UAB Medicine Magazine Spring 2018 by UAB School of Medicine

A Magazine for Alumni and Friends of the School of Medicine

Volume 44 â&#x20AC;˘ Number 1 â&#x20AC;˘ Spring/Summer 2018

STOP THE

BLEED

UAB is teaching the public how to help save lives in a mass casualty event

LETTER FROM THE DEAN

s we all know, Valentine’s Day brought devastating news that our country had been scarred by another deadly mass shooting, this time at a high school in Parkland, Florida. That shooting, in which 17 teenagers and teachers were killed, came less than five months after the shooting at an outdoor concert in Las Vegas that killed 58 people. Then on March 14, UAB experienced the terrible consequences of gun violence when two employees were shot at UAB Hospital-Highlands. Nancy Swift, a nursing supervisor and a skilled care provider for more than 40 years, was killed. Tim Isley, an instrument management supervisor, is in stable condition as of this writing. Trevis Coleman, another employee, the shooter, was pronounced dead at the scene from a self-inflicted gunshot wound. As our UAB family mourns with Nancy’s loved ones and struggles to make sense of this tremendous loss, I am reminded that we work in a very special community that knows how to come together in moments of extreme challenge and grief. For that, I am grateful. As mass casualty events occur with awful regularity—threatening to become part of the backdrop of modern American life—feelings of helplessness can metastasize into despair and cynicism. The best way I know to overcome the hopelessness that can creep in when a problem seems as intractable as gun violence is to, as the maxim says, “Do what you can, with what you have, where you are.” Faculty members in our Division of Acute Care Surgery are doing just that by taking part in a national Stop the Bleed program, which trains civilians to stop uncontrolled bleeding in hopes of saving lives in mass casualty events. In our cover story on page 8, you’ll read about teacher training sessions they are conducting at local schools along with members of an Air Force Special Operations Surgical Team operating out of UAB Hospital, and plans to expand the program. We are also celebrating a major medical milestone this year: the 50th anniversary of our transplant programs. Since Arnold Diethelm, M.D., performed the Medical Center’s first kidney transplant in 1968, our talented transplant specialists have changed the lives of almost 15,000 people, in many cases giving them a second chance at life. Their work has helped make UAB the South’s premier transplant center as well as a place where research is expanding the frontiers of transplant medicine. Read more about our transplant journey and where our programs are heading starting on page 14. Elsewhere in this issue, you’ll be introduced to outstanding scholarship recipients and the fascinating people who created and inspired their scholarships, and you’ll meet graduates of our Regional Medical Campuses’ Rural Medicine Programs who are growing the ranks of primary care providers in our state by opening a new clinic in Alexander City. These are just some of the stories in this issue that I hope will engage, enlighten, and inspire you. As always, thank you for your continuing interest in and support of our School of Medicine. Sincerely,

Selwyn M. Vickers, M.D., FACS Senior Vice President for Medicine and Dean James C. Lee Endowed Chair

COVER FEATURE

Stop the Bleed

UAB is taking part in a national program to teach the public how to help save lives in a mass casualty event.

FEATURES

The Gift of a Second Chance

UAB celebrates 50 years of transplant excellence.

Robot Revolution UAB is developing a new model of precision and rigor in robotic surgery training.

A Magazine for Alumni and Friends of the School of Medicine Volume 44, Issue 1, Spring/Summer 2018 SCHOOL LEADERSHIP

DEPARTMENTS IN BRIEF 3 Patient navigation comes to pediatrics; Fouad elected to the National Academy of Medicine, UAB’s Critical Care Transport program welcomes

new ambulance; and more.

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MEDICAL EDUCATION

Meet scholarship recipients and the donors who are fueling their dreams; learn about the Class of 2018’s successful Match Day.

ALUMNI PROFILES

Rural Medicine Program graduates launch new primary care clinic in Tallapoosa County.

INVESTING IN INNOVATION

ACROSS CAMPUS

Several significant gifts to UAB’s Mood Disorders Program kick off a $10 million fundraising initiative; a roundup of gifts and pledges from current and former faculty; former University Hospital chief of staff and surgery professor establishes new endowed scholarship; combined gifts from Birmingham businessman to Cancer Center top $1 million.

Scenes from the school’s second annual Diversity Fair; Colon on the Green promotes colorectal cancer screening; news from the school’s Regional Medical Campuses; and more.

FROM THE ARCHIVES

Snapshots from the history of the UAB Department of Surgery.

Senior Vice President and Dean Selwyn M. Vickers, M.D., FACS Executive Vice Dean Anupam Agarwal, M.D.

DEVELOPMENT AND COMMUNITY RELATIONS Vice President for Development and Alumni Affairs Thomas I. Brannan Executive Director of Development for the School of Medicine Jackie F. Wood Comprehensive Cancer Center Lisa E. Roth Comprehensive Diabetes Center Christian Smith Departments of Dermatology and Radiology Jackie F. Wood Department of Medicine Megann B. Cain, Christian Smith, Christopher Williamson Department of Obstetrics and Gynecology Erica L. Hollins Department of Ophthalmology and Visual Sciences; Callahan Eye Hospital Morgan Quarles Department of Otolaryngology; PM&R; Spain Rehab Rachel Fornest Department of Pediatrics Andrea Martin Departments of Neurology and Neurosurgery Kayte Fuglaar Departments of Surgery and Anesthesiology Jennifer J. Foster Medical Student Scholarships; Primary Care Jessica Brooks Lane Friends and Family Program Ivy Watson Cardwell Contact Information (205) 975-5659 • somdev@uab.edu

ALUMNI ASSOCIATION BOARD OF DIRECTORS President Timothy P. Hecker, M.D. ’04 President-Elect John R. Wheat, M.D. ’76 Secretary/Treasurer Rebecca R. Byrd, M.D. ’95 Immediate Past President Pink Lowe Folmar, Jr., M.D. ’72 District Representatives First - J. Donald Kirby, M.D. ’72 Second - James H. Alford, M.D. ’63 Third - George C. Smith, Sr., M.D. ’65 Fourth - Alice H. Morgan, M.D. ’82 Fifth - P. Michael Caruso, M.D. ’76 Sixth - Kirby I. Bland, M.D. ’68 Seventh - Michael A. Callahan, M.D. ’71 At Large V. Michael Bivins, M.D. ’96 Julia L. Boothe, M.D. ’02 Theodis Buggs, Jr., M.D. ’80 Mark H. LeQuire, M.D. ’82 Wick J. Many, Jr., M.D. ’73 J. Terrell Spencer, M.D. ’68 Ex-Officio Richard Champion, M.D. ’69 Executive Director Meredith Burns Assistant Director Brenda Joseph Program Coordinator Beth Eddings Contact Information (205) 934-4463 • office@alabamamedicalalumni.org

UAB MEDICINE STAFF

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Executive Director of Communications, UAB School of Medicine Paige Dorman Managing Editor Jane Longshore Art Director Kristin Farmer Associate Editor Emily Henagan Contributing Writers Ryan Broussard, Christina Crowe, Cary Estes, Rosalind Fournier, Tyler Greer Photography Nik Layman, Dustin Massey Multimedia & Graphic Design Kristin Farmer Contact Information (205) 934-0256 • somdev@uab.edu

IN BRIEF

IN BRIEF Photo courtesy of Children’s of Alabama

News and highlights from across the School of Medicine LONGER BLOOD STORAGE HAS ADVERSE EFFECTS Human blood from donors can be stored for use up to 42 days, and it is a mainstay therapy in transfusion medicine. However, recent studies looking at patient records have shown that transfusion with older, stored blood is associated with adverse effects. For severely injured patients who have massive bleeding and receive many transfusion units, older blood was associated with blood flow dysfunction, increased injury and inflammation in critical end organs, and lung infection. In a collaborative study published in PLOS Medicine, UAB researchers from the Departments of Anesthesiology and Perioperative Medicine, Biostatistics, Emergency Medicine, Pathology, and Surgery found mechanistic links between older stored red blood cell transfusions and subsequent bacterial pneumonia. This may reveal new approaches to improve safety of stored red blood cell transfusions.

Left to right: Brant Wagener, Jean-Francois Pittet, and Rakesh Patel.

Bringing Patient Navigation to Pediatrics UAB and Children’s of Alabama are adapting the UAB Comprehensive Cancer Center’s Patient Care Connect Program to children. The Patient Care Connect Program has already proved successful in decreasing stress and improving quality of life for adults diagnosed with cancer. Using nonclinical navigators, the new Family Care Connect Program (FCCP) will provide support and services to children diagnosed with cancer and sickle cell disease and their families. The University of Alabama Health Services Foundation awarded the interdisciplinary team led by the UAB Department of Pediatrics a grant to create the FCCP and test its effectiveness. “When a child is diagnosed with a tumor or is living with a chronic condition such as sickle cell disease the family faces multiple stressors across all major life domains, including frequent medical appointments and hospitalizations, treatment coordination across a variety of medical subspecialty teams, and disruption of school, social, and family life,” says Avi Madan-Swain, Ph.D., principle investigator and professor in the UAB Division of Pediatric Hematology-Oncology. “Taken together these factors lead to substantial psychosocial stress on a family which, left untreated, can compromise medical and psychosocial outcomes for the child and family. Integrating psychosocial care into the treatment plan and addressing family stress leads to improved engagement in care and treatment adherence. Testing the Family Care Connect Program will contribute significantly to existing knowledge given the lack of nonclinical navigation in pediatric hematology and oncology.” Leveraging insights from Anthony Hood, Ph.D., associate professor in the UAB Collat School of Business, the team will support collaborators to develop a sustainable business model for adapting the program in the future. “By collaborating with the Collat School of Business, we expect to show that the program will be cost-neutral, making it an attractive option for other pediatric chronic illness populations,” Madan-Swain says.

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IN BRIEF

Fouad Elected to

National Academy of Medicine Mona Fouad, M.D., MPH, professor and director of the Division of Preventive Medicine, has been elected to the National Academy of Medicine, one of the highest honors a physician or scientist in the U.S. can receive. Fouad is a nationally recognized leader in health disparities whose interdisciplinary approach to health disparities combines original research with research from the biomedical, behavioral, and social sciences. She is the founding director of the UAB Minority Health and Health Disparities Research Center (MHRC). “In the MHRC’s early years, much of my time was spent convincing the scientific community that health disparities research was far more than community outreach; it was science,” explains Fouad. “We look at the whole research continuum, from discovery to delivery.” “Dr. Fouad has a huge impact in her interdisciplinary approach toward the elimination of health disparities,” says Selwyn Vickers, M.D., senior vice president for medicine and dean of the School of Medicine. “As both the dean and a frequent collaborator on Dr. Fouad’s research, I’m pleased that her career is being recognized in a way that truly honors her accomplishments.” Fouad joined UAB in 1991 as an instructor in the Department of Medicine. She was promoted to full professor in 2005, and in 2009 became director of the Division of Preventive Medicine. From 2003 to 2013, she served as co-leader of the Cancer Control and Population Science Program in the UAB Comprehensive Cancer Center. She is also a member of the Diabetes Research and Training Center, the Nutrition Obesity Research Center, the Center for Outcomes and Effectiveness Research and Education, and the Comprehensive Center for Health Aging. In 2005, she was named the inaugural chair of the Commission on the Status of Women at UAB, a position she held until 2008. She was named senior associate dean for diversity and inclusion in the School of Medicine in 2013.

AMBULANCE UPGRADE UAB’s Critical Care Transport (CCT) program has welcomed its newest piece of lifesaving equipment, a ground transport ambulance with a Ford chassis and a Taylormade body. In addition to its striking exterior, the ambulance has the facilities to provide sophisticated, uninterrupted ICU care during hospital-tohospital transport. Safety enhancements include liquid suspension, which lowers the vehicle for easier loading and offers a smoother ride and a mechanism that automatically senses the grade of the road and diverts power to the appropriate wheels. More features include engine braking that assists with wet or slippery roads and automatically slows the engine to avoid extreme manual braking, a valuable feature in a heavy vehicle; captain’s chair seating for the medical team, which provides access to the workspace while safely seated; and Bluetooth technology in the cab so the driver can communicate hands-free. CCT has provided medical transports for more than 30 years and has transported more than 50,000 patients. A twin-engine Cessna Citation Bravo jet is used for long-distance transport and three ground units are used for local moves. The program estimates it has flown or driven more than 42 million miles to 46 states and 38 countries.

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UAB Medicine Spring/Summer 2018

IN BRIEF

CONTRACEPTIVE SHOT LINKED TO HIV RISK Replacing the popular contraceptive shot known as DMPA with alternative methods of contraception could help protect women in sub-Saharan Africa and other high-risk regions from becoming infected with HIV, according to a comprehensive review of available evidence published in the journal Endocrine Reviews. “Human studies suggest DMPA use may raise the risk of HIV infection in exposed women by about 40 percent,” says Zdenek Hel, Ph.D., (pictured below) professor in the Department of Pathology and a co-author of the study. DMPA (depot-medroxyprogesterone acetate) is the predominant contraceptive in sub-Saharan Africa, administered as a birth control shot every three months. An estimated 50 million women worldwide use DMPA. “It is also used at a relatively high frequency in Alabama and other Southern states in the United States,” Hel says.

The researchers note that the increased rate of HIV infection among women using DMPA is likely due to multiple factors including decreases in immune function and the protective barrier function of the female genital tract. “Access to safe, effective, and affordable contraception is critical for women’s health worldwide,” Hel says. “We have to do everything in our power to rapidly replace DMPA with a safer alternative.”

