Robert Wood Johnson Medicine • Spring 07

Transcripción

A PUBLICATION FOR ALUMNI & FRIENDS OF UMDNJ-ROBERT WOOD JOHNSON MEDICAL SCHOOL
RobertWoodJohnson
SPRING 2007
MEDICINE
That you can make a difference in finding
real cures, educating new healthcare
professionals, and improving patient care.
That you can choose the specific area of
medical research, education or healthcare
you wish to support.
That 100% of the dollars you contribute
go directly to the program you wish
to sponsor, with no administrative fees
diluting their power.
That your generosity will work miracles for
so many people right here in New Jersey.
Now, imagine how fulfilling it would
be if your donation could do all of
these things. Through the Foundation of
UMDNJ it can, by funding research,
education and patient care programs
at UMDNJ-Robert Wood Johnson
Medical School.
For more information, call Denise Gavala,
senior director of development, toll-free
at 866-44-UMDNJ or reach us online
at www.umdnj.edu/foundation.
Imagine the difference
you can make
Newark, New Brunswick, Stratford
l e t t e r
f r o m
t h e
d e a n
Dear Colleague,
T
JOHN EMERSON
he articles in this issue of Robert Wood Johnson Medicine reflect the breadth of our endeavors at
UMDNJ-Robert Wood Johnson Medical School. Individually, each feature brings new insights into
our programs. Together, the articles demonstrate our quest for excellence in four intersecting missions:
education, clinical care, research, and community health.
I hope that as you read this issue, you will share my deep appreciation for the people who work to
advance our medical school. Their dedication, skills, and spirit make RWJMS a wonderful place to teach,
study, and learn.
Our cover story on global medicine, The Neighborhood 8,000 Miles Away, explores an RWJMS campus that stretches across the world. Here, you will meet our faculty who provide much-needed care in
Africa, India, and Latin America. And you will meet our students, as they gain the skills of culturally competent physicians and prepare to care for patients worldwide.
New Frontiers in Cardiac Surgery examines our cardiac programs, which offer the full range of cardiac
support, from simple catheter-based assistive devices to artificial-heart implantation. Completing that
spectrum of programs, our heart-transplantation team, led by Mark Anderson, MD, was among the first
in the United States recently approved to implant the artificial heart.
I was pleased, in Rx for Excellence, to have the opportunity to reflect
on my experience in the Department of Pathology and Laboratory
Medicine. We found that good business decisions can drive academic
growth, which we are attempting to achieve school-wide.
At RWJMS, we continue to conduct world-class translational research
in the basic sciences. Patient-focused research is also under way in our
clinical departments. A Cornerstone of Orthopaedic Surgery presents the
research of Charles Gatt, Jr., MD ’89 — a department chair and
physician-scientist who is making impressive strides in tissue engineering.
Family medicine is another area in which we are conducting important
patient-centered research. Social Science Evolves into Practice Jazz introduces you to Benjamin Crabtree, PhD, who leads his department’s
research division in work that is improving the dynamics of family practices nationwide.
Our alumni profile, Comrade-in-Arms, portrays Joseph S. Costabile, MD ’86, a vascular surgeon who
led a U.S. Navy Medical Reserves surgical unit in the Iraq War, helping to save the lives of many coalition soldiers.
As always, we are pleased to recognize the outstanding people who make us proud of this school. I
hope you will enjoy learning about their achievements in medicine here and across the world.
Sincerely,
Peter S. Amenta, MD, PhD
Interim Dean
Robert Wood Johnson ■ MEDICINE 1
S p r i n g
2 0 0 7
D E P A R T M E N T S
1
Letter from the Dean
RWJMS News
4
Research News
6
Education Highlights
8
10
New Appointments
Letter from the Alumni
Association President
43
RWJMS Alumni News
44
Class Notes
48
Last Page
52
RobertWoodJohnson
MEDICINE
A PUBLICATION FOR ALUMNI & FRIENDS OF
UMDNJ-ROBERT WOOD JOHNSON MEDICAL SCHOOL
S p ri n g 2 0 0 7 • Vo l u m e 10 , N u m b e r 1
Interim Dean
Peter S. Amenta,
MD, PhD
Executive Editor
Patricia M. Hansen
Director,
Communications
and Public Affairs
Editor
Roberta Ribner
Writers
Kate O’Neill
Rita M. Rooney
Copy Editor
Richard Slovak
Art Director
Barbara Walsh
Cover Composite
Illustration
Barbara Walsh
Alumni Association
Officers:
President
Geza K. Kiss, MD ’95
Vice President/
President-Elect
Nancy Sierra, MD ’89
Secretary
Tamara LaCouture, MD ’94
Treasurer
Hank Lubin, MD ’83
Chair, Membership
Committee
Andrew Stefaniwsky, MD
’77
Chair, Development
Committee
Ravi Goel, MD ’97
Co-Chairs, Reunion
Committee
Geza K. Kiss, MD ’95
Francine E. Sinofsky, MD
’81
Editorial and Advertising Office
UMDNJ-Robert Wood Johnson Medical School
Roberta Ribner, Editor, Robert Wood Johnson Medicine
335 George Street • Suite 2250 •
New Brunswick, NJ 08903
Telephone: 732-235-6310 • Fax: 732-235-9570
Email: [email protected]
Contents
F
E
A
T
U
R
E
S
Peter S. Amenta, MD, PhD, Interim Dean:
Rx for Excellence
11
During his decade as chair of the Department of
Pathology and Laboratory Medicine, Dr. Amenta led the
development of an extraordinary business plan. He hopes to
expand that plan into a blueprint for growth at RWJMS.
By Kate O’Neill
15
New Frontiers in Cardiac Surgery
From the first totally implantable artificial heart to a
new procedure for treatment of artrial fibrillation, and
with a world-class team directed to pediatric cardiac surgery,
RWJMS leads the way in advanced surgical solutions
to serious cardiac disease.
By Rita M. Rooney
Benjamin F. Crabtree, PhD:
Social Science Evolves into Practice Jazz
20
Under Dr. Crabtree’s leadership, the Department
of Family Medicine’s division of research has earned
$6 million from the National Institutes of Health
to study and improve patient care in family practices
nationwide.
By Kate O’Neill
Rapid HIV/AIDS Testing Initiative
Hailed as Model Program
23
The New Jersey Rapid HIV/AIDS Testing Program
has been recognized as a model for other states to follow.
The Department of Pathology and Laboratory Medicine
oversees this initiative, which is the largest of its kind
in the nation.
By Patricia M. Hansen
25
The Neighborhood 8,000 Miles Away
From Africa to India and Latin America,
global medicine is strengthened through a cohesive
foundation of medical practitioners dedicated to
world health.
By Rita M. Rooney
Research: A Cornerstone of Orthopaedic Surgery
38
Tissue engineering and other orthopaedic breakthroughs
characterize the practice of orthopaedic medicine specialists
at RWJMS.
By Rita M. Rooney
Alumni Profile:
Joseph P. Costabile, MD ’86: Comrade-in-Arms
46
U.S. Navy Medical Reservist Dr. Costabile spent
eleven months in the Iraq War acting on his commitment
to “giving back,” by providing superior medical care to
coalition soldiers.
By Kate O’Neill
NEWS
r w j m s
Dr. Steven Levin Named Family Physician of the Year
T
4 Robert Wood Johnson ■ MEDICINE
vising The Promise
Clinic students one
night a week.
“Caring for patients
with diverse backgrounds and complex
medical illnesses is consistent with the mission
of the clinic and my
own desire to provide
health care to people
who are having difficulties accessing quality
health care services,” says
Dr. Levin.
— K.O’N.
COURTESY OF STEVEN J. LEVIN, MD
he American
Academy of Family
Physicians (AAFP)
has named Steven J. Levin,
MD, associate professor of
family medicine, its 2007
Family Physician of the Year.
The award was presented at
the academy’s Annual
Scientific Assembly. The
AAFP annually honors an
outstanding American family physician who has provided patients with compassionate, comprehensive care
and serves as a role model
professionally and personally
to his or her community, to
other health professionals,
and to residents and medical
students.
Dr. Levin was the first
full-time physician at St.
John’s Clinic in New
Brunswick, which provides
care for the medically underserved. He has held this
position for 18 years and
serves as the clinic’s medical
director and primary physician. The center was created
by Catholic Charities and
receives substantial funding
from St. Peter’s University
Hospital.
Dr. Levin mentors and
educates family medicine residents and medical students
at St. John’s. In 1992, a
group of his students founded the Homeless and
“Caring for patients with
diverse backgrounds and
Kitchen. Physicians from
the Department of Family
Medicine take turns super-
complex medical illnesses
is consistent with the
mission of the clinic and
my own desire to provide
Mission Expands at Center for
Clinical and Translational Services
health care to people who
are having difficulties
accessing quality health
care services,” says
Dr. Levin.
Indigent Population Health
Outreach Project (HIPHOP),
the student outreach group
that he continues to advise.
More recently, Dr. Levin
helped medical students start
The Promise Clinic, which
provides medical care to
low-income and homeless
people who receive meals at
Elijah’s Promise Soup
T
he Center for Clinical
and Translational Sciences (CCTS) opened
this past summer. Newly appointed as medical director is
Ronald A. Morton, Jr., MD,
professor of surgery, chief, division of urology, and director
of urologic oncology, The
Cancer Institute of New Jersey
(CINJ). Dr. Morton’s own research focuses on prostate cancer genetics and the use of biosensors in the diagnosis of
genitourinary malignancies.
Dr. Morton hopes that by
centralizing and streamlining
the translational research
process, the time will shorten
between a basic science discovery and the moment when
that discovery becomes a drug
available for patient care. “The
center will provide an RWJMS
core facility for translational
research,” he says. “It offers
improved opportunities not
just for our student researchers and seasoned investigators, but also our partners in
the pharmaceutical industry.”
The CCTS is designed exclusively for clinical and translational research and serves
all RWJMS clinical and translational researchers. Its regular
NIH Awards $19 Million to Develop Measures Against
Chemical Terrorism: Dr. Laskin to Direct Collaborative Center
T
mustard in the human body
that can be exploited for therapeutic drug development.
The team will also evaluate
drugs that are currently available in pharmacies for use to
treat various types of poisoning caused by an attack. “We
have excellent leads, and we
STEVE HOCKSTEIN
users include
CINJ medical
oncologist
Antoinette R.
Tan, MD ’96,
assistant professor of medicine. Dr. Tan is a
principal investigator on a
phase I clinical trial that involves a novel chemotherapy
drug given as a continuous
24-hour infusion; the goal is
to determine the maximum
tolerated dose. The CCTS provides overnight facilities where
her patients receive the drug.
The nurses at the CCTS observe patients for side effects,
fessor of environmental and
occupational medicine and
chief, division of toxicology,
will direct the center. Its
research team will include faculty from the Environmental
and Occupational Health Sciences Institute (EOHSI), the
Ernest Mario School of Pharmacy at Rutgers University,
and Lehigh University.
“This is a massive effort
designed to coordinate many
different research groups,”
says Dr. Laskin. “We will develop drugs that can be used
against actual chemicals that
could be used in a terror
attack.”
The researchers will work
to identify targets of sulfur
LOWELL HANDLER
he National Institutes
of Health (NIH) has
awarded a five-year,
$19.2 million grant to
UMDNJ-Robert Wood
Johnson Medical School and
Rutgers, The State University
of New Jersey, to support the
creation of a new Center of
Excellence. The center, which
is funded under CounterACT,
a special NIH program, will
focus on the development of
medical countermeasures
against chemical threats. It
will be named the Robert
Wood Johnson Medical
School / Rutgers University
CounterACT Research Center
of Excellence.
Jeffrey Laskin, PhD, pro-
Ronald A. Morton, Jr., MD
take frequent vital signs, and
draw blood samples to assess
drug levels. “The CCTS is an
important resource, as the ability to conduct clinical trials is
important to the mission of
CINJ,” says Dr. Tan. CINJ is
the state’s only National Cancer Institute–designated Comprehensive Cancer Center.
This past summer, a multi-
disciplinary team of leading
RWJMS research faculty and
other translational research
stakeholders submitted a proposal to the NIH titled “The
New Jersey Center for Clinical
and Translational Science.”
The NIH responded in September with the full $233,000
requested. The grant will support the team’s primary, twofold goal for CCTS: to provide the infrastructure necessary for training young investigators and to sustain a robust,
multi-disciplinary translational research program at
RWJMS.
— K.O’N.
Jeffrey Laskin, PhD, professor of
environmental and occupational medicine
and chief, division of toxicology, will
direct the new Robert Wood Johnson
Medical School/Rutgers University
CounterACT Center of Excellence.
are quite hopeful that drugs
will be available in the foreseeable future,” adds Dr.
Laskin.
Deborah Cory-Slechta,
PhD, professor and chair,
Department of Environmental
and Occupational Medicine,
and director, EOHSI, says,
“This award adds strength to
the ongoing commitment of
both Robert Wood Johnson
Medical School and Rutgers
to research in the area of
security, which is so important to our nation and particularly to the citizens of our
state.”
In addition to Rutgers’
Donald Gerecke, PhD, who is
co-director of the center, other
Rutgers faculty working on
the project are Marion
Gordon, PhD; Joshua Gray,
PhD; Diane Heck, PhD;
Debra Laskin, PhD; and
Patrick Sinko, PhD.
— K.O’N.
r
w
j
m
s
NEWS
Dean Amenta Hosts Reception at
Annual Meeting of AAMC
T
he dean’s reception at
the 2006 annual meeting of the Association
of American Medical Colleges
(AAMC) in Seattle was a
highlight for members and
friends of the RWJMS community. Hosting the event
for the first time was Peter S.
Amenta, MD, PhD, interim
dean.
Dr. Amenta warmly wel-
comed the crowd and commented how pleased he was
to have as his guests fellow
deans and other leaders from
the world of academic medicine. Among those singled
out for a special introduction
were Darrell G. Kirch, MD,
president, AAMC; Harold L.
