URMC Rochester Medicine 2023 | Volume 2 by University of Rochester Medical Center

UNIVERSITY OF ROCHESTER MEDICAL CENTER | SCHOOL OF MEDICINE AND DENTISTRY | 2023 VOLUME 2

WHAT THE STREETS

TEACH

Outreach Changes Lives and Minds

Here’s How Academic Medicine Can Thrive Plus: Donors’ Gift Goes Way Beyond Dollars Bonding at Meliora Weekend

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On the cover Nikhil Bamarajpet co-leads Rochester Street Outreach, a student-run program that helps people experiencing homelessness. But the benefits go both ways. The program asks volunteers to have hope for people who have sometimes lost all hope themselves. Students say it can help them understand patients in important new ways.

Photo by Matt Wittmeyer

POINT OF VIEW The 105 members of the Class of 2027 marked the beginning of their medical training at the School of Medicine and Dentistry’s annual Dr. Robert L. & Lillian H. Brent White Coat Ceremony on Aug. 18.

Photo by J. Adam Fenster

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oday, our Medical Center’s clinical enterprise touches a million lives across a 27-county area.

We are growing, both in our physical footprint and in the services we offer. When it comes to patient care, it’s a matter of, “You name it, we do it.” Yet we must never forget that as an Academic Medical Center (AMC), we are called to do more. Therein lies the challenge. How do we best ensure the success of our research and teaching missions while delivering the best possible care to our patients? It’s a balancing act that has been inherent in the AMC model ever since the Flexner Report, back in 1910, recommended putting the three missions under one roof. Then and now, the advantages of this approach far outweigh the challenges. Our three missions support each other. They enrich each other and ensure the others’ futures. So, how do we meet the challenge and reap the benefits? Mark B. Taubman, MD CEO, University of Rochester Medical Center Dean, School of Medicine and Dentistry Senior Vice President for Health Sciences

As you’ll read in this issue’s story on what AMCs need to do to thrive in the coming years, my fellow AMC leaders and I see many paths to success. We know the AMC model needs to keep evolving, but so does health care itself. We face challenges that were unimaginable in 1910, from the lingering impacts of COVID to changing financial models. You’ll also read about a student effort that helps address one aspect of social determinants of health, which is critical to making progress on health equity. Our Street Outreach Program, which assists people experiencing homelessness, is an inspirational story, both because of the impact it has on the community and because one of the medical students who co-leads it experienced homelessness himself as a child. Happily, as my time as CEO and dean draws toward a close, I believe the future is bright. The vision and dedication I see around me fills me with confidence in our ability to help everyone—staff, students, faculty, and patients— live their best lives. Meliora!

What do you think? Rochester Medicine welcomes letters from readers. The editor reserves the right to select letters for publication and to edit for style and space. Brief letters are encouraged. RochesterMedicineMagazine@urmc.rochester.edu

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Read more Rochester Medicine RochesterMedicine.urmc.edu Submit Class Notes RochesterMedicineMagazine@urmc.rochester.edu

Write to Us Rochester Medicine magazine University of Rochester Medical Center 601 Elmwood Avenue Box 643 Rochester, New York 14642

CONTENTS

Medical Center Rounds

Cover Story 10 What the Streets Teach

An Outreach Program Helps People in Need. It’s Also Changing the Lives of Its Volunteers.

Feature Story 20 Taking the Right Steps

What Academic Medical Centers Need to Do to Thrive in the Coming Years.

Bonding and Sharing at Meliora Weekend 2023

Dean’s Circle Awards Honoring Achievement, Dedication, Commitment

Faculty News

Philanthropy Profile

Class Notes/In Memoriam

Rochester Medicine is published by: The University of Rochester Medical Center, Department of Communications, in conjunction with the Department of Alumni Relations and Advancement for the School of Medicine and Dentistry

Editors

Lori Barrette Mark Liu

For questions or comments, contact:

Art Direction & Design

Karen Ver Steeg

for the School of Medicine and Dentistry

Staff Writers

Bethany Bushen Jim Miller

300 East River Road, Rochester, NY 14627

Production Manager

Bethany Bushen

Fax 585.461.2081

Feature Photography

Matt Wittmeyer

Contributors

Emily Boynton Scott Hesel Mark Michaud Sara Miller Leslie Orr Susanne Pallo Sandra Parker Kelsie Smith-Hayduk Kristine Kappel Thompson Kelly Webster

Assistant Vice President of Communications, URMC

Dept. of Alumni Relations and Advancement

Phone 800.333.4428 585.273.5954

To comment on this issue, e-mail: RochesterMedicineMagazine@urmc.rochester.edu

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MEDICAL CENTER ROUNDS

Vaccine Research

How to Build an mRNA Search Engine—and Help Optimize COVID Vaccines In an effort that has deep roots in past URMC discoveries, SMD researchers have helped to develop an algorithm that identifies the most stable, efficient mRNA sequences for vaccines. SMD RNA expert David Mathews (’94, PhD ’02, MD ’03) and computer scientist Liang Huang, PhD, of Oregon State University, created the algorithm, which can assess David Mathews MD both mRNA sequence structure and genetic code—the combination of which is the “secret sauce” for a successful vaccine. Like a Google search for mRNA sequences, their algorithm spits out the top result for a specific protein among the almost infinite number of possibilities. The researchers believe their tool will be valuable to companies that make mRNA vaccines and to research teams developing mRNA-based therapies for genetic disorders, cancer, and a plethora of other diseases. Tests show that the algorithm-derived mRNAs resist deterioration longer, produce more COVID spike protein, and 4

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dramatically increase antibody levels in mice when compared to currently used mRNA vaccines. The results were reported in Nature. “Our tool is designed to identify the best sequence out of a huge space that you could never explore experimentally,” said Mathews, co-corresponding author of the Nature study and the Lynne E. Maquat professor of Biochemistry and Biophysics at the Medical Center. “Prior approaches did a poor job of searching this space. We hope this breakthrough will help companies to develop or improve their mRNA therapies.” “This work addresses the main limitation of current mRNA vaccines— they don’t make enough protein,” said Elizabeth Grayhack, PhD, associate professor of Biochemistry and Biophysics at SMD. “What’s critical is that they took this problem from beginning to end; they came up with a clever design and they show that it actually works. I think this will have a huge impact on vaccine development.” The unusual partnership between Mathews, a computational biologist whose lab develops tools to predict RNA structure, and Huang, a computational linguist with expertise in natural language processing, led to the creation of the algorithm, which produces results in around 10 minutes on a desktop computer.

“The success of COVID vaccines confirmed that mRNA-based technologies can be absolutely transformative,” said Dmitri Ermolenko, PhD, who works with Mathews in the University of Rochester Center for RNA Biology. “I think Dave’s algorithm will be indispensable for making optimal mRNA sequences for vaccines and other treatments.” The new study builds on a long research history. Twenty-five years ago, Mathews was a student in the lab of Douglas Turner, PhD, a now-retired professor of Chemistry at the University of Rochester. Working together, they devised the Turner Rules—a set of parameters that predict the folding stability of RNA (its structural stability). According to Mathews, “In the ’90s, we had no idea that the Turner Rules would be so important for vaccine design. Doug’s work has had a huge impact on the field of RNA biology.”

Vaccine Research

Researchers Lead the Way to Successful RSV Vaccine for Older Adults The FDA’s June decision to approve Pfizer’s RSV vaccine—after nearly five decades of development efforts—resonated deeply here, where researchers had been involved in studying three of the four contenders. Edward Walsh, MD (Res ’77, Flw ’82), professor of Medicine, has a deep history with Pfizer from working on multiple viral pathogens over the years. This long-standing relationship led to URMC being named a lead site, with Walsh as national lead investigator for Pfizer’s phase 3 clinical trial of the RSV vaccine for older adults. Walsh was also a lead investigator on the preliminary trials that preceded the phase 3 study. The promising results show that Pfizer’s vaccine has an efficacy of 66.7 percent in preventing general illness, 85.7 percent in preventing lower respiratory tract infection with three or more symptoms, and 62.1 percent in preventing acute respiratory infection. “RSV is the worst disease that nobody knows about,” said co-investigator Ann Falsey, MD (Flw ’91), co-director of the UR Vaccine Treatment and Evaluation Unit, a part of the National Institute of Allergy and Infectious Diseases (NIAID) network that was instrumental in studying the first FDA-approved COVID vaccine. But the perception of RSV is changing. “It started to get a lot of press last year after activity surged when COVID public health measures were relaxed, but every year it consistently causes significant numbers of hospitalizations and deaths in older people aged 65 and up.” Falsey plays a prominent role in RSV vaccine development. She published phase 2 clinical trial results in the New England Journal of Medicine on the safety and efficacy of a different RSV vaccine for older adults. At another FDA/VRBPAC meeting to review a vaccine candidate from GlaxoSmithKline (GSK), Falsey, while not involved in its clinical trials, presented at the meeting as an expert, testifying to the burden of RSV on the community. Both Walsh and Falsey have been prominent vaccine researchers for decades and were at the forefront of COVID vaccine FDA approval. Walsh has been researching RSV since the 1980s, describing epidemiology and clinical characteristics of RSV in adults. His early work was the first to identify and characterize the RSV fusion (F) protein, which is used in the current vaccine candidates. Falsey has been involved with clinical and translational vaccine research in respiratory viral infections in adults, including RSV, flu, COVID, parainfluenza, and human metapneumovirus. She is a standing member of the Clinical Studies and Field Research Study Section, and a member of the steering committees for Global Influenza Initiative, Infectious Diseases Society of America, and the American Virology Society. Ann Falsey, MD

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MEDICAL CENTER ROUNDS Pediatrics & Oncology

Two New Sets of National Guidelines Have URMC Origins Two faculty members played key roles in developing new sets of national guidelines related to pediatric decision-making and the use of mind-body tools in oncology. Lainie Ross, MD, PhD, chair of Health Humanities and Bioethics, led a group of medical and ethics experts who conceived new consensus recommendations for pediatricians. Wilmot Cancer Institute oncologist Alissa Huston, MD (Res ’03), associate professor of Medicine and Hematology/Oncology, was part of the national team calling for cancer patients to use mind-body techniques to ease anxiety and depression during and after treatment. The pediatric recommendations reframe the focus from “best interest of the child” to the “child’s interests,” encouraging physicians and parents to collaborate in a shared decision-making process that acknowledges that children have many interests—not just medical ones—that influence their well-being. The new approach also strays from past guidance by starting with the presumption that parents know best.