Creating a Safer Psychiatric ICU Turning down the lights and reducing noise levels can decrease assaults and the amount of time patients must spend in restraints on psychiatric intensive care units, according to research findings published in the Journal of the American Psychiatric Nurses Association. “The time period roughly between 4 to 7 p.m. often sees an environment of commotion and disquietude on high-acuity psychiatric units, resulting in a higher incidence of assaults and/or need to place patients in restraints to control aggressive behavior,” says Rachel Fargason, M.D., professor in the UAB Department of Psychiatry and senior author of the study. “On many psychiatric units, this three-hour period between the end of structured activities and the dinner meal is the most problematic of the day.” Fargason says the combination of bright lights, talkative staff, anxious evening visitors, clattering housekeeping carts, and physician traffic can create a highly overstimulating environment. She and her team began a structured change in sensory stimulation on the 20-bed, locked, psychiatric intensive care unit at UAB Hospital in October 2015 by dimming lights in the common spaces of the units at 4 p.m. This was followed by sound reduction and the introduction of music in November. Between December and February 2016, the team added tactile and visual art activities, movement, stretching, and aromatherapy. “Assaults and use of restraints dropped dramatically as we implemented these sensory adaptations,” Fargason says. “Rates for both assaults and restraints fell to close to zero, well below industry benchmarks and regulatory requirements.” The need for restraints fell by 72 percent, and assault rates fell 83 percent. Since the completion of the study, the psychiatric ICU has continued to utilize the stimulation reduction techniques and continues to see positive results. Fargason says the techniques could be adapted for other hospital units, particularly those where patients are behaviorally challenged due to dementia, delirium, or medication. “Our results might be repeatable on any intensive care unit or on geriatric units,” she says. “And since we saw the most profound effects with the dimming of light and lowering of sound levels, such adaptations might be applicable across the board to all hospital or health care settings.”

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IN BRIEF

CREATING RURAL RESOURCES

What Heart Attack Does to the Spleen and Kidneys

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UAB Medicine Spring/Summer 2018

“I believe that increasing access to quality health care for Alabamians in rural areas is essential,” says state Sen. Greg Reed (R-Jasper), who co-sponsored the bill. “The physicians and researchers at UAB are among the best in the world, and this new center will give Alabama’s rural hospitals direct access to game-changing innovations in medicine and health care management.”

Contributing writers: Kendra Carter, Jeff Hansen, Adam Pope, Alicia Rohan, and Bob Shepard

Ganesh Halade, Ph.D., assistant professor in the Division of Cardiovascular Disease, says researchers not only need to look at events in the heart as they seek ways to improve healing after a heart attack, they also need to examine simultaneous changes taking place in the spleen and kidneys. The spleen acts as a reservoir of immune cells that rush to the site of heart injury after a heart attack to begin clearing damaged tissue. Those leukocytes can lead to either heart protection or pathology, depending on how the immune response progresses. In turn, the injury in the heart muscle after a heart attack develops a progressive signal that triggers structural pathology and complications in the kidneys, which can affect survival in heart attack patients. Halade has published a functional and structural compendium of the simultaneous changes taking place in the heart, spleen, and kidneys in mice during the period of acute heart failure immediately following a heart attack and during the longer period of chronic heart failure that comes next. Such a systems biology study of heart-spleen and heart-kidney networks, also known as the cardiosplenic and cardiorenal networks, will be essential to developing novel treatments for chronic heart failure, he says. In the study published in the American Journal of Physiology-Heart and Circulatory Physiology, Halade and co-authors Vasundhara Kain, Ph.D., and Kevin Ingle looked at changes in the three organs at four time points: one day and five days after heart attack, which is the acute heart failure period in the mouse model, and 28 days and 56 days after heart attack, which is the chronic heart failure period. In correlation with changes in heart function, the researchers found definite histological and cellular changes in the spleen, as well as inflammatory responses in kidney inflammatory biomarkers. “The renal histology and injury markers suggest that cardiac injury triggers irreversible dysregulation that alters the cardiosplenic and cardiorenal networks,” Halade says. “Therefore, novel strategies or pathways that modulate comprehensive cardiosplenic and cardiorenal networks during acute heart failure or chronic heart failure could be an effective approach to study either cardiac repair or cardiac pathology.”

The Alabama Legislature recently approved a bill to create a resource center housed at the UAB Health System to provide support for nonprofit, rural, public hospitals in the state that are facing economic pressures. The bill, which has not been funded yet, would create the Alabama Rural Hospital Resource Center, staffed and managed by the UAB Health System. The center would assist rural hospitals in purchasing and supply chain, strategic planning, insurance and cost reporting, coding, recruitment, and compliance, among others. The plan calls for UAB Health System to add staff to provide expertise, advice, and resources to hospitals that request assistance.

Rhonda’s turning 6!

Rhonda Lusco, 2012 Kidney/Pancreas Transplant Recipient The team at UAB’s Comprehensive Transplant Institute has plenty of reasons to celebrate. Reasons like landmark research, breakthrough innovations, and Rhonda Lusco, whose combined kidney and pancreas transplant was one of more than 14,000 successful transplants since 1968. Fifty years of saving lives, impacting our community, and changing the world—all from the transplant experts at the region’s only nationally ranked hospital. Now that’s something to celebrate. Join the celebration and learn how you can be a part of the next 50 years at UABMedicine.org/Transplant50.

Celebrating 50 years of Transplant Success UABMEDICINE.ORG/TRANSPLANT50

S T O P T HE

BLEED

UAB is taking part in a national program to teach the public how to help save lives in a mass casualty event By Cary Estes

person lies before you

bleeding on the ground. Panicked emotions flow as swiftly as the blood. Help is on the way, but will it arrive in time? It is possible, perhaps even likely, that your actions in the next few moments will determine whether this badly injured person lives or dies.

This is a nightmare scenario that, sadly, has become an all-too-common part of the American experience in recent years. Mass shootings have occurred with increasing regularity, particularly—and horrifically—at schools. In just the first month of this year, there were 12 school shooting incidents in the U.S. Then on Feb. 14, 17 people were killed in a devastating mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida. Beginning with the tragedy at Sandy Hook Elementary School in Newtown, Connecticut, where 20 children and six adults were fatally shot in December 2012, there has been an average of one school shooting per week. And this doesn’t include the near-daily occurrence of shootings at other public places, such as offices, churches, malls, and nightclubs. “Unfortunately, that’s just a part of the world we live in right now,” says Jeffrey Kerby, M.D., Ph.D., director of the UAB Division of Acute Care Surgery in the School of Medicine and a former Air Force trauma surgeon. “We don’t have to accept it, but we do have to be prepared for it.” UAB is working to increase that preparation by participating in the Stop the Bleed (STB) campaign, a national initiative organized by the American College of Surgeons (ACS). The program’s primary objective is to teach people how to control blood loss from a badly injured victim from any sort of incident—be it a shooting, explosion, car crash, etc.—in order to improve the victim’s chances of survival until medical professionals can take over. “What we’re trying to do is make this training as commonplace as CPR training, where everybody has the knowledge and the tools to prevent blood loss and save lives,” Kerby says.

FEATURE

Jeffrey Kerby is a former Air Force trauma surgeon and the director of UAB’s Acute Care Surgery Division. He spoke to The New York Times in March about what it’s like to try to repair wounds from military-style rifles. “You will typically see a small penetrating wound. Then you roll the patient over and you see a huge exit wound,” he told the reporters. Photo by Dustin Massey.

STB emerged from the shock and trauma surrounding the Sandy Hook shooting. Hartford Hospital trauma surgeon Lenworth Jacobs Jr., M.D., led a committee formed in April 2013 that included representatives from the federal government, the National Security Council, the U.S. military, the Federal Bureau of Investigation, and a variety of emergency medical response organizations. The committee’s recommendations, called the Hartford Consensus, created a national policy on the best way to respond to mass casualty events. The committee stated that since uncontrolled bleeding is the most significant preventable cause of death in the pre-hospital environment (a person can bleed out in five to seven minutes), it is important for civilian bystanders to have the education and equipment needed to act as “immediate responders” and literally stop the bleeding. “In a situation like Sandy Hook where you have an active shooter, EMS can’t get into the building until they’re sure it’s safe,” Kerby says. “When they analyzed [the victims], they realized that some of them had survivable injuries but had bled to death before they could be treated. So if there had been people inside the building who had the tools and training, they possibly could have stopped the bleeding and saved lives.” UAB is the only ACS-designated Level I Trauma Center in Alabama, and Kerby serves on the ACS Committee on Trauma’s Executive Committee. It is natural, he says, that UAB take the lead on promoting and implementing the STB program. This involves offering training from both medical and military personnel, as well as providing STB kits that consist of tourniquets, compression bandages, gauze, hemostatic dressings, and protective gloves.

We want to get the kits in every classroom in every school in the state of Alabama, and get every teacher trained in how to stop bleeding. You can’t just have a single kit for the school that sits in the principal’s office. It has to be in the classrooms where the teachers can access them right away.”

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UAB Medicine Spring/Summer 2018

—JEFFREY KERBY

FEATURE

Battle Tested

Left to right: Christie Morman and Lars Porter are teachers at Homewood High School who took part in a Stop the Bleed training session conducted by UAB Acute Care Surgery faculty and staff. They say they feel more secure in their ability to act to help save lives if they ever find themselves in a situation like a school shooting. Photo by Dustin Massey.

“We want to get the kits in every classroom in every school in the state of Alabama, and get every teacher trained in how to stop bleeding,” Kerby says. “You can’t just have a single kit for the entire school that is kept in the principal’s office. They have to be in the classrooms where the teachers can access them right away. “Our first focus is on the schools, but we’ll provide the training to anybody who wants it. We’re trying to get kits in more public places. We want them in government buildings, sports facilities, malls—any public place where large groups of people gather. If you go to malls and airports, you see defibrillators hanging on the walls. We want Stop the Bleed kits right next to those, and to have as many people in the area trained as possible.”

To many participants’ surprise, the STB training takes only about 30-40 minutes to complete and is relatively easy to comprehend, even for those with no prior medical training. “Many people think that trauma surgery is something really sophisticated, but most of it is very straightforward,” says Jan Jansen, MBBS, Ph.D., director of research in the UAB Division of Acute Care Surgery. “Put pressure where the blood is spurting out or apply a tourniquet. It’s really as simple as that. But for people who don’t have the background, there is an understandable reluctance and anxiety when faced with somebody who has visible injuries and is bleeding. They think they need a professional. “The message we’re trying to get across is that this isn’t that complicated. If there is visible bleeding, you can stop it with direct pressure or a tourniquet. You can’t really do a lot wrong there.” A typical STB training session begins with a brief slide presentation explaining how best to curtail bleeding through the use of tourniquets or other forms of pressure. Then participants are divided into smaller groups of three or four people per instructor. They are walked through the process of applying pressure, packing a wound, and using a tourniquet. These steps usually are first demonstrated on mannequins, and then the tourniquets are applied to the instructor in order for trainees to get the true feel of working on a person. This is followed by a brief wrap-up discussion to answer any remaining questions. “It’s a lot like CPR training,” says Homewood High School math instructor and cross country coach Lars Porter, who took part in an STB session along with about 100 other teachers at the school. “They’re just giving you the basic instructions. They’re not asking you to be doctors; they’re asking you to simply put a tight belt around someone’s arm.” The knowledge that comes from an STB session enables participants to gain the confidence to do something helpful if an emergency situation arises. “Having knowledge is the best way to be prepared,” Homewood social studies teacher Christie Morman says. “If you’re prepared to some extent, you can at least focus on what you have to do, instead of panicking and not even knowing what the first step is. Doing something to at least give that person a chance is better than sitting there with no idea.” “Now I feel like not only could I do it, but I could turn around and tell a student how to do it, and they would get it,” she says. “I came out of the training thinking that if I had to teach someone how to do this very quickly, I could. It makes me feel better prepared for a potential situation.” The training is also used to dispel the widely held misconception that the use of tourniquets often leads to amputations. It is true that if limbs go too long without blood flow and function cannot be restored, an amputation might be necessary. “However, you can leave a tourniquet on for up to two hours and not lose the limb,” Kerby notes. Moreover, in a worst-case scenario, many would consider it better to lose a limb than to lose a life.

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FEATURE

Still, tourniquets were avoided for decades, even in battlefield situations where there often was no way for an injured solider to receive immediate medical attention. That began to change in the early 2000s when studies conducted during the wars in Iraq and Afghanistan found that the use of tourniquets greatly improved an injured soldier’s chance of survival with no increase in amputations. “There has been a sea change in thinking about tourniquets,” says Jansen, who served as a reservist in the British Army. “The No. 1 cause of preventable death on the battlefield was hemorrhage. Many of the soldiers who died did so before they could get to a medical facility [approximately 90 percent, according to a 2011 article from the Journal of the American Medical Association]. “For a long time, the treatment priorities had always been A-B-C—first look after the airway, then the breathing, then circulation, which includes stopping blood loss. But it was recognized that sometimes blood loss in these modern conflicts was so catastrophic that it had to be dealt with first.”

Homefront Heroes Jansen says the paradigm shift in battlefield medicine, where the top priority now is to stop hemorrhage, has carried over to civilian practice. Lessons learned on the battlefield often can be used in civilian trauma care, which is one of the reasons UAB has hosted Air Force Special Operations Surgical Teams (SOSTs) since 2010. Each six-person unit—composed of a trauma surgeon, emergency physician, nurse anesthetist,

Jan Jansen served in the British Army as a reservist and was awarded a Queen’s Commendation for his service in Afghanistan. As the Division of Acute Care Surgery’s director of research, he is working to identify geographic areas where making the Stop the Bleed intervention more widely available might help save lives. Photo by Nik Layman.

surgical scrub technician, critical care nurse, and a respiratory technician—is designed to offer mobile medical support for wounded American military personnel and the local civilian population during combat operations, packing everything they need into six backpacks. UAB hosts three, six-man SOSTs, who rotate on deployments that typically last about four months. Lt. Col. Benjamin Mitchell, M.D., an SOST leader, was awarded the 2017 Heroes of Military Medicine Award by the Henry M. Jackson Foundation for the Advancement of Military Medicine this past summer. In addition, a UAB-based SOST received Bronze Star Medals for their actions during a 2016 deployment to the Middle East during a Feb. 13 ceremony. Over the course of two weeks during summer 2016, the team treated 750 patients, responded to 19 mass-casualty events, conducted 16 life-saving surgeries, and treated victims of a chemical weapon attack. When not deployed overseas, SOST members hone their skills by working in UAB Hospital’s Level 1 trauma center and assisting in Stop the Bleed training. “They are a high-functioning group that goes to a lot of high-impact areas across the globe,” Kerby says. “They have the expertise and knowledge, and that’s well received by the community when we go out to do this training. They know they’re being trained

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UAB Medicine Spring/Summer 2018

FEATURE

Maj. Ben Von Schweinitz and members of one of the Air Force Special Operations Surgical Teams based at UAB are pictured on deployment in the Middle East. These six-person teams are composed of a variety of health professionals who offer medical support during combat operations. SOST members have helped lead Stop the Bleed teacher trainings at schools across the Birmingham area.

by people who have experience in these types of casualty situations, and that heightens the impact of what they’re learning.” Indeed, Maj. Ben Von Schweinitz, M.D., an SOST emergency medicine physician, says his unit applied more than 500 tourniquets during a recent deployment. And he says most of their techniques can be used just as effectively among the civilian population. “Injuries from gunshots and bombs originally were just seen in the military. Unfortunately, what has happened is those injuries are showing up in the civilian setting in places where large amounts of people will gather,” says Von Schweinitz, a native of South Carolina who has been at UAB since 2015.