Paz, MD, dean, College of
Medicine, Pennsylvania State
University; and Harvey
Research
News
The following UMDNJ-Robert Wood
Johnson Medical School faculty were
recently awarded grants of approximately
$1 million or more:
Peter S. Amenta, MD, PhD,
interim dean (right), greets
Darrell G. Kirch, MD,
president, AAMC.
Left to right: Kathleen W. Scotto, MD,
senior associate dean for research;
David E. Swee, MD, associate dean for
education; and Cheryl A. Dickson, MD,
MPH, assistant dean for student affairs.
By Kate O’Neill
titled “Evaluation of Palliative Prostate Cancer
torial Activities of Akt and B-Raf/Erk
Care among Elderly Men.” • Jianjie Ma, PhD,
Signaling in a Mouse Model of Androgen-
university professor of physiology and biophys-
Independent Prostate Cancer,” an article pub-
ics: a five-year, $2,131,176 grant titled “Ca
lished in the Proceedings of the National
The National Institutes
o f H e a l t h : Joseph P. Dougherty,
Sparks in Muscle Aging and Dystrophy.” • Kiran
Academy of Sciences of the United States of
E. Madura, PhD, professor of biochemistry: a
America 2006:103(39):14477–14482. The
PhD, professor of molecular genetics, micro-
five-year, $1,462,988 grant from the NCI for his
article’s co-authors included Xuesong
biology, and immunology: a three-year,
study “Functional Analysis of RAD23 Protein.
Ouyang, PhD, adjunct instructor of medi-
Screening to Identify Antagonists of HIV-1
I n d u s t r y F u n d i n g : Hoffman-
of pediatrics. • Chavela M. Carr, PhD, assis-
Latency.” • Masayori Inouye, PhD, professor
La Roche awarded $1,286,684 to Moti L. Tiku,
tant professor of pathology and laboratory
and chair, Department of Biochemistry: a five-
MD, associate professor of medicine, for a long-
medicine, senior author of “Specific SNARE
year, $1,084,045 grant for his study titled
term study of safety during treatment with
Complex Binding Mode of the Sec1/Munc-18
“Signal Transduction by Histidine Kinases and
tocilizumab (MRA) in patients completing
Protein, Sec1p,” an article published in
cine, and Michael M. Shen, PhD, professor
$1,595,632 grant titled “High Throughput
Their Response Regulators.” •
treatment in MRA core studies.
National Academy of Sciences of the United
Sunita G. Kramer, PhD, assistant
professor of pathology and laboratory medicine: a five-year, $1,219,350
grant for her study titled “Myotube
Guidance in Drosophila Melanogaster.” • Grace Lu-Yao, PhD, MPH,
Published
Research:
States of America. • An article titled
The following is a representative
sample of articles in leading
biomedical journals by RWJMS
faculty members.
Low-Molecular-Weight Heparin for Acute
associate professor of environmental
and occupational medicine: a fouryear, $916,684 award for a study
November 2006 in the Proceedings of the
“Subcutaneous Unfractionated Heparin vs.
Thromboembolic Disease: Issues of Efficacy
and Cost,” by Jeffrey L. Carson, MD,
Richard C. Reynolds Professor of Medicine,
Cory Abate-Shen, PhD, professor of
was published in the Journal of the American
medicine, senior author of “Combina-
Medical Association 2006:296(8):991–993. •
RWJMS Establishes
Department of Dermatology
PHOTOS BY PATRICIA HANSEN
Dr. Amenta welcomes Johanna VidalPhelan, MD ’01.
Holzberg, former president
and CEO, Robert Wood
Johnson University Hospital.
Among the guests was
alumna Johanna VidalPhelan, MD ’01, a pediatrician practicing in Seattle.
Dr. Vidal-Phelan greeted
Dr. Amenta and shared
memories with him of her
student years in Piscataway.
— K.O’N.
B
abar K. Rao, MD,
clinical assistant professor of medicine,
was appointed acting chair
of the newly established
Department of Dermatology.
Dr. Rao joined the Depart-
STEVE HOCKSTEIN
ment of Medicine in 2000
and established the Dermatology Residency Program in
2002. The program not only
trains dermatology residents,
but also hosts RWJMS residents in internal medicine
and pediatrics and
teaches medical
students on clinical
rotations.
Dr. Rao’s practice focuses on skin
cancer protection
and prevention.
He is a specialist
in melanoma
and also a noted
teacher of derBabar K.
matoscopy, which
Rao, MD
distinguishes
between benign and malignant patterns in pigmented
lesions. In addition, he is
working on the development
of computer-assisted technology that may reduce the need
for invasive biopsies.
Medical dermatologist
Amy S. Pappert, MD ’89,
assistant professor of medicine, serves as program director in the new department;
David A. Wrone, MD, clinical assistant professor of
medicine, is director of dermatologic surgeries. The
department is supplemented
by the services of a pediatric
dermatologist and by a
dematopathologist at Robert
Wood Johnson University
Hospital.
— K.O’N.
Masayori Inouye, PhD, professor and chair, De-
I–like Molecules in Autoimmune Diseases,” pub-
partment of Biochemistry, author of “Signaling by
lished in the November 6, 2006, issue of Journal
Transmembrane Proteins Shifts Gears,” published in
of Experimental Medicine. Co-authors included
the September 8, 2006, issue of Cell 126(5):829–
Gobardhan Das, PhD, adjunct assistant professor
831. • Estela Jacinto, PhD, assistant professor of
of molecular genetics, microbiology, and immunol-
physiology and biophysics, first author of “SIN1/
ogy. • Vasily M. Studitsky, PhD, associate pro-
MIP1 Maintains Rictor-mTOR Complex Integrity and
fessor of pharmacology, senior author of “Nucleo-
Regulates Akt Phosphorylation and Substrate
somes Can Form a Polar Barrier to Transcript
Specificity,” published in the October 6, 2006,
Elongation by RNA Polymerase II,” an article pub-
issue of Cell 2006:127 (1):125–137. • Terri Goss
lished in Molecular Cell 2006:24(3):469–479. •
Kinzy, PhD, professor of molecular genetics,
Harvey R. Weiss, PhD, professor of physiology
microbiology, and immunology, a co-author of
and biophysics, senior author of “Importance of
“Structure of eEF3 and the Mechanism of Transfer
Ryanodine Receptors in Effects of Cyclic GMP Is
RNA Release from the E-site,” published in Nature
Reduced in Thyroxine-Induced Cardiac Hyper-
2006:443:663–668. • Michael P. Matise, PhD,
trophy,” an article published in the May 10, 2006,
assistant professor of neuroscience and cell biolo-
issue of the European Journal of Pharmacology
gy, senior author of “Wnt Signaling Inhibitors
537(1–3):45–51. The article’s co-authors included
Regulate the Transcriptional Response to Morph-
Peter M. Scholz, MD, professor of surgery. •
ogenetic Shh-Gli Signaling in the Neural Tube,”
James Q. Zheng, PhD, associate professor of
published in the September 11, 2006, issue of
neuroscience and cell biology, senior author of
Developmental Cell 11(3): 325–337. • Yufang Shi,
“An Essential Role for Beta-actin mRNA
DVM, PhD, professor of molecular genetics, micro-
Localization and Translation in Ca2+-Dependent
biology, and immunology, senior author of “Pivotal
Growth Cone Guidance,” an article published in
Roles of CD8+ T Cells Restricted by MHC Class
Nature Neuroscience 2006:10:1265–1273.
E D U C A T I O N
T
he Dean’s Scholars Program,
inaugurated in 2006, will provide full four-year scholarships
for seven exceptional students in the
Class of 2010:
■
■
BY
KATE
O’NEILL
■
■
■
Biochemistry major Michael
DiGiacomo is a Phi Beta Kappa
graduate of the College of Holy
Cross, where he did research on
neurofibromatosis type 2. He worked
as both a biochemistry lab assistant
and a pharmacy technician.
Biology major Marie Kim completed her studies at Swarthmore
College in three years. As an intern,
she did prostate cancer research at
Toronto-Sunnybrook Regional Cancer
Center, leading to her co-authoring a
manuscript.
Alan Marcus is a Phi Beta Kappa
graduate of Rutgers, The State
University of New Jersey. As an
undergraduate, he used the flatworm
C. elegans to do research on environmental health. He mentored children in the AIDS Club at Robert
Wood Johnson University Hospital.
Lauren Pallone graduated from
the University of Notre Dame, where
her research in cellular biology
focused on cystic fibrosis. She was a
pastoral care intern at Jersey Shore
Medical Center and also cared for a
seven-year-old child with autism.
Shanon Peter’s undergraduate
work at Harvard included meiosis
research. After graduating cum laude
in 2005, he participated in the
Harvard Initiative for Global Health,
STEVE HOCKSTEIN
HIGHLights
Dean’s Scholars
Above: Carol A. Terregino, MD ’86, associate
professor of medicine and associate dean
for admissions, and Peter S. Amenta, MD, PhD,
interim dean (center), congratulate
the Dean’s Scholars (left to right):
Shanon Peter, Marie Kim, Julianne Pupa,
Michael DiGiacomo, Lauren Pallone,
Alan Marcus, and Emily Porch.
The Class of 2010
T
he UMDNJ-Robert
Wood Johnson
Medical School Class
■
■
including what he described as an
“amazing” few weeks in Guatemala
volunteering at a health clinic.
of 2010 is the largest ever —
Emily Porch graduated from Yale
University with Distinction in Biology
and conducted research at both Yale
and Mt. Sinai Medical Center. She
also was principal flutist in both the
Yale Symphony Orchestra and Yale’s
Berkeley College Symphony
Orchestra.
tions, which was 13 percent
A James Monroe Research Scholar
from the College of William and
Mary, Julianne Pupa doublemajored in chemistry and biology.
With the Woods Hole Oceanographic
Institute, Julianne explored the ocean
floor at 3,000 meters. She also participated in a mission trip to Trinidad.
156 members strong. It was
selected from 3,170 applica-
higher than last year’s applicant pool, according to Carol
A. Terregino, MD ’86, associate
professor of medicine and
associate dean for admissions.
Dr. Terregino reports that
women constitute a majority
of this highly diverse class.
The students’ MCAT scores
broke previous RWJMS
records, and their average
undergraduate GPA was the
highest ever for an incoming
class.
Class of 2010 Pioneers New Two-Year Course
O
ver the summer, the Class of
2010 was launched into PatientCentered Medicine (PCM), a new
two-year course. The incoming students
completed their first assignment, immersing
themselves in recommended reading or
film-watching. In addition, they wrote and
posted the first round of required journal
entries.
They began Orientation well prepared to
develop the skills and mind-set that are the
focus of PCM. “The new course helps
advance our goal of training culturally
competent physicians,” says Carol A.
Terregino, MD ’86, associate professor of
medicine and associate dean for admissions.
“From the start, they will learn to work
collaboratively with their patients and will be
prepared to do so throughout the life cycle.”
Dr. Terregino serves as course co-director
White Coat Ceremony Welcomes Students
into Medical Community
STEVE HOCKSTEIN
D
uring the White Coat Ceremony,
students are transformed into a
unified, white-coated cadre of
future physicians. The ceremony marks the
end of Orientation and is the first RWJMS
event celebrated by incoming classes.
This year, Peter S. Amenta, MD, PhD, interim dean, introduced special guests and welcomed students, their families, and friends.
He underscored the sanctity of the social
contract between doctor and patient and
emphasized the medical school’s focus on
humanism.
The keynote speaker was Jeffrey P. Levine,
Peter S. Amenta, MD, PhD, interim dean,
leads the Class of 2010 in the Hippocratic Oath.
MD, MPH, associate professor of family
medicine and associate professor of obstetrics, gynecology, and reproductive sciences.
The White Coat Ceremony, an initiative of
The Arnold P. Gold Foundation for Humanism in Medicine, was initiated at RWJMS in
1994. It has succeeded and evolved under
the leadership of Susan Rosenthal, MMS
’75, MD, clinical associate professor of pediatrics and assistant dean for student affairs.
Erin Edwards ’09 was student coordinator
for the event.
“The new course helps advance
our goal of training
culturally competent physicians,”
says Carol A. Terregino,
MD ’86, associate professor
of medicine and associate dean
for admissions.
with Norma B. Saks, EdD, associate professor of psychiatry and assistant dean for
educational programs.
Designed by an interdisciplinary faculty
committee, the course incorporates a wide
range of issues related to patient-centered
care. In addition to covering the material
previously taught in physical diagnosis, the
new course addresses humanistic, legal, and
ethical concerns. “We will use multiple
modalities and scenarios,” says Dr. Terregino,
explaining that the course will meet in a
large-group conferences and in Objective
Structured Clinical Exercises (OSCEs) with
standardized patients. The class also will
meet in small groups that will be longitudinally monitored and evaluated by the same
physician faculty member. Students will
regularly don their white coats and observe
the physician-patient relationship in clinical
and private-practice settings.
To build a foundation of cultural and
professional competency, students will be
assigned to community sites and will work
with end-of-life treatment settings and
people with disabilities. They will learn how
patients access social services, and all
students will have a service learning activity.
“We hope not only to train a more
competent group of MDs,” says Dr.
Terregino. “We expect also to better prepare
our medical students for their third and
fourth years, where they will bring more to
the team of residents and fellows in clinical
rotations.”
Appointments
NEW
KATE
O’NEILL
S
tephen F. Lowry, MD,
professor and chair,
Department of Surgery,
has been appointed senior
associate dean for education.
Dr. Lowry, who will continue
to chair the Department of
Surgery, says he looks forward
to working with his colleagues
on the senior management
team: “Each of us has passion,
not just for our specific area,
but for the medical school’s
goals in undergraduate,
graduate, and continuing
education.”
Preparation for reaccreditation is an immediate goal, says
Dr. Lowry. “During the coming year, we will analyze all
aspects of our teaching mission in an effort to optimize
Dr. Izaguirre Appointed
Director of Information
Technology
I
new IT services designed to
meet the needs of RWJMS.
