FALL 2009
A UNIVERSITY OF CALGARY Faculty of Medicine Publication
standing
STRONG
Shot multiple times and left for dead, Bachelor of Health Sciences student Razelle Botha talks about her journey from a South African hospital to the University of Calgary
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SERVICE TO SOCIETY
RESEARCH
PROFILE
How Six Months in Sudan can really change a person
Helping to grow the world’s supply of insulin
Balancing gastroenterology, nutrition and fighting
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14
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Vol 1 Issue 3 | Fall 2009
UCalgary Medicine is published three times a year by the University of Calgary Faculty of Medicine, providing news and information for and about our faculty, staff, alumni, students, friends and community. For more information contact: Managing Editor Kyle Glennie T 403.210.6577 E kglennie@ucalgary.ca Dean Dr. Thomas E. Feasby Vice Dean Dr. Jon Meddings Senior Associate Deans Dr. Richard Hawkes, Research Dr. Benedikt Hallgrímsson, Education Dr. Ronald Bridges, Clinical Affairs Associate Deans Dr. Anthony Schryvers, Undergraduate Science Education Dr. Bruce Wright, Undergraduate Medical Education Dr. Taj Jadvji, International Health Dr. Doug L. Myhre, Distributed Learning & Rural Initiatives Dr. Joanne M. Todesco, Postgraduate Medical Education Dr. Frans A. van der Hoorn, Graduate Science Education Dr. Jocelyn Lockyer, Continuing Medical Education Dr. Samuel Wiebe (Interim), Health Research Dr. John Reynolds, Research Dr. Janet de Groot, Equity & Teacher-Learner Relations Design and Production Imagine Creative Photography Calvin Sun, Janelle Pan, Trudie Lee, Herb Maan, James Maskalyk, Theresa Radwell
On the cover: Razelle Botha at her home in Rocky Ridge.
Free Copy/Alumni Update To receive a free copy of UCalgary Medicine please call 403.220.2819 or email medcomm@ucalgary.ca The Faculty of Medicine is committed to staying in touch with our alumni. Please update your contact information at our website www.alumni.ucalgary.ca (click on “update your info”)
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Contents Volume 1 Issue 3 | Fall 2009
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Individual stories of our combined endeavours | MESSAGE FROM THE DEAN
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A great return on investment | Philanthropy
“There are many individuals who contribute to our success at the Faculty of Medicine. Whether they are researchers, clinicians, faculty members, students or staff, there are always many inspirational and fascinating stories to be told.” The founders of TENET Medical Engineering are not only making it easier for orthopedic surgeons to perform procedures, they’re ensuring future Faculty of Medicine researchers have the tools to succeed.
COVER STORY PG.
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Standing strong | EDUCATION
The journey from South Africa to the University of Calgary was long and arduous for Razelle Botha–not because of the distance, but because of the events that changed her life forever.
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Insulin cost a growing concern | research
Producing synthetic insulin is an expensive endeavour and one that’s led to global supply and demand issues. So where does the possible answer lie? In a thistle-covered desert plant, naturally.
Six months in Sudan equals a lifetime of change | Service to Society After graduating from UCalgary Faculty of Medicine, Dr. James Maskalyk travelled to areas of the world in need of medical aid. In Sudan he found disease, hunger, despair—and a new outlook on life.
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Taking the lead | Education
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Dr. Karate | Profile
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Riding out the storm | Endeavours
Kamala Patel, PhD, has already completed one of the most prestigious leadership programs in North America, so what’s next on her to-do list? Passing on what she’s learned to her colleagues.
Dr. Maitreyi Raman isn’t your typical gastroenterologist or nutritionist. She isn’t your typical national karate champion either. You got something to say about that?
A group of researchers and staff at the Faculty of Medicine are using their brains and brawn to fight cancer.
