D epartment
of
M edicine
Con ne c ti ng T e c h n o lo g y , Ed uca t i o n a n d D i s cove ry w ith H um anis m in Me dicine
Vol. 8 Issue 2 Apr 2019
Service Before Self Volunteering is a foundational element of the Department of Medicine, exemplified by Ms. Kay Rangnekar. While growing up in India, Ms. Rangnekar, director of the UT Internal Medicine Center, recalls a household of up to 35 members. Her family, led by her father’s motto of “service before self,” cared for and educated women in need to provide them a foundation upon which they could stand on their own. Ms. Rangnekar identifies her father’s example as the inspiration for her volunteer work today, which is focused upon women in need. Susannah’s House is one beneficiary of Ms. Rangnekar’s efforts. Founded in 2013, Susannah’s House is a program for women in recovery from addiction. What started as a single act of kindness serving Thanksgiving dinner three years ago “just continued” to a monthly service of meal preparation for workshops or group therapy sessions. Ms. Rangnekar was so taken by the mission of Susannah’s House that she invited others to participate in serving meals and donating items. “The best part,” she said, “is that my staff has joined [in this endeavor].” During the month of December, the staff of the Internal Medicine and OB/Gyn Center, led by Beth Carroll, Janice Farley, and Torre Rismiller, organized an “Advent Calendar,” a daily collection of a designated household or food product, the sum of which was presented in mid-January during a lunch with the women of Susannah’s House. Ms. Rangnekar was “overwhelmed with gratitude and joy,” particularly when the staff announced an ongoing monthly collection for the organization.
Her true passion, however, belongs to Smiles for Hope, a nonprofit organization founded in 2017 by a local dentist. Ms. Rangnekar worked behind the scenes from the organization’s inception and now serves on its board as a liaison to Susannah’s House. Once a month, Smiles for Hope holds a free dental clinic Volunteer Ministry Center for the women who have “been through tough times and are coming out clean.” Part of their reformed life includes interviewing for employment, during which women, helped by Smiles for Hope, can share their beautiful smile. “You should see the [women’s] smiles,” reflects Ms. Rangnekar with joy, following in the steps of her father to provide a foundation for the future of women in need.
Points of View
about the bond that physicians could have with people they had never met before. As time passed and I became a senior attending physician, I became the beneficiary of patients’ trust. I could not help smiling when my students and trainees felt the same mortification that I had as a resident. One of my fellows presented a patient with interstitial lung disease. He had spent over an hour with a woman in her 40s who had bilateral shadows on her chest CT, shortness of breath, and low oxygen levels. He had taken an extensive history and done a thorough examination, and we discussed a variety of diagnoses for her condition. As soon as we walked into her room, she said, ”Oh, I forgot to tell you about my African grey parrot that I’ve had for 12 years. He’s my baby and he is with me all the time.” We had our diagnosis of hypersensitivity pneumonitis! The deflated look on the fellows face was something I could totally relate to. My own experiences have made me careful not to judge residents and fellows for not gathering the special piece of information that patients reserve for senior attending physicians.
As a young resident, I was frustrated when patients withheld crucial information only to relate it to the attending physician. After I had spent a good deal of time taking their history and doing a physical examination, I would synthesize a differential diagnosis, formulate a plan of action, and dutifully present my findings to the attending. Then, as soon as we walked into the Rajiv Dhand, MD, Chair patient’s room, the patient would convey a gem of pivotal information that would clinch the diagnosis! It made me look foolish in the eyes of the team. The attending probably felt that I had not taken an adequate history—otherwise, how could I have missed such an important part of the patient’s story? The patient’s ability to instantly relate to senior attending physicians tormented me throughout my training years, and I often wondered 1
Prescribing Smiles Interventional cardiology fellow Dr. Kayleigh Litton has always been drawn to elderly people, and so she took an opportunity to moonlight at a local nursing home a few years ago. “I would see patients there on my way home,” she recalls. “My husband, Scott, started meeting me there. He would socialize with residents while I did my work.” They found they enjoyed visiting with the residents together and made it part of their routine. They began to think of ways to brighten the residents’ days. “Sometimes little things can mean a lot,” she observed. For example, some residents are hard of hearing. “They are cognitively intact, but wind up being isolated simply because they can’t hear,” said Dr. Litton. “Scott and I brought some white boards that could be attached to wheelchairs so people could write messages to them. One lady didn’t understand what it was for at first. When I used it to write, ‘This is so people can talk to you,’ her whole face just lit up!” Dr. Litton and her husband help organize holiday parties for the residents, bringing gifts like fragrant body wash and tasty snacks. “It’s fun,” she said. “It makes you feel good to be able to bring a little joy to someone’s life.” Dr. Litton looks forward to joining University Cardiology in July after she completes her training. One thing that won’t change? “We’ll keep seeing our people,” she said. “I love being able to make them smile.”