Dr. Izaguirre earned his
PhD in viral immunology at
the UMDNJ-Graduate School
of Biomedical Sciences. As a
graduate student, he cofounded a computer consultant
firm supporting
the biomedical
community, with
clients including
the Department of
Microbiology and
Pathology at
UMDNJ-New Jersey Medical
School (NJMS).
Prior to joining the RWJMS
staff, he worked with the senior associate dean for research
at NJMS and with the director of the NJMS-University
Hospital Cancer Center,
where he developed the first
storage solution built exclusively for research.
STEVE HOCKSTEIN
n a newly created RWJMS
position as director of
information technology,
Alexander Izaguirre, PhD, is
working to improve and
enhance information systems
throughout the medical
school. By consulting with the four
senior associate
deans — in education, research,
community health,
and clinical affairs
— he is advancing
the medical school
in each mission area.
Dr. Izaguirre initially
focused on information technology needs at the Child
Health Institute of New
Jersey and helped develop
demonstrations of patientcentered treatment at the
Clinical Skills Center. He
looks forward to acquiring,
developing, and deploying
JOHN EMERSON
BY
Dr. Stephen Lowry Appointed
Senior Associate Dean for Education
our educational effectiveness
and competitiveness.
“To ensure academic
excellence and professional
competence, we must
become a true electronic
community,” he adds.
“Preparing our trainees to
become lifelong learners by
accessing and integrating
information has become a
very high priority.”
Dr. Lowry joined the
RWJMS faculty in 1997.
One of his most significant
achievements as chair has
been the creation and development of the division of
surgical sciences. Dr. Lowry’s
research team, funded by the
National Institutes of Health
(NIH), has focused on gaining molecular-level understanding of inflammation
and surgical infection.
His pioneering work was
rewarded in 2003, when he
received the Flance-Karl
Award from the American
Surgical Association in recognition of his research contributions to the field of surgery. In 2005, he was elected
an Honorary Fellow of the
Royal College of Surgeons of
Edinburgh.
PETER
S. AMENTA,
M D, P HD ,
I N T E R I M
D E A N :
a
JOHN EMERSON
Rx for
Excellence
A BLACK-AND-WHITE PHOTOGRAPH OF A FAMILY PHARMACY
in Cromwell, Connecticut, hangs directly above the computer
in the dean’s office at UMDNJ-Robert Wood Johnson Medical
School. “Growing up working in my father’s pharmacy was a
major influence on my career development,” says Peter S.
B Y
K A T E
O ’ N E I L L
Amenta, MD, PhD, interim dean, referring to a career that has
combined a love of medicine and basic research with a respect
for sound business principles and practices.
d
DR. AMENTA GRADUATED FROM TRINITY
College in Hartford, Connecticut, and earned both
a medical degree and a PhD in anatomy from
Hahnemann University in Philadelphia. “I feel very
fortunate to have had the opportunity to attend
both medical and graduate school, chair a department, become the chief of staff and quality officer
of a major medical center, and serve as a dean of a
medical school,” he says. “I truly enjoyed all of
these positions and am happy and honored to continue to serve our academic medical center.”
Named interim dean in April 2006, Dr. Amenta
brings considerable experience and enthusiasm to
his new job. In 1989, he joined the faculty of the
RWJMS Department of Pathology and Laboratory Medicine, which was then chaired by Robert
L. Trelstad, MD. Dr. Amenta was attracted by the
prospect of joining a pathology department known
for its interest in extracellular matrix and cell biology. “At the time, I was being recruited to other
institutions. However, I would have been isolated,
with my research interests,” he says. “Anyone
would much rather work with other similarminded investigators.”
Five years later, Dr. Amenta was offered the
position of chief of the clinical service at Robert
Wood Johnson University Hospital (RWJUH).
He accepted the challenge with optimism and within
three years was named chair of the Department of
Pathology and Laboratory Medicine at RWJMS.
A Model for Growth
DR. AMENTA BELIEVES THAT THE DEPARTMENT’S
subsequent steady growth may provide a blueprint for
expansion of the entire medical school. “It did take the
department several years to see substantial, measurable
progress,” he says, “and it came about because we
developed a brisk clinical enterprise, while growing our
research and academic programs.
“We doubled the number of faculty, doubled our NIH
[National Institutes of Health] dollars, and quadrupled
our total grant funding. Today, our educational, residency, and graduate programs are as strong as ever and
are continually improving.” Dr. Amenta emphasizes his
immense appreciation for the efforts of the faculty, staff,
residents, and graduate students who believed in the
pathology program, as well as for the confidence and
support of Harold L. Paz, MD, then dean.
“The faculty deserves tremendous credit for the
department’s growth,” says Dr. Amenta. “This is especially true for those who were present early on. They
Peter S. Amenta, MD, PhD, interim dean, enjoys talking to
members of the Class of 2010 at the White Coat Ceremony.
have a great business sense, and they think outside of the
box.” The department began expanding its revenue
stream by developing departmental services at other hospitals’ laboratories, overseeing specimen processing and
diagnosis. These outside sites include RWJUH at
Hamilton, Bayshore Community Hospital, and Southern
Ocean County Hospital, where the RWJMS Department
of Anesthesiology will soon provide services as well.
“I believe this plan has worked well in our department,”
says Dr. Amenta. “Nonetheless, there is always an opportunity for improvement. We are currently attempting to
add additional hospitals and further extend the enterprise.”
Administration:
The Fourth Leg of the
Academic Stool
DR. AMENTA NOTES THAT, TYPICALLY, PEOPLE
refer to the “academic three-legged stool” of education,
research, and clinical service — which, at RWJMS, also
involves community health. “Many people think it’s
unseemly to talk about administration in an academic
context, but I consider it the fourth and stabilizing leg,”
STEVE HOCKSTEIN
he says. “Success at the administrative level will allow
the school to retain and recruit the best faculty, staff,
and students, to build programs, and to purchase stateof-the-art equipment.
“Ultimately,” he adds, “we are evaluated on making the
right decisions, making the right business move, doing the
right experiment, making the right interpretation of a clinical situation, and recruiting the right faculty.”
Dr. Amenta will rely heavily on his strong, six-member
senior executive team in the decision-making process. He sees
the team members’ support as critical to building excellence in
each of the medical school’s four mission areas: education,
research, clinical care, and community health. “I look to
them to guide those missions, to support our efforts to
build strategic plans, and to work with the chairs and institute
directors to develop their programs and departments.”
Thinking Like a Pathologist
DR. AMENTA HAS ALWAYS APPRECIATED HOW
pathologists approach diagnostic issues, having the
unique capacity to review macroscopic, microscopic,
ultra-microscopic, and molecular data in a clinical situation and provide the definitive answer to a diagnostic
dilemma. “This approach of drilling down to the solu-
tion is also useful in experimental work and even
in business decisions. It has been very helpful in
addressing a variety of issues,” he says.
“My greatest frustration is coping with my
impatience to complete projects quickly. Some
issues you can take care of quickly,” he said, noting that he had a short checklist of items that he
would try to complete promptly. “But some problems are long-term. The pathology department
developments did not occur in one month, four
months, or one year. It took two or three years to
see substantial change, and we needed a lot of
hard work by a lot of good people to get us there.
“I can see this same growth school-wide and hope
that the entire faculty appreciates their crucial contribution to the development of this academic medical center. Not many years ago, the footprint and
programs here resembled those of a community hospital and a fledgling medical school. We should all
be very proud of the developments that have
occurred since then. We owe a great debt not only to
the faculty but to Dean Paz; to our partner, Robert
Wood Johnson University Hospital; and to Harvey
Holzberg, the hospital’s former CEO. I look forward to working with the hospital’s new leadership.
Vision and Strategy
WHEN DR. AMENTA FIRST TOOK OVER THE
Department of Pathology and Laboratory Medicine, someone asked him to describe his vision for
the department. “I responded by saying I was trying to put together enough money to afford one,” he
says. “In summary, it is no secret that a major component of success is a strong financial margin. We are
working very hard to develop a strong financial foundation. Strategic plans are not of much value unless you
can actually implement them, and that requires adequate funding.”
A key component to the success of the majority of
leading academic medical centers is philanthropic support, he says, noting that he is working closely with the
Foundation of UMDNJ to set priorities and implement
programs to raise funds for the school.
How long does Dr. Amenta expect to serve as dean?
Characteristically, he wants to take the job step-by-step:
“I prefer considering myself the current dean. I don’t
want any excuse to inhibit our progress.” So, with no
finale in sight, Dr. Amenta dives into his new job, as he
did in the Department of Pathology and Laboratory
Medicine, with an ambitious plan and huge enjoyment
of the task at hand. M
New
Frontiers
Surgery
in
B
When it comes to
heart replacement
y
◆
cardiac
historical
measurements,
t h i rt y - e i g h t y e a r s i s n ’ t v e r y
procedures, as well as
innovative approaches
to the treatment of
long.
However,
in
the
annals
of
medicine, it might well be recorded
common cardiac defects,
Peter M. Scholz, MD,
James W. Mackenzie
Professor of Surgery
a s a l i f e t i m e . i t wa s i n 1 9 6 8 t h at f a m e d
surgeon Denton Cooley, MD, first transplanted a human heart into
a patient who then lived 204 days. Today, more than 3,000 heart
and chief, division of
transplants are done annually on people who have lived as long as
cardiothoracic surgery,
20 years afterward. Now, through a technology that the U.S. Food
and his team, Sherry
and Drug Administration (FDA) approved in September 2006, a
Smith (left) surgical
selective number of those who need heart transplantation, but are
technician, and Mary
not eligible for the surgery, are being offered an alternative: an arti-
O’Brien, CRNFA,
ficial heart available at Robert Wood Johnson University Hospital
employ only the newest
(RWJUH) / UMDNJ-Robert Wood Johnson Medical School.
JOHN EMERSON
and best technology
to save lives.
B
Y
R
I
T A
M.
R
O
O
N
E
Y
T
The AbioCor heart
operates by moving
blood through
the lungs and to the
rest of the body,
while it simulates
the rhythm of a
heartbeat. It
consists of an internal thoracic unit
that weighs about
two pounds and
has two artificial
ventricles with
corresponding
valves and a motordriven hydraulic
pumping system.
COURTESY OF AbioCor
he new “heart” is the result of more than 25 years
of research and may well be the most complex
medical device ever designed. The AbioCor heart is
the first self-contained and fully implantable artificial replacement heart developed with the support
of the National Heart, Lung and Blood Institute. It
is designed to sustain the body’s circulatory system
and extend the lives of patients who otherwise
would die of heart failure. Unlike artificial hearts
of the past, it is totally implanted within the body;
patients are not connected to an air-pumping console and do not have wires or tubes piercing their
skin.
Mark Anderson, MD, associate professor of surgery, chief of cardiac surgery, and director of cardiopulmonary transplantation at RWJUH, reports
that the artificial heart replacement is not an
option for most heart failure patients.
“Heart transplantation remains the gold standard,” Dr. Anderson says. “The AbioCor heart is
intended for patients with severely damaged hearts
who, because of age or medical circumstances,
are not candidates for a transplant, and have
no other treatment alternative. It’s a lifesaving
procedure that gives end-stage patients mobility to
enjoy a satisfactory lifestyle.”
The FDA granted approval of the AbioCor heart
under a Humanitarian Device Exemption (HDE),
which allows Abiomed, Inc., a Massachusetts-based
company, to sell up to 4,000 in the United States
annually. However, the company plans to have a
controlled roll-out of this sophisticated technology at
five to ten centers, including: RWJUH, The Johns
Hopkins Hospital, Baltimore,
and the Jewish Hospital/
University of Louisville,
K e n t u c k y. D r.
Anderson says
other sites may be
added, but RWJUH
will remain the only
center in the Northeast.
The AbioCor heart operates by moving blood
through the lungs and to the rest of the body, while
it simulates the rhythm of a heartbeat. It consists of
an internal thoracic unit that weighs about two
pounds and has two artificial ventricles with corresponding valves and a motor-driven hydraulic
pumping system. An internal battery continually
recharges from an external console carried by the
patient, and an implantable electronics package
monitors and controls the pumping speed of the
heart based on the patient’s needs.
Heart
Transpl antation
Survival
A
Improves
s exciting as the availability of the artificial heart is to cardiac surgeons and
patients alike, it doesn’t stand alone in the arsenal of advances available to RWJMS patients. As
the result of national donor shortages, there are
probably 10,000 patients on a national waiting
list for transplantation. Wait-listed patients in
New Jersey fare better than the average, though,
since the state has its own organ donor procurement organization, and they do not compete with
those in other states. As survival rates for transplanted patients have improved dramatically in
recent years, this is clearly good news for New
Jersey.
“The transplantation technique itself has had
only minor modifications,” Dr. Anderson reports.
“However, real progress has been made with
immuno-suppression drugs used to prevent rejection following surgery. Drugs are much better than
they were a few years ago, with far fewer side
effects. Rejection is uncommon today, and that
translates to improved outcomes.”
He adds that ten-year survival after transplantation is in the 60 to 70 percent range, and that 20year survival is becoming more common. Except
for the continuing need to take anti-suppression
drugs, the lifestyle of post-surgical transplant
patients is quite good. Many return to work, and
some even begin families.
Dr. Anderson says that at RWJMS, cardiologists
and cardiac surgeons become interactive partners
Mark Anderson,
MD, associate
professor of
surgery, chief
of cardiac surgery,
and director of
cardiopulmonary
transplantation
at Robert Wood
Johnson University
Hospital, says
that implantation
of an artificial
replacement heart
is “a lifesaving
procedure that
gives end-stage
patients mobility
COURTESY OF RWJUH
to enjoy a
satisfactory
lifestyle.”
in the evaluation and medical/surgical treatment of
patients.
“In addition to conventional techniques for
bypass and valvular surgery, and the more extraordinary transplantation and artificial heart procedures, we have implantable ventricular assist
devices that serve as circulatory support for
patients who need immediate assistance, possibly
while waiting for a transplanted heart,” he says.