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Message from the Dean
Individual stories of our combined endeavours We are fortunate at the Faculty of Medicine to have a seemingly endless number of incredible people in our buildings, classrooms and offices every day. Whether they are researchers, educators, clinicians, students or staff, there are always many inspirational and fascinating stories to be told—something we strive to do in this magazine. These people and their efforts embody what the Faculty is about—serving society in a socially accountable way and educating the next generation of medical professionals, scientists and teachers. It’s in this spirit that we’re proud to introduce you to some of the people who are contributing to our Faculty in one positive way or another. In this issue of UCalgary Medicine, you can read about Razelle Botha, a Bachelor of Health Sciences student who just entered her first year of studies with us. After being shot in a home invasion in her native South Africa that left her paralyzed from the waist down, Razelle managed to teach herself to walk with crutches and earn her place at the University of Calgary (page 6). Reaching beyond the communities that surround us is a key priority of the Faculty. Through our efforts in developing countries—like those of Dr. James Maskalyk, whose book “Six Months in Sudan” chronicles his time spent working in a clinic in a small Sudanese village (page 10)—we are redefining the boundaries of our service to society mandate. With this in mind we have assembled an International Health Task Force that will, among other duties, provide us with recommendations on how best to reach these communities and countries in need, places where we can make a difference and provide a good educational experience for our students. We are now searching for a suitable candidate to direct our International Health program. Also in this issue are articles on others who represent key goals we have established. Kamala Patel, PhD, a recent graduate of North America’s only in-depth program focused on preparing senior women faculty at schools of medicine for institutional leadership positions, is a prime example of our leadership development philosophy (page 9). And our aim of translating research into products and services that better the health of all is characterized by the work done at TENET Medical Engineering (opposite page). There are many more individuals who contribute to our success at the Faculty of Medicine; those featured in this issue of UCalgary Medicine are merely a small portion that comprise our very talented team. It’s a pleasure to be able to tell these individual stories that exemplify our Faculty’s broad ambitions, and I hope you enjoy reading them. Please let me have your feedback. ■
Tom Feasby, MD Dean, Faculty of Medicine University of Calgary 4
UCALGARY MEDICINE
Philanthropy
A great return on investment The founders of TENET Medical Engineering are not only making it easier for orthopedic surgeons to perform procedures, they’re ensuring future Faculty of Medicine researchers have the tools to succeed. By Laurie Wang
I
t’s strong, it’s powerful and it’s used to save limbs. The Spider Limb Positioner is a popular tool commonly used by orthopedic surgeons to provide optimal positioning for limbs during surgical procedures. Powered by the compressed nitrogen or air supply in the operating room, the positioner allows the patient to have a more comfortable experience during surgery. But it doesn’t stop there. This robot-like tool is part of what University of Calgary Faculty of Medicine orthopedic surgeon Dr. Cy Frank calls the ‘cycle of innovation’. Manufactured by TENET Medical Engineering, the Spider Limb Positioner is among many products that generate annual revenues of $8 million for TENET—and part of these profits go back to bone and joint research at the University of Calgary. “It’s the model for a cycle of innovation. The university trained people who created a business that’s generating revenue, and in turn this business is paying to train more people and advance research,” says Frank. “Everyone wins. And ultimately it’s the patients who are benefiting from these products.”
“TENET is very unique,” adds Frank. “I don’t think there are many companies out there doing what they are doing.”
As TENET continues on, Moore sees the company further developing products that are easier for surgeons to use.
Frank, Executive Director of the Alberta Bone and Joint Health Institute, was part of the original scientific advisory committee for the orthopedic design and manufacturing company. He supported the initiative but has stayed with the University of Calgary.
“Bone and joint research is continually advancing. The key thing is for us to be able to understand injury conditions and create devices that help surgeons in the operating room,” Moore says. “It is also important to understand the healing process and how surgeons help restore normal function in the joint.”
“There were several people who helped come up with the idea but stayed with the university. Their concept wasn’t to create a company that would make millions; it was to help research,” Moore explains. “The word ‘tenet’ means fundamental principle. We’ve created a profitable company and we’re putting funds back into research—the cycle of innovation.”
That’s where UCalgary surgeons and researchers play an integral role. “Everyone has been very helpful in testing our products and giving us ideas on how to improve them. Together, we are taking Spiders—and bone and joint health— to the next generation.” ■
TENET’s President, Ken Moore, was part of a joint injury research group headed by Frank at UCalgary’s McCaig Institute for Bone and Joint Health. He started the company in 1994 with the support and advice of many colleagues at the Faculty of Medicine including Dr. Bob Bray, professor, Department of Surgery; Nigel Shrive, PhD, McCaig Institute for Bone and Joint Health; and Frank. “At the time, myself, Nigel Shrive and Cy Frank noticed that a lot of research had turned into good products, but the university didn’t really get the credit for it,” Moore explains. “So we thought, let’s see if we can start a company and put the profit back into research.” Since its first profit in 2001, TENET has grown steadily by 25% to 30% each year. It has made a name for itself internationally, with sales in about 50 countries. The philanthropic gifts from TENET have contributed to scholarships and bursaries for students and trainees at the Faculty of Medicine. As well, TENET is proud to have many UCalgary graduates on staff. “Our engineers are UCalgary grads. We’ve also hired interns and summer students from the university,” Moore explains.