Fundraising Initiatives within the Department of Medicine
Endowed chairs ensure that the UT Medical Center and UT Graduate School of Medicine continue to recruit high caliber faculty to educate residents and fellows who will in turn serve the needs of East Tennesseans. Such faculty members bring prestige to the department and the medical center, and they provide valuable services for our patients. The department of medicine is partnering with the development office to raise funds for the Wahid T. Hanna, MD Endowed Chair of Medicine. Dr. Hanna is an internationally known physician, faculty member, and research specialist in hematology and oncology who has practiced medicine at UTMC for more than 40 years. To date we have raised a total of $1,400,000 in cash and commitments towards our $2,000,000 goal. The department is also raising funds for the Dale C. Wortham, MD Endowed Fellowship in Cardiovascular Disease. Dr. Wortham, Professor Emeritus in the department of medicine provided decades of exceptional cardiovascular patient care at UTMC. He also led efforts to establish our cardiovascular disease fellowship and served as its program director from 2007-2017. His leadership has made a lasting impact at our medical center, in our region, and across the country. We currently have cash and commitments totaling over $300,000 toward our $500,000 goal. Another on-going drive is fundraising for the Stephen Y. Coleman Endowed Fellowship in Medical Oncology. In 2011, Stephen York Coleman, son of Steve and Brenda Coleman, lost his battle against brain cancer at age 37. In 2011, the Coleman family created Tailgating Against Cancer, a not-forprofit organization dedicated to raising funds for the fellowship. They have currently raised over $250,000. Once fully funded at $500,000, the fund will support fellows in the discipline of medical oncology. We greatly appreciate the efforts of Erica Arem, Senior Major Gifts Officer, and Kathy Boyd, Chief Development Officer, in these fundraising efforts. They can be contacted in the Development Office at 865-305-6611 or development@utmck.edu.
Resident and Fellows Spotlight: Ashish Thakkar Dr. Ashish Thakkar came to UT Medical Center from Long Island, New York, and will complete his pulmonary and critical care fellowship this June. Dr. Thakkar attended St. George’s University and then completed his internal medicine residency at Rochester General Hospital in Rochester, NY. He then chose to pursue a career in pulmonary and critical care medicine, and has made the most of Knoxville while training here at UT Medical Center. He is a food and beverage connoisseur, having visited hundreds of restaurants in the greater Knoxville area. His favorite restaurant is the Oliver Royale in Market Square. While Dr. Thakkar has enjoyed his time in the south, he is still a New Yorker at heart. He has recently accepted a position at Jacobi Medical Center, Bronx, NY, where he will work as an academic pulmonologist and intensivist for the residency program affiliated with Albert Einstein College of Medicine. He would like to thank the faculty and staff at UTMC for their support in his training over the last three years. He would also like to encourage other residents and fellows to take advantage of the abundant extracurricular opportunities Knoxville and surrounding cities have to offer. 2
New Faculty We are delighted to welcome Dr. David Aljadir as a Clinical Assistant Professor in the Division of Hematology and Oncology. Dr. Aljadir graduated with his Bachelor of Mechanical Engineering degree from the University of Delaware in Newark, Delaware. He received his Doctor of Medicine from Jefferson Medical College in Philadelphia, Pennsylvania. He completed an internal medicine residency at Christiana Hospital in Newark, Delaware. He completed a fellowship in hematology/oncology at Roger Williams Medical Center in Providence, Rhode Island. Dr. Aljadir joined University Cancer Specialists in 2013. We are delighted to welcome Dr. Jeffory Jennings as an Assistant Professor in the Division of Cardiology. Dr. Jennings graduated with his Bachelor of Science degree from the University of Tennessee in Knoxville, Tennessee. He received his Doctor of Medicine from the University of Tennessee Health Science Center in Memphis, Tennessee. He completed a pediatric residency at Letterman Army Medical Center in San Francisco, California. He completed a fellowship in pediatric cardiology at Duke University Medical Center in Durham, North Carolina. Dr. Jennings has been staffing a once-weekly adult congenital heart disease clinic in the University Cardiology offices since January 2019.