Finding A
A
Better Way
nother instance of surgical leadership
is a procedure to treat atrial fibrillation, modified by Peter M. Scholz, MD,
James W. Mackenzie Professor of Surgery and
chief, division of cardiothoracic surgery.
Dr. Scholz reports that of the two to three million
Americans with atrial fibrillation, approximately
400,000 are candidates for mechanical or surgical
correction of the condition. The primary complication of atrial fibrillation is stroke, and many
patients take drugs to prevent this. Other treatment
options exist, including a major procedure during
which the surgeon creates an electrical corridor for
the electricity to be controlled and prevented from
setting up re-entry circuits that perpetuate the fibrillation. The operation is highly successful but
incurs a risk of bleeding and other complications.
For many years, medicine has sought a modification that would be equally effective but without
risk. That is exactly what Dr. Scholz succeeded in
doing by performing a corrective procedure that
was the first of its kind in New Jersey.
JOHN EMERSON
Peter M. Scholz,
MD, James W.
Mackenzie Professor
of Surgery and
chief, division of
cardiothoracic
surgery, performs
a corrective
procedure — the
first of its kind
in New Jersey —
to treat atrial
fibrillation.
“The procedure involves three small incisions on the right side of the chest,” he says.
“A video camera is inserted through one incision. We open the sac around the heart and
insert an antenna around the back of the heart
to form an electrical isolation line that isolates
the pulmonary veins from the rest of the left
atrium.”
He says that’s done by opening the heart sac
without a major incision and putting two
catheters behind the heart, then making a hole
on the left side to connect the two guiding
catheters. That creates a loop around the
heart.
“The antenna is tied to this loop, and the
new antenna is snaked around the heart,” he
adds. “The antenna uses microwave energy to
create scar tissue that forms to prevent the
abnormal electrical impulses from affecting
the rest of the heart.”
Dr. Scholz says anyone who has atrial fibrillation without structural heart disease for
more than six months is a candidate for this
minimally invasive procedure.
“The reason it is so important to correct
atrial fibrillation is that it can lead to changes
in the heart muscle, and that leads to more
persistent fibrillation, which can lead to
stroke,” he says.
When it comes to heart replacement procedures, as well as innovative approaches to the
treatment of common cardiac defects, the bottom line at RWJMS is a cutting-edge mind-set
in which leading clinicians in an academic medical environment are willing to employ only the
newest and best technology to save lives. M
Surgery
for
special people
Y
JOHN EMERSON
oungsters requiring complex cardiac surgery
now have the skills of a world-class
pediatric cardiac team in their corner, thanks to the Children’s Heart
Program of New Jersey, an initiative
that pairs RWJMS and the BristolMyers Squibb Children’s Hospital at
Robert Wood Johnson University
Hospital (RWJUH) with the Morgan
Stanley Children’s Hospital of New
York–Presbyterian Columbia University Medical Center.
The program on the New Brunswick campus, which is the first in
central New Jersey and the third in
the state, is headed by a dedicated
surgery faculty with extensive experience in all types of congenital and
acquired cardiac defects.
One patient, a 13-month-old baby
boy, underwent surgery a year ago
for an abnormal connection between
the main artery from the heart and
the main artery to the lungs. The
defect was corrected, and the child is
developing normally.
Ralph S. Mosca, MD, clinical associate professor of pediatrics and
director of the pediatric cardiac surgery program at RWJUH, who performed the procedure with Jonathan
Chen, MD, clinical assistant professor of pediatrics, reports, “When
this congenital abnormality occurs,
blood circulates between the lungs
and the heart, forcing the heart to
overwork and leading to congestive
heart failure.”
A state-of-the-art pediatric catheterization laboratory is another
previously unavailable advance at
RW J M S / RW J U H . W i l l i a m E .
Hellenbrand, MD, clinical professor of pediatrics and director of the
pediatric cath lab at RWJUH, is an
internationally regarded interventional pediatric cardiologist responsible for the design of such labs
worldwide.
“The lab is a cutting-edge center
featuring the newest technology, two
dedicated anesthesiologists, and an
impeccably trained support team
that combines to provide New Jersey
families with services they once had
to leave the state to receive,” he says.
Joseph W. Gaffney, MD, associate professor of pediatrics, chief,
division of pediatric cardiology, and
Joseph W. Gaffney, MD,
associate professor of pediatrics,
chief, division of pediatric
cardiology, and director of
pediatric cardiology at RWJUH
director of pediatric cardiology at
RWJUH, adds, “Catheterization for
young children is a high-level procedure often requiring general anesthesia and close monitoring. At
RWJMS, we employ a coordinated
team approach with intensive care
from sedation and pain management
to post-procedure intensive care,
provided by skilled specialists trained
in the cardiac management and care
of infants and children.” M
Benjamin F. Crabtree, PhD:
Social Science
Evolves into
Practice
Jazz
L
B Y
K A T E
O ’ N E I L L
Hours of brainstorming have produced fresh ideas,
reflected in notes that slant between the columns of
information, while the unmistakable scent of permanent
markers lingers in the air.
A trained anthropologist, Dr. Crabtree initially
planned for a career in public health. He worked on
eradicating smallpox in Ethiopia and controlling tuberculosis in South Korea. During a break to teach English
in Japan, he met his future wife. Dr. Crabtree completed
his doctorate in medical anthropology at the University
of Connecticut, where a research position in the
Department of Family Medicine first “got him hooked,”
he says, on studying and improving health care delivery
in primary care settings, where Americans receive many
of their clinical services.
Building the Division
I
n 1999, David E. Swee, MD, professor and thenchair, Department of Family Medicine, recruited Dr.
Crabtree from the University of Nebraska to establish, develop, and coordinate a family medicine research
division at UMDNJ-Robert Wood Johnson Medical
School. In six years, Dr. Crabtree has built a 30-person
division that is now engaged in 12 research projects.
Among 120 academic family medicine departments
nationwide, the RWJMS division of research is ranked
NAT CLYMER
ike an anthropologist studying a subculture, Benjamin F. Crabtree, PhD, professor
of family medicine and director, division of
research, studies primary care practices
and patient care delivery. Working in a
variety of settings — large and small practices, rural and urban groups, and independent and
health-system affiliates — Dr. Crabtree and his colleagues gather comprehensive data and observe the
dynamics that influence practice operations. His
researchers use this information to form improvement
teams, where ideas are shared among practice members
in the hope of helping the practice evolve and improve
its delivery of patient care.
Dr. Crabtree’s office is filled with clues to his energetic, team-based style of leadership. Here, he regularly
gathers project leaders to update their colleagues,
employing the same interactive Reflective Adaptive
Process (RAP) that they use to elicit ideas in their studies. Adorning the walls are poster-sized sheets of paper,
covered with bright, handwritten columns listing investigators’ names, deadlines, and funding sources. Project
names such as ULTRA, SCOPE, and STEP-UP stand
out, hinting at the group’s informality and creativity.
11th in grants from the National Institutes of Health (NIH)
for family medicine research. In 2005, the National Cancer
Institute (NCI) approved the division’s newest R01 (investigator initiated) proposal, Dr. Crabtree’s third straight R01
to receive funding on first submission. The award brought
his current NIH support to $6 million. In addition, the
Centers for Disease Control and the Robert Wood Johnson
Foundation have awarded major grants to the division.
“Dr. Crabtree’s approach has
been emulated by many
up-and-coming departments. It is
fair to say that our department
has achieved national eminence in
large part due to the fantastic
team he has built.”
– Alfred F. Tallia, MD ’78, MPH
Dr. Crabtree, whose extensive publications set the bar
high, reports that “the division has come of age.” At the Fall
2005 annual conference of the North American Primary
Care Research Group, 14 members made podium or poster
presentations. “What was especially impressive was the
diversity and scope of the research presented, from sophisticated biostatistical methods to complex theoretical perspectives,” he says.
“Ben’s idea of building diverse research teams was operational long before it was in the literature,” says Alfred F.
Tallia, MD ’78, MPH, associate professor and acting chair,
Department of Family Medicine. Dr. Tallia, who helped
recruit Dr. Crabtree, has become not only a colleague, but
also a friend. He says of Dr. Crabtree, “His approach has
been emulated by many up-and-coming departments. It is
fair to say that our department has achieved national eminence in large part due to the fantastic team he has built.”
Practice Jazz and MAP/RAP
I
n 2001, Dr. Crabtree and several colleagues coauthored “Practice Jazz: Understanding Variation in
Family Practices Using Complexity Science,” published
in the Journal of Family Practice. In the article, the authors
equate integrated performance in a medical practice to
listen-and-respond communication among jazz musicians.
When practice members do not all communicate effectively,
solve problems, and collaborate to optimize each patient
visit, clinical care suffers. In addition, a practice may be
overwhelmed by the tasks of communicating with commu-
nity and government organizations, pharmacies, and insurance companies.
Intentionally or not, clinicians and patients have issues that
impede the delivery of good health care. “Within the time limits
of patient visits, clinicians want to address their own priorities,
such as smoking, obesity, and depression,” says Dr. Crabtree.
The broad focus and competing demands of primary care can
also restrict clinicians’ ability to translate evidence-based strategies such as cancer screenings into routine preventive services.
Normal human resistance to change creates challenges for
practices trying to evolve, says Dr. Crabtree. One case study
discusses a practice that introduced electronic medical
records (EMR). Problems with planning, communication,
and decision making inhibited the applications of the EMR,
leaving the practice no better equipped to deliver excellent
patient care than when it used paper records.
Complexity science is a novel approach for understanding
complex adaptive systems. It provides the research division
with an ideal theoretical framework for organizing and
interpreting its observations and, ultimately, for harnessing
improvements in a medical practice. Starting with the multimethod assessment process (MAP), research teams gain initial insights into the unique structure and function of family practices from a variety of sources, including medical
charts and interviews with employees and patients.
Next, in 12 one-hour sessions, RAP teams meet, eliciting
the ideas of a physician, office manager, nurse, receptionist,
and, if possible, a patient. A member of the research division
serves as RAP facilitator, drawing out each participant’s perspective, helping develop conflict resolution techniques, and
establishing a process by which practice members can plan
their organization’s evolution.
Growing Collaborations
and Grant Support
C
ollaborations link the division to family medicine
departments at the state and national levels, while
international ties further broaden the scope of its
work. The division is a member of the National Center for
Research in Family Medicine and Primary Care, headquartered at Case Western Reserve University. It serves as the
qualitative center of this five-department research collaboration, which is supported by a research enhancement initiative of the American Academy of Family Physicians.
Each of the division’s projects focuses on improving particular areas of care. Its first study, funded by the National
Heart, Lung, and Blood Institute, targeted diabetes, cholesterol, cardiopulmonary health, and disease prevention. With
partial funding from The Cancer Institute of New Jersey at
RWJMS, the division established the New Jersey Family
— Continued on Page 50
Rapid
HIV/AIDS
Testing Initiative
Hailed as a
Model
Program
By Patricia M. Hansen
W
When the State of New Jersey
STEVE HOCKSTEIN
calls and asks for help, who can say
no? Not the Department of
Pathology and Laboratory Medicine, and certainly not Professor
Evan M. Cadoff, MD, or Associate
Professor Eugene G. Martin, PhD.
Dr. Cadoff and Dr. Martin oversee
the Rapid HIV/AIDS Testing Program that recently won a prestigious ASTHO (Association of State
and Territorial Health Officials)
Vision Award for the New Jersey
Department of Health and Senior
Services, Division of HIV/AIDS
Services.
Along with Sindy Paul, MD,
medical director of the Division of
HIV/AIDS Services, Dr. Cadoff and
Dr. Martin have taken a fledgling
program statewide. Perhaps even
more importantly, due to this
award, the program may become a
model for other states to duplicate,
helping to save countless numbers
of lives.
The citation for the ASTHO
award, which was presented at the
annual meeting of state and territo-
rial health officials, reads in part,
“This innovative program will
serve as an outstanding example to
the public health community and
will encourage replication of such
initiatives in other states.”
It was only three years ago, in
November 2003, when rapid
HIV/AIDS testing became available
in New Jersey. The advantages of
rapid testing are obvious: instead of
waiting a week or more for test
results, patients could have results
in as little as 20 minutes. “The new
test was dramatically better. We
saw a 25 percent increase in testing
during the very first year,” says Dr.
Cadoff.
Because of state regulations designed to protect New Jersey’s citizens from quality problems at clinical laboratories, state officials
needed help with the oversight and
implementation of the proposed
program. “That is when the state
asked for help. They needed a
Eugene G. Martin, PhD, associate professor of
pathology and laboratory medicine (left), and Evan M.
Cadoff, MD, professor of pathology and laboratory
medicine, oversee the Rapid HIV/AIDS Testing Program
that recently won a prestigious ASTHO (Association of
State and Territorial Health Officials) Vision Award for
the New Jersey Department of Health and Senior
Services, Division of HIV/AIDS Services.
STEVE HOCKSTEIN
licensed site, and we already had one
in place at Robert Wood Johnson
Medical School,” Dr. Cadoff adds.
That site became one of six in the
state, funded by grants, to offer confidential, free rapid HIV/AIDS testing. The success of this program
prompted state officials to approach
the doctors again, this time for help
in expanding the program statewide.
“Today every county in New Jersey
is covered,” explains Dr. Martin.
“There are now 106 sites licensed by
the New Jersey Department of Health
and Senior Services that provide this
test.”
The Proof Is
in the Numbers
he return rate for patients undergoing traditional HIV/AIDS testing at counseling and testing facilities
has always been problematic. According to Dr. Cadoff, “Approximately
35 percent of the patients never came
back for their results. Now the results
are immediate.”
The numbers for this highly successful rapid-testing model program
are staggering: more than 50,000
tests are expected to be performed
this year throughout New Jersey.
With 88 locations, 18 licensed mobile
facilities, and over 70 trained counselors, this is the largest centralized
T
HIV/AIDS testing program in the
United States.