Alissa Huston, MD

“As a health care provider, the only recommendation I can give to a parent is what I think is medically best for their child,” noted Ross. “But the parent might not want to act solely on a health interest; they may want to consider spiritual or financial interests. If a medication I recommend would lead to significant hardship for the family, they may opt for a less expensive option, even if it is less effective.” The new principles flip the script from the traditional idea that doctors know best. Physicians are advised to give parents plenty of latitude, respecting their knowledge of their child and trusting them to use it to make the right choices for their family. “As doctors, we love to say that health needs are always the highest priority, but that’s not the case for all people at all times,” Ross said. The new guidelines appeared in Pediatrics. Huston’s work, meanwhile, was published in the Journal of Clinical Oncology. She and her co-authors reviewed 110 studies on mindfulness-based oncology interventions for anxiety and depression related to treatment. Recommendations were made to address anxiety symptoms during treatment with mindfulness-based interventions, yoga, music therapy, reflexology, and aromatherapy (using inhalation); and for after treatment, mindfulness-based interventions, acupuncture, tai chi and/or qigong, and reflexology. For symptoms of depression during treatment, mindfulness-based interventions, yoga, music therapy, relaxation, and reflexology were recommended; and for after treatment, mindfulness-based interventions, tai chi, and/or qigong. “Now, we have evidence-based guidelines for mind-body therapies, similar to what we use to guide other treatments for cancer,” Huston said. “This will help our patients with decision-making, and we can educate them about what is effective and safe.” One interesting outcome of the study: Supplements were not recommended.

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Lainie Ross, MD, PhD

Cancer Care

Groundbreaking Lymphoma Study Likely to Change Standard Treatment This historic clinical trial, which for the first time in the modern era included both adolescents and adults with advanced Hodgkin Lymphoma (HL), showed that 94 percent of the patients treated with an experimental immunotherapy plus chemotherapy were cancer-free or had no progression of disease after one year. The results are likely to change standard treatment for this type Jonathan Friedberg, MD, of cancer, said Wilmot Cancer MMSc Institute Director Jonathan Friedberg, MD, MMSc. Friedberg is senior investigator of the study and chair of the Lymphoma Committee at the SWOG Cancer Research Network, which designed the S1836 trial as a part of the National Cancer Institute-funded National Clinical Trials Network. “We hypothesized that the newer treatment would turn out to be most beneficial for patients,” Friedberg said, “but the magnitude of the benefit exceeded our expectations.” The American Society of Clinical Oncology (ASCO) showcased the research at a June plenary session and press program because of its high merit and great impact on oncology research. A key part of the study design, Friedberg said, was to include pediatric patients ages 12 and older. The standard treatment for

them has often included radiation therapy, which carries risks of serious side effects later in life, such as second cancers, thyroid dysfunction, and heart disease. “By eliminating radiation for children enrolled in this trial, we essentially took away the risks of many toxic late effects,” Friedberg said. “But we only have one year of follow-up data for our trial at this point, and we will continue to watch for side effects in the future.” The randomized, phase 3 study compared standard treatment with chemotherapy and brentuximab vedotin (brand name: Adcetris) against the immunotherapy (nivolumab [brand name: Opdivo]) plus chemotherapy. About 86% of the people in the standard treatment group achieved remission, compared to the 94% who received the newer therapy. When the strong data came in, the National Cancer Institute (NCI) stopped the trial early to facilitate a faster review by the FDA for ultimate approval of nivolumab-AVD as an initial treatment for stage 3 or 4 HL. Nivolumab is already being used to treat HL that has spread later or relapsed. In this study, it was evaluated as front-line therapy in people who had advanced disease when they were newly diagnosed. The goal, Friedberg said, was to improve the remission rates in those patients. Wilmot recruited the second-highest number of people with Hodgkin Lymphoma to the study, led locally by Wilmot oncologist Carla Casulo, MD, associate professor of Hematology/Oncology, and an international expert and clinician-researcher for lymphoma.

School of Medicine and Dentistry

Rochester Sees Rise in National Medical School Rankings US News & World Report’s 2023–24 Best Graduate School rankings place SMD as the nation’s 32nd best among 192 research-intensive medical schools, up from 37th best last year. In addition to the research ranking, US News also ranks schools that focus on producing primary care physicians; in that ranking, the University of Rochester scored 40th best. US News introduced methodology changes likely in response to an increasing number of medical schools—including Harvard, Columbia, Stanford, Duke, NYU and others— arguing that its methodology favors affluent students and doesn’t reward schools that recruit promising students from disadvantaged groups. Improvements in SMD’s component scores and the reweighting changes drove its substantial rise in the rankings. “I’m proud of the improvements we’ve made and appreciate that US News appears to be listening to long-standing scrutiny,” said SMD Dean Mark Taubman, MD. “We’ll decide whether or not to continue to actively participate in these rankings. I am committed to providing prospective students with useful, comparative tools to help them choose the right school for them, and to continuing our diversity and inclusion efforts.” ROCHESTER MEDICINE

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MEDICAL CENTER ROUNDS Community Outreach

Meet the Unlikely Team that Protected Some of Rochester’s Most Vulnerable from COVID This isn’t just another story about COVID. It’s a story about some of the things SMD does best: cross-disciplinary collaboration, community outreach, and innovative thinking. It’s also a story about hard-won data that could change how organizations respond to airborne viruses in settings that support the intellectual and developmental disabilities (IDD) community. The effort grew out of the University of Rochester’s April 2020 NIH designation as one of only about a dozen Intellectual and Developmental Disabilities Research Centers (IDDRC) in the country. This strengthened the long-standing relationship between SMD’s Neuroscience community and the Mary Cariola Center, a Rochester-based nonprofit providing education, residential programs, and other services for people with complex disabilities.

vulnerable population safe.” “Very few IDDRCs could have done what we were able to do in this project,” said Steve Dewhurst, PhD, vice dean of research, UR vice president of research, and co-principal investigator of the RADx-UP study. Dewhurst credits the strong relationship, based in mutual trust and respect, that has grown between the University and the Mary Cariola Center. He also cites the benefits of URMC's size. “We are small enough that we know each other but diverse enough that we could create this team that included me, a virologist, the senior associate dean of clinical research, and the co-director of the IDDRC.”

A year into the pandemic, the NIH Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) program funded the UR-IDDRC and Mary Cariola in a $4 million project to better understand COVID’s spread in the IDD population. Working with Cariola staff, the SMD team brought hard-toobtain on-site testing to the center, which was crucial to its vital effort to remain open during the pandemic. “Almost immediately, we were able to catch positive cases early and identify asymptomatic people as well,” said Martin Zand, MD, PhD, senior associate dean of clinical research. Isolating people with positive tests and tracking antibody levels within the Mary Cariola Center community helped keep the virus at bay. Antibody levels—from vaccinations and illness—were collected and considered.

Martin Zand, MD, PhD, (left) and Christopher Seplaki, PhD.

“We could see how the immunity progressed and changed in both vaccinated and unvaccinated people within the study,” said Zand. “Because of this, we know we achieved herd immunity at the school.” Zand and Christopher Seplaki, PhD, associate professor of Public Health Sciences, used this data along with COVID tests and other school-specific information to create hundreds of models in order to understand how an airborne virus could travel through the buildings, hallways, and classrooms. At weekly meetings, the models were used to guide real-time decisions. Now, the data is pointing to ways of mitigating COVID’s spread. “We are working on the datasets and are starting to tee up a series of publications about our observations,” said John Foxe, PhD, co-director of the IDDRC. “We wanted to see the whole picture and use dense data over a long period to be able to say something substantive to be used to help keep this

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Andrew Cameron, PhD, assistant director of Clinical Microbiology Laboratories, in the lab that ran 16,000 COVID tests for the project.

Maiken Nedergaard, MD, DMSc

An Unexpected Doorway into the Ear Opens New Possibilities for Hearing Restoration An international team of researchers has developed a new method to deliver drugs into the inner ear, allowing them to restore hearing in deaf mice. The discovery was made possible by harnessing the natural flow of fluids in the brain and employing a little-understood back door into the cochlea. They used this to deliver a gene therapy that repairs inner-ear hair cells. “These findings demonstrate that cerebrospinal fluid transport comprises an accessible route for gene delivery to the adult inner ear and may represent an important step towards using gene therapy to restore hearing in humans,” said Maiken Nedergaard, MD, DMSc, senior author of the new study, which appears in the journal Science Translational Medicine. Nedergaard is co-director of the Center for Translational Neuromedicine at the University of Rochester and the University of Copenhagen. The study was the product of a collaboration among researchers at the two universities and a group led by Barbara Canlon, PhD, in the Laboratory of Experimental Audiology at the Karolinska Institute in Stockholm, Sweden.

The number of people worldwide to have mild to complete hearing loss is expected to grow to around 2.5 billion by mid-century. The primary cause is the death or loss of function of hair cells found in the cochlea—which are responsible for relaying sounds to the brain—due to mutations of critical genes, aging, noise exposure, and other factors. While hair cells do not naturally regenerate in humans and other mammals, gene therapies have shown promise. In separate studies, gene therapies have successfully repaired the function of hair cells in neo-natal and very young mice. But as both mice and humans age, the cochlea—already a delicate structure—becomes enclosed in temporal bone. At that point, any effort to reach the cochlea and deliver a gene therapy via surgery risks damaging this sensitive area and altering hearing. In the new study, the researchers describe that back door into the cochlea. While the name of it—the cochlear aqueduct—might conjure images of a monumental stone structure, it is actually a thin, boney channel no larger than a single strand of hair. The study shows that the cochlear aqueduct, suspected to play a role in balancing pressure in the ear, also acts as a conduit

between the cerebrospinal fluid found in the inner ear and the rest of the brain. Scientists are developing a clearer picture of the mechanics of the glymphatic system, the brain’s unique process of removing waste, which was first described by the Nedergaard lab in 2012. Because the glymphatic system pumps cerebrospinal fluid deep into brain tissue to wash away toxic proteins, researchers have been eyeing it as a potentially new way to deliver drugs into the brain—a major challenge in developing drugs for neurological disorders. Researchers have also discovered that the complex movement of fluids driven by the glymphatic system extends to the eyes and the peripheral nervous system, including the ear. The new study represented an opportunity to put the drugdelivery potential of the glymphatic system to the test while, at the same time, targeting a previously unreachable part of the auditory system. “This new delivery route into the ear may not only serve the advancement of auditory research but also prove useful when translated to humans with progressive genetic-mediated hearing loss,” said Nedergaard. ROCHESTER MEDICINE

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Nikhil Bamarajpet (left) catches up with Jay at Peace Village in Rochester.

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An Outreach Program Helps People in Need. It’s Also Changing the Lives of Its Volunteers. By Mark Liu

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Nikhil Bamarajpet and his mom had become homeless, living on Long Island among others in the same position. One night, a man in their group doubled over with excruciating pain.

If the future of medicine depends on more equitable health care, participants in this program would say that learning on the streets of Rochester is helping to prepare them for that future.

EMTs eventually came, but “it took them longer to arrive than they stayed,” said Bamarajpet. They dismissed the man’s pain and said there was no room in the hospital, anyway, and then left. A few days later, the man died.

What They Need, What They Learn

Bamarajpet was only 12, but he knew something about the encounter wasn’t right. At the same time, what could people living on the streets do about it?

Rochester Street Outreach began in 2011 as UR Street Medicine, to help Rochester’s unsheltered population living under bridges, in alleyways, or in public parks.