Shooting victims can die from uncontrolled bleeding as quickly as five or seven minutes after injury. “The military has the expertise to deal with these kinds of injuries that the civilian side really hadn’t seen. What we’re doing with Stop the Bleed is showing people that these techniques are not that hard to learn, and they can potentially save many lives.” Of course, practicing such tactics on a mannequin or a healthy individual in a controlled environment is completely different from dealing with a real person who is suffering from traumatic blood loss in a chaotic emergency situation. But while there is no way for a civilian to truly prepare for such a situation, Von Schweinitz says the STB training can help. “The way to get over that feeling of panic is to turn it into a muscle-memory task,” he says. “That way, you’re more likely

in a stressful situation to focus on the task, and remember how the tourniquet is used and how it goes on.” In addition to the training, UAB is conducting research on how to make the STB campaign more effective. In particular, Jansen has been working with hospital data and the medical examiner’s office to identify geographic areas where STB interventions possibly could have helped saved lives. “With Stop the Bleed, people think of a shooting or another mass casualty event, but these events are fortunately not daily occurrences,” Jansen says. “What we’re interested in is to see if this can be useful in day-to-day life. “We’re examining data about patients who came into UAB Hospital and patients who never made it because they died before medical assistance was available. We’re trying to see where patients would benefit from having these interventions more widely available.” If Kerby has his way, geography eventually won’t matter because STB training and kits will be available nearly everywhere. UAB is promoting the program on social media through the hashtag #EveryClassroomEverySchool, and through events such as a Facebook Live demonstration in February that highlighted bleeding-control techniques. Kerby says he hopes members of the public will help expand the program’s reach through philanthropic support to buy and distribute more STB kits. “We’re also trying to arrange a day at the state capitol to train our lawmakers and educate them about the program,” Kerby says. “We want to train people to go out into their communities and organize their own training efforts. It doesn’t have to just be us. This can be a grassroots campaign.”

To learn more about giving to support the Stop the Bleed program, contact Jennifer Foster at 205-934-2875 or jenfost1@uab.edu.

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Second Chance The Gift of a

UAB celebrates 50 years of transplant excellence By Tyler Greer and Jane Longshore

Moving to a new city and

changing schools is a difficult transition for any teenager, never mind a senior in high school. But in 2010, that’s exactly what happened to 18-year-old Megan Gagliardi when she and her family moved from Memphis, Tennessee, to Birmingham. She says starting at a school where she knew no one was hard. Therefore, when she began experiencing health issues, she ignored them because she was focused on making it through the school year. “I would go to bed at night, and I felt like there was a pressure in my chest,” Gagliardi says. “I had this constant cough that never went away, but it was the end of the school year so I just tried to push through. After graduation, I told my mom how I felt. She took me to UAB where they ran a whole bunch of scans, test, and panels. They noticed there was a ton of fluid in my chest.” Gagliardi’s UAB Emergency Medicine care team gave her a diuretic. “The next morning I woke up 15 pounds lighter,”

Gagliardi says. “I had lost 15 pounds of fluid during the night.” After more tests, Gagliardi was diagnosed with a genetic form of dilated cardiomyopathy, which enlarges and weakens the heart muscle, preventing the heart from pumping blood efficiently. Gagliardi’s unexpected diagnosis came with another frightening blow: She was in end-stage heart failure and would need a heart transplant to survive. “To get that news at 18, it just throws you into shock,” Gagliardi says. “But I knew I would have great doctors taking care of me.” She was put under the care of Salpy Pamboukian, M.D., and Jose Tallaj, M.D., both professors in the Division of Cardiovascular Disease, and James Kirklin, M.D., the James K. Kirklin Endowed Chair of Cardiothoracic Surgery in the Department of Surgery. Since the first heart transplant in the Southeast was performed at UAB in 1981, the UAB Heart Transplant Program has evolved into one of the most distinguished programs of its kind in the nation, with hundreds of heart transplants to its credit. Patients are cared for in a state-of-the-art, 23-bed Heart Transplant Intensive Care Unit, one of only a handful of its type in the country.

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UAB Medicine Spring/Summer 2018

The day of her 19th birthday, Gagliardi got the news that a heart had been found. “I received my heart transplant on my 19th birthday, the best birthday present I’ll ever get,” Gagliardi says. “I just remember feeling so grateful. The night we went in for the transplant, my whole family was around me praying. I remember everyone crying, and at the same time I was thinking, ‘I’m so excited to be on the other side of this and to finally have my health back.’” Gagliardi’s transplant was a success, and her doctors expect that her heart will last 15-25 years before she may need another transplant. She has since graduated from college, completed three half marathons, gotten engaged, and is co-writing a book with her mother about her transplant journey. “When I look in the mirror, my transplant scar represents to me my battle scar; it shows everyone what I’ve been through and what I’ve achieved,” she says. “After the transplant, people would give me advice like, ‘You can put oil on that’ or ‘You can use a scar cream and fade it away.’ I didn’t want to do that. I love my scar, and I love showing people what I’ve been through. It’s a huge part of me.”

Bringing Brighter Futures

Gagliardi’s transplant is one of more than 14,000 organ transplants UAB Medicine has completed since 1968, when Arnold Diethelm, M.D., performed the Medical Center’s first kidney transplant. Fifty years later, UAB performs heart, lung, liver, kidney, pancreas, and bone marrow transplants, as well as multi-organ procedures. Led by Interim Executive Director Devin Eckhoff, M.D., and Co-Director Charles Hoopes, M.D., the UAB Comprehensive Transplant Institute has pioneered groundbreaking research, new therapies, and innovative techniques. It also helps UAB train the next generation of transplant leaders. UAB’s kidney transplant program, one of the three largest in the country, has completed more living donor transplants than any other program in the U.S. since 1987. This past December, UAB reached the 10,000 kidney transplant milestone. The program is known for taking on complex cases that other transplant centers can’t manage thanks to a high level of expertise and the ability to combine multiple technologies to “push the envelope” to restore patients’ quality of life and save lives. In 2017 alone, under the leadership of Michael Hanaway, M.D., and Cliff Kew, M.D., kidney program surgical and medical directors, respectively, UAB completed almost 100 living kidney donor transplants at a time when the nation was seeing a decline in the number of living kidney donations. This bold attitude is reflected in the Incompatible Kidney Transplant Program, by which a living donor kidney can be transplanted into a patient despite the donor and recipient having different blood or tissue types, a problem in almost half of all living donor transplant cases. Many programs offer living donor kidney transplantation but require a fully compatible match. UAB offers desensitization pretreatment to overcome blood group and/or tissue incompatibility barriers. The program also collects incompatible donor-recipient pairs in a database and identifies connections among incompatible

pairs to facilitate transplants. UAB is one of three locations in the nation and the only one in the Southeast able to combine desensitization with paired donation at a single center, helping to meet a serious need in a state that ranks ninth in kidney disease. With roughly 2,500 people on the kidney transplant waiting list, Alabama has more people per capita in need of a kidney transplant than any other state in the nation. “Living donor transplants that result from combining kidney paired donation and desensitization programs now account for almost a third of all living kidney donor transplants at UAB,” says Vineeta Kumar, M.D., medical director of the Incompatible Kidney and Kidney Paired Donation Programs. “Growth seen through these programs is only possible because of the generosity of our many wonderful living kidney donors and their recipients.” The UAB Kidney Chain is also tackling the problem of donor incompatibility. Through the Kidney Chain, a transplant candidate becomes eligible to receive a kidney if a family member or friend volunteers to donate a kidney to another patient. The chain began in December 2013 with Helena, Alabama, resident Paula King, who felt called to donate a kidney despite not having an intended recipient. King’s gift launched what is now the world’s longest kidney transplant chain, which reached 88 transplants this past December. Eighteen Kidney Chain donors are altruistic donors like King, but the program is full of stories of tremendous generosity.

Megan Gagliardi, pictured here with her mother Lynne Klinke, got the call that a heart transplant organ had been found on her 19th birthday. She calls the transplant “the best birthday present I’ll ever get.” Photo by Spindle Photography.

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FEATURE

“We’ve had compatible pairs who elected to receive from and give to a stranger instead of a direct donation so they could help others in need of transplant,” says Jayme Locke, M.D., surgical director of the Incompatible Kidney and Kidney Paired Donation Programs, and Kidney Chain coordinator. “That kind of sacrifice showcases a sense of community here that is very different from anything I have ever experienced in any of the places where I have previously worked. It’s one thing to give directly to your loved one; it’s something else to say, ‘I want to do more.’”

Setting Records

Advances like these plus long-running efforts by UAB transplant specialists to increase organ donation resulted in a significant increase in transplants at UAB in 2017, part of a national trend. UAB surgeons performed 462 total transplants in 2017—up from 398 in 2016—helping to fuel a national record of more than 10,000 deceased-donor transplants performed for the first time in a calendar year in the U.S. Deceased organ donor transplants at UAB rose from 318 in 2016 to 361 in 2017. Living kidney donors who donated through UAB’s Division of Transplantation also rose significantly, from 68 in 2016 to 96 in 2017. The number of organ donors within the state likewise has increased more than 53 percent over the past five years, while organs recovered for transplant have increased 55 percent. The increase in deceased donations recovered for transplant is in part thanks to the growth of the Alabama Organ Center (AOC) housed at UAB, which opened a new Donor Recovery Center in February 2016. The AOC recovered and transplanted 495 organs in 2017, a record year for the organization. The Recovery Center is the second busiest in the nation and is the only in-house center of its type connected to an academic medical center the size of UAB. This attribute and the addition of critical care specialist Sam Windham, M.D., have helped improve donor management protocols at the Recovery Center, which has resulted in more organs utilized for transplant. Traditionally, when an organ donor is declared brain dead, the process of maintaining the health of the donor’s vital organs until transplant surgeons can remove them occurs in the donor’s hospital. Recovered organs are then chilled and brought to the hospital where the transplant will occur. The amount of time that passes during transport can potentially diminish the quality of the organs. As part of the new Recovery Center process, the AOC transports the donor to the Recovery Center with the donor family’s permission and at no cost to the family. The organ and tissue evaluation and recovery are then performed at the Recovery Center. Afterward, the donor is transported to the funeral home of the family’s choosing or to the state medical examiner for an autopsy if necessary. Bringing donors to the AOC Recovery Center significantly decreases the time from procurement to transplant, improving transplant outcomes. Eckhoff says the increase in living donors in 2017 can be tied to the successful implementation of a Living Donor

Left to right: Vineeta Kumar and Jayme Locke are using their roles with UAB’s Incompatible Kidney and Kidney Paired Donation Programs to alleviate the problems of donor incompatibility and the lack of available kidneys for transplant. (photo by Steve Wood); Devin Eckhoff and Charles Hoopes are co-directors of the UAB Comprehensive Transplant Institute. Photo by Nik Layman.

Navigator Program. As part of the program, each patient identifies a “living donor champion” to oversee his or her search for a compatible kidney. UAB surgeons performed six kidney transplants within the first six months the program was implemented in 2017. These donors were directly attributed to the advocacy role played by living donor champions. Living donor navigators are trained UAB Medicine employees who help potential donors navigate the living donor evaluation process by answering questions, assisting them with completing required paperwork, setting medical appointments, and ensuring that donors have the support needed after surgery. In addition, the navigators are responsible for training and assisting the living donor champions, providing them with educational materials and other resources designed to help them be more comfortable with initiating conversations, and spreading awareness about living kidney donation. The program is modeled after a highly successful patient navigator program developed by the UAB Comprehensive Cancer Center. “The goal is to improve the chances of locating a donor, given that some patients may be too sick, too busy with treatment and other responsibilities, or too withdrawn from social circles to effectively manage the search,” Eckhoff says. “In some cases, the patient simply may not want to ask others to donate such a priceless gift. Choosing a living donor champion helps eliminate the need for patients to serve as their own advocates.”