The laboratorians retain records of
every test and monitor each aspect of
the testing to ensure accuracy and
credibility. The established protocols
allow for benchmarking studies that
can provide data for laboratories
worldwide.
The Test
IV/AIDS testing began as a blood
test that required a trained phlebotomist to collect the specimen and
a trained laboratory technologist to
perform the test. Rapid HIV/AIDS
testing allows a single drop of blood
to be used for testing, leading to the
use of finger-stick samples. Today,
even an oral version of the test is
available. Trained counselors administer the test by swabbing between the
patient’s upper and lower gums and
cheek. The sample collected on the
testing device (referred to as an oral
mucosal transudate) is placed into a
solution. The solution passes up
through the device, revealing the
result; the answer becomes perfectly
clear in much the same way that a
pregnancy test can be read.
If this test is positive, more testing
follows. Today, confirmation of a
positive screening result requires an
additional complex, labor-intensive
H
procedure. Most commonly, laboratories perform a Western blot before
reporting a confirmed positive result
to a patient. This improves the reliability of the screening procedure and
reduces the possibility that the result
is a false positive.
Because approximately one to two
tests per 1,000 result in a false positive, any discordant results — a difference between the screening test
and the confirmatory test — are
cause for review by one of the
pathologists. Because these events are
rare, the experience gained by the
whole program is available each and
every time it happens, assuring the
best possible outcome and the rapid
resolution of any ambiguity.
“We want anyone who receives a
positive result to speak with a physician
and begin treatment immediately,”
explains Dr. Cadoff. “Statistics show
that once individuals receive their diagnosis, they take extra precautions with
their own health and the health of others by reducing risky behavior.” The
Centers for Disease Control (CDC)
concur with this approach and have
undertaken a major initiative to help
make individuals more aware of their
HIV status as early as possible.
Looking Ahead
hat’s in the future? Manufacturers are beginning to explore
the feasibility of making over-thecounter rapid HIV tests available, but
the likelihood is that for the time
being, testing will continue to be provided at locations where trained
counselors are available whenever a
result positive for HIV is discovered.
W
name was
Nundemesa, and she
was about nine years old,
with chronic lung disease
and all the symptoms of HIV
infection. She stood out
among others in the South
African hospital ward
because she looked much too
comfortable there.
portraits by john emerson
Scurrying about, like a little mother’s helper, she took younger children by the hand, and was seen
feeding an infant. This place, where
HIV-infected youngsters were cared
for, was home to her. Her mother
lay in a nearby bed, in the final
stages of AIDS and tuberculosis.
By R i ta M . R o o n e y
Amisha Malhotra, MD, assistant
professor of pediatrics, division of
infectious diseases, one among many
UMDNJ-Robert Wood Johnson Medical
School physicians and allied health
professionals volunteering on
global medical missions to under developed countries.
COURTESY OF AMISHA MALHOTRA, MD
undemesa was overheard crying herself to sleep at night, but during the day,
she kept herself useful — one might even
think happy. Then the time came for hospital rounds. The children lined up to be seen by the
doctor, their mothers close by. Nundemesa was
alone, because her mother was too sick to join her
for the routine checkup. With bravado, the child
stood tall and waited. Big brown eyes darted left
and right, looking for a friendly face. The American
woman they told her was a doctor saw her and
smiled. Nundemesa managed a big, toothy grin in
response. It never took much to make her smile.
The friendly face belonged to Amisha Malhotra,
MD, assistant professor of pediatrics, division of
infectious diseases, one among many UMDNJRobert Wood Johnson Medical School physicians
and allied health professionals volunteering on
Amisha Malhotra, MD, assistant professor of pediatrics,
division of infectious diseases, volunteered at a clinic
in South Africa through a program sponsored by BristolMyers Squibb.
global medical missions to underdeveloped countries. Dr. Malhotra was in South Africa for three
weeks through a program sponsored by Bristol-
Myers Squibb. Her days were long and hard.
“Conditions at the hospital and in the clinics were
very bad,” Dr. Malhotra says. “There weren’t
enough doctors, nurses, or HIV counselors. Ancillary
services were lacking as well. We had to ship blood
by car, over rough terrain, to another city. A child’s
life often depended on that one vial that was at risk
of being mislabeled or improperly collected.”
Patricia N. Whitley-Williams, MD, professor of
pediatrics and chief, division of pediatric allergy,
immunology, and infectious diseases, spent almost
six weeks on the same Bristol-Myers Squibb tour
to South Africa.
“There was one hospital covering 15 clinics, none
of which were equipped to handle pediatric disease
of any kind,” Dr. Whitley-Williams says. “Clinics
linics were housed in mobile homes
with one waiting room. When it filled, people
had to wait outside in 90-degree heat,
followed by heavy downpours. Many were
very sick and had walked for miles,”
says Dr. Whitley-Williams.
were housed in mobile homes with one waiting
room. When it filled, people had to wait outside in
90-degree heat, followed by heavy downpours.
Many were very sick and had walked for miles.”
Prior to the program for the prevention of mother-
Patricia N. Whitley-Williams, MD,
professor of pediatrics and chief,
division of pediatric allergy,
immunology, and infectious diseases,
spent almost six weeks on the
Bristol-Myers Squibb tour
to South Africa.
Sunanda Gaur, MBBS, professor of pediatrics
and director of the RWJMS AIDS program,
has always had a global mind-set when it comes
to the treatment of infectious diseases.
n this program, one dose of an inexpensive
anti-HIV drug taken by a pregnant woman,
COURTESY OF SUNANDA GAUR, MBBS
and another dose given to her infant
at birth, was enough to reduce the probability
of transmission of HIV to the
child by 50 percent,” says Dr. Gaur.
to-child transmission of AIDS, conducted by volunteers such as Dr. Malhotra and Dr. Whitley-Williams,
three or four children died each week from AIDSrelated causes. Most were malnourished. Many had
respiratory illnesses. When the American doctors
weren’t treating children, they were training nursecounselors to recognize the first signs of HIV in
Sunanda Gaur, MBBS, professor of pediatrics and
director of the RWJMS AIDS program, counsels children
at a homeless shelter in India.
infants and administer Bactrim, a drug to prevent the
pneumonia that is the leading cause of mortality in
HIV-infected children during the first year of life.
Was it worth it to leave home and family, and
spend their vacations in an underdeveloped country
where a devastating illness claims the lives of so many
women and children? Both women say it was, and
that they are exploring the possibility of another tour.
“It was challenging, but I think we made a difference,” Dr. Whitley-Williams says. “That makes it
worthwhile.”
Sunanda Gaur, MBBS, professor of pediatrics and
director of the RWJMS AIDS program, has always
had a global mind-set when it comes to the treatment of infectious diseases. Dr. Gaur has worked
extensively with HIV-infected youngsters, so when
she had an opportunity to travel to South Africa,
through a program sponsored by the Columbia
University Mailman School of Public Health, she
eagerly packed her bags.
“The program was designed to train physicians
and nurses in South Africa in the use of antiretroviral-class medications to treat HIV infection,”
Dr. Gaur reports. Subsequently, she traveled to
southern India, where she worked in a program to
prevent mother-to-child transmission of the virus.
“In this program, one dose of an inexpensive antiHIV drug taken by a pregnant woman, and another
dose given to her infant at birth, was enough to
reduce the probability of transmission of HIV to the
child by 50 percent,” she says.
She adds the group was there to evaluate what the
local medical authorities were doing, and to help
them improve their methods. She reports being
impressed by what had already been accomplished
with minimal resources. Part of her work involved
testing and counseling patients, while educating
local clinic staff about the importance of counseling.
“There is such an enormous stigma attached to
AIDS in India,” she says. “The number of suicides
by people diagnosed with the disease is tragic. There
have been instances of entire families jumping into
the river and drowning to escape the shame.”
Asked about her motivation for such global
involvement, Dr. Gaur says simply, “It’s just one
way of giving back.”
A Sm all World
globalization of health has led to
a collaborative network among
the world’s nations, a sharing of
intellect and technology to cure diseases. In July,
leaders of a global Alzheimer’s study among 100
centers in 21 countries announced positive results
How Her Garden Grows
Margaret Kilibwa, PhD
W
hen she describes her work in the rural Kenyan clinic she founded, her enthusiasm is as contagious as
laughter. The animation in her eyes says what it’s
like — exhilarating — and the listener understands it must be all
that and more. Characteristically, she refers to the single entity
“clinic” as plural.
“We call them Tropical Clinics,” says Margaret Kilibwa, PhD,
clinical assistant professor of obstetrics, gynecology, and reproductive sciences, and clinical nutritionist at the Women’s Health
Institute. “There’s only one now, but there will be more soon.”
Never doubt it. Dr. Kilibwa radiates a resolve that impresses even
Bill Gates, whose foundation is donating vaccines so she can reach
a goal of immunizing 80 percent of area children within five years.
Dr. Kilibwa participated in a Johnson & Johnson program
several years ago in which individuals could apply for medical
supplies to send to underdeveloped countries. She personally
took the drugs to Nairobi, Kenya, and recalls that it was a fulfilling adventure — just not fulfilling enough.
“The medications were being disbursed all over the country,”
she says. “I decided I could do better, and provide more direct
help, from a central location.”
Not only did she do better, she has done a great deal more.
The clinic she directs opened in 2003 in the heavily populated
Janusz J. Godyn, MD, professor of pathology
and laboratory medicine and chair of the
pathology departments at Robert Wood
Johnson University Hospital at Hamilton,
Bayshore Community Hospital, and Southern
Ocean County Hospital, participated in a
collaborative exchange of information and
experience with Narutowicz City Specialty
Hospital in Kraków, Poland.
urs is a valuable collaboration, one
that is evenly balanced,” Dr. Godyn says.
“We have learned as much from medical
leaders in Poland as they have from us.”
from a transdermal patch used on 1,100 patients. In
August, international experts gathered in New Delhi
to explore the potential for e-health, ranging from
wireless solutions for telemedicine to mobile ehealth for developing nations. Such partnerships are
landmark programs with reciprocal benefits for all.
At RWJMS, Janusz J. Godyn, MD, professor of
pathology and laboratory medicine and chair of the
pathology departments at Robert Wood Johnson
University Hospital at Hamilton, Bayshore
Community Hospital, and Southern Ocean County
Hospital, participated in a collaborative exchange
of information and experience with Narutowicz
City Specialty Hospital in Kraków, Poland.
“Ours is a valuable collaboration, one that is
evenly balanced,” Dr. Godyn says. “We have
learned as much from medical leaders in Poland as
they have from us.”
He cites discussions on the issue of quality of
care, and reports that they focus primarily on
maintaining and improving the quality of medical
outcomes, and that certain patient comforts are
secondary items in their budgets.
“I think some of our shared experience may lead
to questions regarding the organization of our own
health care,” Dr. Godyn reports. “For instance, the
ratio of nurses to patients in Polish maternity units
is significantly lower than in U.S. hospitals.
Nevertheless, infant mortality per pregnancy is similar in both countries. Therefore, it seems that indicators other than hospital staffing may influence
results of medical outcomes.”
I n t e r n at i o n a l
Co n s ort i um
strong advocate for global medicine is Javier Escobar, MD, professor and chair, Department of Psychiatry. Dr.
Escobar recently took a year’s sabbatical to work as
senior adviser to the director of the National Institute
of Mental Health (NIMH), where he helped create
an office of global health and, as a result, was specifically involved in collaborative studies with foreign
countries. He participated in the development of an
international consortium in psychiatric epidemiology,
and has been a liaison between the NIMH and the
World Health Organization in Geneva.
“One project we developed was with the InterAmerican Drug Abuse Control Commission
(CICAD), an agency of the Organization of
American States (OAS), which has oversight for
drug control programs in all Latin American countries,” Dr. Escobar reports. “I talked to CICAD officials in Washington and showed them how RWJMS
could help them develop estimates of the cost of
drug use — on economy, health, disability, and
police services — in Latin American countries.”
He explains that the argument always had been
that these are drug-producing but not drug-using
countries. The study included Barbados, Chile,
Costa Rica, El Salvador, Mexico, and Uruguay, and
while statistics varied from one country to another,
they showed an overall increase in drug use for all.
The program brought people from Latin America to
New Brunswick to acquire expertise, resources, statistical reports, and methodologies, giving the medical school visibility in the OAS, a critically important group for the Americas.
Following his NIMH stint, Dr. Escobar coordinated a collaboration involving the Pan American
Another Perspective
A
s globalization makes health care more internationally interactive than ever before, an
awareness of cultural competency has grown.
Robert C. Like, MD, MS, professor of family medicine and director of the Center for Healthy Families
and Cultural Diversity, defines this as treating
patients with a respectful attitude toward people
from different cultures.
Regarded internationally as an expert on the treatment of diverse populations, Dr. Like is a consultant
to the European Union’s Migrant-Friendly Hospitals,
and he contributed to the nine-module physician
training course on cultural competency developed by
the U.S. Department of Health and Human Services’
Office of Minority Health.
“Whether they are treating patients in underdeveloped nations or their own offices, American physi-
Robert C. Like, MD, MS
cians need to practice in a culturally competent environment that recognizes differences in cultures that
go beyond language to history, customs, religious
beliefs, family relationships, and more,” he explains.
“Such awareness needs to be within a human relations and social justice framework designed to eliminate health care inequities around the world.” M
Javier Escobar, MD, professor and chair,
Department of Psychiatry, is another strong
advocate for global medicine.
hat does this mean to the concept of
global medicine?” Dr. Escobar asks.
“Here in New Brunswick, more than
40 percent of city dwellers are immigrants
from more than 11 Latin American countries.
. . . So what we learn from other countries can
be applied here.”
Health Organization, NIMH, and several U.S. universities. As a result, he received NIMH funding to
lead the Medically Unexplained Physical Symptoms
in Primary Care Research Center, located on the
RWJMS New Brunswick campus. This multi-disciplinary collaboration that includes international colleagues is researching the important problem of
patients with common mental disorders who present with physical symptoms, and how these patients
might be treated within a primary care environment.