That’s how Bamarajpet learned that medical care is a matter of life and death—and it’s when he decided he wanted to be a part of it. In high school, he tried to volunteer with an ambulance company but had no way to get there other than an hour’s walk, so they sent him home. In college he became an EMT. When he began applying to medical schools, he wanted to find one that had an outreach program for people experiencing homelessness.

Lo, the founder, had been an art major at Haverford College, where she built her senior thesis around portraits and sculptures of people who were experiencing homelessness.

He researched the Street Outreach Program at the University of Rochester School of Medicine and Dentistry and was impressed. Today he’s a second-year medical student at Rochester, where he co-leads Street Outreach with Haley Chesbro—and has plans to expand it. Bamarajpet’s story—from homelessness to medical school—is testament to the value of the kind of program that helped attract him to Rochester. He himself was helped along the way, including financially at Rochester as recipient of the Dr. Frank Fowler Dow and Harriet Brown Dow Scholarship and the Dr. Jean D. Watkeys Medical Student Scholarship. The larger story is what the Street Outreach Program teaches medical students. Bamarajpet called it “one of the best learning experiences that I think you can get in medical school.” The founder of what would become Rochester Street Outreach, Emma Lo (MD ’15), came to her career in Psychiatry in large part due to her experience with the program. She’s now assistant professor of Psychiatry at Yale School of Medicine. She’s also medical director for the Street Psychiatry Team at the Connecticut Mental Health Center, furthering the kind of outreach she began in Rochester. Both Bamarajpet and Lo talk about the invaluable things they learned as they tried to help people living day to day, in encampments or on the streets. They came in thinking they knew what was needed and ended up learning something entirely different. Classes teach medicine, but Street Outreach helps teach how to connect with patients in ways that most students would never expect. It asks student volunteers to have hope for people who have sometimes lost all hope themselves, mirroring how society tends to view them. At times, these volunteers are trying to support people who have nobody else left who believes in them. 12

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“My goal with the project was to show the faces of homelessness and show these are the real stories that people have,” said Lo. That same year, she met Jim Withers, MD, one of the founders of street medicine. He allowed her to shadow him in his work with Operation Safety Net in Pittsburgh. That experience and a year with Americorps set her direction: She would pursue medicine, specifically to serve people who are often isolated from the medical community and society in general. “I really couldn’t imagine going into medicine for any other purpose,” she explained. “And so, when I came to Rochester, I had this dream in mind that this is what I want to be doing.” But she wasn’t the type to wait. In her first year, Lo would hop on her bike to explore her new city, looking for people who were unsheltered. She knew the school wouldn’t have liked her exploring alone, but she wanted to see if a need for outreach even existed. She was uncertain—until she met a man named Hubert, who had been living on the streets but had turned his life around and found housing. “Hubert knew everybody who was unhoused in Rochester and knew where they were and could bring me there,” Lo said. “A lot of my initial work was just going with Hubert to places where people were staying—in the parking garage, in town spaces.” Jared Lunkenheimer (MD ’14) was an early volunteer with the program. Others joined them along the way. Tuesdays and Thursdays, around 7 p.m., a handful of students would carpool downtown. They made rounds on the streets and parking garages, carrying a backpack of simple medical supplies and any other items they could gather: socks, fruit, granola bars. At the insistence of the Rochester Police Department, they also carried a two-way radio that could summon officers even where cell phone service might not reach. Sometimes the students would struggle to find people. Other times, the people they approached made it clear they didn’t want their help.

“I really couldn’t imagine going into medicine for any other purpose.” Program founder Emma Lo, MD, learned from street medicine pioneer Jim Withers, MD, in Pittsburgh.

As an art major at Haverford College, Emma Lo created portraits and sculptures to humanize people experiencing homelessness near campus.

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But one defining moment came when Hubert brought Lo to an encampment area by the train tracks where people were playing cards. Lo decided to stay and learn the game they were playing. She didn’t push health or medicine. She simply played cards. “Looking back on it, it was a test,” said Lo. For people who had difficult associations with health care, trust had to come before anything else. Many were grappling with mental health issues and substance-use disorders, as well as the stigma that goes along with them. Some had felt judged in past visits to emergency rooms. Many felt they weren’t presentable enough even to walk into a clinic. By spending time with them on their terms, Lo passed the test. After that, Hubert would introduce her, saying, “This is Emma. She played cards with us on the train tracks.” It was a signal she could be trusted. But she soon learned that trust didn’t necessarily lead where she had expected. “I think initially, I thought we were going to offer formal medical care.” But many of the people they encountered didn’t want medical help. What they did want was someone to truly engage with them and show them respect. The key, she realized, was to “show them that you are somebody that cares about them when potentially their entire family, everyone they've ever met, has disappointed them or traumatized them and hurt them.” She called this realization one of the most important things the team had to learn. The focus turned to listening and building relationships. Even as the program grew connections with

community groups and medical clinics for referral, and even as Lo scored a major victory by recruiting Lois Van Tol, MD, as the program’s preceptor who could offer medical care, the volunteers learned that other problems had to be addressed before medical ones could be. One man Lo tried to help on a hot July night explained he had lost 50 pounds due to his “vodka diet.” “Why do you drink?” she asked him. He thought for a bit. “To try and forget all this. I try and erase it from my mind. But sometimes it just doesn’t work anymore. I stepped up to the plate! I stepped up to the plate,” he said about his time serving in the Vietnam War. “They wanted me to shoot people. I didn’t want to shoot nobody, but I had to. I didn’t want to do it, but I did it. Some people went to Canada. Cowards. I stepped up to the plate.” He was crying now. Lo had been collaborating with community groups that could offer hotel stays for those in need. She tried to convince the man to take a room in a nearby hotel, but he hesitated—Lo sensed the man didn’t feel he deserved it. Yet, he explained that sleeping outside was dangerous because of what he called “the vermins”: the people who showed up to harass the homeless through the night. He demonstrated by holding one eye open as he pretended to sleep. Finally he agreed to the overnight stay. When they took him to the room, the bed wasn’t made up. In her notes for that night, Lo wrote: “It was unclear if the manager had done that on purpose or if it was an honest accident.” They brought him to a different room. It was swelteringly hot inside. “I could see how he’d prefer to sleep outside,” Lo wrote. “To be honest, I would have, too.” It was one of many teaching moments, when Lo and her fellow volunteers learned how complicated it could be to try to help this population. It wouldn’t be the last.

The Homebuilder Without a Home See Street Medicine in Action When Emma Lo was running the Street Medicine program as a medical school student, a camera crew followed her to create “The Street Medicine Chronicles.” Watch the episodes at http://bit.ly/45R6JRN. 14

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On a warm evening in August, Nikhil Bamarajpet drives his Ford Bronco to Industrial Street between the highway and train tracks in downtown Rochester. He parks at Peace Village, the city encampment for people experiencing homelessness, and unloads supplies: juices, hot water for coffee, bagels, and two kinds of sandwiches. The program brings food donated from St. Peter’s Church in Rochester and the medical center’s SNACCs volunteer group. Today, Bamarajpet also prepared almond butter sandwiches himself. Peace Village consists of sagging tents, small hut-like structures, a

(From left) Medical students Jayesh Menon and Nigel Bowles, a Peace Village resident, and medical student Nikki Neequaye on a rainy October evening.

metal-handled spigot for water, and not much else. Without those things, the space would blend right in with the urban emptiness of the landscape. Bamarajpet sets up at a makeshift table—really a large, wooden cable spool turned on one end—and calls out: “We’re here from Rochester Street Outreach! We’ve got some food, we’ve got some drinks. Juices. Rochester Street Outreach.”

He says they’re lucky to have Street Outreach bring things they need—shoes, socks, sleeping bags, and other items, much of it donated by medical students. He says counselors visit occasionally. But so did the river rats. “Thousands of rats. The rats were bigger than cats. Cats wouldn’t mess with them.” Still, he says he won’t accept outside help to get him off the streets. “I put myself here. I gotta get out of here myself.”

Two women and a man walk over, and Bamarajpet greets them. “We have coffee,” he says. “Would you like me to make you a cup?”

Later Bamarajpet says, “How ironic—Country builds houses but he doesn’t live in one.”

The man says, “Sure,” joining the others in choosing a sandwich. One woman takes two sandwiches and says, “Thank you so much.”

Usually, four or five program volunteers go out on a shift—including some nursing students—twice a week.

Another man approaches and tells his story. He was born in Miami but after his mother died, relatives in rural North Carolina took him in. That’s how he got the nickname “Country.” When needed, he says he goes to work fixing up rental properties for his brother.

On Thursdays, they also visit Open Door Mission homeless shelter, where Mike Hudson, MD, runs Regional Health Reach, a federally qualified health center that provides medical care to people experiencing homelessness in Rochester.

“Plumbing, floors, roofs, drywall—I can do anything with houses,” he says.

Bamarajpet calls Hudson “a great role model for medical students” because he understands that this population can be fearful and skeptical of the medical system.

He used to live with his brother’s family, but tensions arose, so he has been living at Peace Village for eight months. “I like my own rules. When you live with somebody, you gotta live by rules.” Along the way, Country also learned that “the drug life goes nowhere. The problem goes away for a moment, but then it’s there afterward.”

Bamarajpet has seen how Hudson’s slow, patient approach with people who are experiencing homelessness helps build trust. Letting the patients lead the conversation can create a rare moment in which they feel they’re in charge and important enough to be heard.

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“A large part of what we do is just listen.” Nikhil Bamarajpet makes coffee for Country, who says he is determined to get housing on his own without outside help.

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It's vital that the outreach effort and the medical clinic take similar approaches, because it can take a lot for Street Outreach to establish a relationship and persuade people to go see Hudson. When that trust is honored in a medical setting, “they leave the clinic happy that they could get help,” Bamarajpet says. Likewise, Hudson sees immediate and long-term benefits of the learning experience. “At the shelters, students see mental health pathology and addiction that they only rarely would experience in the outpatient setting,” he explains. “And beyond getting to talk with residents of the shelters and understand their personal and medical histories, they get to learn about and witness firsthand the structural violence that creates a society where so many people are pushed to the margins and left to fend for themselves.” In an important way, Bamarajpet sees this as a perfect complement to classwork: “In a course about the brain, you might learn about problems of the brain. But you never see the human behind the problem. You never see the problem behind the life. We learn about diseases in the class. When I’m out, I see how that disease affects someone’s life.” Back at Peace Village, the sunlight is fading. Bamarajpet begins to pack up. The food is gone, to the disappointment of a man who arrives late to the table. Somehow, as if intuitively, the woman who took two sandwiches returns and gives one to the man. As Bamarajpet walks toward his car, a man in a colorful jacket steps forward. He had been on the outskirts, observing silently. Now he walks closer. “What are you doing here?” he asks. “Why are you here?” “Because I care,” Bamarajpet answers. Soon the man is talking—about his struggles, about being good at heart. “I just need some guidance,” he says. His name is Peter. Bamarajpet shakes his hand and gives him a hug. It’s the first time Peter has come over to engage with Street Outreach. “He just needed someone to listen,” Bamarajpet says later. “A large part of what we do is just listen.” On his way out, Bamarajpet asks Peter if he needs anything. Peter doesn’t hesitate. He would like a chess set. “Checkers, chess. I play all that,” he says. Bamarajpet nods. “I think we can arrange that.”