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UAB Medicine Spring/Summer 2018

FEATURE

Looking Ahead

UAB Transplant Fast Facts The South’s largest comprehensive transplant program

462 transplants

completed in 2017

14,000+ organ transplants completed at UAB since 1968

1st heart transplant in the

Southeast performed at UAB in 1981

10,000+ kidney transplants completed as of December 2017

47 post-transplant years lived by UAB’s longest-surviving organ recipient

When discussing Alabama’s heavy burden of kidney disease and the limited supply of available organs during his annual State of the School of Medicine Address this past January, Selwyn Vickers, M.D., FACS, dean and senior vice president for medicine, did not mince words: “We will never have enough human organs to solve this problem.” Approximately 22 people die each day waiting for a transplant in the U.S. The School of Medicine is pursuing a cutting-edge solution to the lack of transplant organs thanks to multimillion-dollar grant received in 2016 from biotechnology company United Therapeutics Corp. to launch a pioneering Xenotransplantation Program. The program is aimed at generating kidney transplants from genetically modified pigs to humans by 2021. Two of the country’s foremost xenotransplant researchers, Joseph Tector, M.D., Ph.D., and David Cooper, M.D., Ph.D., joined UAB in 2016 to lead the program. “Drs. Cooper and Tector are asking the hard biological questions—not just can you take an organ from a pig, but can you genetically engineer the pig to protect its kidneys from the human immune response?,” Vickers said during his address. “It’s the vision of the Department of Surgery and the school to be the first in the world to transplant a pig kidney in a human. This is another example of how we as an institution can have local, national, and global significance.” Xenotransplantation is not entirely novel. Pig heart valves have been used for years without ill effect and are generally rejected only very slowly. UAB scientists believe whole organ transplants from genetically modified pigs are possible in the near future if immunological and physiological barriers can be overcome. The first step is kidneys, but possibilities also exist in pig islet transplantation in patients with diabetes; neuronal cell transplants for patients with certain neurodegenerative diseases, such as Parkinson’s; corneal transplantation; and eventually in providing pig red blood cells for transfusion into humans, particularly in areas where the availability of human blood is limited. “We want UAB to be the premier center for end-stage organ disease, whether it’s liver, heart, or kidney. There is no doubt that our list of those awaiting transplants—especially kidney transplants—is steep, and the cost of ongoing dialysis care is prohibitive,” Eckhoff says. “Even if you had 100 percent consent from every brain-dead donor in America, you still wouldn’t have enough organs to fill the need. And here in the South, we’re in the hotbed of organ failure—kidney failure, liver failure. People are dying waiting for organs. Xenotransplantation is a natural fit for us as a university and may spur many more biomedical opportunities in our region.” To learn more about giving to UAB’s transplant programs, contact Christian Smith at 205-934-1974 or cnsmith@uab.edu. To learn about becoming a kidney donor, call 888-822-7892 or visit uabmedicine.org/transplant/living-donor-program.

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Robot Revolution UAB is developing a new model of precision and rigor in robotic surgery training By Christina Crowe Photos by Nik Layman

obotic surgery may be on the leading edge of surgical techniques, but it is the time-tested approach of spending time with and listening to residents that is helping make UAB’s robotic surgery training program one of the most advanced and rigorous in the country. “I am a little bit crazy,” admits Kenneth Kim, M.D., associate professor in the Department of Obstetrics and Gynecology. “No normal surgeon sits with every resident—and I have 32 of them—for an hour each, every three months to train on the robot. That’s 32 hours for motion and simulation, one-on-one.” Kim, who pursued a Master in Health Professions Education degree following his medical degree, made it his mission to revamp the training program for robotic surgery at UAB. Thanks to his efforts, UAB’s is the nation’s only hands-on robotic surgery training program that starts at the outset of medical school; is highly rigorous in both its measurement protocols and the amount of time logged on the robots; and is cross-disciplinary, spanning multiple surgical fields. “The best educators and teachers are the ones who can adapt their teaching style to the learner,” Kim says. “I specifically study how people best learn surgical techniques and procedures. From the outset the process is coded in the motor cortex section of the brain and then eventually gets coded in the cerebellum—like when you learn to brush your teeth or walk. It becomes automatic over time and with practice.” Along with fellow surgeons across various fields, he has created a robotic surgery training program that is unique in its quantitative measurement protocols and tracking of residents’ progress as they train. Kim’s passion for robotic surgery, his experience as an educator, and his collaborative nature have combined to create a unique training program that reflects the excellence of UAB’s robotic surgery programs, which on track to achieve a major milestone. This spring, UAB will surpass the 10,000 robotic surgeries mark, a feat that helps make UAB the leader in robotic surgery volume in the country.

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FEATURE Clockwise from left: Benjamin Wei, Jeffrey Nix, Kenneth Kim, John Porterfield, and Jamie Cannon are some of the faculty members who have contributed their time and expertise to making UAB’s one of the most advanced robotic surgery training programs in the country.

The best educators and teachers are the ones who can adapt their teaching style to the learner. I specifically study how people best learn surgical techniques and procedures. From the outset, the process is coded in the motor cortex section of the brain and eventually gets coded to the cerebellum—like when you learn to brush your teeth or walk. It becomes automatic over time and with practice.” —KENNETH KIM

Robots in the OR

There are three types of surgery: open, the traditional form; laparoscopic, using a laparoscope to view inside the body from a small incision; and robotic surgery, which is a form of minimally invasive surgery and provides surgeons with precision movement and 3-D camera views of the patient. “Robotic surgery is certainly more advantageous for specific procedures,” says Drew Gunnells, M.D., administrative chief resident in the Department of Surgery. “You have more dexterity and your visualization is often better.” Jamie Cannon, M.D, associate professor in the Department of Surgery, is one of the highest volume colorectal robotic surgeons in the country. “The tools the robot gives you make it easier to conduct an operation, so you can do more complex, difficult surgeries,” she says. “I can help more patients using a minimally invasive approach than with laparoscopic or open.” The training program Kim and his colleagues designed uses simulation to measure hand motion and manipulation of the camera. UAB is the only hospital to employ a measurement system to track residents as they learn to use these tools. “We are five years ahead of the rest of the world in training robotic surgery to residents,” says John Porterfield, M.D., associate professor in the Department of Surgery and director of the General Surgery Residency Program. Porterfield also advocates educating medical students about robotic surgery as early as possible in medical school. “Early in medical school, people are more teachable,” he says. “We moved this training from the fifth year to the first, starting with bedside training, then a virtual simulator.”

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UAB Medicine Spring/Summer 2018

FEATURE

“Learning surgery is a lot like learning a sport,” Kim elaborates. “We’d never have an athlete learn a sport while they’re playing the game. We revamped our training program to make it more high-yield for the residents.” This includes the acquisition and use of teaching consoles with each robotic surgical system, allowing for simulation and practice outside of the operating room, with the oversight of a surgeon while residents practice. “This is incredibly rare,” says Andrew Papoy, M.D., administrative chief resident in the Department of Surgery. “Without the teaching consoles, it’s like watching the procedure on TV, rather than doing it myself. Dr. Porterfield can stop what I’m doing in a surgery and move my hands, for example.” There is a set score that trainees must achieve on the simulator before they can sit next to a surgeon with a patient. “They hate to watch, because watching surgery for a surgeon is just terrible,” Porterfield says. “We’re training them by putting them in a live environment, then guiding them through that environment very closely. Then we’re looking at it from a bit of a distance standing at a monitor, and finally they operate independently.” According to Porterfield, of the 254 general surgery programs in the U.S., about a dozen allow their surgeons to train enough in robotic surgery that they can perform a surgery upon completion. The result, UAB surgery residents say, is they are noticeably advanced among their peers. “It has helped tremendously in my comfort and ability with the robot,” says Danny Mounir, M.D., an administrative chief resident in the Department of Obstetrics and Gynecology. “I feel very comfortable now and confident in my future goals.” “I knew UAB was one of the best programs in the nation for robotic surgery, but I didn’t realize how good it is until I talked to my peers enrolled in other programs nationwide,” says Teresa Boitano, M.D., a PGY-2 resident in the Department of Obstetrics and Gynecology.

Quantifying Progress

UAB has a one-of-a-kind simulator designed in collaboration with Intuitive Surgical—a manufacturer of robotic surgery systems—that has programs for all of the procedures currently existing in robotic surgery, including hernia repair, lung lobectomy, prostatectomy, and hysterectomy, among others. UAB surgical residents—who specialize in everything from gynecology to general surgery to urology—are training on these tools to test them, which will also assist in collaborating with the company to design the next generation of teaching tools and simulations. The extensive training also allows for the simultaneous collection of data, which can then be used to quantify performance on the simulator. Jeffrey Nix, M.D., assistant professor in the Department of Urology and director of Robotic Surgery, specializes in the use of robotic surgery to treat cancers. He is working with Kim and colleagues across campus to expand and improve the robotic surgery curriculum, focusing on data collection. “Any time a resident gets on the simulator and touches the

console, everything they do is plotted on an X-Y-Z graph,” Nix says. “We’ll have objective data on how many clicks it took them, what their path was, if they ran into the floor or ceiling, and how far in they zoomed, among other measurements.” Nix hopes these data will allow for the development of a credentialing process for robotic surgery. “From open surgery you can’t collect these data; they are very subjective,” he says. “Here you can show what an expert surgeon looks like on a simulator, and compare novice and experienced surgeons. Our hypothesis is that you can then move trainees from novice to experienced surgeons more quickly.”

Patient Benefits

Residents are not the only beneficiaries of advanced training in robotic surgery. Because robotic surgery is a form of minimally invasive surgery, patients stand to gain from decreased post-operative hospitalization time and pain at the site of the incision. “It’s amazing how much the post-operative course is accelerated and improved with this,” Mounir says. “Patients usually respond with joy when hearing their discharge may be the same day, versus the next day.” Additionally, radiation and other treatments for certain cancers may start sooner after surgery in some cases. “We can do the surgical procedure through a tiny little hole, and if chemotherapy is required, the patient can start it quicker because they recover faster,” Boitano says. Nix sees personalized medicine and improved patient outcomes—with reduced health care costs—as the vanguard of robotic surgery. “This isn’t where minimally invasive surgery will stop,” he says. “We want it to continue to become less invasive. As the technology develops, we see patient-specific simulation coming online.” “Right now we’re helping develop the next generation of training tools and simulations, but we also have to adapt with the technology as it evolves,” Kim says. UAB remains on the forefront with this training, says Porterfield, who travels nationally—either joining forces with Kim or going on his own—to teach others about UAB’s training program. Kim notes this approach helps them cover as much ground as possible. It also speaks to their collaborative nature, which is rare among surgeons in different disciplines. “In the past five years more than 750 surgeons in all specialties have visited UAB to learn this program,” Porterfield says. “Very few places are willing to do what we’re doing, and even fewer are giving it away. It keeps UAB as a leader.” As he talks, he pauses to receive an incoming text from Kim, thanking him for assistance on a combination surgery performed together earlier that morning. “This is what it’s all about,” Porterfield says. “The collaborative spirit here is palpable,” Nix agrees. “We just know this is the right thing to do.”

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MEDICAL EDUCATION

A GIFT TO THE FUTURE Meet scholarship recipients and the donors fueling their dreams

he School of Medicine is fortunate to have many scholarship supporters whose impact on the lives of our students and their future patients, as well as the school’s mission to train skilled and compassionate physicians, is immeasurable. Thanks to their generosity, the school distributed more than $2.9 million in scholarship dollars to 171 students for the 2017/2018 academic year—meaning almost a quarter of the medical student body received a scholarship. In the following pages, you’ll meet a few of our outstanding scholarship recipients and the philanthropic supporters whose generosity is helping make their dreams of a career in medicine a reality.

Visionary Support

Stephen Kelly, M.D., a prominent Birmingham ophthalmologist and former chair of the UAB Department of Ophthalmology, lived a remarkable life of overcoming hardship, serving his country in wartime, and taking a chance on working at a fledgling medical center. When he died in 1986, his family wanted to create a memorial to honor his inspiring legacy. Kelly was strongly committed to medical education, and his widow, Patricia White Kelly, was a longtime member of the Philanthropic Educational Organization (PEO) Sisterhood. The family decided it would be fitting to establish the Stephen J. Kelly Memorial Scholarship Fund for medical students at UAB. Born in 1925, Kelly grew up an orphan in San Francisco but thrived at a prep school that gave him a scholarship. He served as an ophthalmologist in the Air Force during the Korean War before coming to UAB.

Left to right: Christopher Kelly and his son Stephen are continuing the tradition of excellence in ophthalmology established by their father/grandfather, Stephen Kelly; Sydney Middleton is the recipient of a scholarship that honors Kelly’s life and career (photo by Nik Layman).

“My dad became the Department of Ophthalmology chair in 1955 when he was 30, very young for a chairman of a department,” says his son, Christopher Kelly, M.D. Kelly also established a private practice on Birmingham’s Southside, where Christopher and his own son, named Stephen Kelly after his grandfather, now practice ophthalmology together. Both are School of Medicine alumni, and Christopher served as chief of staff at UAB Callahan Eye Hospital from 2012-2017. Stephen says his grandfather’s dedication to UAB was evident. “Teaching and helping run a department along with seeing patients in private practice required significant time and effort,” he says. “He considered it a high priority.” Christopher points out that while the idea for the scholarship came quickly, the family did not have the ability to make their goal an overnight reality. Instead, Patricia, their children, extended family, and close friends made regular contributions until, about 10 years later, the fund was large enough to begin making yearly awards. “When you think of a scholarship fund, you think of an old family with tons of money,” he says. “You don’t necessarily have to have that. If you do it over time, you can accumulate enough to make a significant difference.” Sydney Middleton, a third-year medical student, is one of the students who have benefitted from the legacy the Kelly family created. A Pinson native who attended BirminghamSouthern College, Middleton became interested in medicine when she was diagnosed with Type 1 diabetes at 14. “I was a patient at Children’s of Alabama, and my experience inspired me to want to help heal illness and help people manage disease,” she says.