“What does this mean to the concept of global
medicine?” Dr. Escobar asks. “Here in New
Brunswick, more than 40 percent of city dwellers
are immigrants from more than 11 Latin American
countries. A majority of these immigrants speak
only Spanish. So what we learn from other countries can be applied here.” That, he says, is the
essence of international health liaisons — the
blending of research and clinical knowledge across
borders to serve patients throughout the world.
Personal Mission
was to be the family vacation of a lifetime, the kind held precious in photos
and memory. In 2000, James Aikins, Jr., MD,
associate professor of obstetrics, gynecology, and
reproductive sciences, Camden campus, and his
wife, Charletta Ayers, MD, associate professor of
obstetrics, gynecology, and reproductive sciences
and chief, division of general obstetrics and gynecology, took their two children to Cape Coast,
Ghana, to meet his 100-year-old grandmother for
the first time.
Upon their arrival, there was a joyous welcoming from aunts, uncles, and cousins. They
joked about a cousin of Dr. Aikins who was
about to have her first child, laughing that the
two physicians had gotten there just in time.
The next day, however, there was little joy in the
family: the young woman had been rushed to
the local hospital, and she died giving birth, as
a result of a postpartum hemorrhage. The midwives in attendance couldn’t control the bleeding, and they couldn’t find a doctor.
“I had talked for years about doing something in Africa, but that day it was in my face,”
Dr. Aikins says.
The family returned to the United States, and
Dr. Aikins talked to his students and residents
about putting together a group of volunteers for a
two-week mission to rural Africa the following
year. Ricardo Caraballo, MD, assistant professor
of obstetrics, gynecology, and reproductive sciences and chief, division of female pelvic medicine
and reconstructive surgery, was on that first tour
and now serves as deputy medical director of the
volunteer organization. He says that out of respect
for Dr. Aikins, all the residents and students signed
on, enlisting an anesthesiologist and support staff.
“A year later, with a group from both the New
Brunswick and Camden campuses, we made our
first trip to Cape Coast,” Dr. Caraballo says. He
GLOBAL FOCUS IN THE
L A B O R AT O R Y
hlamydia is a bacterium that knows no geographic boundaries, and while it affects people worldwide, there is reason
to assume its impact is more devastating to women in
underdeveloped countries.
“The disease is transmitted sexually,” says Huizhou Fan, PhD,
assistant professor of physiology and biophysics. “Women infected
with chlamydia often have no symptoms, so they remain undiagnosed until the infection reaches a severe stage with irreversible
complications such as infertility.”
The most realistic preventive measure, according to Dr. Fan,
would be a topical medication, with no serious side effects, that can
be administered by women themselves. Solutions, however, can be
elusive in the laboratory.
Dr. Fan, who began his research as a PhD candidate, says the
pathogen for chlamydia is different from other bacteria in that it
grows only inside the cell of a higher organism. For that reason, he
decided to study how chlamydia interacts with human cells.
He found a family of compounds with strong anti-chlamydial
activity. Although the compounds were known to inhibit some cellular events, experimental
findings didn’t prove the
events had anything to do
with the prevention of
chlamydia. Ultimately, he
discovered that the compounds inhibited growth of
chlamydia by blocking a
chlamydial enzyme.
“This is exciting to us
because it appears that the
compounds can be modified to target only the
chlamydia, and not human
cells or good bacteria that
normally protect the reproductive tract,” Dr. Fan says.
His laboratory currently
is conducting animal studies, and so far the results
look promising. The next
Huizhou Fan, PhD
step is to determine whether some of the small molecules remain effective when put into a
topical medication.
The relevance to global health initiatives is significant in that
chlamydia causes ulcers in the reproductive tract, and that assists
the transmission of HIV, which causes AIDS — a worldwide health
crisis, which is most prevalent in Africa, but is gaining momentum
in Asia as well.
Dr. Fan appears to be a prime example of the reverse of the norm:
sometimes, laboratory solutions are not as elusive as they seem. M
C
James Aikins, Jr., MD, associate professor
of obstetrics, gynecology, and
reproductive sciences, Camden campus
COURTESY OF JAMES AIKINS, JR., MD
adds that they did so at their own expense —
although, since then, Dr. Aikins has founded
International Healthcare Volunteers, an organization
that helps underwrite expenses for the annual trip.
Dr. Ayers reports that 28 volunteers went on the
2005 medical mission, including a pediatrician, cardiologist, general surgeon, gynecologic sub-specialists,
and a urologist. They evaluated 1,500 patients and
performed 66 surgeries during their two-week stay.
“There is such a need for experienced medical personnel,” Dr. Ayers says. “It’s unlikely my husband’s
cousin would have died in a hospital in this country.
There, blood supplies are extremely low, and technically trained people are not available around the clock
as they are in the U.S. Most good physicians and welltrained nurses go to Europe and the United States,
where there is access to the technology they need.”
James Aikins, Jr., MD, associate professor of obstetrics,
gynecology, and reproductive sciences, Camden campus,
founded International Healthcare Volunteers. In 2005,
28 volunteers went on a medical mission to Ghana.
The shortage of physicians and nurses makes the
mission a dual one. Dr. Aikins, who hopes the group
soon will be able to make two trips annually, says
education is a major component in what they do.
“We are training nurses to evaluate conditions
in the absence of trained doctors,” he says. “We’re
showing them how to recognize abnormalities.
There are no Pap smears available, and we’re trying to change that.”
Another educational goal is to encourage young
physicians to specialize in critically needed medical
disciplines. A program established by International
Healthcare Volunteers assists OB/GYN residents at
Ghana Medical School by bringing them to the
Camden campus for three-month observational
rotations each year. Dr. Aikins hopes it soon will be
possible to expand the program to both campuses
and to include residents from other much-needed
specialties, such as pathology, surgery, and medicine.
Dr. Caraballo says, “One of the big problems we
face is that we see patients much later in the pathological process. Last year, we treated a woman
with an ectopic pregnancy. Her tube had ruptured,
and she was bleeding into the abdomen. Our team
e are training nurses to evaluate
conditions in the absence of trained doctors.
We’re showing them how to recognize
abnormalities. There are no Pap smears
available, and we’re trying to change that,”
Dr. Aikins says.
Charletta Ayers, MD, associate professor of
obstetrics, gynecology, and reproductive sciences
and chief, division of general obstetrics and
gynecology
R icardo Caraballo, MD, assistant
professor of obstetrics, gynecology,
and reproductive sciences and
chief, division of female pelvic medicine
and reconstructive surgery
r. Caraballo says, “Truth is,
we get as much as we give. We come
back exhausted but revitalized.”
wound up donating blood to save her life. That
happens often. Truth is, we get as much as we give.
We come back exhausted but revitalized.”
“We live in a global world,” Dr. Escobar says.
“RWJMS is already in the international arena,
and is working in different ways toward the crossfertilization of ideas from around the world.
“We have as much to learn from people in other
parts of the globe as they do from us. A mechanism linking us with other countries is, I believe,
critical to our identity as a leading player in medical education.”
If there is one collective element that drives
these varied medical missions, it is compassion.
Each one of the RWJMS physicians who boards a
flight to some underdeveloped country instead of
taking the kids to Disney World has a different
way of expressing it. The source, though, is always
an intrinsic kind of caring, which makes a health
crisis 8,000 miles away a very personal one.
Someone asked Dr. Aikins why he took his children to Africa each year, instead of giving them a
“real” vacation. He says his grandmother always
told him that whatever you give, you get back in
multiples.
“I used to argue with her about that,” he says.
“Now that I’m older, I know she was right.” M
STUDENTS ON A MISSION
A
s a fourth-year student at RWJMS, Guesly Delva,
MD ’05, participated in an international health
elective at the Community Hospital of Mirebalais
in Haiti. While he was there, a 27-year-old man was
admitted with moderately impaired breathing. He was
given antibiotics, but before he could be adequately cared
for, his family insisted on his release so they could take
him to a local voodoo priest. Later, tests came back showing a significantly increased white blood count. The
patient was again admitted, this time in very serious condition, suffering from high fever and chills. He was
placed on oxygen and intravenous antibiotics, but in spite
of intensive efforts, the young man died several hours
later.
“The patient was about my age, and his death affected
me very deeply,” Dr. Delva says. “I knew that if he had
been treated at a hospital in a developed country, he
would not have died. The closest hospital with facilities
to deal more appropriately with his condition was more
than an hour away. The ambulances there were not
equipped with oxygen, and he would not have survived
the trip without it. We could only do our best, and it
wasn’t enough.”
As heartbreaking as the experience was for Dr. Delva,
it cemented his goals to get further training in infectious
diseases and tropical medicine, following his residency in
internal medicine and pediatrics at Tulane University
School of Medicine.
Such international experiences are available through a
parallel program at the New Brunswick and Camden campuses of RWJMS. Last year, students served in countries on
every continent, with the exception of Antarctica.
Sponsorship, from several sources, provides third- and
fourth-year students with invaluable global insights about
medical care administered with extremely limited resources.
Paul R. Mehne, PhD, associate professor of family
medicine and associate dean for academic and student
affairs, Camden campus, says, “We believe, if we are
going to prepare physicians as the health leaders of
tomorrow, these global experiences are important to the
health systems they will design.”
The significance is reflected by students themselves
who report that they have become more culturally competent as a result of their travel to underdeveloped
nations. They say, too, that the experience underlines the
critical need for public and community health programs,
and is a dramatic lesson in the importance of preventive
care and early diagnosis.
Susan Rosenthal, MMS ’75, MD, clinical professor of
pay b a c k w h e r e i t co u n ts
S
ukumar Nagendran, MD ’94, acquired considerable knowledge about health care internationally,
and he wants American medical school students to
have the same advantage. Add to that his gratitude for
the training he received at RWJMS and with Edward D.
Viner, MD, professor and chief, Department of Medicine, Camden campus, and his group, and the result
became the Nagendran Scholarship for International
Studies. This scholarship has benefited 15 students in
the past three years.
Dr. Nagendran says that when he was in medical
school, he had concern about access to health care issues
in this country.
“After I became a doctor, I traveled to places
throughout the world, and I realized that our system
here is one of the best worldwide,” he says. “American
students have no idea of the advantages we have. They
can’t imagine working in a hospital where a bone marrow aspirate needle is boiled and used for a year.”
He says he hopes the scholarships provide an appropriate way to show his appreciation for his own medical
education. He hopes, too, that the global studies he is
making possible for students will give them an appreciation for medical capabilities in this country, and will
help them do their best for their patients.
Susan Rosenthal, MMS ’75, MD, clinical professor of
pediatrics and assistant dean for student affairs, says Dr.
Nagendran’s scholarships have made a significant
humanistic impact on the international experiences
offered to students.
“His support of the international program continues
to provide very important experiences for our students,”
she says. “And his own commitment to the globalization
of health care and to underdeveloped countries makes
him a role model as well.”
A strong advocate of global health, Dr. Nagendran
believes U.S. medical schools should do as much outreach in populous countries as possible.
“We live in a global business community, and health
care is becoming the same,” he says. “The medical
problems of one country become the problems in all
countries. I would like to see medical schools set up a
presence in foreign countries and have an exchange of
both students and doctors. This could become an intellectual consortium in which we help each other across
inter-national borders. But this is costly and complex,
and it would take a huge investment of social conscience.”
Dr. Nagendran has received letters and emails from
Research:
A Cornerstone of
Orthopaedic
Surgery
oth bench and clinical research have long
B
been the underpinnings of orthopaedic
medicine, a discipline that continually
probes new and better ways of repairing broken
bodies, stimulating the regeneration of tissue and
bone, and generally furthering advances in surgery.
Recently, orthopaedic studies have reached a
remarkably promising crossroads in the development
of the relatively new field of tissue engineering. They
include technologies being developed at UMDNJRobert Wood Johnson Medical School, in the
Department of Orthopaedic Surgery laboratories.
By Rita M. Rooney
■ Photos by John Emerson
Charles J. Gatt, Jr., MD ’89,
associate professor and
chair, Department of
Orthopaedic Surgery, reports:
“Most orthopaedic surgeons
today believe the future
of surgery lies in tissue
engineering strategies
to replace tissue.”
C
harles J. Gatt, Jr., MD ’89,
associate professor and chair,
Department of Orthopaedic Surgery has
a sub-specialty in sports medicine, and
has been conducting tissue engineering
research related to torn meniscus, the
most commonly injured part of the knee.
“Most orthopaedic surgeons today
believe the future of surgery lies in tissue engineering strategies to replace tissue,” Dr. Gatt reports.
The technology employs the use of
biocompatible materials, or polymers
the body will accept. The materials are
shaped as fibers and combined with a
collagen sponge to serve as a scaffold or
temporary device that ultimately stimulates its own replacement by the body.
“The meniscus is a C-shaped rubbery
shock absorber that fits between the
bones in the knees,” Dr. Gatt explains.
“When it tears, we usually have to
remove the torn part because the tissue
generally doesn’t have the ability to
heal. We’re trying to use tissue engineering technology developed at the medical
school to repair this condition.”
Michael G. Dunn, PhD, associate
professor of orthopaedic surgery, has
developed a tissue engineering technique for replacing the primary ligament in the knee, and now he and Dr.
Gatt are researching the potential of the
same strategy applied to the meniscus.
“As it is today, by removing the torn
part of the meniscus, we lose a big part
of this shock absorber,” Dr. Gatt says.
“Dr. Dunn and I are working to come
up with an implant that will stimulate
the regeneration of the meniscus.
Currently, this can be done with a
meniscus from a cadaver, but the
results are only short term.”
Emphasizing his enthusiasm for the
advances possible through tissue engineering, Dr. Gatt says that the current
method of performing ligament reconstruction is to remove part of the patella tendon or hamstring tendons and
use either to rebuild the torn ligament.
wenty years from now,
we’ll look back and say
there was never any reason to do that,” he says. “We’ll be able
to implant something in the knee, and a
new ligament will grow in its place.”
