DOCTOR VISITS

UB MED DOCTOR VISITS

“I hope to help create conditions that help trainees and physicians fl ourish despite the challenges of our work.”

CARE FOR PATIENTS AND PHYSICIANS Archana Mishra, MD, confronts the stresses of medicine Recently, in the middle of a busy day, Archana Mishra, MD, clinical associate professor of medicine in the Jacobs School of Medicine and Biomedical Sciences and a physician at the Buff alo VA Medical Center, was asked to evaluate a patient for transfer to the intensive care unit. As she walked into the room, she was embraced by the patient’s wife and daughters. To her surprise, the patient was someone she had cared for more than a decade ago during a critical illness. The family not only recognized Mishra, but said they had prayed to meet her again, attributing the care she had provided to their being able to share so many more years with their loved one. Moments like this are what make being a physician immensely rewarding, says Mishra, who specializes in pulmonary and critical care medicine and serves as clerkship director for fourth-year students at UB. “It gives you the energy to thrive.” In addition to providing patient care, Mishra has a strong interest in helping faculty enhance their mentoring skills and in encouraging trainees to develop into compassionate, well-rounded physicians who exhibit sound clinical judgment combined with humanistic qualities. In patient interactions, she believes it’s paramount for practitioners to provide their expertise while acknowledging that each individual knows his or her body best. The goal, she says, “should be to work together toward improving the quality of life and S t o r i e s by Susan Kreimer

gaining professional fulfi llment as a result of that.” Helping to prevent physician burnout is another area of interest for Mishra, who teaches mindfulness and other preventive tactics to faculty, students, residents and fellows. Being a burnout survivor herself, she is dedicated to sharing her experience with others. She says that “it was a life-altering experience” and that it led her to discover better ways to cope with the stresses of being a physician and to rediscover joy in her work. “Joy is something that’s fundamental to our existence, and I hope to help create conditions that help trainees and physicians fl ourish despite the challenges of our work and training,” she says. Mishra, who joined UB in 2001, see patients and conducts research at the Buff alo VA Medical Center, Veterans Aff airs Western New York Healthcare System. She has received many awards for teaching, including the Women Leaders in Medicine Award from the American Medical Student Association, and the Humanitarian Award from the CHEST Foundation. She has also received the Leonard Tow Gold Humanism Award given for clinical excellence and outstanding compassion in the delivery of care. Regina Makdissi, MD, a clinical assistant professor of medicine, considers Mishra a role model, having trained under her as an intern and resident before joining the Jacobs School faculty in 2006. Under Mishra’s guidance, Makdissi says she learned to be her own selfevaluator and to acknowledge positive moments that transpire every day in tending to sick and challenging patients, a perspective that continues to motivate her today. “It is still invigorating to watch her do what she does best,” Makdissi says of Mishra.

“I try to help children fi nd ways to get the most out of their lives based on the conditions they have.”

NEUROLOGIC CARE FOR CHILDREN Osman Farooq, MD, is expanding treatments The brain’s inner workings intrigued Osman Farooq, MD, unlike anything else in medical school. A heart or liver can be transplanted, but not the brain. “It’s the one organ,” he explains, “that controls everything our body does and helps process information.” Farooq also felt a calling to care for sick children, so pediatric neurology presented him with an opportunity to integrate his passions in a fulfi lling career. “I try to help children fi nd ways to get the most out of their lives based on the conditions they have,” says Farooq, clinical associate professor of neurology in the Jacobs School of Medicine and Biomedical Sciences, and division chief of pediatric neurology at UBMD Neurology. A specialist in comprehensive neurologic care of infants, children and adolescents, Farooq joined the faculty in 2012 aft er completing residency training in pediatric neurology and a fellowship in neurophysiology at UB. “Dr. Farooq has been instrumental in starting new programs to benefi t children with neurological issues in Buff alo,” says Arie Weinstock, MD, professor of clinical neurology and director of the epilepsy monitoring unit and the electroencephalography labs at Oishei Children’s Hospital, a UB teaching affi liate. As director of the Pediatric Neuromuscular Clinic at Oishei, Farooq established a program for newborns diagnosed with spinal muscular atrophy. All cases in Western New York identifi ed through New York State’s newborn screening program are referred to him. “It is an exciting time to be treating neuromuscular disorders given

1 9 UB MEDICINEWINTER 2020 that new treatments have emerged for some conditions that never had meaningful therapies in the past,” says Farooq. “These new medications can potentially slow disease progression and help patients retain muscular function.” In 2017, Farooq identifi ed a gap in managing children and adolescents with concussions, and worked with other departments, including trauma surgery and neurosurgery, to develop a pediatric concussion center. At the center, he arranges for patients to be seen soon aft er their head injury in order to expedite potential care and limit ongoing symptoms. Farooq’s research includes unraveling the mysteries of autoimmune, demyelinating and infectious processes within the nervous system. The 2009 infl uenza A-H1N1 pandemic spurred him to delve into the neurologic complications aff ecting the region’s pediatric patients and compare these fi ndings to communities globally. He has presented UB’s results at international conferences. Excelling as a teacher and mentor, Farooq has garnered awards yearly at UB for best educator in pediatric neurology. “Above all,” says Weinstock, “Dr. Farooq’s compassion and humanism resonate with patients, families and those he teaches and mentors.” Humanism is something Farooq views as essential to practicing medicine, but acknowledges that it can dissipate during “relentless hours” of training. “When doctors are constantly busy, it is easy to develop a distance from our compassion,” he notes. As a result, Farooq continually reminds residents to tap into the heart of why they became doctors. “It’s important that we not allow encounters with our patients to turn into mere business transactions,” he says. “What good is a doctor if he or she cannot empathize with their patients?”