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UAB Medicine Spring/Summer 2018

MEDICAL EDUCATION

When you think of a scholarship fund, you think of an old family with tons of money. You don’t necessarily have to have that. If you do it over time, you can accumulate enough to make a significant difference.” — CHRISTOPHER KELLY

Since entering the School of Medicine with assistance from the Kelly scholarship and the Henry Harland Hoffman Endowed Medical Scholarship, Middleton has looked for opportunities to help others while she earns her degree. She served this past year as an executive officer for Equal Access Birmingham, the School of Medicine’s student-run free clinic for the medically underserved. “That was a lot of work while completing my second year, but I really enjoyed doing it because I was helping individuals in the community who can’t otherwise get care,” she says. Middleton says she feels a strong draw to the field that was her initial introduction to medicine: pediatric endocrinology. “The first time I, as a medical student, talked to kids who have diabetes and understood firsthand what they’re going through and how to help them manage it was incredible,” she says. Middleton is grateful to the Kellys for helping make her dreams possible. “I hope the family realizes how much they impact the students they are helping,” she says, adding that one day she’d love to create a scholarship fund. “It’s powerful, and I think very needed in this day and age when students have lots of potential but sometimes need a little help to go as far as they can.” – Rosalind Fournier

Legacy of Excellence

When he was 6, John Ahn’s family moved from South Korea to Huntsville. Now the 24-year-old Ahn is a second-year medical student at the School of Medicine leaning toward either pediatric oncology or otolaryngology. He says receiving the McLester Endowed Medical Scholarship, along with other scholarship support from the school, is helping him realize his dream. “Coming from an immigrant family and an immigrant background, it’s a tremendous blessing to live in the U.S.,” says Ahn, who is one of six students receiving the scholarship in the 2017-2018 school year. “This scholarship was a huge help financially, and knowing that someone believes in me as a future physician means the world to me.” The McLester Endowed Medical Scholarship is named after James Somerville McLester, M.D., the first chair of medicine at what would become UAB. The scholarship is the brainchild of Birmingham businessman Jamie French and his wife Mary Dunn French. Jamie French, whose full name is James Somerville McLester French, is a grandson of McLester, along with his brother Billy. “We consider ourselves fortunate to be descended from him, and we recognize that he was an eminent physician in his career who made a significant contribution to medicine at UAB,” French says.

Left to right: John Ahn and Jamie French stand before a portrait of Dr. James McLester, for whom the McLester Endowed Medical Scholarship is named; Ahn is one of several medical students to be helped in the 2017/2018 academic year by the McLester Scholarship, established by Jamie and Mary Dunn French (front row) as well as other members of the French family and McLester descendants.

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MEDICAL EDUCATION

Born in 1877 in Tuscaloosa, McLester was the chief of medicine at the School of Medicine when it was in Tuscaloosa, and the first chair and professor of medicine at the Medical College of Alabama when it opened in Birmingham in 1945. Overall, he served at the medical school from 1921-1949 and was a key figure during its transition from a two-year, pre-clinical medical school to a four-year medical school. McLester was a pioneer in nutrition studies and wrote an influential textbook, Nutrition and Diet in Health and Disease, first published in 1927. He helped put the then-recently discovered vitamins nicotinic acid, thiamin, ascorbic acid, and folic acid to use in the treatment and prevention of major deficiency diseases, including pellagra, beriberi, and scurvy. He was the chair of the Council on Food and Nutrition of the American Medical Association (AMA) and served as president of the AMA in 1935. “That was quite an achievement in the 1930s for a gentleman from Alabama,” French says. The School of Medicine unveiled a portrait of McLester by artist Jay Wesley Jacobs in the main lobby of the UAB Community Health Services Building on Jan. 18. The event was attended by the Frenches as well as more than 20 family members. The building stands on the same site where McLester’s primary care-focused practice once stood. The portrait was commissioned in the late 1940s by the AMA to acknowledge McLester’s significant contributions to medicine. French says he hopes students who encounter his grandfather’s portrait will learn more about him and try to emulate the high standards McLester set in his medical practice. “Dr. McLester lived an exemplary life,” he says. “It is beneficial for the students who receive the scholarships to learn a little bit more about him, because it sets a high goal for them in their future practices.” The genesis of the McLester Endowed Medical Scholarship came about 15 years ago when French says School of Medicine leaders approached him with the idea. “That was attractive to us as a way to honor my grandfather’s legacy, so we launched the program,” he says. After that meeting, he and his wife made the initial gift to establish the scholarship. Over time, they made additional gifts and convinced more than a dozen other family members to contribute to the scholarship as well.

Scholarship Stats $2.95 million total scholarships distributed 171 medical students awarded scholarships 120+ donor-funded scholarships, loans, and travel funds

13 new scholarships * All figures for AY 2017/2018

“The education of a single medical student can touch hundreds if not thousands of lives,” he says. “We enjoy supporting gifts that can have that multiplier effect, so this has been a good project for the entire family.” Jamie French says he sees the endowed scholarship as a way for his family to help train future physicians, and he hopes to keep in touch with the recipients. “They seem to appreciate that someone or a group of people with no relationship to them thinks enough of their future medical careers to help them with their education,” he says. – Ryan Broussard

Living History

William “Blake” Swicord, a first-year medical student, has a classic “first in his family to go to college” story. But in his case, he’s also one of very few people in his entire hometown of Eclectic, Alabama—population approximately 1,000—to graduate college. “It’s a wonderful place to grow up, but it’s hard to dream big sometimes when you’re in a small town,” Swicord says. The oldest of five children born when his parents were just out of high school, Swicord had early dreams of pursuing a career in medicine. He traces that back to a single event in his life: his 13th birthday when his father was badly injured in a motorcycle accident. “That had a huge impact on me,” he says. “My dad was like my superhero, and I was terrified.” But he also learned from the experience. “I remember the doctors giving me this feeling of, ‘Anything that can go right will go right if we can help it,’” he says. “That comforted me a lot. After seeing my dad get better I thought, ‘One day, I want to be able to fill that role of helping people and getting them through tragedy.’ Swicord attended Troy University, where he shadowed local physicians whenever he could, testing the waters for his hoped-for career in medicine. When Swicord was accepted at the UAB School of Medicine through the early decision program, he felt he’d fulfilled his greatest goal to date. He then learned he had been awarded a Comer Foundation Medical Scholarship, of which the UAB School of Medicine grants one per class per year. “It’s just a huge help and really levels the playing field in a lot of ways,” Swicord says. “Getting the scholarship made me realize that UAB believes in me. I think it’s a huge statement about the Comer family that the foundation is investing in people they think will represent their goals and see them prosper and do well. To have this scholarship is very humbling, and it’s the purest motivation I’ve ever had to succeed.” Swicord adds that after graduating and beginning his medical career, he hopes to help his younger siblings afford higher education, too. “In the meantime, my experience has helped them realize that you can be successful if you work hard, regardless of where you’re from,” he notes. UAB’s medical and nursing students have been the beneficiaries of charitable scholarship dollars totaling more than $1.95 million from The Comer Foundation since 1987. Medical students considered for The Comer Foundation medical scholarships are selected by the UAB School of

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UAB Medicine Spring/Summer 2018

MEDICAL EDUCATION

Left to right: Braxton Bragg “B.B.” Comer served as the 33rd governor of Alabama from 1907-1911 and as a U.S. senator in 1920. The Comer Foundation Medical Scholarship is awarded to one student per class per year. Firstyear medical student Blake Swicord says receiving the scholarship boosted his confidence in his ability to succeed in medical school (photo by Nik Layman).

Medicine Scholarship Committee based on academic merit, financial need, and Alabama residency. The Comer Foundation, originally called the Avondale Charitable and Educational Foundation, was the philanthropic arm of Avondale Mills, a textile corporation controlled by the Comer family of Sylacauga and founded in 1897 in Birmingham by Braxton Bragg “B.B.” Comer. When Avondale Mills was sold in 1985, the foundation reverted to the Comer family and was renamed The Comer Foundation. It supports organizations primarily within the state of Alabama and places greatest emphasis on education. Comer Medical Scholars like Swicord extend the legacy of four generations of Comer family service and leadership beginning with “B.B.” Comer, a successful industrialist and planter who served as Alabama’s governor from 1907-1911. Comer was born in 1848 in Barbour County. In 1864, he went to the University of Alabama but was forced to leave in April 1865 when General John T. Croxton’s troops burned the university during the Civil War. Comer graduated from Emory and Henry College in Virginia and returned to Spring Hill to help manage the family property. In 1872 he married Eva Jane Harris of Cuthbert, Georgia, with whom he eventually had eight children. In 1890 he and his family moved to Birmingham, where he later became president of City National Bank. In 1897 he began Avondale Mills, a cotton manufacturing firm, in Birmingham. He and subsequent generations expanded their cotton milling business by acquiring other mills across Alabama. In 1904, Comer was elected president of the State Railroad Commission. In 1906, he successfully ran for governor in a campaign whose primary issue was railroad regulation. His gubernatorial term was marked by progress in education,

railroad regulation, tax funding, and conservation. One important reform to emerge from his term as governor was the establishment of a State Board of Assessors to equalize taxation by equalizing property values throughout the state and establishing franchise taxes for businesses. The resulting rise in state income led to an increase in education funding. Appropriations were made to build rural schools, a program was launched to ensure that every county had at least one high school, and state appropriations were increased for the University of Alabama, the Alabama Polytechnic Institute at Auburn, and other schools across the state. Comer later served a short time as a U.S. Senator in 1920, filling the unexpired term of John H. Bankhead. He died on August 15, 1927. According to a statement from the trustees of The Comer Foundation, “Our family is proud to continue the legacy of Governor Comer’s commitment to education through the annual scholarships The Comer Foundation awards throughout the state. Blake’s inspirational story and commitment to giving back to his community reflect the values that were the foundation of Avondale Mills and the Comer family. We are pleased to support Blake in his pursuit of a career in medicine and hope that he and the many other scholarship recipients at UAB will help others pursue their educational aspirations some day when they are in a position to do so.” – Rosalind Fournier To learn more about giving to support medical student scholarships, contact Jessica Brooks Lane at 205-975-4452 or jblane@uab.edu.

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MATCH DAY MAGIC

he members of the Class of 2018 celebrated the culmination of what was for many the most exciting and challenging period of their lives at Match Day on March 16. Graduates’ families and friends cheered from their seats at the Alys Stephens Performing Arts Center or watched the livestream online as students took to the stage to share the contents of their Match letters. Joining in the celebration along with the graduates were classmates who are taking part in the School of Medicine’s Medical Scientist (M.D./Ph.D.) Training Program and who will remain at UAB to complete their dual-degree training.

98% of UAB students

matched into residencies

UAB students will conduct residencies at 74 institutions in 28 states across the U.S.

214 new residents from 60 U.S. and 27

international universities start UAB residencies in Birmingham, Huntsville, Selma, and Montgomery this summer

Class of 2018 Match Results 26 Internal Medicine 25 Family Medicine 17 Pediatrics 13 Emergency Medicine 13 Surgery 12 Obstetrics/Gynecology 8 Neurology 6 Anesthesiology 6 Diagnostic Radiology 5 Medicine-Pediatrics 4 Psychiatry 3 Dermatology 3 Neurological Surgery 2 Otolaryngology 2 Thoracic Surgery 1 Child Neurology 1 Neurodevelopmental Disabilities 1 Ophthalmology 1 Pathology 1 Physical Medicine & Rehabilitation 1 Plastic Surgery 1 Preliminary Medicine 1 Transitional Year

Residency Sites Alabama Arkansas California Colorado Florida Georgia Illinois Indiana Iowa Kentucky Louisiana Maryland Massachusetts Michigan

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UAB Medicine Spring/Summer 2018

Minnesota Mississippi Missouri New Jersey New York North Carolina Ohio Pennsylvania South Carolina Tennessee Texas Utah Virginia Washington, D.C.

The University of Alabama Medical Alumni Association thanks everyone who attended the 45th Annual Medical Alumni Weekend March 9-10, 2018. It was a weekend filled with fun, learning, and reconnecting with old friends. Mark your calendars for the 46th Annual Medical Alumni Weekend taking place February 22-23, 2019.

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alabamamedicalalumni.org • (205) 934-4463 • office@alabamamedicalalumni.org

ALUMNI PROFILES

THE COUNTRY LIFE Rural Medicine Program graduates launch new primary care clinic BY RYAN BROUSSARD

ate Hinkle, M.D., a 2014 School of Medicine alumnus, has wanted to practice rural medicine for as long as he can remember. He grew up in Lanett, about 30 miles northeast of Auburn in Chambers County, and has fond memories of staying on his grandparents’ farm. “It was a big part of my upbringing, being from a small town in a rural area,” Hinkle says. “That’s why I was drawn to rural medicine.” Tallassee native and 2014 alumnus Justin Vines, M.D., also dreamed of practicing medicine in a rural community. “I feel that a rural doctor is the quintessential doctor,” Vines says. “A rural physician personifies the ideal of being able to deal with whatever comes through the door.” “It’s a different kind of practice, practicing in a rural community versus an urban setting, because we don’t have everything at our disposal,” Hinkle says. In addition to graduating from the School of Medicine in 2014, Hinkle and Vines share something else: They both participated in Rural Medicine Programs at the School of Medicine’s Regional Medical Campuses in Huntsville and Tuscaloosa, respectively. Now they, along with two other Rural Medicine Program graduates, are providing care for residents of Alexander City and the surrounding area at the new Total Healthcare primary care clinic at Russell Medical, an affiliate of UAB Health System. The ribbon cutting for Total Healthcare took place on Nov. 30 and an associated Urgent Care Clinic opened on Dec. 4. The 11,000-squarefoot building, which includes labs and the extended hours urgent care facility

run by a nurse practitioner, is the result of years of planning by Russell Medical’s board of directors and management to invest in primary care for rural Tallapoosa County.