Dr. Nigel Shrive (left) and Dr. Cy Frank with the Spider Limb Positioner
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Education
standing
STRONG
Razelle Botha was shot multiple times and left paralyzed from the waist down by three gunmen in her South African home. Now the first-year UCalgary Bachelor of Health Sciences student is sharing her incredible story—and taking her first steps towards her dream of becoming a doctor. By Kyle Glennie 6
UCALGARY MEDICINE
Education
H
e came into my room and stood
She didn’t do either.
near my doorway about six feet
“I was frozen with fear,” recalls Botha with a look of disbelief on her face.
from me. He didn’t say anything,
didn’t make any gestures, didn’t smile. He just looked me in the eye, raised his gun and shot me. In an instant Razelle Botha’s life was changed forever. As she fell back onto her bed, blood gushing from her left arm, she could barely breathe. Later she would learn the bullet had gone through her left arm and into her left lung, causing it to collapse. It wasn’t until she tried to get up that she realized she couldn’t walk. After dragging herself to the doorway of her bedroom, Botha and her father Willem—who had also been shot—stayed there on the floor together until the ambulance arrived. A promising future Razelle Botha was in her bedroom packing the night she and her father were terrorized by three armed men. Razelle, who was 19 at the time, was set to fly from her home in Pretoria, South Africa to Paris the next day to work as an au pair with a French family. She had studied French in high school—where she was one of the top students in her entire province— and was hoping to become fluent in the language before starting medical school at the University of Pretoria. “I was really looking forward to the trip. The medical school at the University of Pretoria is a seven year program that includes all of our pre-med and regular medical education, so after I was accepted I thought a little break would be nice,” says Botha. Unfortunately, those plans would never come to fruition. “I had just got out of the shower and was wearing a towel when I heard my father speaking quite angrily,” Botha remembers. “I thought maybe he was having an argument on the phone or something.” That of course was not the case. Seconds later three young men stormed into her bedroom with their guns drawn. “I was so shocked and everything seemed so unreal that I just started yelling and swearing at them to get out of my room!” The men threatened Botha and told her to keep quiet or they would kill her. After two of the intruders left her room, a third stayed behind. Botha asked him if she could get dressed as she was still in a towel. He agreed.
That fear quickly turned to panic as she heard gunshots from her father’s bedroom. Moments later, two of the invaders ran past her with the third—the same young man who allowed her to dress—stopping at her room before he left. That’s when he pointed his gun at Botha and pulled the trigger five times. “The force of the gunshots threw me back to my bed, and I knew I was hit in the arm. The strange part was after it was over, I felt relieved and just happy they were gone. That’s when I tried to stand up but I just collapsed to the floor,” Botha says.
Razelle’s leg calipers that help her walk
Unbeknownst to her, one of the bullets had severed her spinal cord. Long recovery After what seemed like an eternity, the ambulance arrived at Botha’s home and took her and her father to the hospital. Willem had been shot in the leg in the attack and was lucky to be alive. The three men had him cornered in his bedroom when he reached for his gun that he kept on the nightstand. In a flash the men opened fire, hitting him once as he dove behind a wall for cover. Botha spent her first two weeks at the hospital in the intensive care ward. Doctors performed an operation to re-inflate her collapsed lung, and she was able to breathe on her own just two days later. While she didn’t have any movement in her legs, Botha says no one actually told her the severity of her back injury.
Playtime with Wookie, Razelle’s beloved yellow labrador
“I found out much later that my parents made an agreement with the doctors to not tell me that I was paralyzed.” When she did find out she would no longer have use of her legs, Botha fell into a deep depression. Struggling with the realization that she was now a 19 year-old girl in wheelchair was hard enough, but it was the neurological pains—or phantom pains as they are commonly known—that affected her the most. “In the beginning I would cry and cry because the phantom pains were too much. It’s an intense burning sensation that I feel mostly in my right leg yet I can’t feel anything in that leg normally, how ironic is that?”
Razelle’s father, Willem, helps put on her leg calipers
Ironic perhaps, but quite normal for people suffering from spinal injuries. It’s also the same affliction that amputees suffer—the feeling of intense pain in a limb even after it’s been removed. As Botha understandably struggled with her new reality, her tears quickly turned to anger—and changed her outlook completely.
“I thought, ‘okay at least there is one nice guy amongst them’, so I put on the dress I was planning to wear on the plane the next day as it was hanging on my door.”
“When I began physiotherapy I refused to learn how to get in and out of my wheelchair. I told the staff, ‘I’m going to walk out of here so don’t bother teaching me how to do wheelchair transfers,’” laughs Botha.
The man then left the room, leaving Botha alone. Her first thought was to phone the police, or perhaps to grab her can of mace that she kept for protection.
While her rehabilitation may have begun out of anger, it was now fuelled by determination. As her physiotherapy continued three times a week, Botha
Continued on page 8
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FALL 2009
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Education
managed to convince her physiotherapist to teach her to walk with crutches. “It took eight months, but now if I go through a weekend without walking on my crutches I get depressed and irritated.” The fact doctors only gave her a 30% chance to walk again makes her achievement even more impressive. And that’s not the only major strides she’s taken since the shooting; Botha now has full use of her left leg. While she’s been able to overcome some of her physical injuries, the emotional scars remain. “After two months in hospital I was finally able to return home, but when we pulled into the driveway I couldn’t get out of the car, I was too distraught. My home was so beautiful with a swimming pool and a garden, but in those few seconds that these men were in my room they destroyed the whole house for me.” A new life Seeing his daughter’s reaction to the sight of her once beloved home forced Willem to do two things: buy a new home; and find a way to help ease Razelle’s psychological difficulties. After finding the home, Willem made another key purchase for his daughter. “He bought me my Wookie,” exclaims Botha happily, referring to her beloved Yellow Labrador puppy. “He’s easily my best friend, and he helped me get through some really difficult times.” But even with a new home and a new sidekick, Botha couldn’t get past the constant fear she now felt living in South Africa. Her resolve to become a doctor was stronger than ever, driven by her experiences during her ongoing recovery process. But her desire to leave her homeland eventually reached a breaking point, and her father agreed that a move to Canada would be best.