He points as well to numerous other
applications for this relatively new science, and reports that the orthopaedic
research laboratory is currently collab-
“T
device for animal implantation.
“Meniscus tearing is a serious medical problem, resulting from trauma,
the degenerative process, or a combination of both,” Dr. Gatt says. “It happens to older people with arthritis as
well as to ‘weekend warriors.’ The
implications of tissue engineering offer
us a method to eliminate the resulting
pain in ways never before possible.”
“Something that excites me is
the possibility of working with the
fantastic molecular biologists at
the medical school,” Dr. Gatt says. “One of
my interests is in connecting with
someone doing basic research so that we
might direct that kind of work toward
orthopaedic studies.”
orating with Siobhan A. Corbett, MD
’87, associate professor of surgery, in
research aimed at being able to use collagen sponges for repair of abdominal
defects, such as hernia. He predicts that
his laboratory soon will attempt to
apply tissue engineering to the restoration of cartilage lost through trauma
and arthritis. Tissue engineering may
also play a role in replacing bone damaged by tumors. Instead of replacing
bone with bone from other parts of the
body, collagen or another biocompatible material could be used.
At present, Dr. Gatt and his colleagues are developing a prototype for
the meniscus implant. They are studying a mixture of a collagen sponge reinforced by biocompatible fibers, and are
trying to optimize the mixture of fiber
and sponge to re-establish normal
meniscus mechanics as closely as possible. They want a material with the
same properties as the original tissue.
Once they have developed this mixture,
they will do mechanical testing. After
that, they will fabricate a full meniscus
The Department of Orthopaedic Surgery was developed from the existing
division of orthopaedic surgery in
2003, and its faculty consisting of an
11-member surgical team, is one of the
most prestigious orthopaedic services
in central New Jersey, and one staffed
by physicians representing most subspecialties within orthopaedic medicine. Joseph P. Leddy, MD, at the time
a clinical professor of orthopaedic surgery, was appointed the department’s
first chair; upon his recent retirement,
Dr. Gatt was named chair. Prior to the
creation of the department, the surgeons had served as volunteer faculty,
responsible for teaching both medical
students and residents.
“We consider this a perfect match,
an opportunity for both the school and
our group,” Dr. Gatt reports. “We
brought with us a strong clinical practice. In turn, our surgeons enjoy teaching and wanted to expand their efforts
in that direction. Perhaps most important, we looked forward to becoming
more involved in research, benefiting
from collaboration with colleagues at
the medical school, as well as from the
stature RWJMS gives to NIH funding
applications.”
“Something that excites me is the
possibility of working with the fantastic molecular biologists at the medical
school,” Dr. Gatt says. “One of my
interests is in connecting with someone
doing basic research so that we might
direct that kind of work toward
orthopaedic studies.”
He adds that the medical school
association paves the way for the addition of research personnel in the department. In private practice, he points
out, there is neither time nor the necessary resources for follow-up on prospective studies.
“The medical school has been extremely helpful in offering us research
assistants, and giving us an opportunity to collaborate with researchers in
other departments,” he says. “Obviously, this underlines the capabilities of
department clinicians engaging in
research.”
The growth of the orthopaedic residency programs became an early priority of the new department, one subscribed to by both Timothy P. Leddy,
MD, instructor of orthopaedic surgery
and Dr. Gatt.
“The medical school has a history of
attracting top candidates in its orthopaedic program,” Dr. Leddy says.
“Those of us on the faculty are committed to accelerating recruitment efforts to
draw the highest-caliber residents.”
He adds that the department is
becoming more competitive in its recruitment efforts, and that Dr. Gatt
conducts regularly scheduled meetings
with all residents to review the research
they are doing, and to stimulate brainstorming for new ideas.
Dr. Leddy’s own research centers on
a bench study evaluation of techniques
for treating forearm fractures. In
adults, surgery is the only treatment for
these fractures, and his research focuses on techniques that may decrease the
complications of the procedure. His laboratory has designed an instrument that
tests the procedure for bending and torsion
in cadaver models. After generating a fracture of the bone, the lab repairs the fracture and then stresses it to failure. In this
way, the research team is gathering valuable data comparing surgical approaches.
Another area of research being conducted in Dr. Gatt’s laboratory focuses
on the mechanical testing of allografts,
or tissue from cadavers used in ligament reconstruction of the knee. Until
recently, surgeons discarded donor allo-
grafts if the donor was beyond 55 years
of age. Dr. Gatt’s group spent more
than two years assessing the impact of
the donor’s age and gender on the
mechanical properties of these tissues.
“Our extensive testing showed that
tissue from a 60-year-old donor is just
as effective as that from a 30-year-old
donor, and donor gender is insignificant as well,” Dr. Gatt says.
The significance of this research is
that allograft supply doesn’t meet the
demand, and, prior to the study, the
cutoff age was considered to be
between 50 and 55. As a result of Dr.
Gatt’s work, which has been presented
at the American Academy of Orthopaedic Surgeons, an increase in the acceptable age of the donor is under way,
and that will increase the supply of
appropriate donor allografts.
With its compelling commitment to
research, teaching, and comprehensive
clinical care, the Department of Orthopaedic Surgery has taken a commanding
leadership position that underlines the
highest caliber of service to the RWJMS
community. M
Charles J. Gatt, Jr., MD ’89:
At Home, On the Field, and in the Lab
ust about any autumn Friday
evening, Charles J. Gatt, Jr., MD
’89, associate professor and
chair, Department of Orthopaedic
Surgery, can be found on the sidelines
of a high school football game. As a
sub-specialist in sports medicine, Dr.
Gatt treats injuries incurred by young
athletes as well as by professionals. His
presence at school athletic events
makes it clear that one group is just as
important to him as the other.
“The formalization of sports medicine has raised awareness of athletic
injuries, and has placed emphasis on
high school and college sports,” Dr.
Gatt says. “My presence at games assures that a specialist is the first to examine an injury and decide whether or not
a player should stay in the game, and
what immediate treatment may be
needed to avoid permanent damage.”
An alumnus who graduated from
UMDNJ-Robert Wood Johnson Medical School in 1989, and from the orthopaedic residency program in 1994, Dr.
Gatt says he never left RWJMS for long.
He followed his residency with a fellowship at the Cleveland Clinic Foundation,
J
An alumnus who graduated from
UMDNJ-Robert Wood Johnson Medical
School in 1989, and from the orthopaedic
residency program in 1994, Dr. Gatt says
he never left RWJMS for long.
and after two years on staff at Glendale
Adventist Hospital in California, he
returned to RWJMS as a clinical assistant
professor in 1997. In 2003, when the division of orthopaedic surgery became a full
department, he was appointed associate
professor. Dr. Gatt met his wife, Sandra
Gatt, MD, a plastic surgeon, while completing his residency at the medical school.
“I enjoyed my residency training
tremendously,” he says. “I know many
doctors say residency is laborious, but I
never thought so. The people who were
my role models were exceptional surgeons who took great care of their
patients. Looking back, I think I was
attracted to my field because orthopaedic
surgeons seemed to enjoy their work.”
The role models to whom he refers
include Joseph P. Leddy, MD, now retired
clinical professor and former chair,
Department of Orthopaedic Surgery, and
Joseph Zawadsky, MD, professor emeritus of orthopaedic surgery.
Dr. Gatt, who obviously enjoys both
the clinical and the research elements of
sports medicine, is a volunteer coach
for Montgomery High School’s flag
football, recreation basketball, and
baseball teams, and is the team physician for Rider University and
Hillsborough High School. He also is a
member of the Skyland Conference
Team Physicians’ Association, and is on
the graduate faculty at the School of
Biomedical Engineering at Rutgers, The
State University of New Jersey.
ROBERT WOOD JOHNSON
UNIVERSITY MEDICAL GROUP
http://umg.umdnj.edu
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l e t t e r
f r o m
t h e
a l u m n i
a s s o c i a t i o n
p r e s i d e n t
Dear Alumni and Friends:
t has been a great honor to serve as president of the Alumni Association. I would like to thank every-
I
one for their cooperation and enthusiastic support. I want to extend a warm welcome to our new pres-
ident, Geza Kiss, MD ’95, and the following officers: Nancy Sierra, MD ’89, vice president/president-elect;
Tamara LaCouture, MD ’94; secretary, Hank Lubin, MD ’83, treasurer; Andrew Stefaniwsky, MD ’77,
chair, Membership Committee; Ravi Goel, MD ’97, chair, Development Committee; and Francine
Sinofsky, MD ’81, co-chair, Reunion Committee.
Please save the date for the next Alumni Reunion Weekend, October 12–14, 2007, honoring the following anniversary classes: 1971, 1972, 1976, 1977, 1981, 1982, 1986, 1987, 1991, 1992, 1996, 1997,
2001, 2002. The gala Dinner Dance will be held on Saturday evening, October 13, at The Heldrich, the
beautiful new hotel on Livingston Avenue in downtown New Brunswick. If you would like a class list to
get an early start on communicating with your classmates, please contact Roberta Ribner, coordinator,
alumni affairs, at [email protected] or 732-235-6310.
I am very proud of the Alumni Association’s commitment to supporting
RWJMS students. Thank you for your generous contributions to the Annual
Fund. Your donations last year enabled our Board of Trustees to allocate
$200,000 for scholarships and loans for the 2006 – 2007 academic year.
The Alumni Association sponsored a breakfast during Orientation to welcome the Class of 2010, the largest class in RWJMS history. We know you
understand the escalating financial needs of our students, and we invite you to
NAT CLYMER
support us again this year. Annual Fund contributions can be made online.
Please visit our Web site at http://rwjms.umdnj.edu/alumni.
Please stay in touch by sending professional and personal news for Class Notes, as well as updated
addresses, phone numbers, and email addresses, to [email protected].
I plan to remain actively involved in the Alumni Association as a member of the Board of Trustees, and
I look forward to your continued support and participation as well.
Sincerely,
Steven H. Krawet, MD ’89
President, RWJMS Alumni Association
NEWS
r w j m s • a l u m n i
Alumni Association Awards Hippocrates Scholarship
T
he Alumni Association awarded the Hippocrates Scholarship
to Urania Ng ’10. In each
incoming class, one student
is selected to receive the
Hippocrates Scholarship,
based on academic excellence. The Hippocrates
Scholars receive $20,000 per
year toward tuition during
Carol A. Terregino, MD ’86, associate
professor of medicine and associate dean
for admissions (left), and Peter S. Amenta,
MD, PhD, interim dean, congratulate
Urania Ng’10, recipient of the Alumni
Association’s Hippocrates Scholarship.
their four years at RWJMS.
A 2005 Phi Beta Kappa
graduate of Johns Hopkins
University, Ms. Ng majored in molecular and cellular
mark your
STEVE HOCKSTEIN
Calendar:
May 21, 2007
Convocation
May 22, 2007
Commencement
October 12 –14, 2007
Cardiovascular
Symposium 2007:
Innovations and Trends in
Cardiovascular Disease
Alumni Reunion Weekend
Saturday, October 6, 2007
Saturday evening
October 13:
Alumni Reunion
Dinner Dance
The Heldrich
New Brunswick
The Heldrich Hotel
and Conference Center
New Brunswick
Honoring the following
anniversary classes:
35th: 1971, 1972
30th: 1976, 1977
25th: 1981, 1982
20th: 1986, 1987
15th: 1991, 1992
10th: 1996, 1997
5th: 2001, 2002
For additional information,
contact Roberta Ribner,
Coordinator, Alumni Affairs,
732-235-6310 or
email: [email protected].
For additional information,
please visit:
www.rwjuh.edu/symposium
or call 732-418-8030.
Continuing Medical
Education
April 2007
17th Annual GI Symposium
For additional information
on these or future CME
activities, visit
www.umdnj.edu/ccoe or
contact RWJMS-Continuing
and Outreach Education at
732-235-7430.
biology and minored in
psychology. She committed
to the pre-med track as a
junior and conducted translational research using
drosophila (fruit flies) to
investigate the transcription
factors involved in the
development of salivary
glands. “I would like to continue to do research,” she
says. “It will help me understand the applications of
basic science in clinical
work. At the same time,
when I look at my patients,
I will know what problems
most need to be answered
by research.”
As an undergraduate, Ms.
Ng volunteered in a
Baltimore hospital and
worked with women and
children at My Sister’s Place,
a center for women and
Ms. Ng feels honored
to have been awarded
the Hippocrates
Scholarship and thanks
the Alumni Association
for making it possible
for her to attend
medical school at
RWJMS.
children who are homeless.
At an urban clinic for the
uninsured, she gained
patient-centered experience
taking patients’ vital signs.
Ms. Ng feels honored to
have been awarded the
Hippocrates Scholarship
and thanks the Alumni
Association for making it
possible for her to attend
medical school at RWJMS.
— K.O’N.
Alumni Association Awards $200,000 in Loans and Scholarships
T
he Alumni Association Board of Trustees
approved $200,000 in
contributions to RWJMS for
the 2006–2007 academic
year. This sustains a tradition that has led to contributions totaling more than
$1.8 million in the past two
decades.
For the current academic
year, students have been
awarded scholarships and
low-interest loans totaling
$175,000. In addition, the
association made its fourth
$25,000 contribution to the
$100,000 RWJMS Alumni
Association Scholarship
Fund. “The students are our
focus and our mission,”
says Steven H. Krawet, MD
’89, president, Alumni
Association. “Scholarships
and low-interest loans help
defray the high costs of
today’s medical education
and ease the burden for stu-
Alumni who contribute
$1,000 or more to
the Annual Fund can
name a scholarship in
honor or memory of
a classmate, friend, or
family member.
dents at a time that is
already incredibly stressful.”
This year’s Alumni
Association scholarships
include one new Hippo-
crates Scholarship and three
continuing ones.
In addition to the Alumni Association scholarships,
individual alumni have
endowed scholarship funds
of $25,000 or more. Alumni
who contribute $1,000 or
more to the Annual Fund
can name a scholarship in
honor or memory of a classmate, friend, or family
member.