Primary Care Crisis

In its 2017 report “Complexities of Physician Supply and Demand,” the Association of American Medical Colleges (AAMC) predicts a looming shortage of physicians in the U.S., with one of the deepest deficits in primary care. The shortage is even more pronounced in rural areas, and 54 of Alabama’s 67 counties are considered rural. The AAMC has ranked Alabama 45th in the nation for the number of active primary care physicians per 100,000 in population. Tallapoosa County is experiencing health care challenges common to rural areas across the country: an aging population and an aging primary care physician workforce concentrated primarily in Alexander City. One of those physicians is in his early 70s and another is in his 80s, both with large practices. Russell Medical CEO Jim Peace says he and the board realized the remaining doctors could not absorb those patients alone when those physicians retire, so they began working to create a team-based care model

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UAB Medicine Spring/Summer 2018

Left to right: School of Medicine alumni John Adams, Robert Edwards, Tate Hinkle, and Justin Vines all participated in Rural Medicine Programs at the school’s Tuscaloosa and Huntsville Regional Campuses. They have joined a new primary care practice at Russell Medical in Alexander City. Photos courtesy of Russell Medical.

with telemedicine capabilities at Russell Medical. “We’re looking at a community with a service area of about 55,000 in our primary and secondary areas,” Peace says. “We knew that we had a shortage of primary care, but we had to approach the problem in a different way. And we had to not think about next year, but 10 years from now. This is not a race; it’s a journey. It is a piece of the future of primary care.” Helping provide health professionals for rural communities in need is what both the Rural Medical Scholars Program (RMSP) at the Tuscaloosa Regional Medical Campus and the Rural Medicine Program (RMP) at the Huntsville Regional Medical Campus were created to do. Students from rural communities in Alabama apply to those programs in hopes of returning to their home areas to practice medicine. The

ALUMNI PROFILES

programs include a pre-matriculation year at The University of Alabama or Auburn University, in which the students take coursework related to rural health and bolster their science courses. Once that year is complete, the students spend their first two years of medical school at the School of Medicine’s main campus in Birmingham before completing their final two years in Tuscaloosa or Huntsville. “The four of us have ties to this part of the state and all came through the Rural Medicine Programs, so we have a unique ability to set up a practice where we can use that training and knowledge to realize what rural medicine should be in Alabama,” Vines says. “As Alabama’s premier medical school, part of our responsibility to the state is to train more primary care

4.1 primary care physicians per 10,000 population in Alabama’s rural counties compared to 7.9 for urban residents

physicians and alleviate the lack of access to health care in our rural areas,” says Selwyn Vickers, M.D., FACS, senior vice president for medicine and dean of the School of Medicine. “We are very proud of alumni like these, who through their actions are helping us meet the critical mission of our Rural Medicine Programs.”

Rural Roots

The first physician to join Total Healthcare was Robert Edwards, M.D., a 2011 alumnus who completed the Rural Medicine Program and a family medicine residency in Huntsville. An eight-year veteran of the U.S. Navy, Edwards is an engineer-turned-physician originally from a small town in North Carolina. He says he realized soon after his interview that Alexander City was where he wanted to practice. “It was that connection with the town that reminded me a lot of where I grew up. I felt at home,” Edwards says. For Edwards, another advantage to working in the rural clinic is the fact that he can treat a patient who walks through the door, admit that patient to the hospital if needed, and visit that patient throughout his or her hospital stay. “I even drove two of my patients to the emergency room recently,” Edwards says. “They had the flu, and I put them

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in my pickup and drove them myself.” The next physician to join the practice was John Adams, M.D., a 2012 alumnus and a Calera native who says he wanted to work somewhere similar to his hometown that had a Catholic church. Alexander City fit the bill. “I’ve always liked the small-town feel,” he says. “Everybody down here is pretty genuine and honest.” Adams says he spends 90 percent of his time talking to patients, reminding them—many of whom have poorly managed diabetes and/or high blood pressure—of the importance of a healthy diet. He says he also deals with many patients who have psychiatric issues. “Anybody who is thinking about practicing in a rural area should pay attention in psych,” Adams says. “Get ready, because it’s out there.” In addition to working in Alexander City, Adams also spends time each week at a rural health clinic in Goodwater that is staffed by a nurse practitioner. That clinic was intended to be one of four satellite clinics, with each of the four Total Healthcare physicians visiting the four clinics each week. For the plan to work financially, Russell Medical is working to get Tallapoosa County federally designated as a Health Professional Shortage Area, or HPSA, to obtain federal dollars. But Peace says their efforts to recruit primary care doctors to Alexander City is a double-edged sword because it becomes harder to qualify for shortage area designation at the same time that new physicians are being recruited to the area. Peace says if they are unsuccessful in their application this year, they will look at other options for financially sustaining the remaining satellite offices. In the meantime, the four doctors continue assisting the roughly 14,000 residents of Alexander City plus the residents of the surrounding area while integrating themselves into the community and planting roots in Tallapoosa County. “Medical school teaches you how to be a doctor,” Hinkle says. “But being a doctor is more than medical care; it also turns you into a leader in the community.”

INVESTING IN INNOVATION

GIVING HOPE One woman’s fight for her life spurs $10 million initiative to support the UAB Depression and Suicide Program BY EMILY HENAGAN

bout four years ago, Beth Seibels opened her mouth to speak, but words wouldn’t come out. She couldn’t take part in her favorite pastime, talking and laughing with family and friends, and was robbed of her ability to enjoy life. She knew exactly why: her depression. “People could see despair in my eyes,” Seibels recalls of that traumatic time, which spanned nearly two years in her over 30-year bout with depression. “I don’t think a lot of people understand what depression does to the nervous system. My vocal chords and the muscles in my face were shutting down, making it extremely difficult to speak and smile. I lost so much weight I felt like I was dying. I became suicidal because the anxiety was unbearable

and the future looked hopeless.” Her friend, Mallie Ireland, encouraged her to make an appointment with Richard Shelton, M.D., a professor in the UAB Department of Psychiatry and Behavioral Neurobiology. Ireland’s family endowed the Charles Byron Ireland Chair of Psychiatric Research that Shelton holds. “Mallie told me, ‘I heard Dr. Shelton speak, and he just described you,’” Seibels says. “Dr. Shelton was immediately different than the other doctors I had seen. He said, ‘If plan A doesn’t work, I have plans B and C.’ No other doctor had given me that hope.” Shelton heads the UAB Depression and Suicide Program. It is a cohort of scientists and clinician-scientists developing more effective treatment, prediction, and prevention models in the fields of depression and suicide. Their goal is to reach those patients who have difficult-to-treat depression and provide immediate relief to patients suffering from depression or having thoughts of suicide. Seibels benefitted directly from this treatment. Her experience not only resonated with Ireland, but it also inspired a group of Seibels’ friends from her prayer group Left to right: Sally Legg, Courtney Brown, Richard and other circles to Shelton, and Beth Seibels at an event at Crestline launch an initiative to Elementary School where Shelton spoke. Seibels’ support and promote struggle inspired her friends to launch a $10 million Shelton’s work. The fundraising initiative for the UAB Depression and Suicide group consists of Program. nine Birmingham

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UAB Medicine Spring/Summer 2018

residents, who are also raising money to support the program he leads. They are spearheading a $10 million fundraising initiative for which over $4 million in philanthropy has already been raised. UAB will provide a $2.5 million investment as part of this $10 million initiative.

Making an Impact

Raymond and Kathryn Harbert recently gave a generous $3 million matching gift to kick off this initiative. “It all started on a mule-drawn wagon at a quail hunt in southwest Georgia,” says Laura Abernethy, one of the original founding members and the unofficial spokesperson of the group. “The gift came about from an initial conversation Margot Shaw, who is in our group, had with Raymond Harbert on that excursion.” Shaw brought Shelton to meet Harbert, who says it felt right to help the world-renowned physician-scientist with over 30 years’ experience advance his work. “We all have friends, relatives, or know someone who has mental health issues,” says Harbert, the founder, chairman, and CEO of Birminghambased alternative asset investment management firm Harbert Management Corp. “Dr. Shelton talked about the

INVESTING IN INNOVATION

problems,” says Shelton of the impetus behind the UAB Depression and Suicide Program. “We needed better ways to address these particular problems in the state of Alabama.” Those “better ways” involve a multidisciplinary approach from various health care professionals in psychiatry, psychology, neurology, precision medicine, and more. The team has goals in research, training, and clinical care that include developing and dispersing new medications, educating practitioners about the new approaches, and having a full-service clinical branch at UAB. “The work Dr. Shelton and his team are doing Above left: Kathryn and Raymond Harbert is vital to the people of recently gave a $3 million gift to support the UAB Birmingham, the state of Depression and Suicide Program. Above right: Alabama, and the country,” Richard Shelton of the Department of Psychiatry and Behavioral Neurobiology leads the UAB says Selwyn Vickers, M.D., Depression and Suicide Program. FACS, vice president for medicine and dean of the opportunity we have at UAB to make School of Medicine. “It a tremendous impact in the areas of is also a significant step forward in depression and suicide. I thought it was addressing the public health crises a very worthwhile cause to get behind.” that are depression and suicide. We are very grateful for the Harberts’ and Statistics Speak the community’s support to advance Volumes the extraordinary work taking place Harbert notes that it is imperative within the UAB Depression and Suicide to support a program like this in Program every day.” Birmingham and Alabama, and the statistics back up his viewpoint. Effective Treatments According to the Centers for Disease That work includes a six-year Control and Prevention, Alabama has effort to develop a series of new the third-highest rate of depression in medications starting with an old drug the U.S. and ranks toward the bottom called ketamine. Ketamine has been in access to care. More than 12 percent around in the U.S. since the 1970s and of Alabama’s population is depressed is traditionally used for anesthesia. on any given day, which is double the Shelton’s team has helped establish that rate of the national average. The CDC administering ketamine in an extremely also reports that Shelby County has one low dose to patients not responding of the highest rates of suicide among to other treatments for depression and children, adolescents, and young adults suicidal ideation can help many of them in the country. recover in about 24 hours. “We really wanted a program “Instead of making patients wait that focuses on the dual problems weeks, months, or even years in a of depression and suicide, because trial-and-error process of finding an these are very important public health effective treatment, we can get many

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people much better in 24 hours,” Shelton says. “That doesn’t mean everybody is going to recover, but we’ve found that it works quickly in many patients and seems to maintain its effect long-term with repeated administration.” Since ketamine can only currently be administered intravenously, Shelton’s team is working with a division of Johnson & Johnson, Janssen Pharmaceuticals Inc., to test an intranasal version of the medication. This will help make it more easily accessible to patients who need it. They are also looking at a drug called rapastinel that acts in a way similar to ketamine but doesn’t seem to have ketamine’s side effects. “We think that these treatments we have worked on at UAB will have active studies and will be approved, and our experience in using them will benefit the whole state,” asserts Shelton. “That’s really important because the majority of people in the state who have depression and suicidal ideations don’t get treated effectively.” Seibels was once part of that majority, but now she and her friends who fought for her survival count themselves among a different group: a hopeful one. “Within two weeks of her initial visit with Dr. Shelton, Beth began to respond to treatment,” says the Rev. Gates Shaw, Margot’s husband and an Episcopal priest in Fairfield who is a member of the group. “It was such a dramatic change that it was undeniable.” “Seeing the change in her made us all passionate about this program,” adds Abernethy. “We are going to keep going until we raise this money, until we can give everyone we know and beyond the hope coming from Dr. Shelton’s research.”

To learn more about giving to support the UAB Depression and Suicide Program, visit www.uab.edu/give/ depression or contact Jackie Wood at 205-996-0815 or jfwood@uab.edu.

INVESTING IN INNOVATION

Clockwise from top left: Kirby Bland, Herbert Chen, Robert Bourge, Suzanne Michalek, and Moon Nahm.

INNER STRENGTH

Advancing Research

Faculty giving fosters excellence across the School of Medicine BY JANE LONGSHORE

here is a longstanding tradition in academic medicine of faculty members giving back to their institutions, and some of the School of Medicine’s most steadfast philanthropic supporters are current and former faculty. Highlighted here are a few of the many men and women from across the school who have made a commitment to securing the future of the School of Medicine. “The School of Medicine is doubly fortunate to benefit not only from our faculty members’ expertise and commitment to service, but also from their spirit of philanthropy,” says Selwyn Vickers, M.D., FACS, senior vice president for medicine and dean of the School of Medicine. “Faculty gifts are especially meaningful because they are a lasting testament to the faith these men and women have in our school and the good it can do in our community and across the globe.”

Originally from Chicago, Suzanne Michalek, Ph.D., is a professor emeritus in the UAB Department of Microbiology. Following her initial training in genetics, she spent several years doing research in immunology at the University of Chicago. She earned her Ph.D. at UAB, where her research in mucosal immunology showed that oral immunization with a vaccine induced salivary IgA antibody responses that protect against tooth decay. These studies provided evidence for the existence of a common mucosal immune system and for the potential development of a human oral vaccine against tooth decay, as well as other infectious diseases that affect mucosal surfaces. Following postdoctoral studies at the National Institutes of Health, she joined the Mucosal Immunology Group at UAB in 1979. Michalek’s history of giving to UAB dates back to her earliest days at the School of Medicine. While she has made gifts to programs across the university over the years, her greatest philanthropic effort has been establishing the Michalek Microbiology General Research Fund. Recently, Michalek has taken advantage of an IRA charitable rollover option to grow the fund. Michalek says the purpose of the research fund is to bridge gaps in funding for her own research and for colleagues who might need a helping hand. “This was created as a source of

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UAB Medicine Spring/Summer 2018

INVESTING IN INNOVATION

discretionary funds, as a way to level out the highs and lows both for my own work and others’ work,” she explains. “We can use it to direct funds to researchers who might need a little boost and to support visiting researchers as well.” Michalek says her desire to leave a legacy at UAB has grown as her career has progressed. “I have devoted many years of my life and my career to this institution, and I’m very proud of that,” she says. “I would like to give something back to it, for posterity if possible. There are several different types of endowments I am considering—lectureships, professorships—but for now we need to be flexible with the money.” As for her own research, she continues to be involved in studying immunological mechanisms in host/microbial interactions and in developing an anti-caries (tooth decay) mucosal vaccine, as well as mucosal vaccines against a variety of infectious diseases, including tularemia. “Very recently I have also been involved in providing an animal model to determine the effectiveness of anti-microbial compounds in protecting against tooth decay,” she says. “My collaborators are developing small molecules that can be taken orally or painted on the teeth of the experimental rats to inhibit the bacterium that causes tooth decay without affecting the oral microbiome. The results so far are really exciting.”