How to Be Radically Patient-Centered Early on, Lo stated a goal of the program was “connecting homeless people with medical, social, and psychiatric resources in the community.” What she and others discovered through the years was that many in the unsheltered population didn’t share that goal. “It’s so easy in medical care and any service field to think, ‘This is what I can offer—I should be giving that thing to this person,’” Lo says. But that can easily turn into a “take it or leave it” approach. If someone doesn’t seek out care, it’s easy to assume they don’t need or want it. People experiencing homelessness often do need care, but they face too many barriers. So Lo turned to what she calls being radically patient-centered or radically person-centered. “It’s really about truly, truly listening to what the person wants for themselves,” Lo explains. ROCHESTER MEDICINE

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Often, she found that formal medical care wasn’t what would lead to a meaningful intervention—it was hearing out people’s stories of injustice and trauma that began to help. Her instinct might have been to get someone into rehab or housing, but what that person wanted first for a better life was, say, to reconnect with an estranged son. One person the team met would drink every day and lash out at people. He had a lot of medical problems but was difficult to approach because of his behavior. The outreach team worked with him for more than two years, starting with simply saying hello and tolerating him. They stayed respectful—for months. “Eventually he would invite us over and say, ‘These are my sisters. These are the people that care about me.’ And because of that relationship, we were able to advocate for him getting housing.” His behavior had led him to be banned from housing in the past. “We kind of felt like we were the only people left to believe in him.” Once he was housed, “he almost completely stopped drinking on his own, without any kind of medications,” Lo says. “He was so grateful. I think he didn't see us as much as providers as his extended family.” In this case, “radically patient-centered” meant being radically patient. It also meant addressing a root cause of this person’s medical issues, not the issues themselves. What made the outreach team not give up? Lo says, “I think partly because we, in our hearts, knew that there was no one else out there for him.”

The Future and Legacy of Outreach Program participants say what they learn through outreach can have a career-long effect. Lo says the hope is that volunteers, even if they do this kind of outreach for only a few sessions, will see their future patients in a different light. Even a health care provider in a highly specialized realm, she says, will inevitably treat an unhoused patient or one who presents challenges to care. The provider might be in an office setting, but ideally they would remember the people they encountered on the street, and that will help them better understand the person in front of them. In her career, Lo says, she has seen how the system can lead to certain patients being "dehumanized and judged and labeled, and they don't get proper care because of that.” Street Outreach, she says, helps answer the question, “How can we humanize that group and be able to build practitioners who are empathic?” Once students become physicians, they’re in a position to 18

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do more. As a resident in the Yale School of Medicine, Lo shadowed a street-medicine program in New Haven and learned there was no psychiatric component to it. She created an elective to start doing street psychiatry, then was promptly called into an overdose emergency in New Haven that made national news. The pilot work she was doing was seen as a potential solution. In just a few months, her team was able to get funding to start a full outreach program and hire a clinical social worker, program manager, recovery coach, and Lo herself once she graduated from residency. “We go out four days a week to different areas of New Haven, doing outreach. And still, most of what we do is engagement and trust building and relationship building,” she says. Haleh Van Vliet (MD ’12), who first learned about street medicine while at Rochester, now practices it as an emergency medicine physician with Tower Health Medical Group in Pennsylvania. She wrote about her experience for the American Association of Women Emergency Physicians, saying: “The settings and circumstances of street medicine may be difficult to navigate, but the work is beyond rewarding.” Van Vliet is part of a group of emergency medicine physicians who work with homelessness agencies to visit encampments and other spots so they can administer care. At a time when the business of medicine can sap precious time and energy, she describes an encounter with someone she helped as “the unadulterated, pure practice of medicine that first fueled my interest in becoming a physician. In that moment, it was just me, another human being, and care. That’s it.” She says that "street medicine is an opportunity to move beyond the conventional modern-day practice of health care and feed our souls, and a soul that is well fed is a soul that has more to give to ill patients stuck in the hospital." And there's no telling when this kind of work can change lives. After all, Bamarajpet was on the other side of this as a child. He and his mother became homeless when his father, a lawyer, got lung cancer and died. They had spent all of their money on medical bills, and family members urged them to return to India. But his mother didn’t believe in “running away from your problems,” Bamarajpet said. “And she believed in the American education system.” She looked for work, but it was difficult for her. They slipped into homelessness and only recovered when an old family friend found her a job. Bamarajpet saw a lot of suffering along the way, and it made him want to be in a position to help someday. Now, Bamarajpet would like to bolster the medical side of Street Outreach with more funding and donations. In the meantime, he and his fellow students continue to make connections and help however they can. After the conversation with Peter at Peace Village, he used some of the program’s funds to buy him a chess set. But the next few times the group visited, Peter was nowhere to be found. The chess set stayed in the backpack, ready when Peter is. RM

Nigel Bowles (left) and Nikki Neequaye (center) at Peace Village.

Is Street Outreach Ethical? Medical students, of course, are not medical doctors. Yet when they do outreach in the community, they see people with medical needs, and their instinct is to help them. But how much should a student do? Rachel Johnson, who is in her final year of medical school, wasn’t sure at first. After volunteering, she decided she didn’t want to continue because she was leery of what she called “pseudo-care” without oversight. Most students have time to participate only in their first year. Almost every year, the leadership changes. In a way, the program gets reinvented every year. At the time that Johnson volunteered, there was no faculty preceptor. Then she met Dr. Hudson, the leader of the health center for people experiencing homelessness. She and fellow student

Sarah Crowe shadowed him at his clinic at the House of Mercy shelter, then established a partnership so students could gather medical histories and do some aspects of physicals such as take blood pressures— with faculty oversight. That’s when Johnson felt ready to become an administrative coordinator for Street Outreach. But the ethical debate among students remained. “We had different ideas of what was within our purview and what was not as students, and what we could do with and without faculty overseers,” she says. She and Crowe brought their ethical concerns to Margie Shaw (Flw ’12), associate professor in SMD’s Department of Health Humanities and Bioethics. Shaw replied this was nothing new: medical students often want to talk about the moral integrity of the work they do with the community.

Rachel Johnson

Johnson says they were somewhat comforted but also “frustrated that has been happening year over year.” Again, street outreach can be complex—and variable. Johnson is interested in staying in Rochester for her residency and reconnecting with the program as a faculty member, down the line. “I love Rochester. I would like to stay here and provide some of that consistency to this work,” she says. “Even though it gets crazy as a resident, I can still maybe provide some mentorship or assistance in any way that I can to Street Outreach students.” ROCHESTER MEDICINE

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Taking the

Right Steps What Academic Medical Centers Need to Do to Thrive in the Coming Years. By Sandra J. Parker

Mark B. Taubman, MD

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“Send them to Strong.” Mark B. Taubman, MD, hears that refrain often. As the region’s only academic medical center and a Level 1 Trauma Center, the University of Rochester Medical Center is well established as the fulcrum of medical care in a 27-county catchment area in western and central New York. “If you name it, we do it,” says Taubman. URMC now partners with eight regional hospitals and touches a million lives through its care. Taubman, who in 2015 became the first leader in the University’s history to serve as both Medical Center CEO and dean of the School of Medicine and Dentistry, is stepping down from those roles but will remain in the position until a successor is named. He leaves with the institution in a strong position but facing what he calls “unprecedented” clinical challenges. It also must grapple with the ongoing need to fund teaching and research programs in light of rising costs, tight government funding, and falling care reimbursements. In some ways, the challenges facing AMCs have remained constant for over a century, ever since the Flexner report of 1910 recommended the tripartite mission of clinical, research, and education under one roof. But recent years have presented new twists, such as COVID-19. The pandemic highlighted the role of the AMC as a vital center of both care and cure while exposing the potential vulnerability of relying on clinical dollars to fund other missions. And patient expectations are bringing new challenges for technology, speed of services, and the additional need for better health access and equity—an imperative laid bare by the pandemic. We asked several health-care leaders, all with connections to URMC, to weigh in on the future of AMCs. The question isn’t whether such challenges are new; the question is how to adapt to the latest iteration.

Shifting the AMC Paradigm

“This growth allows us to have the volumes to recruit and retain specialists, so nobody has to leave Rochester to get state-of-the-art treatment,” he says. “That creates value.” He has also integrated the budgets of all three arms (hospital, faculty practice, and medical school), which helps better distribute funds to develop and support key initiatives. David H. Perlmutter, MD (BA ’74), executive vice chancellor for Medical Affairs and dean of the Washington University School of Medicine, says he is a “devout believer” in AMCs. “I believe the academic medicine paradigm is not only sustainable but it’s the answer to the questions of, how can we lower the cost and get better outcomes? The academic medicine paradigm is what got the David H. Perlmutter, MD country out of COVID by responding to the need for a vaccine and acute care.” It’s why, interviewees say, the tripartite model is crucial to retain. “The exposure to research exposes our learners to the habit of seeking answers to questions that have no known answer,” says Deborah C. German, MD (Res ’79), founding dean of the University of Central Florida College of Medicine and vice president for Health Affairs. “This ability to go beyond what is known is important in clinical practice,” she says. “When students are trained in an environment where all questions have known answers, they may miss diagnoses that are new or unusual. Some may have a checklist approach to every patient. These physicians may miss a new infectious disease as it emerges.”

“What really needs to change,” Taubman says, “is not necessarily the academic system but the care-delivery system.” The clinical side of health care is burdened by the intricacies of government regulations, health-care worker shortages, political winds, insurance reimbursements, and the shift toward payment for value-based and ambulatory care. And help is not on the way from Washington, where deep ideological divisions have deadlocked discussion of revamping the nation’s approach to health management. So Taubman has been proactive in expanding the scale of URMC.

Deborah C. German, MD (center) ROCHESTER MEDICINE

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Once again, the pandemic showed the value of AMCs. In an environment that doesn’t deal in questions, “COVID might have been diagnosed as flu even when many patients presented with atypical findings because flu was on the checklist and was the best-known fit,” German explains. “When you hear hoofbeats, you think horses. But the academically trained physician thinks horses and is questioning whether it could be a zebra or something unknown.” In short, an AMC advances care. “Medicine is constantly evolving, and we must address the unanswered and consider the unknown questions,” German says. “That’s what being in an academic environment gifts to our doctors. They may not all be scientists, but they will be ‘thinking doctors.’ ”

“Collaboration and teamwork have become the cornerstone of modern health care, so it begs the question, why aren’t we all training health science students together, beginning on the first day of school?” he asks. “We have to train a workforce that is interdisciplinary, that works in teams.” Part of that restructuring could include releasing some physicians from performing all three functions of clinician, researcher, and educator. “We have to recognize that people can have a specific expertise and talent in one or two areas,” says Eric J. Topol (MD ’79), executive vice president of Scripps Research and director/founder of Scripps Research Translational Institute.

