension for the Neurosurgical Resident on-call room at Temple University Hospital, and the five club members were the upper level Neurosurgical residents at Temple. The new initiate arrived, prepared for any eventuality, with two bags of chips and pretzels, two liters of soda, a suitcase with a change of clothes, and a copy of Schmidek’s Textbook of Neurosurgery. It was reminiscent of going to band camp, as he had been a saxophonist in the Reading High School band. We studied the Schmidek Textbook more closely; every word in every line was underlined with a yellow magic marker. “That’s no way to study,” we thought, until we soon enough realized that the new member, Craig Johnson, remembered everything he had underlined. We were pleased with our new club member’s disposition, which was jovial and self-effacing, no hint of the brilliant mind, the compulsive work ethic, the caring bedside manner, and the meticulous technical expertise which became apparent to us during Craig’s residency years. One of us went on to become a junior faculty attending neurosurgeon at Temple University Hospital, assigned to supervise Craig’s education and surgical training. What an intimidating task to mentor a student who knew as much as the teacher. Since those early associations, one or both of us has been a close associate of Craig Johnson, a colleague
that we have loved and admired over the years.
July 1, 1978 was a landmark day for the Johnson family. Arguably, it was likewise important for Berks County, as the ensuing years would show. On this day, Craig Johnson, having finished his neurosurgical residency at Temple University Hospital, joined his father and Dr. Ernie Reigh in the practice of neurological surgery at the Reading Hospital, St. Joseph’s Hospital, and Community General Hospital. His father, Herbert, had been trained in Chicago by the renowned neurosurgeon A. Earl Walker. He was a protégé of Walker, and when Walker was given the chair of neurosurgery at Johns Hopkins, following Walter Dandy’s death, he took Johnson with him. For several years, Dr. Johnson essentially ran the neurosurgical clinical and teaching service at Hopkins as Dr. Walker’s first assistant.
Craig was born in Baltimore and much to the delight of his father, showed interest from a very young age in following in his father’s footsteps. As a toddler, Craig would sit on Dr. Walker’s lap and recite the lobes of the brain pertinent to whatever places on little Craig’s head Dr. Walker would touch (frontal, temporal, parietal, etc.). The Johnsons moved to Reading in 1953 and Herbert became the initial chair of neurosurgery at all three hospitals, but primarily at Reading. After ten years of tireless effort, and with help from his loyal partner, Ernie Reigh, Herbert Johnson developed the most successful community-based private practice of neurological surgery in Pennsylvania, while transforming the Reading Hospital from a sturdy dispensary into a national-class medical center.
Craig was well acquainted with the challenges of community neurosurgery by virtue of the fact that he lived it in his father’s
household. Craig’s academic record can best be summarized in one word: ONE. He was always first in his class, all through the Reading school system, Franklin and Marshall College, Temple University School of Medicine, and finally, the American Board of Neurological Surgery. It is a gross distortion, therefore, to think that Craig stepped into a family legacy when he arrived in Reading to fulfill a lifelong dream of working with his dad. Such was not the case! Of all his accomplishments, Herbert was most proud of Craig’s intelligence, his skill, and his extraordinary work effort. The two, father and son, worked together for the last ten years of Herbert’s life. Herbert continued to teach those in the operating room as well as his partners, and especially Craig. Craig, on the other hand, brought Herbert new methods and ideas that he had learned during his residency. The quality father and son time that was often missing as Craig was growing up was more than made up for as they worked together night and day, and continued to make neurosurgery prosper and grow in Berks County.
Craig was a blue-collar type surgeon. He worked tirelessly to deliver to each and every patient the best possible result. There were some eye-popping cases, such as a trans-oral resection of a displaced odontoid in a rheumatoid patient, and on another occasion he removed a lawn dart from the posterior fossa of a preschool child with complete recovery. These accomplishments were only known by those immediately involved. The Johnsons never boasted.
After Herbert’s death, in 1990 the three of us reunited to carry on the Neurosurgical tradition at Reading Hospital. It was a common sight to see Craig at his desk at midnight, dictating the notes from the day’s office visits, only to reappear at 07:30 the following morning to undertake a lengthy surgical procedure. This began to take a toll on Craig. His discomfort became apparent when EPIC was introduced to Reading Hospital, as Craig was never a fan of computers. The transition of our neurosurgical practice into the Reading Health System in 2010 reduced our practice autonomy and
further influenced Craig’s decision to retire in 2015 at age 67.
In retirement, Craig was able to devote more time to the things he loved outside of medicine: his cars, his family, travel, ice cream, and golf. In 1986, Craig was the club champion at the Moselem Springs Golf Club (see Reading Eagle photo), and he continued to play recreationally with his medical associates after retirement. Ever the collector, at one point he had 34 sets of golf clubs in his garage, and usually had four or five luxury automobiles, one for every occasion. Craig and his wife, Sue, purchased a home at Baywood Greens in Delaware, along with a pontoon boat that he loved to captain, and a snappy golf cart to tool around in. Craig and Sue were very happy there.
But the golden years were not kind to Craig, and after but 10 months of retirement, illness robbed him of his vitality. In 2016 he developed bladder cancer, and required an extensive surgery to reconstruct his excised bladder. This was followed by chemotherapy, and Craig required ongoing skilled postoperative nursing attention, which was provided by his devoted wife and capable nurse, Sue. Shortly thereafter, Craig began to manifest memory difficulty, and in his last years was diagnosed with Alzheimer’s Disease, causing him to move to the memory unit at Heritage at Green Hills, which was the site of his passing. What a cruel irony that such a fantastic intellect was destroyed by an illness of the organ system Craig understood so well.
Craig is survived by his wife, Sue; sons Christopher and Keith; stepsons Steven Hafer, Mark Hafer, and Greg Hafer; and his sister, Cynthia Texter. A memorial service was held at the Bean Funeral Home in Shillington on February 5, 2025, attended by family, friends, former patients, and office and hospital staff members; it was a bittersweet reunion. Craig Johnson’s extraordinary neurosurgical career and the Johnson family’s legacy to Berks County Medicine are treasured memories that deserve historical recognition and will not be soon forgotten by those that loved and respected him.
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Left to Right:
Domenic C. Izzo, Jr., MD, Benjamin Nicholas, MD, Francisco L. Tellez, MD, FACS, Michael C. Izzo, MD, Peter D. Calder, MD, Kasey L. Pierson, MD, Guri Bronner, MD