Heart of Giving

Robert Bourge, M.D., senior vice chair in the Department of Medicine and holder of the E. A. and Abbie Drummond Endowed Chair in Cardiovascular Medicine, among other roles, has a deep knowledge of the history of cardiovascular medicine at UAB. Having experienced UAB as an internal medicine resident, cardiology fellow, academic physician, clinical and translational researcher, and educator, he has the perspective to evaluate the School of Medicine’s mission from every angle. He has leveraged that perspective by committing several strategic gifts to the school, building on a giving history that dates to 1982. His most recent philanthropic efforts interweave Bourge’s professional and personal interests. They include several projects in the Division of Cardiovascular Disease, where he formerly served as division director: an endowed scholar position in heart transplantation, created in partnership with David McGiffin, M.D.; an endowed scholar position in mechanical circulatory support—a life-saving treatment option for critically ill patients with advanced heart failure— established in concert with James Kirklin, M.D.; a pledge to elevate the recently established Robert C. Bourge and Cutessa D. Bourge Endowed Professorship in Cardiovascular Disease to a fully funded endowed chair; and a planned gift to establish the Robert C. Bourge and Cutessa D. Bourge Endowment for Cardiovascular Disease General Support. The endowed scholar funds have become important faculty recruitment and retainment assets—Jose Tallaj, M.D., was named the inaugural Bourge-McGiffin Endowed Scholar in Heart Transplantation, and Salpy Pamboukian, M.D., MSPH, became the inaugural Bourge-Kirklin Endowed Scholar in Mechanical Circulatory Support.

Bourge has also established, in conjunction with the Division of Nephrology, the Detraz Family Endowed Professorship in Polycystic Kidney Disease in the Department of Medicine, an effort that hits close to home. Polycystic kidney disease is a hereditary condition with complications ranging from hypertension to renal failure, and it often leads to the need for a kidney transplant. The disease runs in the family of Bourge’s wife, Cutessa Detraz Bourge, so he designated that the fund bear the Detraz name. “I asked Dr. Anupam Agarwal, director of the Division of Nephrology, for recommendations for a researcher that the fund can support, and he suggested Dr. Michael Mrug as an established star in that area and offered matching funds to our gifts as well,” Bourge says. Bourge also recently provided funding to the Department of Medicine as a founding member of the national Society of Bedside Medicine, an organization dedicated to bedside teaching and improving physical examination and diagnostic skills. Bourge says he believes that philanthropy is vital to advancing the school’s missions in patient care, research, and medical education, and has earmarked gifts to address immediate needs and provide for future success. “With all our mission areas—in clinical care, research, and teaching— funding can wax and wane,” he says. “I believe these endowments can provide stability and help us keep the best people here at UAB and continue our history of excellence.”

With all our mission areas—in clinical care, research, and teaching— funding can wax and wane. I believe these endowments can provide stability and help us keep the best people here at UAB and continue our history of excellence” — ROBERT BOURGE

Surgery Leaders Give Back

Herbert Chen, M.D., an internationally recognized endocrine surgeon, researcher, and medical educator, joined UAB from the University of Wisconsin School of Medicine in 2015 as the chairman and Fay Fletcher Kerner Endowed Chair of Surgery in the Department of Surgery and surgeon-in-chief of UAB Hospital. Less than two years into his tenure at UAB, Chen and his wife Harriet made a significant pledge to establish the Herb and Harriet Chen Endowed Professorship for Surgical Leadership. He says he was motivated to make the pledge so soon after joining UAB by a desire to “walk the walk” in modeling the commitment he hopes to inspire in others.

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“One reason I made the pledge is to emphasize that I’m committed for the long term to UAB,” he says. “In my role as chair, I have the honor of working with talented faculty, residents, and students who want to make a big impact for the people of Birmingham and Alabama. I am committed to supporting them in any way possible. Our department depends on philanthropy to drive our clinical, research, and education missions, so it’s hard for me to ask individuals to give to this cause if I don’t do that myself.” In an increasingly competitive faculty recruitment environment, Chen says having endowed positions to offer candidates can be a deciding factor. This was a major motivation for him to make the pledge for the endowed professorship. “Our department is increasingly being recognized as one of the best in the country,” he says. “Creating endowed professorships provides vital support for faculty development, retention, and recruitment. We have been able to recruit and retain the most talented faculty in the country in large part due to these endowed professorships and chairs.” Chen succeeded longtime chair Kirby Bland, M.D., who now serves as a professor of surgical oncology and chair emeritus in the Department of Surgery and is a distinguished faculty scholar in the School of Medicine and a senior advisor for the UAB Comprehensive Cancer Center. Bland made a pledge to an endowed chair that, once fully funded, will bear his name in recognition of his 16 years as chair of surgery. “I made the gift to help kick off the fundraising campaign that’s not quite finished yet,” he says. “It was very gratifying to see that we raised more than $1 million for the endowed chair from many individual donors fairly quickly, mostly from former residents who trained with me as well as friends and former patients. “To have a chair named after you is a significant honor, but more importantly it provides salary support for the person who will eventually hold that chair,” he says. “It demonstrates nationally to other surgery departments that UAB is committed to the development of careers through this kind of continuing support. That’s the way you recruit the best people and retain them. And it’s not a one-shot deal. It will be sustained through generations.”

Supporting Students

As a child growing up in post-war Korea, Moon Nahm, M.D., was fascinated by science but could not access any science books in his then-poverty-stricken country. His family later moved to the U.S. and he attended Washington University in St. Louis, Missouri, for his undergraduate through postdoctoral training. Since joining UAB 17 years ago, Nahm has built what a National Institutes of Health (NIH) review called “a national treasure”: the World Health Organization (WHO) Pneumococcal Serology Reference Laboratory at the School of Medicine. Nahm’s research focuses on immune responses to pneumococci, the diagnosis of pneumococcal infections, and the development of vaccines against pneumococcal infections. In addition to the WHO Reference Laboratory, his laboratory

One of the reasons I’m interested in helping students is because I came to the U.S. as a senior in high school and our family was still getting settled when I was going through college and medical school. I got some scholarships, and I would like to pay back the benefits I got when our family was new to the country” — MOON NAHM serves as the Bacterial Respiratory Pathogens Reference Laboratory for the NIH. Nahm uses the labs to help achieve a new goal: affordable pneumonia vaccines for the world. His research focuses on helping scientists around the world produce pneumococcal vaccines at prices that will propel their widespread use against S. pneumoniae infections. S. pneumoniae is the leading cause of pneumonia. “We need to reduce the cost for use in developing countries—from more than $100 a dose in the United States to less than $10 per dose,” Nahm says. “We developed the tools with which companies can develop low-cost vaccines and UAB has licensed the tools to various companies at extremely low-cost. That effort is beginning to bear fruit—several companies are beginning to produce vaccines and are testing them right now.” Nahm says he considers attending medical school to be a critical turning point in his life. In hopes of helping more young people achieve their dreams of a career in science and medicine, he recently made a gift to establish the Moon H. Nahm, M.D., and Laura S. Nahm, M.D., Endowed Scholarship in Medicine. “One of the reasons I’m interested in helping students is because I came to the U.S. as a senior in high school and our family was still getting settled when I was going through college and medical school,” he says. “I got some scholarships and I would like to pay back the benefits I got when our family was new to the country.” Nahm specifically wanted the name of his daughter, Laura Nahm, M.D., a 2011 School of Medicine graduate, included in the name of the scholarship, in hopes she will one day take ownership of it as a multigenerational philanthropic effort. “She went to UAB for medical school, and I want her to be part of giving back to the university,” he says. “I hope in her lifetime she will continue to nurture this scholarship so it will increase over time.”

To learn more about giving to the School of Medicine, visit uab.edu/medicine/home/give.

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UAB Medicine Spring/Summer 2018

INVESTING IN INNOVATION

CREATING OPPORTUNITY Thoracic surgery pioneer establishes medical student scholarship BY EMILY HENAGAN

self-proclaimed “Yankee,” Richard McElvein, M.D., was recruited to start the first General Thoracic Surgery program at UAB by John Kirklin, M.D., and stayed because of the kindness of Alabama’s people. “The people in Alabama are nice to one another because that’s the way they live,” he says. “They’re not nice because they want to get something from you; they’re nice because that’s in their makeup. They’re wonderful to be around.” Now, at age 90 and living in Massachusetts, McElvein is finding another way to help the people of Alabama by establishing a scholarship that benefits UAB School of Medicine students: the Dr. Richard and Priscilla McElvein Endowed Scholarship. It is partly named after his late wife of 58 years, Priscilla, with whom he had three children. “Alabama, its people, and UAB changed our professional and personal lives,” says McElvein, a New York native who earned his medical degree from Tufts University School of Medicine. “I achieved academic stature and had the pleasure of working with my patients, my students, and my fellow faculty members. When it came time to decide where to give a gift, I thought it was only appropriate that I support the organization so important in my development and success.”

He was instrumental in UAB’s and its affiliated medical centers’ successes, too. McElvein served as professor of surgery at the School of Medicine, where he educated and mentored hundreds of students, residents, and fellows. He was the assistant chief of staff of University Hospital for over 10 years, where he helped with the planning and building of several buildings and was responsible for getting large elevators installed in the hospital to seamlessly transport patients between floors. McElvein also served as the chief of thoracic surgery at University Hospital and the Birmingham VA Medical Center, helping establish their thoracic surgery programs. Since his programs were so successful, fellow thoracic surgeons across the country asked him for advice on how to get their programs started. “I always told them it was really simple: have a boss who gets behind you,” he says. “John gave me all the tools I needed and believed in me. Everything else followed suit.” McElvein says everything seemed to fall into place from his very first recruitment meeting with Kirklin. During that visit, they ran into Warren E. Burger, chief justice of the United States, in the elevator. “John knew the chief justice from being on the board at the Mayo Clinic,” recalls McElvein. “I thought it was very impressive to see your future boss meet and converse with the chief justice of the United States. It made me think I was going to be in the right place.” McElvein also knew that the UAB School of Medicine was the right place to establish his scholarship because it allows a donor to see his or her gift used over several years if requested. By endowing his scholarship, McElvein’s gift will earn interest. The interest will be dispersed to deserving students while the corpus is held in a protected fund for several years. “I thought that was a very nice way to do it,” he says. “Normally, you give an organization some money, and it gobbles that money up. At UAB, my gift affects more students. It is a very nice program well worth supporting. My money is not used up; it’s used for.” Now retired, McElvein uses his free time practicing his beloved hobbies, which include traveling, golfing, and painting. He used to put his sketches of chests complete with lesion locations in his charts. He is currently taking a class in portraiture and has worked with watercolors, charcoal, oils, and pen and ink. “When I retired, I had some time available,” he notes with excitement in his voice. “I started taking painting courses and then thought, ‘I’ll keep at it. It keeps me off the streets and out of the saloons.’”

Left to right: Richard McElvein photographed at UAB circa 1987, courtesy of UAB Archives; McElvein is currently pursuing painting as a hobby, as this self-portrait demonstrates.

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To learn more about giving to support medical student scholarships, contact Jessica Brooks Lane at 205-975-4452 or jblane@uab.edu.

ACROSS CAMPUS

Gene Siegal, M.D., Ph.D., has been named interim chair of the Department of Genetics. A prominent physician and researcher with more than 25 years’ experience, Siegal recently served as the interim chair of the UAB Department of Pathology. He continues to serve as the executive vice-chair of the Department of Gene Siegal Pathology, a position he has held for nearly 10 years. Previously, he was the director of the Division of Anatomic Pathology for 25 years.

Events, announcements, and achievements in the academic life of the School of Medicine WELCOMING LEADERS

Bruce Korf

Juhan Paiste

Bruce Korf, M.D., Ph.D., has been appointed to lead clinical implementation of precision medicine at UAB as the new chief genomics officer for UAB Medicine. He will work with UAB Hospital, UAB Health System, clinical department chairs, and program and center directors to establish clinical programs in precision medicine.

Juhan Paiste, M.D., MBA, CPE, has been named interim chair of the Department of Anesthesiology and Perioperative Medicine. Keith A. (Tony) Jones, M.D., who led the department as chair for 11 years, was named UA Health Services Foundation president and chief physician executive for UAB Medicine last year.

David Rogers, M.D., MHPE, senior associate dean for faculty affairs and professional development in the School of Medicine, has been named UAB Medicine’s inaugural chief wellness officer. Rogers will collaborate with UAB employee wellness leadership and UAB Medicine nursing leaders to develop a comprehensive David Rogers and integrated approach. He is also focused on addressing physician burnout.

CELEBRATING DIVERSITY The School of Medicine’s Office for Diversity and Inclusion hosted the second annual Diversity Fair with food, drinks, and entertainment in January. The 2017 Diversity Fair had more than 500 attendees. This year’s Diversity Fair moved to a larger space in UAB Hospital’s North Pavilion and welcomed approximately 700 guests from across UAB Medicine. Departments were encouraged to bring food and décor that represented an aspect of their faculty and staff. Some chose to bring food representing as much of the national and international composition of their employees as possible; others focused on a single region or nation.

Craig Powell, M.D., Ph.D., has been named chair of the Department of Neurobiology and director of the Civitan International Research Center. He joins UAB from the University of Texas Southwestern Medical Center’s Department of Neurology and Neurotherapeutics. Powell is a national leader in research pertaining to Craig Powell molecular mechanisms of learning and memory, synaptic plasticity, and neuropsychiatric disorders such as autism, intellectual disability, and Alzheimer’s. He will officially join UAB on Sept. 1.

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UAB Medicine Spring/Summer 2018

ACROSS CAMPUS

“The Diversity Fair is a unique opportunity to come together as UAB Medicine and celebrate the many ways in which we are different and the same,” says Mona Fouad, M.D., MPH, senior associate dean for diversity and inclusion at the School of Medicine. “We draw strength, creativity, and excellence from our diversity. The Diversity Fair offers us a chance to enjoy that wonderful reality.”

School of Medicine Dean and current UAB President Ray Watts, M.D.; luncheons and reunion dinners; and a CME program on Precision Medicine that featured UAB experts in a variety of specialties.