city as they searched for a new home and a new life. The transition was made easier by the fact that both hold Canadian citizenship, something Razelle calls “the best gift my father ever gave me.” If Canadian citizenship was the best gift she ever received, then perhaps her hard work and determination—not just after the shooting but in all her days prior—is how she’s repaying it. Shortly after deciding her life would be better in Canada, Botha applied to the University of Calgary. “I was looking at the Bachelor of Health Sciences website and discovered the biomedical sciences stream, which is perfect for me because I want to study stem cell research,” she says. “Then when I was accepted, the feeling was indescribable.” After completing their move to Calgary—a task that included finding a home and having an electric chair installed to help her navigate the stairs—Botha prepared herself for student life. “I’ve already found a car and had it specially equipped with hand controls, I have a parking stall at the University, and I’ve mapped out all the elevators to get to my classes.” Being the victim of a violent crime has given Botha an incredible new perspective on life. Her positive outlook has already had a tremendous impact on one Canadian in particular. “She inspires me, and she helps me to see what life can be like,” says Cindy Mazer, Botha’s Calgary neighbor and close friend. “I started out trying to do what I could to help, but in reality she helps me as much as I help her.”
The two have become so close that Mazer, along with her husband and two children, is quick to count Razelle as a member of the family. They’ve even started doing an exercise program together three times a week. “I told her I was out of shape but there was no discussion, she just said ‘that’s it we’re doing this.’” That spirit and determination, evident in all her efforts before and after the shooting, has come to define the now 20 year-old. Her positive attitude unwavering, Botha’s desire to help those with spinal cord injuries will no doubt form the foundation of her educational goals and future success. “I really believe through stem cell research that I will walk again in my lifetime. And if I can make a contribution to stem cell research for myself and others, that would be incredible.” With her life in Canada already taking shape, Botha does think about her native South Africa often. Her days of living in the troubled nation are definitely over—a testament to the emotional and psychological damage she will likely never recover from—but returning to help her fellow countrymen once she’s completed medical school is something she hopes to do. Her endless compassion and selflessness will likely force such a journey. When asked how she would describe Razelle in one sentence, Cindy ponders the question before offering a final thought. “Despite what she’s been through she comes across like she can conquer the world, and I believe she can.” Would you bet against her? ■
Having lived and worked in Calgary for four years earlier in his career, Willem and Razelle targeted the
Razelle and Wookie in her bedroom
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Education
Taking the
Lead
As if earning a spot in one of the most prestigious leadership programs in North America wasn’t hard enough, then she had to actually complete the course. So what does Kamala Patel, PhD., get for all her hard work? The opportunity to pass on what she’s learned to her Faculty of Medicine colleagues. By Kyle Glennie
S
itting in front of a computer as the clock nears midnight, Kamala Patel is surrounded by a group of woman giving instructions to her as she puts the finishing touches on a PowerPoint presentation.
Her day began about 16 hours earlier at the Ace Conference Centre just outside Philadelphia, Pennsylvania. The women she is surrounded by are like her: professors and assistant professors at well-known universities across North America, some hold medical degrees, some hold PhD’s, many hold both. “We were told to act as the leadership team of a fictional medical school that was $8 million in debt, and we had to put forth a presentation to a panel on how we were going get this school out of its deficit,” explains Patel. After finishing the project and resting for about three hours, Patel and her team presented their plan to the panel, consisting of the dean of Drexel University College of Medicine as well as the chief financial officer, a member of the Drexel University board of directors, and others. “They grilled us, each member of the panel,” laughs Patel. So begins another day in the Executive Leadership in Academic Medicine (ELAM) program, sponsored by Drexel University.
create a strategic plan,” Patel recalls. “So as I began to step into more leadership roles, I needed to learn those skills.” The leadership roles Patel speaks of include running her own laboratory and helping build the Live Cell Imaging Facility at the Faculty of Medicine into what it is today: a centralized research environment with state-of-the-art microscopy systems and imaging capabilities.