We are excited to welcome Dr. Megan Edwards as a Clinical Assistant Professor in the Division of Infectious Diseases. Dr. Edwards graduated with her Bachelor of Science degree in Biochemistry, Cellular, and Molecular Biology from the University of Tennessee in Knoxville, Tennessee. She received her Doctor of Medicine from East Tennessee State University/Quillen College of Medicine in Johnson City, Tennessee. She completed residencies in internal medicine and pediatrics at Baystate Medical Center/ Tufts in Springfield, Massachusetts. She completed a fellowship in infectious disease at Maine Medical Center/Tufts in Portland, Maine. Dr. Edwards joined University Infectious Disease in November 2018. We are pleased to welcome Dr. Rod Ramchandren as Professor and Division Chief in the Division of Hematology and Oncology. Dr. Ramchandren graduated with his Bachelor of Science in Biology with a minor in English writing from the University of Pittsburgh in Pittsburgh, Pennsylvania. He received his Doctor of Medicine from Ross University School of Medicine in Dominica. He completed an internal medicine residency at Drexel University College of Medicine – Hahnemann University in Philadelphia, Pennsylvania. He completed a fellowship in hematology and oncology at St. John Health – Providence Hospital Southfield, Michigan. Dr. Ramchandren joined University Cancer Specialists in February 2019.
We are excited to welcome Dr. Neil Faulkner as a Clinical Assistant Professor in the Division of Hematology and Oncology. Dr. Faulkner graduated Summa Cum Laude with his Bachelor of Science degree in Biology from the University of the Virgin Islands in St Thomas, US Virgin Islands. He received his Doctor of Medicine and Doctor of Philosophy in Cellular and Molecular Biology from the University of Michigan School of Medicine and Horace H. Rackham Graduate School in Ann Arbor, Michigan. He completed a residency in internal medicine at Wayne State University/Detroit Medical Center in Detroit, Michigan. He completed a fellowship in hematology and oncology at Karmanos Cancer Institute in Detroit, Michigan. Dr. Faulkner joined University Cancer Specialists in 2017.
New Staff Robin Underwood recently joined the department as a medical administrative coordinator. She graduated from Tusculum College with her bachelor’s degree in Business Administration and Management. Among her many responsibilities, Robin will provide support to the department chairman, be responsible for purchasing, and handle reconciliation of departmental ledgers. We are pleased to have Robin as a part of our department and look forward to working with her.
CME Opportunities—Mark Your Calendars! • Primary Care CME Conference, offering up to 10.25 hours of CME credit, will be held April 5-6, 2019, at the Crowne Plaza, Knoxville. We hope you can join us for this informative event. Registration available onsite! View course information, agenda, and fees at: http://gsm.utmck.edu/cme/courses/primarycare2019/main.cfm • Cardiology Conferences, held weekly on Wednesdays for .75 hour CME credit. • Medicine Grand Rounds, held on the 2nd and 4th Tuesdays of each month for 1.00 hour CME credit. • Ethics Case Rounds, held on the 4th Thursday of the month at noon in Wood Auditorium, are available for 1.00 hour CME credit. 3
In Touch
Ethics Education at UT Medical Center By Annette Mendola, PhD, Division Chief of Clinical Ethics
Vol. 8, Issue 2: April 2019
Ethics Case Rounds features stories of ethically difficult situations. However, in this issue we will tell a different kind of story: the story of how the clinical ethics program began at UT Hospital, and was among the founding programs in the country for the discipline of medical ethics. In 1974, a discussion series on issues in medical ethics was held in Knoxville, organized by Dr. Charles Reynolds from UTK’s Department of Religious Studies. 1974 was two years after the story of the Tuskegee Syphilis Study broke, raising concerns about ethics in research, and one year before Karen Ann Quinlan would lapse into a coma, igniting debates about the right to die. Living wills, kidney dialysis, and organ transplantation were all relatively new. A new awareness of the ethical complexities of contemporary medicine was dawning. Dr. Alfred Beasley, MD, then chair of the Department of Medicine at the University of Tennessee Medical Center, and Dr. Glenn Graber, PhD, ethics professor in UT’s Department of Philosophy (now both emeritus), were among the attendees. Both were inspired by the need to address ethical issues in medicine in a robust and interdisciplinary manner. “There were no degree programs focused on ethical issues in medicine then,” Dr. Graber