Some shifts in the paradigm, however, would help AMCs cope with the projected changes in health care. AMCs should draw further on the breadth and depth of all resources, namely the intellect of other schools in the university, such as business, public health, and engineering, says Edward D. Miller (MD ’68), who retired in 2012 as dean/CEO of Johns Hopkins Medicine and is a member of the University of Rochester board of trustees.

Eric J. Topol, MD

The Virtuous Cycle of Research Funding

Patient care and research remain inseparable partners. Researchers need to understand patient hurdles firsthand, and clinicians are at their best when they’re aware of advancements in biomedical research.

Edward D. Miller, MD For example, he explains, financial experts in the business school could scrutinize the budget to ensure efficiency. Engineers could meet with clinicians to develop new tools for health care. “Coupling these schools with the medical school, hospital, and health system is a fertile area to make change. There is a bright future, but we need to be bold enough to undertake innovative approaches,” Miller says. Restructuring the organization to promote collaboration and eliminate silos would benefit everyone, says Harold L. Paz (BA ’77, MD ’82), executive vice president of Health Sciences and CEO of Stony Brook University Medicine.

Harold L. Paz, MD 22

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“You can’t do that if you’re working in isolation,” says Paz. “Physicians trained in an organization that is part of a research enterprise focused on discovery and translation is exceptionally important.” As Topol puts it, “Lack of integration would be an awful outcome. If I were doing just one of those things, I would be restless. I can’t even foresee a different model.” The AMC’s role in research and clinical trials will not be performed by any other entity. So institutions would do well to place greater focus on obtaining needed funds through new means. Supporting research and education mainly on margins that rely on clinical growth is unsustainable, says Taubman, who is looking to other sources such as endowments, royalty payments, industry partnerships, and philanthropy. While looking at these other avenues to generate revenue, there are opportunities to work with

commercial payers to develop care management strategies that enhance value, increase clinical margins, and provide additional support for the academic missions. “The challenge has been that funding research is expensive,” Taubman says. “However, it’s a lot cheaper than the cost of treating disease.” Basic science research is fundamental to reducing health care costs. “Basic science is what finds the cure—and any time you find the cure, you cut the cost,” Taubman explains. He cites the role of RNA biology in developing COVID vaccines, breakthroughs in immunobiology and cell biology leading to new cures for cancer, and novel approaches to treating neuromuscular diseases. “That’s’ what we do. That’s what makes U of R special,” Taubman says. To make research less dependent on clinical margins, Taubman is calling for an increase in NIH funding.

Although the research and education aspects of AMCs have issues to solve, the clinical side is in turmoil, says Topol. He suggests that artificial intelligence could help create a system to synthesize the information for physicians and liberate them from keyboards so they can spend more time on direct patient care. Miller agrees with this idea. “Younger people will accept this and not see it as a barrier to health care but as more efficient health care,” he says. “Key to this success is adapting patient expectations and comfort level.” “Hopefully it will provide the gift of time for the patient-doctor interaction and restore this critical human bond, because it can’t get much worse,” Topol adds. “For medicine, AI is a win.” “The underpinning of any AMC is innovation,” says Paz. “The minute it stops innovating, it becomes challenging to justify the cost.” With some community hospitals failing, the pressure is even greater on AMCs to expand their reach to assure the health of their regions.

“When I came in, we contributed about 27 cents for every NIH dollar. Now, it’s 60 cents. That’s because of the flattening of the NIH budget. Realistically, NIH funding needs to increase.” Jack Rowe (MD ’70), professor at the Joseph Mailman School of Public Health at Columbia University, suggests a fundamental change in the financial model.

Using Intelligence— Artificial and Otherwise

“Medical centers have become major employers, but we don’t have large margins—and those margins need to go into supporting our tripartite mission,” Taubman notes. “Yet the community necessarily looks to us, as the major employer, to ensure the health of the community and to solve problems, such as health care inequities. We do have a responsibility to our community, and in particular to address the social determinants of health. But we cannot do it alone.” Jack Rowe, MD

“Hospitals will no longer be cash cows,” Rowe says. “If the medical center catches a cold, the anthropology department gets pneumonia.” Universities can’t assume that medical centers will perform well financially. Two changes he suggests are coordinating with other AMCs to get volume discounts on certain supplies and building up the technology department to find ways to increase efficiency. When he was CEO of Aetna, Rowe found that the number of claims adjudicated in one day at Aetna would likely take a year at an AMC. One thing that has helped fill holes in the financials at Scripps is patents, says Topol. “We have immense intellectual capital, and we have to protect that.” Perlmutter says he accelerates research by exploring new types of funding for the research portfolio. He suggests boosting the institutional investment in research, “but I want something for that. I want more solutions.” Research also draws talent. Without the research arm, Taubman says he would not have been able to attract our outstanding clinicians and division and departmental leaders.

Lawrence G. Smith, MD (Res ’79), dean emeritus of the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, agrees that social determinants are key. Another pandemic lesson: Smith says that COVID data clearly shows that “health is more dependent on zip code than genetic code.” Social determinants have long been discussed, Smith notes, particularly by the legendary URMC faculty member George Engel, MD, who pioneered the biopsychosocial model. The topic has risen to the forefront again as one of a “new wave of unfunded great ideas,” Smith says. “AMCs create the research to identify the issue, but there is no possibility that the delivery system can fix it; government has to step up, and we need to be seen as valued partners.” In this time of unprecedented numbers of hospitals failing, sick people still have to go somewhere—and that’s why Taubman often hears that refrain, “Send them to Strong.”

The Change Ahead

AMCs have a bright future, particularly because they have historically responded to outside pressures by “forging new paths in scientific discovery, patient care, and clinical training,” says ROCHESTER MEDICINE

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on the institution. “It takes the suspense out of it,” he says. “Most of the time when you put something into practice and it didn’t work, you could have predicted it.” The future of health care is about personalized care solutions that leverage technology to address patients’ evolving expectations for achieving health and well-being, Paz says. This should begin in the home, leveraging digital, virtual, and mobile solutions; and in community-based clinics in addition to the hospital, Paz says. “The national question becomes how to move from a health system to a health platform that advances innovative patient-centered care.” Lawrence G. Smith, MD David S. Guzick, MD, chancellor of Louisiana State University Health Shreveport and former dean of SMD. “When well done, as has been the case at URMC—now the dominant health care force in western New York—the AMC model not only brings strength and stature to the parent university but serves as an economic engine for its community and region, and improves the health of the population it serves,” Guzick says. Medical schools like SMD that do not have huge endowments— SMD’s stands at just over $1 billion—have to find ways to compensate, says Philip A. Pizzo (MD ’70), former dean of the Stanford School of Medicine. He credits Taubman for reconfiguring the funding model by putting everything together on one bottom line. Change is not wholly predictable, of course, but Taubman has tried to anticipate future health care directions and also mitigate possible problems by using math models to play out the myriad scenarios that might occur in the next 20 years. “I’ve always used math,” Taubman says. “I always assume that bringing math to any situation makes it easier to solve.” If he has an idea, he can turn to his models to help predict the effect

Pizzo says that “the future of AMCs depends to a great degree on the leader and the leadership team. ... Rochester is poised to continue to grow and do well because of the efforts of Dr. Taubman. He’s in the role of conductor of the orchestra, and he makes it better with the right musicians. Sometimes it will be discordant, but it will keep going.” URMC will need to increasingly rely on endowment and philanthropy, says Taubman, who adds that “the money alumni put in has led to wonderful things. It’s the money they’ll feel most proud of.” Philip A. Pizzo, MD He also emphasizes the importance of other sources of revenue. “Partnering with industry and developing relationships with venture capital so we can develop our intellectual property: I think that’s a real opportunity.” A great future is in store for URMC, Taubman adds. “We built a wonderful infrastructure, and we can build on that infrastructure to help transform health care such that we provide high-quality, low-cost care and at the same time support the academic and research missions.” All the while, he says, it’s vital to prioritize the wellness of staff, students, and faculty while continuing to make the Medical Center culture more diverse and inclusive. No one is sure exactly how the AMC model will change to meet future challenges. But these experts agree it's a critical component in American health care. “There are lots of options,” says Miller. “It requires perseverance and willingness to consider new paradigms. That’s how we are going to win the battle.” RM

David S. Guzick, MD

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Be the light.

MAKE YOUR YEAR-END C H A R I TA B L E D O N AT I O N BY DECEMBER 31.

Behind many shining moments are dedicated donors whose generosity helps to make them possible. Your gift—of any amount to any area of the University or Medical Center that inspires you—promises an even brighter 2024. G I V E T O D AY

giving.rochester.edu #meliora ROCHESTER MEDICINE

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MELIORA WEEKEND 2023

Bonding and Sharing at Hundreds gathered at the School of Medicine and Dentistry during Meliora Weekend, the University of Rochester’s annual fall event combining reunions, alumni programs, and various other activities and celebrations. Weekend highlights included the Class of 1973’s 50th Reunion, MED Talks, the annual “State of the School” update, tours and poster sessions, and two new additions: the George M. Engel Memorial Lecture and a panel discussion on the future of medicine and mentorship in diverse communities. This Meliora Weekend was particularly noteworthy as it marked the final year for Mark B. Taubman, MD, CEO of the University of Rochester Medical Center and dean of the School of Medicine and Dentistry, before he steps down from his positions at the end of 2023. Every year, the dean of the School of Medicine and Dentistry and the school's Alumni Council recognize alumni and friends for demonstrating extraordinary achievement in their professional accomplishments, dedication to underserved populations, and commitment to the ideals of the school. Dean Taubman (fourth from right) joined this year’s award honorees (from left) Meng Wang (MS ’04, PhD ’05); Ismail Mehr, MD (Res ’02); James M. Haley (MD ’85, Res ’88); John M. Vierling, MD (Res ’74); Philip Pizzo (MD ’70), and Marcia P. and Mark R. Siewert.

Members of the MD Class of 1998

Members of the MD Class of 1983 Kenneth Burchard (MD ’73) and Marion Burchard at the Class of 1973’s 50th Reunion dinner. 26

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Meliora Weekend 2023

Dean Taubman joined members of the MD Class of 1973 for their milestone 50th Reunion at the annual Medallion Ceremony.

(From left) Amit Chowdhry (MA ’13, PhD ’16, MD ’18); Matthew Brockway (BS ’09, MD ’13, Res ’16); Aisha Siebert (PhD ’16, MD ’18); and Jesse Schenendorf (MD ’13, Res ’16) at Reunion celebrations.

Medical students presented their research at a Meliora Weekend poster session in Flaum Atrium. ROCHESTER MEDICINE

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MELIORA WEEKEND 2023

Meliora Weekend 2023 (continued)

(Top left) During MED Talks, George Alfieris, MD (Res ‘92, Flw ‘94), director of Pediatric Cardiac Surgery at Golisano Children’s Hospital and associate professor of Surgery at SMD, shared how the Pediatric Cardiac Consortium, a group of surgeons in upstate New York, improved outcomes. (Top right, and bottom) The second speaker, Paige Lawrence, PhD, discussed the new Institute for Human Health and its role as a University hub for cross-disciplinary teams to research environmental health impacts. She also addressed URMC’s commitment to grow, train, and diversify the environmental health workforce and transform knowledge into action to improve health of communities. 28

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“Shaping the Future of Medicine: Mentoring within Diverse Communities” panelists included (from left) Nathan Smith (MS ’10, PhD ’13); SMD students Camila Lage Chavez, Bryan Redmond, and Sydney Barrett; Myra Mathis (MD ’15); and moderator Norma Holland, director of Public Relations for the University’s Office of Equity and Inclusion.