Kamala Patel, PhD
When Patel, a professor in the Departments of Biochemistry and Molecular Biology, and Physiology and Pharmacology, talks about her experience in ELAM, you can see the sense of accomplishment—and perhaps a look of relief that it’s over–written on her face. As North America’s only in-depth program focused on preparing senior women faculty at schools of medicine for institutional leadership positions, ELAM’s year-long program develops the professional and personal skills required to lead and manage in a complex health care environment. The program also pays special attention to the unique challenges facing women in leadership positions.
It’s from her decades long research into inflammation—and from her current efforts to understand why white blood cells move from the bloodstream into tissue causing inflammation—that started the process of developing the Live Cell Imaging Facility. It was Patel and colleagues Stephen Robbins, PhD, associate professor in the Department of Biochemistry and Molecular Biology, and Dr. Paul Kubes, director of the Calvin, Phoebe and Joan Snyder Institute of Infection, Immunity and Inflammation, who decided to pool their Canadian Foundation for Innovation (CFI) grants to purchase several advanced microscopes.
“When you look at the leadership of most faculties, they are not very diverse,” says Patel. “One of the goals of the program is to diversify this leadership.”
“After that we put in another application for a CFI grant, and when it was successful, we started buying more equipment.”
The graduates of the program—or Elums as they are called—are an impressive list. 21 are current or former deans, and another 120 are department chairs or institute directors. Dr. Rose Goldstein, the University of Calgary’s Vice President of Research is also an Elum, and was the first Canadian to graduate from the program. Candidates are chosen from a competitive selection process and must be nominated by either the dean of their medical school, or the CEO of their academic health centre.
Patel says the goal of expanding the Live Cell Imaging Facility was always to promote collaboration. Today, the facility is used by researchers at virtually every Institute in the Faculty of Medicine, and by scientists from around the world including Sweden, Germany, Australia, Spain, Britain and the U.S.
While the workload may have seemed almost overwhelming at times—Patel had to juggle her assignments with the daily tasks associated with her Faculty of Medicine position—the opportunity to participate in such a prestigious program was too great to pass up. “As a graduate student in a research lab, they don’t teach you things like how to manage and fund a large project, negotiate with diverse groups of people and
It was partly her success in building the Live Cell Imaging Facility that started her quest to gain the skills necessary to become an effective leader. Now, after completing the ELAM program, Patel hopes to put what she’s learned to good use. “In an academic environment we need people to step forward to help create a community that will benefit all of our research. ELAM has provided me the skills to do this and I hope to continue to do it at different levels in our Faculty.” Spoken like a true dean. ■ medicine.ucalgary.ca
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Service to Society
Six Months in
Sudan a Lifetime of change After graduating from the medical school at UCalgary, Dr. James Maskalyk travelled to areas of the world in need of medical aid. In Sudan he found disease, hunger, despair—and new outlook on life. By Krista Goheen
Dr. James Maskalyk speaks to Faculty of Medicine students in the Clara Christie Theatre
D
octor James Maskalyk lives his life according to an overarching principle: if you have the chance to see the world and make a difference, well, why wouldn’t you seize that opportunity? This dictum may seem simple enough, but Maskalyk’s own decision to eschew stability to spend six months working in Sudan seems a bit bold, brave, even crazy to people who spend their entire lives working toward that very thing. “I have, I suspect, an enthusiasm for work that takes me far away from the comforts of having a home,” he says. “But I choose it willfully because the work is its reward; the experience is its own true gift.” Maskalyk is, in his own words, drawn to the hard parts of the world, a passion sparked by an elective spent working in Chile’s public health system, while he was enrolled in medicine at UCalgary. “It was an important part of my career as I learned how much pathology and disease is contained in poverty.” An emergency room doctor at St. Michael’s hospital in downtown Toronto and assistant professor at 10
UCALGARY MEDICINE
the U of T, Maskalyk accepted a temporary posting with Médecins Sans Frontières (Doctors Without Borders/MSF) in 2007, an international medical humanitarian organization. The six-month position took him to Abeyi, a small contested border town in Sudan. “You’re on the plane and you pass over this little patch of huts and it’s so hot and so dry and in your medical mind these pictures tell you a thousand words: people are going to be starving,” remembers Maskalyk. “They can’t grow any food, there are no animals, there is no water, no irrigation, no power lines. And so you start to anticipate the problems you’re going to see.” The problems he saw were vast. The MSF team tended to a population infected with diseases like malaria, meningitis and tuberculosis—diseases that were made worse by a lack of immunization, clean food and water. It was also a starving population facing a measles epidemic. “Two patients turned to five; five became fifteen and that’s when I realized that we were in trouble. There was an epidemic and the population hadn’t been immunized,” he says.