COLON ON CAMPUS In March, a 30-foot inflatable colon returned to the UAB Campus Green for Colorectal Cancer Awareness Month. The second annual Colon on the Green, which took place March 2, was attended by Birmingham community members as well as UAB faculty, staff, and students. The event featured information tables, raffles, photo booths, music from Blaze Radio, and the 30-foot, walk-through inflatable colon. In 2015, UAB, UAB Medicine, and the UAB Comprehensive Cancer Center in conjunction with the American Cancer Society launched the “80 by ‘18” initiative to promote colorectal cancer screening among employees. The goal was to encourage 80 percent of eligible UAB employees to get screened by 2018. Colon on the Green is an effort to keep this momentum going by encouraging employees to learn about their colorectal screening options and urging students to start a conversation to determine their own family histories with the disease. “With early detection, colorectal cancer is one of the most preventable and treatable cancers, and this Colon on the Green event is a fun and engaging way to raise awareness,” says Anna Threadcraft, RDN, L.D., director of UAB Employee Wellness, which hosted the event.

“Alumni Weekend is a great opportunity for our graduates to come together to reconnect with old friends and classmates and continue the lifelong learning that is so much a part of the medical profession,” says Selwyn Vickers, M.D., FACS, senior vice president for medicine and dean of the School of Medicine. “It’s also the perfect time to learn about how medical school has changing since our alumni graduated, and how we’re responding to the evolving health care landscape both in our training methods and curriculum.”

TUSCALOOSA STUDENTS TAKE ACTION Two School of Medicine students at the Tuscaloosa Regional Campus are researching the effectiveness and cost benefits of a University of Alabama-City of Tuscaloosa program to treat 911 callers with low-emergency conditions at the scene. The program, ACTION (Appropriate Care and Treatment in Our Neighborhoods), aims to meet less critical medical needs of the community and reduce costly ambulance transports of people with low-emergency conditions, thereby reducing costs for patients and communities and easing emergency room overcrowding.

ALUMNI WEEKEND

First responders routinely answer “low-acuity” calls for things like minor falls, cuts, headaches, elevated blood pressure, and abdominal pain, often transporting callers to hospital emergency rooms. The University of Alabama’s College of Community Health Sciences and the Tuscaloosa Fire and Rescue Services partnered last year to create ACTION, a first-of-its-kind program in Alabama.

The Medical Alumni Association hosted the 45th annual Medical Alumni Weekend March 9-10. The weekend began with Mini Medical School, which gives attendees a chance to observe and experience what medical school is like for today’s students. Other events included a tour of the Historical Collections at Lister Hill Library; a portrait unveiling of former

“This program is unique because it’s the first such collaboration between UA and a municipality,” says Richard Friend, M.D., co-director of ACTION and chair of the College’s Department of Family, Internal, and Rural Medicine. “We’re creating an innovative and common-sense solution so that we can better utilize the resources of hospitals and the city.”

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ACROSS CAMPUS

In 2016, 26 percent of 911 calls in Tuscaloosa were considered low-level emergency. At a cost of about $645 per call, avoiding ambulance rides for this purpose could save $1.7 million in transportation costs and reduce unnecessary hospital admissions and emergency room treatment. “Using data from Medicaid, the analysis will aim to quantify potential savings achieved by diverting low-acuity patients from the emergency department,” says third-year medical student Andres Arciniegas.

Below is a list of the projects presented by the Huntsville Regional Medical Campus students, trainees, and faculty.

Wilson King, a third-year M.D./MBA track student, says he anticipates “substantial cost savings to Medicaid and other payers, lower unreimbursed emergency department costs, and increased patient satisfaction.” “I understand the burden on health care organizations by improper utilization of emergency services,” adds Arciniegas. “I am confident our work will help ensure efficient allocation of limited resources for the purpose of delivering high-quality health care to the community.”

HUNTSVILLE CAMPUS POSTER AND PRESENTATION SUCCESS

• Superior Mesenteric Artery Syndrome: A Rare, but Real, Cause of Abdominal Pain. Jeremy Johnson, M.D.; Colin Cantrell, Roger Smalligan, M.D., MPH; and Shivani Malhotra, M.D. • Double Trouble and a Delay: Necrotizing Fasciitis in a Septic Postpartum Patient. Justin Pruitt, D.O.; Bethany Johnson; Lynda Gilliam, M.D.; and Roger Smalligan, M.D., MPH • When All Else Fails: A Case for Doxycycline in Pertussis. Mary Smithson; Roger Smalligan, M.D., MPH; David Kimberlin, M.D.; Lea Eiland, Pharm.D.; and Pippa Abston, M.D., Ph.D. • A Global Health Trip Examined: Rural Peru. Hunter French; Tim Littmann; Caroline Studdard, M.D.; Anne Herren; Jose Cavo Acosta; Samantha Ashley; Delmy Caton, M.D.; and Roger Smalligan, M.D., MPH • Fever with Monoarticular Arthritis: Autoimmune or Infectious? Bria N. Williams and Scott Field, M.D. • Triple Threat after Craniopharyngioma Resection Requires Close Attention. Haley Gates; Nisha Arshad, M.D.; Naven Tangutur, M.D.; and Roger Smalligan, M.D., MPH • Successful Hepatitis C Treatment with DAA’s Improves Hepatic Fibrosis presentation by Vishnu Kommineni, M.D. Co-authors: Yuqi Guo, MSW; Omar Sims, Ph.D., Mohamed Shoreibah, M.D.; John Romano, M.D.; Tasnia Matin, M.D.; Krishna Lakshmi, M.D.; Omar Massoud, M.D., Ph.D. • A Retrospective Case-Control Study on the Effects of Pharmacist Intervention on A1C in an Ambulatory Setting presentation by Aadil Lodhi, M.D. Co-authors: Zainab Kakakhel, M.D., and Brad Wright, Pharm.D. • Effects of Physician-Pharmacist Collaboration on Diabetic Patients in an Ambulatory Setting. A Closer Look at Cardiovascular Outcomes in Diabetic Patients presentation by Aadil Lodhi, M.D. Co-authors: Zainab Kakakhel, M.D., and Brad Wright Pharm.D.

UAB School of Medicine Huntsville Regional Medical Campus students, family medicine and internal medicine residents, full-time and volunteer faculty, and their dean, Roger Smalligan, M.D., MPH, had three oral presentations and six posters accepted to the Southern Regional Meeting (SRM) that took place Feb. 22-24 in New Orleans. The SRM is a joint achievement sponsored by the Southern Society of Clinical Investigation and its partnering organizations. “Regional and national scientific meetings provide a wonderful opportunity for our students and residents to compete, share their research and writing efforts, and network with people from other universities,” says Smalligan. “We are happy to support them in these efforts, and it improves the visibility and reputation of the School of Medicine’s Huntsville campus in the academic arena.”

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UAB Medicine Spring/Summer 2018

FEATURE WATTS PORTRAIT UNVEILED AT MEDICAL ALUMNI WEEKEND A portrait of UAB President and former School of Medicine Dean Ray Watts, M.D., was unveiled at the 45th Annual Medical Alumni Weekend, hosted by the University of Alabama Medical Alumni Association March 9-10. Portraits Inc. assisted in commissioning the portrait, which was painted by Russian-born artist Sergei Chernikov. School of Medicine Senior Vice President for Medicine and Dean Selwyn Vickers, M.D., spoke at the unveiling, which numerous alumni attended. Watts and his wife Nancy were joined by their sons Alex and Evan, daughter-in-law Katy, and granddaughter Finley. The portrait has joined several portraits of former School of Medicine deans that hang in the first floor hallway of Volker Hall, the main medical education building on the School of Medicine campus.

AWARDS & ACCOLADES Elizabeth (Cason) Benton, M.D., associate professor in the Department of Pediatrics, received the 2018 Paul V. Miles Fellowship Award from the American Board of Pediatrics, which highlights a pediatrician who is dedicated to improving the quality of health care for children. S. Louis Bridges Jr., M.D., Ph.D., director of the Division of Clinical Immunology and Rheumatology, has been appointed vice president of the Rheumatology Research Foundation, the largest private funding source for rheumatology research and training in the U.S. W. Winn Chatham, M.D., professor in the Department of Medicine, received the American College of Rheumatology Distinguished Clinician Scholar Award. The award recognizes a rheumatologist who has made outstanding contributions in clinical medicine, clinical scholarship, or education. James Cimino, M.D., director of the UAB Informatics Institute and Endowed Professor in Informatics, has been elected to the board of directors of the American Medical Informatics Association. David Cooper, M.D., Ph.D., professor in the Department of Surgery, was presented the John P. McGovern Compleat Physician Award. The award recognizes a physician who embodies the ideals of Sir William Osler — medical excellence, humane and ethical care, commitment to medical humanities and writing, research, and harmony between the academic and medical practitioner. William Curry, M.D., MACP, has been elected governor of the Alabama Chapter of the American College of Physicians, the national organization of internists. Curry is professor in the Division of General Internal Medicine and associate dean for primary care and rural medicine in the School of Medicine, and senior vice president for population health for UAB Health System. Ellen Eaton, M.D., assistant professor in the Department of Medicine, was selected for the 2017 National Academy of Medicine Fellows. She is one of five health professionals chosen based on her professional qualifications and accomplishments, reputation as a scholar, and the relevance of her current field expertise. Will Ferniany, Ph.D., UAB Health System CEO, has been named to the 2017 list of Becker’s Healthcare “183 nonprofit hospital and health system CEOs to know.” The list reflects some of the largest and most successful nonprofit health care organizations in the country.

DEPARTMENT OF OPHTHALMOLOGY CHANGES NAME The UAB Department of Ophthalmology has changed its name to the Department of Ophthalmology and Visual Sciences. “This department name change reflects the broadening scope and achievements of our faculty,” says Christopher Girkin, M.D., MSPH, EyeSight Foundation of Alabama Chair of the Department of Ophthalmology and Visual Sciences. “The new name now features not only our clinical and educational missions, but also our research accomplishments. It is my sincere hope that the department continues to develop as a national leader in all aspects of its mission.”

Contributing writers: Kendra Carter, Laura Coulter, Paige Dorman, Holly Gainer, Tyler Greer, Randa Smith Hall, Emily Henagan, Christy Lemak, Jessica Martindale, Bob Shepard, Kevin Storr, Leslie Zganjar

John Mountz, M.D., Ph.D., J.W. and Virginia Goodwin-Warren D. Blackburn Jr. Endowed Chair in Rheumatology, was honored with the American College of Rheumatology Master Designation. Michael Niederweis, Ph.D., professor in the UAB Department of Microbiology, has been elected as a Fellow to the American Academy of Microbiology (AAM). This honor recognizes his excellence, originality and leadership in the microbiological sciences. Vladimir Parpura, M.D., Ph.D., professor in the Department of Neurobiology, has been elected as a 2017 Fellow of the American Association for the Advancement of Science. He was chosen for his contributions to the field of neuroscience, particularly for the discovery of gliotransmission. Keith Swetz, M.D., section chief and medical director of palliative care at the Birmingham VA Medical Center and associate professor in the Department of Medicine, became editor-in-chief of the Journal of Palliative Care. Tarak Vasavada, M.D., professor and regional chair of psychiatry at the Huntsville Regional Medical Campus, received the Outstanding Contribution to Organized Medicine award from the Madison County Medical Society during its annual meeting in December 2017.

J. Michael Wyss, Ph.D., has been elected to the Dana Alliance for Brain

Initiatives, a nonprofit organization of more than 580 leading neuroscientists from around the globe who are committed to advancing public awareness of brain research.

FROM THE ARCHIVES

A PICTURE OF LEADERSHIP Images capture past leaders of the UAB Department of Surgery COMPILED BY TIM L. PENNYCUFF IMAGES COURTESY OF UAB ARCHIVES

Champ Lyons, M.D., performs surgery in 1968. Lyons was appointed the first full-time chair of the Department of Surgery in 1950.

James Kirklin, M.D., reviews a chart (undated). Kirklin, son of John Kirklin, is the director of the James and John Kirklin Institute for Research in Surgical Outcomes and holds the James K. Kirklin Endowed Chair of Cardiovascular Surgery.

John Kirklin, M.D., with Penny Williamson, president of University Hospital Auxiliary, in 1973. The auxiliary provided funds in 1973 to help equip a new open-heart surgical suite. In 1966, Kirklin left the Mayo Clinic to become the third chair of surgery at UAB.

Arnold Diethelm, M.D., speaks to the press following performing a kidney transplant in October 1988. Diethelm served as surgery chair for 17 years beginning in 1982 and helped develop an internationally recognized transplantation program at UAB.

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UAB Medicine Spring/Summer 2018

Carla Falkson, M.D., Helen Krontiras, M.D., and Kirby Bland, M.D., in the Kirklin Clinic circa 2002. Bland was named chair of the Department of Surgery in October 1999, a position he held until 2015. Krontiras is now director of the Division of Surgical Oncology. Falkson is a professor in the Division of Hematology and Oncology.

FEATURE

What do you call total gifts of more than $33 MILLION from 3,300 School of Medicine alumni to The Campaign for UAB?

A GREAT START. Learn more about how our generous alumni are changing everything at UAB. UAB.EDU/CAMPAIGN

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UAB — Alabama’s leading provider of genomic and precision medicine — has launched the Alabama Genomic Health Initiative (AGHI) in partnership with the HudsonAlpha Institute for Biotechnology. The statewide effort is being funded with a $2 million award in the first year, with additional funding expected during the fiveyear project. With the goal of obtaining genetic information from 10,000 Alabamians, the AGHI is one of the most ambitious singlestate initiatives of its kind ever undertaken. The program launched in spring 2017 in Birmingham and Huntsville, and recruitment will gradually be expanded to the entire state. To learn more about the AGHI, register for updates, or inquire about participating, contact us directly or visit our website. Phone: 855.462.6850 • Email: aghi@uab.edu • aghi.org