recalls. “No one was addressing issues about end of life in hospital settings. But there was a lot of interest.” The two realized that there was tremendous opportunity for collaboration. “Both philosophy and medicine benefit from the cross-fertilization of the two disciplines,” observes Dr. Beasley. They formed the foundation for what would become a seminal program in biomedical ethics. Together with Dr. John Eaddy from the Department of Family Medicine, they developed a curriculum for a concentration in medical ethics within the graduate philosophy program at UTK. Just one year later in 1975, the first graduate students enrolled in the University of Tennessee’s medical ethics concentration. The following year, the medical ethics program started a clinical practicum in medical ethics at the Health Sciences Center in Memphis. Students spent a semester in residence in Memphis, shadowing health professionals and residents, and spending time with the medical students. “Dr. Beasley and Dr. Eaddy proposed that we bring our students to UT Medical Center in order to inform our seminar discussions with clinical realism,” recalls Dr. Graber. The practicum later relocated to the Knoxville campus. The clinical practicum was truly innovative, and set UT’s program apart from the programs subsequently developed by other universities. For years, the medical ethics program at UT was among the only programs in the country to include a clinical component. In 1978, the National Network of Humanities awarded the University of Tennessee a half-million dollar grant for development of a graduate program in medical ethics. “That’s when things took off,” says Dr. Graber. The program admitted students steadily after that, with many of its faculty and graduates going on to make substantial contributions to the growing field. Students came from around the world, including England, Israel, Switzerland, and Canada. A Masters-level practicum at Lakeshore Mental Health Institute was added. Conferences on topics such as Ethics and Women’s Health and Violence, Neglect, and the Elderly drew national participants. Dr. Graber began presenting monthly Ethics Grand Rounds in 1980, a practice he continued until 1999. Today, bioethics is an established discipline. While the UT Department of Philosophy no longer offers a concentration in bioethics, the influence of the program is evident in the culture of the hospital and the Graduate School of Medicine. As a proud alumna, I am grateful for the training and mentorship I received from the faculty of the medical ethics program, and the opportunity to carry on this work at The University of Tennessee Medical Center.
Publisher Rajiv Dhand, MD, Chair, Department of Medicine and Associate Dean of Clinical Affairs Editor Annette Mendola, PhD Administrative Director Susan Burchfield, CAP-OM Contributors Susan Burchfield Rajiv Dhand, MD Kandi Hodges Annette Mendola, PhD Kimberly Givens David Wilson, DO Elana Smith Sister Teresa Mary Kozlovski, MD Design J Squared Graphics In Touch is produced by the University of Tennessee Graduate School of Medicine, Department of Medicine. The mission of the newsletter is to build pride in the Department of Medicine by communicating the accessible, collaborative and human aspects of the department while highlighting pertinent achievements and activities. Contact Us In Touch University of Tennessee Graduate School of Medicine Department of Medicine 1924 Alcoa Highway, U-114 Knoxville, TN 37920 Telephone: 865-305-9340
Presentations, Publications, Awards
Department of Medicine faculty, residents, and fellows share their knowledge and experience by publishing and presenting across the world. For a list of our most recent accomplishments, visit http://gsm.utmck.edu/internalmed/scholars.cfm.
Thank You For Your Support
For information about philanthropic giving to the UT Graduate School of Medicine, Department of Medicine, please contact the Development Office at 865-305-6611 or development@utmck.edu. If you would like more information about any of the topics in this issue of In Touch, please contact the Department of Medicine at 865-305-9340 or visit http://gsm.utmck.edu/internalmed/main.cfm. We look forward to your input. Thank you.
Stay In Touch!
Alumni, please update your contact information by completing the simple form at http://gsm.utmck.edu/internalmed/alumni.cfm or by calling the Department of Medicine at 865-305-9340. Thank you! 4
E-mail: InTouchNewsletter@utmck.edu Web: http://gsm.utmck. edu/internalmed/main.cfm The University of Tennessee is an EEO/AA/Title VI/ Title IX/Section 504/ADA/ ADEA institution in the provision of its education and employment programs and services.