UB MED Q&A

Gallo

HOW HAS THE NEW BUILDING IMPACTED EDUCATION AND TRAINING? —A conversation with Mary Gallo, MD-PhD, Class of 2020

It has been two years since the Jacobs School of Medicine and Biomedical Sciences’ new building opened on the Bu alo Niagara Medical Campus (BNMC), marking a pivotal milestone in the school’s 174-year history. How has the new facility impacted students and their education and training? In this issue of UB Medicine, we asked this of Mary Gallo, a student in the MD-PhD Program, who in June of 2018 completed her PhD work in microbiology and immunology and will receive her MD and PhD this spring as a member of the Class of 2020.

A native of Western New York, Gallo grew up in Lewiston, New York. She earned her undergraduate degree at Niagara University, where she majored in biology and minored in chemistry and philosophy. She completed her doctorate at UB in the laboratory of SUNY Distinguished Professor Timothy F. Murphy, MD. Her research project focused on characterizing strains of a bacteria—nontypeable Haemophilus in uenzae— during persistent infection in the lower airways of patients with chronic obstructive pulmonary disease.

Gallo’s goal is to pursue a career as an OB-GYN physician-scientist, seeing patients as well as conducting research related to infectious diseases during pregnancy and the neonatal period.

Q: What is your strongest impression of the new building? A: I think the architectural “wow” factor of the new building is most striking. The history of architecture in Buff alo is rich, and this structure adds to the diversity of building styles in the city and will continue to do so for years to come. The locally sourced terra cotta creates a beautiful façade, symbolizing the changing landscape of medical education within its walls.

Q: What are some of your favorite spaces in the building? A: I fi nd myself drawn to the seating areas off the staircase featuring couches and coff ee tables, between the fi rst and second fl oors. They are sophisticated little nooks that strike a balance between privacy and quiet for studying, and openness and accessibility for impromptu socializing with classmates or professors.

Q: How have you used the new building in your third and fourth years? Is this diff erent from how it would have been if the medical school had stayed on the South Campus? A: Like all third- and fourth-years, most of my time is spent on the wards, so to speak. However, I study in the new building a lot, as do many of my classmates. We also attend lectures and seminars and take practical examinations there for some clerkships. We also appreciate having the Clinical Competency Center and Behling Simulation Center closer to our clinical sites because these facilities are crucial to helping us prepare for interactions with patients and for our national clinicalskills examinations. If the medical school had remained on the South Campus, it would have been more diffi cult and time consuming for us to get to our clinical sites, most of which are located downtown within walking distance of the BNMC. Too, I think that the learning spaces for formal lectures and clinical preparation would not be as state-of-the-art as they are now.

“So when faculty encourage us to turn and talk with our neighbors to discuss questions or to participate in more formal small-group discussions, the space is designed to do this.”

Q: How has the move impacted your MD training and your PhD training? A: I completed my PhD in [UB’s] Clinical and Translational Research Center (CTRC), so I made the move downtown before many other students, staff and faculty did. For awhile, however, the Department of Microbiology and Immunology was still on the South Campus, so I had to commute between downtown and the South Campus a couple of times a week for classes and departmental seminars. Once the department’s laboratories moved to the fi ft h fl oor of the new building, all of my classes and seminars for my PhD program, as well as the longitudinal MD-PhD seminar series, were located within a short walk of the CTRC, and the effi ciency of my days increased tremendously. My third and fourth years of medical school—which I returned to aft er completing my PhD—have included clinical rotations at various sites and across specialties. Having one home base where the majority of my education and examinations take place simplifi es and better integrates the student experience.

Q: Do you feel the new building has changed the culture and atmosphere of the Jacobs School for students? A: The spaces in the building feel as though they were designed with students in mind, both educationally and socially. Medical-education innovations that focus on provider collaborations are a priority for curricula across disciplines, and having areas like the Sol Messinger Active Learning Center—which features small-group tables—helps to nurture a culture of support versus competition. The large lecture halls, like the M&T Auditorium and the Dozoretz Auditorium, also accommodate this type of learning because the chairs pivot. So when faculty encourage us to turn and talk with our neighbors to discuss questions or to participate in more formal small-group discussions, the space is designed to do this.

“Having one home base where the majority of my education and examinations take place simplifi es and better integrates the student experience.” Q: The building was intentionally constructed to create more collaborative learning and research spaces. Do you feel it accomplishes this? A: The design of the scientifi c research areas—featuring joint lab spaces and open banks of desks and work stations—does promote collaboration between and among laboratory groups. If you are interested in learning a new technique and you see somebody performing that method through the glass walls, you have an opportunity to learn from them. However, I will admit, when the time comes to focus and get work done, the open desk areas can present a challenge. Wearing headphones has become somewhat of a universal cue for “Please only disturb me for something very important!” or “Please take your social conversations elsewhere.” Q: As a physician-scientist in training, what impresses you the most about having the school downtown? A: I feel that having the school downtown as part of the BNMC is helping to propel it—and UB—toward becoming a comprehensive biomedical powerhouse. Having Buff alo General Medical Center, Oshei Children’s Hospital, Roswell Park [Comprehensive Cancer Center], the CTRC, Conventus, the Gateway building, the Gates Vascular Institute and other facilities located within a couple-of-block radius fosters collaboration between biological research and clinical practice, and helps scientists and clinicians to realize the power of translational research and medicine. Bridging the gap between scientifi c innovation and medical practice is the epitome of cutting-edge health care, and this is absolutely necessary for advancing the human condition, not just in Buff alo, but globally.

Q: How has your experience at the Jacobs School infl uenced your career goals? A: It has infl uenced me in a very positive way. My goal is to stay in Buff alo to train and to practice. I just love this institution, the people and city!

—S. A. Unger

Photos by Douglas Levere and Sandra Kicman