Within a month, he and his colleagues had 150 patients, all of them with measles, in a hospital meant to hold 60. The MSF team also dealt with a host of other trauma not exclusive to third world countries,
Service to Society
An infant holds on to Maskalyk’s pinky
but not entirely familiar to many in the western world either: food shortages, malnourished children and those affected with HIV, women dying from childbirth, civilians and soldiers wounded by gunfire, and the constant threat of war. “In Canada I work in a medical system where there’s a greater capacity to say I can offer the best medicine in the world and mean it,” Maskalyk says. “But in places like Sudan and Cambodia I have to do the best I can, and when it doesn’t work I feel like I didn’t live up to my end of the bargain.” The team was faced with few resources and an overwhelming need. “At the time you try to make peace and do the best you can. And you can rationalize it and build up a certain amount of layers, but it’s still spiritually and emotionally
The makeshift waiting room of a mobile medical clinic in Sudan
difficult to be surrounded by the sorrow that inhabits that loss of life.” In an effort to understand his own experiences and to bridge the distance between Sudan and the life he left behind, Maskalyk started chronicling his experiences in a blog. That blog turned into a book, Six Months in Sudan. “I knew that if I could tell the story and make what I experienced seem closer, I could change things. The knowledge that people suffer so much and the heaviness of that truth is inside of me.” Through his writing, Maskalyk says he has gained a greater understanding of his work and why it’s important. Now he’s sharing that knowledge with medical students, most recently in August at UCalgary Faculty of Medicine.
“As medical students, there’s that wonderful truth that you can really enunciate what you want to see in the world through your actions,” he says. “The privilege that you have been given to understand the world is unique and has the opportunity to encourage personal change and perhaps, with time, societal change as well.” In some regards, articulating his experiences has given Maskalyk a greater sense of peace, though he admits he may never make complete peace with it. Although he physically left Sudan some time ago, the country, its people, and the work he did there stays with him. “My title, Six Months in Sudan is disingenuous,” Maskalyk says. “My engagement in Sudan and talking about it is much longer; it lasts a lifetime. And the only real truth I see in the world, unfortunately, is that we have to leave it at some time. The rest of it—what you do with the time that you’re given—is really up to you.” ■
Measles patients in a separate ward of the Abeyi clinic in Sudan A hospital ward at the Abeyi clinic in Sudan
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Research
Insulin Cost
Producing synthetic insulin is an expensive endeavour, one that’s lead to global supply and demand issues. In an effort to ease the problem, two UCalgary researchers are looking to the safflower as a possible solution. By Marta Cyperling
C
anadians may soon claim another insulin innovation. SemBioSys, a Canadian biotechnology company borne out of the University of Calgary has made a scientific breakthrough producing insulin in a genetically modified plant. It was in the early 1920’s that Canadians Dr. Fredrick Banting and Dr. Charles Best first discovered insulin, the protein hormone used in controlling diabetes. When first discovered, insulin was produced by extracting the pancreas of animals. Then in the 1980’s researchers discovered a way to produce human insulin biosynthetically using bacterial cultures. It is this form of insulin that most diabetics receive today. The idea to grow insulin in safflowers was first developed by Maurice Moloney PhD, in the Biological Sciences Department at the U of C, and he naturally began collaborating with his colleagues in the Faculty of Medicine. 12
UCALGARY MEDICINE
Safflower plants at the SemBioSys laboratory
“Insulin is right now the single largest protein pharmaceutical that’s used in the world. There’s roughly six tons of insulin produced per year right now” says Moloney. “If you’re looking at something that’s required in large amounts per year then you might want to look at the idea that plants are very productive and an inexpensive way of doing it.” Producing insulin synthetically is an expensive enterprise resulting in a significant disparity between global supply and demand. According to the World Health Organization (WHO), the west has only 35% of the world’s diabetics and yet consumes over 70% of the world’s insulin. “It’s very expensive to build the facilities that produce synthetic insulin. Some of the companies that are experts in this don’t see how they’ll get the rate of return that they do in the western world. It’s one thing to do it in Canada, but if you tried to do the same thing in Bangalore then you’re going to get a third of the price for your insulin, so you’ve got to be making it for a third of the price”, says Moloney. “Hence the idea of producing it in plants. If we do it in plants we can potentially break the price barrier in many parts of the world and give people an alternative source of insulin.” Dr. Morley Hollenberg and his colleague, Joe Goren, helped with the preliminary animal trials of the plant-derived human insulin at the University of Calgary. Hollenberg is working with Moloney to get the product to market.
Research
Clockwise from top left: An employee working with small safflower seedlings; safflower seedlings in a SymBioSys greenhouse; an employee wearing eye protection while working in a greenhouse; seedlings being transported from a greenhouse; Maurice Maoloney, PhD (left) and Dr. Morley Hollenberg at the SymBioSys laboratory; the main laboratory at SymBioSys
Photographer Mark Coffey
“Being able to produce a lot of insulin at a cheaper price will also be very useful in developing an alternate route of delivery of the drug, something like a nasal spray which needs two to three times the amount of insulin as an injection.” Not only is SemBioSys creating a less expensive way of producing and delivering insulin, but the Calgary lab is also creating jobs for locally-trained scientists. “A number of individuals who trained as post-docs in the Faculty of Medicine now work at SemBioSys,” says Hollenberg. “We are building a pharmaceutical infrastructure in Alberta. Right now, we are training great people here but where will we employ them? Trainees often go outside of the country for work because Canada does not have a large pharmaceutical drug infrastructure.”