Lainie Ross, MD, PhD, inaugural chair of the Department of Health Humanities and Bioethics, discussed how the biopsychosocial model—originated at Rochester—is critical to the future of bioethics in medicine and translational research.

Lawrence Smith, MD (Res ’79), dean emeritus of the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, presented the George M. Engel Memorial Lecture, “Innovating Minds, Reshaping Wellness, Illness, and Doctoring: The Legacy of Dr. George M. Engel.”

SMD student Hanadi Tajir at the “Shaping the Future of Medicine: Mentoring within Diverse Communities” program.

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MELIORA WEEKEND 2023

Dean’s Circle Awards

Honoring Achievement, Dedication, Commitment The School of Medicine and Dentistry (SMD) held its 52nd Annual Dean´s Circle Dinner and Awards on Oct. 15 during Meliora Weekend. Dean Mark Taubman, MD, and the SMD Alumni Council recognized alums and friends who have demonstrated extraordinary achievement, dedication to underserved populations, and commitment to the ideals of the school. The night also provided an opportunity to acknowledge Taubman—in his last Dean’s Circle ceremony before he steps down from his roles as dean and URMC CEO—for more than a decade of achievement at the helm. The awards honored some truly impressive accomplishments:

ALUMNI COUNCIL AWARDS Ismail Mehr (Res ’02): Robert G. Newman (MD ’63) Humanitarian Award

John M. Vierling (Res ’74): Distinguished Alumnus Award

Mehr is actively involved in the Islamic Medical Association of North America (IMANA), a professional organization for Muslim health care professionals with a strong commitment to providing emergency and long-term medical relief in disaster-hit areas. Mehr volunteered for his first medical mission after the Indonesian tsunami in 2004 and was the coordinator for IMANA’s medical response to the 2005 earthquake in Pakistan.

Vierling has authored nearly 300 manuscripts and chapters and is co-editor of Liver Immunology: Principles and Practice, now in its third edition. His clinical interests include autoimmune and alloimmune liver diseases, liver transplantation, acute liver failure, viral hepatitis, non-alcoholic fatty liver disease, Wilson disease, and drug-induced liver injury (DILI).

Ismail A. Mehr, MD, is chair of the Department of Anesthesiology and medical director of operating room services at St. James Mercy Health System, a URMC affiliate, in Hornell, New York.

In 2009, Mehr became chair of IMANA Medical Relief (IMR). Under his leadership, IMR has evolved into a globally recognized medical relief organization with projects in more than 30 countries. Mehr has served on nearly two dozen medical missions, including ones in Bangladesh, Gaza, Haiti, Pakistan, and Somalia. During Mehr’s tenure as president from 2013–2015, IMANA was invited to the White House, presented at the State Department, and was invited to the United Nations General Assembly. His priority as president was the “passing of the IMANA torch” as he worked to make IMANA more visible on medical campuses and in training programs across the country, bringing new members into the organization. Mehr serves on the board of United Muslim Relief and previously served as a member of the Islamic Society of North America Majlis Ash-Shura. He has served on numerous local boards, is involved in local youth programs, and has coached varsity football as an assistant for the past 21 years. Mehr received his medical degree from Universidad IberoAmericana (Santo Domingo, Dominican Republic) in 1998 and completed a general surgery internship at Robert Packer Hospital, followed by an anesthesiology residency at SMD in 2002.

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John M. Vierling, MD, is professor of Medicine, professor of Surgery, chief of Hepatology, and director of Baylor Liver Health at the Baylor College of Medicine in Houston. He also serves as director of advanced liver therapies and was formerly program director of the hepatology and liver transplantation fellowship.

Throughout the years, Vierling has been honored with numerous awards, including being named to the “Best Doctors in America” list for the past 24 years. He has also earned a top 1% physician rating by U.S. News and World Report; a “Who’s Who” in America, in the World, in Science and Engineering, and in Health Care; the Albert Nelson Marquis Lifetime Achievement Award; and the 2021 American Association for the Study of Liver Diseases Distinguished Service Award. He serves on the Liver Tissue and Cell Distribution System Coordinating Committee of the NIH National Institute of Diabetes and Digestive and Kidney Diseases and on the DILI Network’s Data Safety Management Board. Vierling graduated from Stanford University with a degree in Biology, received his medical degree from Stanford University School of Medicine, and completed his residency at SMD. He was a clinical associate in the liver unit at the NIH prior to completing a gastroenterology fellowship at University of California, San Francisco. Vierling also was the founding medical director of the liver transplantation programs at the University of Colorado Health Sciences Center and at Cedars-Sinai/UCLA.

Meng Wang (MS ’04, PhD ’05): Alumni Achievement Award

Meng Wang, PhD, is a senior group leader in 4D Cellular Physiology at Howard Hughes Medical Institute’s Janelia Research Campus in Ashburn, Virginia. She is dedicated to peering inside organisms and cells to reveal new insights about one of life’s biggest mysteries—the fundamental mechanisms behind aging and longevity.

Technological developments based on stimulated Raman scattering (SRS) microscopy in Wang’s laboratory have provided new ways to visualize and track lipid molecules as a function of time and space in living cells and organisms. Wang’s research focuses on the molecular mechanisms governing somatic aging, reproductive senescence, and lipid metabolism, along with their sophisticated interrelationship, through harnessing the power of functional genomics, metabolomics, chemical engineering, and optical biophysics. While Wang was at Baylor College of Medicine, her group uncovered the first lysosome-to-nucleus retrograde lipid messenger pathway, provided new regulatory mechanisms of reproductive longevity, and demonstrated a novel mode of signaling communication between bacteria and mitochondria in regulating the host’s lipid metabolism and longevity. Wang is the recipient of the NIH Director’s Pioneer Award, the Edith and Peter O’Donnell Award in Medicine, the Gibco Emerging Leader Prize of the American Society for Cell Biology, the Howard Hughes Medical Institute Faculty Scholars Award, the Early Career Life Scientist Award of the American Society for Cell Biology, and the Society of Chinese Bioscientists in America Kenneth Fong Young Investigator Award. She is also an elected fellow of the American Association for the Advancement of Science. After receiving a bachelor of science from Peking University, China, and a PhD from the University of Rochester, Wang completed a postdoctoral fellowship at Harvard Medical School. She joined the faculty of Baylor in 2010, where she was an investigator at the Howard Hughes Medical Institute, a professor and the Robert C. Fyfe Endowed Chair on Aging, and the co-director of the Genetics and Genomics Graduate Program.

James M. Haley (MD ’85, Res ’88): Alumni Service Award

James M. Haley, MD, a clinical professor of Medicine at SMD, has dedicated his career to improving quality, safety, and the patient experience as well as fostering provider wellness, the biopsychosocial approach, and patient-centered care.

Haley has been an advocate for education throughout his career. He has been deeply involved in medical student and resident education and mentoring—providing departmental oversight for Unity Hospital’s Internal Medicine Residency Program. He serves as Unity’s designated institutional official for medical education, maintains involvement with SMD clinical teaching and student recruitment, and serves on the Medical School Admissions Committee and other committees. Haley was past president and currently serves on the board of the Rochester Academy of Medicine and is a longstanding member of the Monroe County Medical Society. In 2009, Haley received the Academy of Medicine’s Award of Merit. He is an active alum, serving as Class of 1985 class agent. He is a longstanding Alumni Council member and is a charter member of the George Eastman Circle. A New Jersey native, Haley completed his undergraduate education at Fairfield University in Connecticut. He earned his medical degree from SMD and completed an internal medicine residency at Strong Memorial Hospital. Following a chief residency year at St. Mary’s Hospital in Rochester, Haley entered primary-care practice in Brighton and was an attending physician at Strong. During that time, he was a Lawrence A. Kohn Teaching Scholar and received the James M. Stewart Award for Distinguished Clinical Teaching. After 12 years in full-time practice, Haley was recruited to Rochester’s Unity Hospital where, until his retirement in 2020, he held various posts, including chair of Medicine, chief quality officer, chief medical officer, and senior vice president while also continuing as a primary-care physician. Haley received Unity’s Physician Recognition Award in 2016.

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MELIORA WEEKEND 2023

SMD AWARDS Mark R. and Marcia P. Siewert: John N. Wilder Award

Married for more than 40 years, the Siewerts have dedicated themselves to causes that help meet the needs of children in the Rochester area, including continued support of both the Golisano Children's Hospital (GCH) and the Mary Cariola Center, which provides education and other services for people with complex disabilities. Mark serves as board chair for the Mary Cariola Foundation and is a board member, past chair, and current executive committee member for GCH. He is a former board member and past chair of the Bivona Child Advocacy Center. Additionally, he has served on the boards of the Heritage Christian Foundation, the Al Sigl Foundation (which supports people with disabilities and special needs), McQuaid Jesuit High School, and the Rochester Area Community Foundation. Mark graduated from Clarkson University with a bachelor of science in Industrial Distribution and began his career at Clow Corporation as an application engineer. He later became a sales engineer. Marcia graduated from SUNY Oswego with a bachelor of science in Elementary Education and earned a master’s degree from Nazareth College. After graduation she developed, implemented, and taught a preschool program, called KinderCare, in a local YMCA. She later taught kindergarten at Rochester-area schools. In 1974, Mark returned to his hometown of Rochester to work as a sales engineer and, eventually, as executive vice president of sales at Siewert Equipment Company, the business started by his father in 1949. In 1981, he became co-owner with his brother and, in 2003, became the sole owner and president and CEO. After a 35-year career in the family business, Siewert sold the business but serves as a consultant and board member. Marcia and Mark married in 1981 and two years later their son, Mark Daniel, was born with a rare chromosomal abnormality that yielded multiple impairments and developmental disabilities. In 1986, their second son, Christopher, was born. In 2001, at age 18, Mark Daniel required intestinal surgery and was a patient of the Golisano Children´s Hospital Pediatric Intensive Care Unit for eight and a half months. Mark Daniel passed away in July 2002, just after his 19th birthday.

Philip A. Pizzo (MD ’70): Dean’s Medal

Philip Pizzo, MD, has devoted much of his medical career to the diagnosis, management, prevention, and treatment of childhood cancers and the infectious complications that occur in children whose immune systems are compromised by cancer and AIDS.