The safflower crops are processed into insulin at the Calgary lab, but the plants are actually grown on three regulated farms in Lethbridge, Alberta, Washington state and Chile. Moloney says the raw materials are handled very carefully, according to government permits and regulations. Because the safflower is a desert plant, it grows on marginal land and can easily be isolated from other crops using isolated fields. In this way, SemBioSys can avoid any cross pollination and residual effects in the environment after harvest. Based on their Phase I and II clinical trials in the United Kingdom, Moloney says the results look promising. The pivotal Phase III of the clinical trials will begin once a partner has been identified, and SemBioSys anticipates its first insulin product could be approved by 2013. Hollenberg hopes the Endocrine Division of the Faculty of Medicine can participate in future trials of plant-produced insulin in diabetic patients. The company is also researching the idea of placing other pharmaceutical crops into production. ■
Working in the greenhouse with full size safflower plants
Insulin: the
Safflower seeds in storage
final produc
t
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Profile
Dr. Karate Gastroenterologist by day, karate champion by night By Andrea Di Ubaldo
Dr. Karate’s guide to becoming a champ
D
r. Karate—sounds like the title of a Hollywood script doesn’t it? Intelligent woman deals with the pressures of being a well-respected doctor on her quest to becoming a Canadian karate champion. Well, Dr. Karate is in fact a real person. Dr. Maitreyi Raman, clinical assistant professor at the Faculty of Medicine, is a medical doctor specializing in gastroenterology and nutrition, and a third degree black belt in karate. Raman started taking karate classes when she was in grade 11 and, having always been interested in nutrition because of her other athletic training, decided to go into medicine. “The two just fit together because they both require a great deal of discipline and single-mindedness in achieving a goal,” says Raman. “Karate has made it easier for me to challenge my energy and focus for longer.” Her work finds her researching non-alcoholic fatty liver disease, nutrition support and medical education, while her karate preparation for the competitive season finds her training 20 hours a week, eight to 10 months of the year. As a medical student and resident it was easy to study and train for matches, but according to Raman, now it can be a challenge to balance her work with her hectic training regimen. “It can be a lot, but I thrive on stress,” says Raman. “When I take breaks my focus declines.” She explains that karate requires an enormous amount of discipline and focus, and that you must prioritize to help you move to the next level of training. The same can be said for her research. “Being able to train lets me put all my energy into the task at hand and keep focused,” says Raman. “Karate is good training to apply to real life. It helps clear your mind and it’s also a great stress reliever.” 14
UCALGARY MEDICINE
Raman’s karate career has been full of accomplishments. Specializing in the kumite style of karate, she is a nine-time provincial team member and has represented Canada at the World Chito-Ryu Soke Cup Championships three times. For the last two years she’s won gold in her weight division at the Canadian National Championships and qualified for other international tournaments including the Pan American Games in Curaçao, where she narrowly lost out on the bronze medal. “It came down to a judges’ decision in Curaçao,” says Raman. “I learned more about my strengths there, but I didn’t take advantage of my speed.” Her speed is something she can hopefully use when she spars in open weight class competition. At 5’3”, Raman once fought a woman who was 6’ tall. “It’s not always a disadvantage to be smaller. Because reach is limited, it can be harder for a taller person to score on someone shorter,” says Raman. However, the potential for injury can be much higher. The sport’s strict rules prevent most injuries, but she has received cuts, scrapes and bruised ribs before. To be able to accomplish so much in her sport, one would have to have a great coach, a Mr. Miyagi if you will. Raman does and it’s her husband, Gary Sabean, a nine-time Canadian National Champion in karate. He is both her provincial and national team coach and has been instrumental in her training. “It’s a double-edge sword because he frustrates the heck out of me, but I wouldn’t have anyone else in my corner,” says Raman. Next up for her karate career is the Commonwealth Championships in New Zealand in September. After that, she thinks it may be time to call it quits. “This might be my last year of competition,” says Raman. “I’m satisfied with my accomplishments. It’s time to switch gears and start coaching.” ■
As if Dr. Maitreyi Raman’s work schedule isn’t busy enough, she still manages to find time to train for her karate competitions. Here’s a breakdown of her weekly routine: Monday 7:00pm-7:30pm - Cardio inter val training - Plyometric activity - Speed/agility
7:30pm-8:15pm - Basic karate training (punches/kicks/combinations) 8:15pm-9:00pm - Spar ring scenarios - Ring side strategy