Pizzo is now professor emeritus at Stanford University, where he served as the David and Susan Heckerman professor and founding director of the Stanford Distinguished Careers Institute. He also served as dean of the Stanford School of Medicine, where he was the Carl and Elizabeth Naumann Professor of Pediatrics and of Microbiology and Immunology. In the fall of 2022, Pizzo began rabbinical studies at the Academy for Jewish Religion in California. Pizzo is the author of more than 650 scientific articles and 16 books and monographs, including Principles and Practice of Pediatric Oncology, now in its seventh edition. He has also received numerous awards and honors, including the Public Health Service Outstanding Service Medal, the Barbara Bohen Pfiefer Award for Scientific Excellence, and the Ronald McDonald Charities Award of Excellence. He received the 2012 John Howland Award, the highest honor for lifetime achievement bestowed by the American Pediatric Society. Pizzo has been elected to several prestigious organizations and societies, including the Association of American Physicians, the American Society of Clinical Investigation, the American Pediatric Society, and the Institute of Medicine of the National Academy of Sciences. He has served as chair of the Association of Academic Health Centers and of the Council of Deans of the Association of American Medical Colleges. He was elected to the University of Rochester Board of Trustees, serving from 2009 to 2022. Pizzo received his medical degree from SMD. After graduating, he completed an internship and residency at Children’s Hospital Medical Center in Boston, a teaching fellowship at Harvard Medical School, and a clinical and research fellowship in pediatric oncology at the National Cancer Institute (NCI). His career continued at NCI, where he served as head of the infectious disease section, chief of the pediatric department, and acting scientific director for the Division of Clinical Sciences. Before joining Stanford in 2001, he was the physician-in-chief of Boston Children’s Hospital and chair of the Department of Pediatrics at Harvard Medical School, where he was also the Thomas Morgan Rotch Professor of Pediatrics.

Congratulations to all of this year’s award recipients. To nominate a graduate for future SMD alumni awards, visit uofr.us/SMDawards. 32

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FACULTY NEWS

faculty news URMC Bioethicist Lainie Ross Elected to National Academy of Medicine "We knew we'd recruited someone of national prominence when Dr. Ross joined us, and this honor highlights that fact beautifully," said Mark Taubman, MD, CEO of URMC and dean of SMD. "Her election to NAM is a well-deserved recognition of her exemplary contributions to the field, including her prominent work on ethical and policy issues related to pediatrics, organ transplantation, genetics and genomics, and research, and she is arguably the most influential, accomplished, and important pediatric ethicist of our time. I know NAM will benefit from her expertise just as we are here at URMC, where she is working to focus further attention on the moral aspects of our research and patient care programs."

Lainie Ross, MD, PhD Lainie Ross, MD, PhD, an internationally renowned bioethicist who is building a bold new department at the University of Rochester Medical Center, has been elected to the National Academy of Medicine (NAM). Academy members, the best of the best in American health care and academic medicine, are elected by their peers and provide expert advice nationally and internationally on health, medicine, and related policy. Ross, a pediatrician and philosopher, joined URMC in 2023 as the inaugural chair of the department of Health Humanities and Bioethics and director of the Paul M. Schyve, MD, Center for Bioethics. She was recognized by the Academy for her nearly three decades of work on ethical and policy issues related to organ transplantation, genetics and genomics, clinical research ethics, human subject protections, and pediatrics. Ross recently led a group of national experts who developed new consensus recommendations for pediatric decision-making (see page 6). She is also known for her work around issues of equity and inclusion relating to solid-organ transplant patients. Ross, who has been active on several NAM committees, was nominated for NAM membership just prior to her arrival at URMC. “To be honest, I’d forgotten about it,” she said, laughing. “I was totally surprised when I learned I’d been elected: My first reaction was, ‘What?!’ It’s awe-inspiring to see the company this puts me in, both nationally and here at URMC, and I’m looking forward to playing an increased role in NAM and to furthering its valuable mission.”

Ross has published five books and more than 225 peer-reviewed journal articles, and she lectures both nationally and internationally. At URMC, her work focuses on the moral aspects of research and patient care. These aren’t abstract issues: They directly impact the patient experience. “We help doctors understand that patients are people, and that it’s vital to contextualize disease within a patient’s life and to listen and validate the patient’s perspective,” she said. “Every clinical encounter is a moral encounter. Clinicians constantly face new situations, and we can offer tools and resources to address controversial and complex cases, as well as ensure that future clinicians are equipped with the best education and training in bioethics and health humanities.” URMC has made a commitment to that cause through the new department Ross leads. The Medical Center—known for its innovative biopsychosocial framework, which emphasizes caring for the whole person, not just a given condition—was among the first in the country with a humanities division. Now it’s just one of eight academic medical centers in the nation with a dedicated humanities and bioethics department. “We want all medical students, regardless of their areas of study, to discuss ethics and humanities in every course, because that’s what will make them better physicians,” Ross said. “In an age of medical skepticism, we want our institution to be a national beacon in these areas.” Past NAM inductees from URMC include Lynne Maquat in the department of Biochemistry and Biophysics; Seymour I. Schwartz in Surgery; Elizabeth R. McAnarney in Pediatrics; Paul S. Frame in Family Medicine; and Robert C. Griggs in Neurology.

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FACULTY NEWS

Stephen Dewhurst Appointed University of Rochester’s Vice President for Research Stephen Dewhurst, PhD, will continue to serve as SMD’s vice dean for research while also taking on a larger role within the University as vice president for research. He had held that title on an interim basis since 2021. An accomplished virologist, HIV researcher, and respected scientific and academic leader, Dewhurst was appointed to this Stephen Dewhurst, PhD key leadership role by University President Sarah Mangelsdorf after a national search and board of trustees approval. “We are so very fortunate to have Steve leading our unified research enterprise,” said Mangelsdorf. “A highly distinguished scientist, scholar, and proven academic leader, he is the right person to help us embark upon our strategic plan and work to enhance our reputation as a consequential global research university. He understands well our unique areas of distinction and sees the real opportunities for growth and innovation.” The vice president for research leads the University’s vast research program, which spans disciplines including clinical applications and basic sciences, optics, humanities, social sciences, and more. Dewhurst will continue to facilitate and support partnerships among the University’s many research offices in order to make thoughtful and strategic investments in centers, labs, institutes, and initiatives.

He will also lead efforts to secure increasing levels of sponsored research funding. He will oversee the Office of the Vice President for Research, the Office of Research Projects Administration, the Laboratory for Laser Energetics, UR Ventures, the Office of Human Subjects Protection/ Research Subjects Review Board, and the Health Sciences Center for Computational Innovation (HSCCI). “Steve Dewhurst is an outstanding colleague and has been a remarkable thought partner to me,” said Provost David Figlio. “I am certain that his exceptional expertise, his visionary leadership, and his commitment to transdisciplinary collaboration will inspire our research enterprise to even greater success.” Dewhurst has more than 30 years of experience at the University as both a faculty member and an administrator. In 2013, he was appointed associate vice president for health sciences research to work directly with the senior vice president for research to create and implement a University-wide research strategic plan. As vice dean for research at SMD, he advises on strategic planning, core facilities, and funding priorities. He has also taken a lead role in evaluating graduate-level offerings and curriculum and has recommended new courses to ensure University students get the best education possible and are trained for a broad range of careers. He previously served as senior associate dean for basic research at SMD from 2007 to 2009.

Mark Oldham Named American Delirium Society's President-Elect

Mark Oldham, MD

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Mark Oldham, MD, assistant professor of Psychiatry, will serve as the American Delirium Society’s president beginning in mid-2024.

Oldham joined the Medical Center in 2017 after a stint at Yale-New Haven Hospital. He has launched a proactive psychiatry consulting service at Strong Memorial Hospital and collaborated with colleagues to develop resources on catatonia assessment.

He currently serves as the organization’s treasurer, assisting with its efforts to advance research, education, advocacy, and implementation of evidence-based interventions to minimize delirium's impact.

He also leads an interdisciplinary team that works to improve the care of patients with delirium or who are at risk for developing the condition.

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His research, which is supported by a K23 award from the National Institute on Aging, focuses on the relationship between sleep/ wake disturbance and cognition, including within delirium and Alzheimer’s disease and related dementias.

Roberto Hernandez-Alejandro Recognized by International Society, Transplant Congress Roberto Hernandez-Alejandro, MD, professor of Surgery and chief of Abdominal Transplantation, received the 2023 REAL Advancing in Liver Transplantation Award from the International Liver Transplantation Society (ILTS) for his efforts to expand education in Asia and Latin America.

Roberto HernandezAlejandro, MD

Hernandez-Alejandro was also appointed chair of the Scientific Program for the 2024 American Transplant Congress, to be held in Philadelphia in May 2024.

Hernandez-Alejandro joined URMC In 2016. He is an expert in transplantation, with a special interest in caring for patients diagnosed with advanced liver cancer. He is one of the world’s foremost authorities on a procedure called ALPPS, a two-step surgical technique that separates out cancerous liver tissue while promoting the rapid growth of healthy tissue. The surgery can be used for major liver resections in patients who were not previously considered because of the risk. The procedure is extending lives and improving quality of life for patients. Hernandez-Alejandro was the first in North America to perform the procedure and is still one of only a handful of surgeons in the world with this expertise.

In Memoriam: Remembering Former Pediatrics Chair Patrick Brophy Patrick Brophy, MD, former chair of the department of Pediatrics and physician-in-chief of Golisano Children’s Hospital, passed away in October after a long battle with lymphoma. As we reported in the previous issue of Rochester Medicine, Brophy had accepted a position earlier in the year to serve as the provincial head of Child Health and Pediatrics for the Canadian province of Saskatchewan, where he would be closer to family. He is remembered by colleagues for his upbeat personality, warm and generous spirit, passion for helping children, and excellent leadership in advancing GCH as one of the top children’s hospitals in the state. “Pat was a formidable force who channeled his enthusiasm and positive energy into building a reinvigorated Golisano Children’s Hospital,” said Mark Taubman, MD, CEO of URMC and dean of SMD. “Today, GCH is recognized as the undisputed pediatric referral center for all of upstate New York. Personally, I admired his courage as he battled his disease, always staying focused on the future, and working hard to achieve the goals he outlined for GCH. Pat’s legacy and spirit will always shine brightly at URMC.” Patrick Brophy, MD

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PHILANTHROPY

Changing Lives—Including Their Own

Alexander A. Levitan (MD ’63) and His Wife, Lucy, Have Given More Than Any Living Donor to Support the Medical Experience of Students from Around the World By Kristine Kappel Thompson

Inspired to make education and research experiences possible for students at the University of Rochester’s School of Medicine and Dentistry (SMD), Alexander (Al) A. Levitan (MD ’63)—a retired internist and oncologist—and his wife, Lucy, have given nearly $10 million to the school. Their philanthropy makes them the largest living donors in SMD’s history who have supported the medical experience of students from around the world through scholarships and fellowships. But for the Levitans, supporting students goes far beyond financial assistance. They offer friendship, advice, and mentorship, long after the students have earned their degrees. They save every communication they receive, attend their weddings and other major life events, and even travel abroad to meet the families of the international students whose lives they’ve changed.

Just ask Akosua Korboe, (MD ’16), the inaugural recipient of the Levitan Family Endowed Scholarship. As a student from Ghana, Korboe was ineligible for federal loans without a US citizen co-signer. Thanks to the Levitan Scholarship, she was able to pursue her dream of attending medical school. Today, she is an accomplished internist at Brigham and Women’s Hospital in Boston. “Without the Levitans' support, I would not have been able to attend medical school,” says Korboe. “And although they aren’t my biological family, they feel like they are to me. They have become family, pouring into me in countless ways, instilling values, believing in me, and always providing me with love and support. I’m forever grateful.” Generosity brings generosity Support from others has inspired the Levitans to make education and research

experiences possible for 19 students to date and many more to come. “Education has been the most valuable experience of my life,” says Al, who was a scholarship student at SMD and at Cornell University. “Without the generosity and the example of others, I never would have earned my degrees and I never would have had the life nor the career I’ve had.” The couple started supporting SMD in 1976 with gifts to SMD’s annual fund and the Class of ’63’s reunion fund. Their specific support of students began in 2006, 43 years after Al’s graduation from medical school. That’s when they made a gift of $125,000 to establish the Levitan Scholarship. They have continued to contribute generously to that fund, growing its value and reach. In fiscal year 2023, they added an additional $5.2 million, ensuring that a Levitan Scholar graduates and joins the medical school each year, in perpetuity. “The Levitan Family Endowed Scholarship stands out not only for its size but also for being the sole need-based full tuition and living expenses scholarship at the school, with a special focus on supporting international students,” says David Lambert, MD, senior associate dean of SMD. “These international students are not eligible for the kinds of support that US students can get and without the scholarship could not attend medical school.”

The Levitans with scholarship recipient Akosua Korboe (MD ’16)

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A legacy of giving and learning Al and Lucy also established the Alexander and Lucy Levitan Endowment for Medical Student Research Fellowships with a gift of $1.7 million. Because of this fund, every year three medical students can take a year out of their four-year SMD curriculum to participate in a research program under the direction and mentorship of an established physician-scientist or basic scientist.

“Many of our alumni have shared that these experiences were career-transforming,” adds Lambert. The family knows this from experience. Al’s father, Sacha, received financial support from the French government when he emigrated from Russia to France and attended college and medical school there. Later, Al’s family traveled the world due to his father’s work with the World Health Organization. Al and Lucy named funds at both SMD and Cornell to recognize the importance of scholarship support and international experiences as well as to honor Al’s father and the couple’s late daughter, Lara, who lost her battle with cancer in 2019. “The story of Al and Lucy is one of inspiration and compassion, a testament to the power of giving and its potential to change lives,” adds Mark Taubman, MD, University of Rochester Medical Center CEO and dean of SMD. “Their philanthropic legacy will forever resonate within the medical school, empowering future generations of students to realize their dreams and make a difference in the world of medicine and research.” In turn, the couple enriches their own lives with connections to people they view as members of their extended family. “We are tremendously grateful for the support given to us,” says Lucy. “We have always wanted to give back in a similar way—to provide access and opportunities to talented, deserving medical students from around the world. As a result, we have met so many brilliant young people who will do great things in their lives and careers.”

Lucy Levitan and Alexander A. Levitan (MD ’63)

About the Levitans

Born in Boston, Al received his bachelor’s degree in chemistry from Cornell University at the age of 19 and his medical degree from the University of Rochester School of Medicine and Dentistry a few years later. He then completed his internship at Vanderbilt University Hospital and his residency at the Harvard Medical Unit at Boston City Hospital. Al then served as a lieutenant commander of the US Public Health Service Commissioned Corps. At the same time, he worked as a clinical associate for the National Cancer Institute at the National Institutes of Health and contributed to the development of early chemotherapy protocols. He went on to complete a fellowship in Medicine at the University of Minnesota Hospitals in Minneapolis. He received a master of public health in Epidemiology from the University of Minnesota in 1970. In 1973, Al sat for the first board exam ever given in oncology. As an undergraduate and a medical school student, Al worked in Rochester as a chemist at the former Strasenburgh Labs and Eastman Kodak Company. In 1967, he was certified as an independent investigator for the U.S. Food and Drug Administration, a post he held until his retirement from medicine in 1998. In tandem with his private medical practice, he taught for two decades in the Department of Family Medicine and Community Health at the University of Minnesota, rising from instructor to clinical associate professor. Al is known for his expertise in many realms, including clinical hypnosis. He participated in numerous surgeries that used hypnosis as the sole agent for pain control. Lucy graduated from Vanderbilt Peabody College—Vanderbilt University’s education school—with degrees in English, mathematics, and secondary education. She began her professional life as a high school math and English teacher. She then became a computer programmer and software writer, and, later, the first office manager at Al’s private medical practice. The Levitans are licensed real-estate brokers who co-own A & L Management, LLC, a real-estate management company based in the Minneapolis area, where they live and raised three daughters: Lara Levitan, Denise Levitan, and Karen Matros, ’96. They are members of the Wilson Society, the University’s planned-giving society. Learn more at uofr.us/Levitans. ROCHESTER MEDICINE

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CLASS NOTES

MD Alumni 1960s

Share your news Your classmates want to hear about you! Did you move to a new city, begin a new project, or make a career shift? Tell us about your recent travels, job developments, family updates, or anything else you want to share by submitting a class note. Submit notes to your class agent or to uofr.us/smdclassnotes. Or use this QR code:

Note: Alumni are listed by decade, then chronologically by class year under their respective degree categories, which include Resident & Fellows and PhD & Graduate Alumni.

James Allison (MD ’68) received the C4 Visionary Award from the California Colorectal Cancer Coalition (C4) for his work as the Champion of Low Cost CRC Screening Options. Jim is currently a board member of the California Colorectal Cancer Coalition.

1980s

David Nash (MD ’81) is thrilled to report that he and his team have published a special 25th anniversary edition of their very successful journal, Population Health Management.

1970s

Robert Ozols (BS ’66, PhD ’71, MD ’74) was selected by a committee of peers as the 2023 Giant of Cancer Care in Gynecologic Cancers. This is considered the premier oncology award in the country, recognizing physicians who have made significant contributions to the cure and treatment of cancer patients. The recognition program was started in 2013 and each year inducts a new class of Giants of Cancer Care (usually about 10 people) covering the major cancer types. Vincent Mosca (BA ’73, MD ’78) retired from clinical practice as an academic pediatric orthopedic surgeon at Seattle Children’s Hospital and professor of Orthopedics at the University of Washington School of Medicine (UWSOM) in April 2022. In April 2023, he was inducted into the Hall of Fame of the Pediatric Orthopedic Society of North America. As a professor emeritus of Orthopedic Surgery at the UWSOM and Seattle Children’s Hospital, he is continuing his academic work: writing the second edition of his book on pediatric foot deformities, performing and publishing clinical research, and lecturing on pediatric and adolescent foot deformities nationally and internationally.

Rosanne Leipzig, PhD (BA ‘72, MD ‘82) published a book titled Honest Aging, which she describes as “essentially a ‘What to Expect When You’re Expecting’ for aging. Leipzing is the Gerald and May Ellen Ritter Professor and Vice Chair Emeritus for the Brookdale Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai. She is editor-in-chief of the monthly newsletter Focus on Healthy Aging and coeditor of the fourth edition of Geriatric Medicine.

Ralph Lanza (MD ’86) was appointed system division chief of Internal Medicine for Main Line Health.

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1990s

Edward J. Fox (BA ’91, MD ’95), the chief of Penn State Health Milton S. Hershey Medical Center’s Division of Musculoskeletal Oncology, was recently featured in an article in Orthopedics Today discussing the benefits of 3D printing in reconstructing bone defects.

2010s

(Photo above) Julie Allen (MD ’10), Tom Pashalides (MD ’10), and their family visited Calla Brown (MD ’11) and Bela S. Denes (MD ’11) in Minnesota. They’re pictured here alongside Ben Faustich (MD ’10) and his family at a Minneapolis farmers market.

Resident & Fellow Alumni

PhD and Graduate Alumni

1980s

1970s

Jerry J. Marty (Res ’82) published a nonfiction account of the Bronx after World War II titled Memories of Da’ Bronx.

Robert Ozols (BS ’66, PhD ’71, MD ’74): see MD alumni.

2000s

Michael Palone (MPH ’05) recently moved into a new role after more than eight years at Swisslog Healthcare, leading their global product-management organization focused on pharmacy automation solutions. The company’s experiential program continues to grow with various schools of pharmacy, and he enjoys working with students in the program. He has lived in the Boulder, Colorado, area for more than 15 years.

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In Memoriam

The School of Medicine and Dentistry expresses its sympathy to the loved ones of alumni and friends who have passed. (Updated September 2023)

1947

John C. DeMocker passed away on Sept. 17, 2023.

Betty Szymanski Garver passed away on March 21, 2023.

1949

Bruce Breckenridge passed away on Feb. 19, 2023.

1952

1967

Gerald Warren Grumet passed away on May 30, 2023.

Sanford C. Spraragen passed away on June 12, 2023.

1968

1954

Larry Lee Hall passed away on March 16, 2023.

Harold Edward Coleman passed away on May 26, 2023.

1955

Kendrick Luther Griggs passed away on March 9, 2023.

1958

Russell Wyman Sanders passed away on March 26, 2023.

Albert C. Gaw passed away on Feb. 1, 2023.

Alexander J. MacGillis passed away on Sept. 7, 2023.

1969

Richard James Davey passed away on June 13, 2023. Frederick G. Guggenheim passed away on Sept. 6, 2023.

1960

Arnold Jay Jules passed away on Dec. 15, 2022.

Edgar R. Miller passed away on Feb. 19, 2022.

David M. Magder passed away on Aug. 24, 2023.

1961

1970

David Shander passed away on July 31, 2023.

1971

William Clewell passed away on Dec. 13, 2022.

Robert S. Crumrine passed away on Aug. 8, 2023. E. Neal Gipson passed away on Sept. 2, 2023. Kenneth Walter Klimpel passed away on July 25, 2023.

1972

Charles Heam Hoke passed away on Sept. 21, 2023. Michael L. Jacobs passed away on June 19, 2023.

1973

1963

Joseph L. Andrews Jr. passed away on April 24, 2023. Sandor Harry Wax passed away on June 27, 2023. Sally D. Wilkins passed away on May 19, 2023.

1964

Renner Michael Johnston passed away on May 9, 2023.

1965

Christopher Cheyne passed away on June 4, 2023.

1966

Terry Ronald Baker passed away on Aug. 18, 2023. John Turner Chard passed away on April 8, 2023.

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J. Peter Harris passed away on March 14, 2023. William Clewell passed away on Dec. 13, 2022.

1962

Donald W. Parsons passed away on Aug. 8, 2023.

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Frank Richard Mirabella passed away on May 4, 2023.

1976

Morris Wortman passed away on May 28, 2023.

1977

Martin B. Gingras passed away on April 17, 2023.

1980

Kathleen A. Van Demark passed away on April 20, 2023.

1982

Daniel J. Courtade passed away on July 27, 2023.

1987

John Francis Murphy Jr. passed away on June 25, 2023.

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