Tuesday 7:00pm- 8:30pm • Explosive speed/strength training using hand weights • Explosive leg training using weight vest/ankle weights • Shadow spar ring using stationar y dummy Wednesday 7:00pm-8:30pm • Par tner training • Setting up techniques • Spar ring Thursday 7:00pm-9:00pm • Basic karate class Friday 8:15pm-9:30pm • Advanced sparring class Saturday 10:00am-1:00pm • Provincial team training OR; • Endurance training – running/ core training/cross-training • Mental training Sunday 9:00am-10:00pm • Mental training • V isualization • Meditation
Endeavours
Riding out the
storm A group of researchers and staff at the Faculty of Medicine are using their brains and brawn to fight cancer, a disease that in some form will strike 50% of all Canadians in their lifetime. By Ian Weetman
S
taff at the Southern Alberta Cancer Research Institute (SACRI) and the Tom Baker Cancer Centre (TBCC) have been busy giving the term “weekend warriors” a whole new meaning recently. In addition to spending their days in the labs and clinics finding new methods to battle the life-threatening disease, an 11-person team—led by co-captains Dr. Peter Forsyth and Theresa Radwell—also spent countless evenings and weekends training for this summer’s inaugural Ride to Conquer Cancer. Biking alongside some 1,742 participants from all walks of life—including many current cancer patients—the team contributed an impressive $50,000 towards the staggering $6.9 million raised for the Alberta Cancer Foundation during the 200-kilometre, two-day event, which took place in late June along the Cowboy Trail (Highway 22). The determination of cancer patients to survive even in the face of adversity is what continues to impress Dr. Peter Forsyth, the director of SACRI.
“The event was an amazing display of courage. In addition to friends and family members of those with cancer, there were several survivors riding as well. In fact, three of my own patients who are actively receiving cancer treatment were biking alongside us,” beamed Forsyth. “Chemotherapy typically makes you slow and tired, so to see them ride was incredibly inspiring to see.” And with a 50% chance of being diagnosed with some form of cancer in a lifetime, Forsyth stressed that events like the Alberta Cancer Foundation’s Ride to Conquer Cancer are the key to finding a cure now more than ever. “Fundraisers like these are extremely important to our organization because they contribute a very significant portion of our annual research budget, and they play a significant role in taking our research to the next level, especially during tough times like these when stable funding is even more critical.” Although emotionally rewarding, Theresa Radwell, associate director of SACRI, confessed her efforts got off to a rather bumpy start. “To say I was an occasional cycler would be very generous. When I decided to do the ride back in December, I wasn’t sure how I was going to get there! I had a bike which was about 13 years old and my fitness level was pretty low.” Despite these early challenges, with the help of a trainer Radwell was soon up to speed and training at least four times a week, despite the less than ideal conditions.
“I started training indoors on a stationery bike until I bought my road bike in March, when I started training outside some of the time. I had fun, although the minus temperatures and wind chill were a little challenging!” Thankfully that wasn’t the case when the event got underway on June 27. “Although the route was beautiful and made you really appreciate where you live, the cross winds that are common in southern Alberta provided new challenges, most of all on the second day,” recalls Radwell. “One section in particular towards the end meant that you were brought almost to a standstill.” Besides her professional connection to the cause, the event had an even more personal significance for Radwell. “At a young age, I lost two of my grandparents to cancer and then in my early twenties my mother was also diagnosed with lung cancer. Although she lost her twoyear battle with cancer, she left me with an admiration for her courage and determination, qualities which helped fuel me in my training and on the ride.” Even as fundraising for this year’s race winds down, both Radwell and Forsyth say they are already gearing up for next year’s event, which they hope to enter with an even larger team. For more information on how to get involved, contact Theresa Radwell at tradwell@ucalgary.ca or visit www.conquercancer.ca ■
From far left: Rachel Syme (left) and Theresa Radwell; team members gather before the race; at the finish line after day one
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The Foundation
The University of Calgary Presents The 2009 Gairdner Foundation Lectures Nationally Supported by the Canadian Institutes of Health Research
Clincal Associate Professor, Faculty of Medicine, University of Virginia; Founder and President, Helicobacter Foundation
PM AGREEMENT NO. 41095528 RETURN UNDELIVERABLE CANADIAN ADRESSES TO: University of Calgary Faculty of Medicine Communications & Media Relations Teaching, Research & Wellness Building 7th Floor 3280 Hospital Drive NW Calgary, Alberta T2N 4Z6
David Sackett, OC, MD, FRSC, FRCP Professor Emeritus, Clinical Epidemiology & Biostatistics, McMaster University; Founder, Trout Research & Education Centre
Dr. Lucy Shapiro
Barry J. Marshall, M.D.
Dr. David Sackett
Dr. Barry Marshall
Please join us on Tuesday, October 27th, 2009 at 2:30pm In the Libin Lecture Theatre of the Health Sciences Center Lucy Shapiro, Ph.D. Director, Beckman Center for Molecular and Genetic Medicine; Professor, Developmental Biology, Stanford University School of Medicine