— K.O’N.
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Joseph P.
Costabile, MD’86:
Comrade•in•
Arms
Kuwait, 2005
•“A Humvee rolled over on one of
our soldiers, splitting his face into a million pieces; his arm was
nearly severed. When they
brought him in, the flight paramedic was doing CPR on him.
After I got out of
the OR, I thought,
‘This kid’s never
going to survive.’
But he not only survived, he lived to see
his daughter born,
three months later,
back in the States. It
required a huge team effort, and
I was proud to be part of it.”
•“One soldier was unfortunately
dead on arrival and pronounced by the ER doctor, a good
physician with a lot of experience. We all stepped outside
Casualty Receiving (the ER),
and I saw tears welling up in
his eyes. We talked awhile and
agreed that, although we have
pronounced patients before,
something here makes the job
more touching and awful. The
loss of anyone is a loss of our
own, and we all feel it. Any soldier who died in our care
received full military honors as
they left the hospital.”
“Giving Back”
oseph P. Costabile, MD ’86, acts on his beliefs:
“Whether you’re giving back to the people who gave
you your educational opportunities or giving back to
your country, I believe you should contribute.” Dr.
Costabile emphasizes his credo, whether he is writing in his blog, speaking to the press, talking to a
friend, or addressing
a crowd. He made his point
again last spring in a remarkable
talk to guests at the Association of Families and Friends/
Alumni Association Brunch.
He also serves on the Alumni
Association Board of Trustees.
In 1994, Dr. Costabile joined
the U.S. Navy Medical Reserves, because, he says, “Despite all its warts and foibles, we
live in a great nation, and giving back is the most important part of being a citizen.”
Since the end of the Vietnam War, when he was barely
21, Dr. Costabile had wondered how he could best contribute to his country. In 1990, when recruiters from the
U.S. Navy Medical Reserves began to call, he realized that
the military structure and mission of the Reserves were
well suited to his skills, goals, and personality.
In 1994, he joined up. At that time, he had completed
his general surgery residency and a trauma fellowship at
J
Above: Joseph P.
Costable, MD ’86, performs surgery, assisted
by Petty Officer Amalia
Serrano, an operating
room technician.
Right: Dr. Costable,
in Kuwait, with fellow
Navy reservist
Commander Jim Flood,
a nurse anesthetist.
By Kate O’Neill
Joseph S. Costabile, MD ’86,
joined the U.S. Navy Medical
Reserves, because, he says,
“Despite all its warts and foibles,
we live in a great nation, and
giving back is the most important
part of being a citizen.”
PHOTOS COURTESY OF JOSEPH P. COSTABLE, MD ’86
Cooper Hospital/University Medical Center, Camden, and
was doing a second fellowship, in clinical vascular surgery,
at UMDNJ-Robert Wood Johnson Medical School, in
New Brunswick. “I knew people who’d rallied to the cause
during Desert Storm and was impressed by their commitment,” he recalls. “I knew I’d found my niche.”
After his fellowship, Dr. Costabile returned to his alma
mater, the RWJMS, Camden campus, and served on the
faculty for three years before joining the Surgical Group
of South Jersey. Then, in September 2004, he had the
opportunity to put his beliefs on the line. He accepted a
commanding officer’s call to serve as director of surgical
services for a medical unit in Kuwait, the staging area for
Operation Iraqi Freedom. By December, his new unit,
Expeditionary Medical Force – Dallas (EMF-Dallas), had
shipped out for an eleven-month tour of duty, which he
believes may be the first of several mobilizations in the
Middle East. “It would be a privilege to serve again in the
Navy tradition of honor, courage, and commitment,” he
says.
Esprit de Corps
r. Costabile’s support for the U.S. mission in Iraq
is secondary to his support for the troops. “In
every generation, Americans have put themselves
in harm’s way to keep the rest of us safe,” he
says. “We take care of the soldiers who take care of us.”
“Welcome to the fight,” said Major General Paul E.
Mock, deputy commander, Coalition Forces Land
Combat Component, Kuwait, as he greeted the 350
members of EMF-Dallas. That “fight,” says Dr.
Costabile, would be to “make medicine better in the theater. Our unit got to make history for Navy medicine: we
saw more than 100,000 patients, performed 1,800-plus
surgeries, wrote more than 65,000 prescriptions, did
32,000 radiology procedures, and achieved an 83 percent
return-to-unit rate, within six weeks of treatment.”
For the most part, EMF-Dallas saw routine cases, as
the unit cared for members of the Coalition Forces in
Iraq or returning home. With the exception of occasion-
D
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COURTESY OF JOSEPH P. COSTABLE, MD ’86
al maneuver-related traumas, Dr. Costabile’s
work was similar to what he does in private
practice. The difference lay in the intense
camaraderie of EMF-Dallas. Everyone shared
the sense of having left his or her safe world
behind to serve those who were sent to protect
their country — of being a comrade-in-arms.
Although most
combat-related
injuries were treated in Iraq, Dr.
Costabile says his
trauma fellowship
stood him in good
stead: “Thinking
affects performance, and emergencies aren’t like
scheduled surgery,
especially in a combat zone. You have to be able to make splitsecond decisions individually and as a team.”
In war, a physician must practice the art of
medicine as often as the science, he explains,
respecting the supreme role of the military unit
in a soldier’s life. “When a wounded Marine
came out of surgery, he would never ask, ‘How
am I doing?’ or ‘Am I going home?’ His first
question always was, ‘When can I get back to
my unit?’”
Sharing Credit
r. Costabile, a prolific writer, created
an in-depth journal through his correspondence from Kuwait. He frequently
emailed his former mentor, Alan M.
Graham, MD, professor of surgery and
Norman and Ruth H. Rosenberg Chair in
Vascular Surgery. Dr. Graham has seen his former protégé regularly over the past ten years,
and he remains impressed by the energy, eagerness, and gratitude that characterize Dr.
Costabile. “Above all, he’s a team player,” says
Dr. Graham. “He always transfers the credit
for his accomplishments to others on his
team.” When Dr. Costabile wrote about his
work in Kuwait, he thanked Dr. Graham for
having helped him develop the skills he would
need. “He always said that I was there with
him,” adds Dr. Graham. M
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NOTES
’70 ’86
’87
9
’
’82 0
91
’
’83
’85
NINETEEN
SEVENTY
NINETEEN
EIGHTY-SIX
Alan Pyor reports: “Retired after
31 years as an oncologist at San
Rafael, Calif. Kaiser and hoping to
get my beautiful wife, Sunny, to
retire as well. Our children are
part of an extended family with
nine grandchildren, ages 15 to 3.
Anya is in Seattle with Swedish
Hospital and its information system implementation. Sundy is in a
Seattle suburb in her cosmetic dermatology practice. Brad, a contractor, will remodel our bathrooms. Noel works for Heartlab,
capturing cardiac catheterization
data. Debra works for a cath lab
with our other daughter, Sharla.
I’ve been busy just keeping up-todate. Fond memories of our two
years in Piscataway. Best to everyone.”
Wendell Jones writes: “I am taking
a break from medicine after 15
years of emergency medicine. I am
alive and fairly well living on
Nantucket. I have started a new
career in real estate.”
NINETEEN
EIGHTY-TWO
Lynn Helmer writes: “We’re
grandparents! How cool is that!
Harris William, born May 23,
2006. . . . We started a non-profit
called ‘Caring Neighbors Healthcare
Center,’ which will provide free care
to the uninsured who do not meet
the criteria for government programs and make less than 200%
of the federal poverty level.”
NINETEEN
EIGHTY-THREE
Mitchell Berger is director of medical oncology at the Georgia
Cancer Center of Excellence at
Grady Health System.
NINETEEN
EIGHTY-FIVE
Edward Niewiadomski, is senior
vice president of medical affairs at
Southern Ocean County Hospital.
He was appointed to serve on the
New Jersey Health Care Access
Study Commission by Governor
Jon S. Corzine.
NINETEEN
EIGHTY-SEVEN
Mark Blumenthal reports:
“Family: Mindy Goldberg, MPH,
PA-C, Hila (10), Ilana (7), and I
have lived in Knoxville, Tenn.,
since 1997. Professional: medical
director, Roane County Health
Department, Rockwood, Tenn.
Board certifications: family medicine, occupational medicine.
C’mon down, y’all.”
NINETEEN
NINETY
Kenneth Cooke is an associate
professor at the University of
Michigan Cancer Center,
Department of Pediatrics and
Communicable Diseases. His current responsibilities include clinical
trial studies and grant research.
NINETEEN
NINETY-ONE
Vanita (Kamath) Braver writes:
“I published ‘Pinky Promise’
and ‘Party Princess’ in my wellreceived children’s book series
called ‘Teach Your Children Well’
for kids ages 4 to 8. Please visit
www.drvanitabraver.com for more
information. I continue to work as
psychiatric medical director of
Bonnie Brae, a residential treatment center for adolescents in
Liberty Corner, and am on staff at
Morristown Memorial Hospital.
I am happily married to Joel
Braver and have three wonderful
daughters, Alyssa, India, and
Samantha.”
’92
’93
’96
NINETEEN
NINETY-TWO
’97 ’01 ’04
’02
’98 ’03
’05
’00 W
Elizabeth Talbot is the deputy
state epidemiologist for New
Hampshire.
NINETEEN
NINETY-THREE
Lisa Taylor has been named
the 2006 Community Clinician
of the Year by the Barnstable
District Medical Society of the
Massachusetts Medical Society.
She is a board-certified internist
who serves as medical director
at the Cape Cod Free Clinic
and Community Health Center
in Falmouth.
NINETEEN
NINETY-SIX
Eric Bleickardt writes: “I
joined Bristol-Myers Squibb
after three years in hematology/oncology private practice
in New Haven, following the
completion of my fellowship at
Yale. Over the last year and a
half, I have served as a director
in oncology global clinical
research and was part of the
dasatinib team that received FDA for CML and
Philadelphia positive ALL.
I was also a co-author in the
June 15, 2006, New England
Journal of Medicine phase 1
trial results of dasatinib. My
wife and I are pleased to
announce the birth of our third
child, Abigail, in March 2006.”
Deborah Horowitz writes:
“Hello to all. For the last three
years I’ve worked part-time at
PediatricArts of Northern N.J.
in Butler. I love it there. I have
been married to David Salanon
for the last year. I live with him
in my first house (finally!), and
with my two sons from my first
marriage, Daniel Frey (7) and
Eric (5). We are all enjoying
our new family situation.”
NINETEEN
NINETY-Seven
TWO THOUSAND
ONE
TWO THOUSAND
FOUR
Carl-Christian Jackson completed his residency in general
surgery at the University of
Chicago Hospitals. He is currently doing a two-year fellowship in pediatric surgery at the
Children’s Hospital of Eastern
Ontario in Ottawa. He and
Diana DiRaffaele were married
in August 2005.
Jamie Decker is a pediatric cardiac fellow at Texas Children’s
Hospital, Baylor College of
Medicine, in Houston.
Sara Bonamo and Christopher
DeMauro were married in
October 2005.
Parag Patel is an interventional
cardiologist at Robert Wood
Johnson University Hospital
and Somerset Medical Center.
NINETEEN
NINETY-EIGHT
Ramesh Karra is board certified in family practice and is on
staff at the Cliff Whetten Clinic
in Elfrida, Ariz. After completing his residency, he worked for
Doctors Without Borders in
southern Sudan and the Indian
Health Service in New Mexico.
Jacqueline Luzniak writes: “My
husband and I live in Castle
Pines, Colo. I am currently a
board-certified anesthesiologist.
I practice in the south Denver
area as a partner in South
Denver Anesthesiologists, PC.”
TWO THOUSAND
Aaron Auerbach reports: “I have
been working as a staff pathologist at the Armed Forces
Institute of Pathology in the
Department of Hematopathology. I finished my fellowship in
hematopathology after completing my residency at the
National Institutes of Health.”
Brian Watabe has joined Intermountain Legacy Obstetrics
and Gynecology in American
Fork, Utah. He is a junior fellow of the American College of
Obstetrics and Gynecology.
TWO THOUSAND
TWO
Carrie Rubenstein writes: “After
my family medicine residency at
Swedish Medical Center and a
fellowship in geriatrics, I’ve just
started my first job doing fullspectrum family medicine at a
community health center in
Seattle.”
TWO THOUSAND
THREE
Jamie Goralnick is doing a fellowship in child and adolescent
psychiatry at ColumbiaCornell.
Anthony Mazzarelli is currently
a chief resident at the
Department of Emergency
Medicine, RWJMS, Camden
campus. He has accepted a fulltime faculty position in the
department, with an interest in
health policy and ethics.
Christina and Mark Reiter are
pleased to announce the birth
of their daughter, Jenna Rose
Reiter, on July 30, 2006.
Lasanta Horana is one of the
chief residents in emergency
medicine at Johns Hopkins
Hospital. He and his wife are
pleased to announce the birth
of their daughter, Alyssa
Yasmin, in April 2006.
Alisa Meny is a family medicine
resident at Maine Medical
Center in Portland. She and
Richard Freed were married in
April 2006.
Elizabeth Robinson is a surgery
resident at the Medical Center
of the University of California,
Los Angeles. She married Ross
Benjamin on October 21, 2006.
TWO THOUSAND
FIVE
Daisy Wynn is a family
medicine resident at Thomas
Jefferson Hospital in
Philadelphia.
IN MEMORIAM
Sarinne Dascalu, MD ’80
Salvatore Zelano, MMS ’72,
MD
e love hearing from you! Please send
your professional and personal news for C l a s s N o t e s to:
Roberta Ribner • Editor, Robert Wood Johnson Medicine
Coordinator, • Alumni Affairs • UMDNJ-Robert Wood Johnson
Medical School • Alumni Association
335 George Street • Suite 2250 • New Brunswick, NJ 08903
Phone: 732-235-6310 • Fax: 732-235-9570
Email: [email protected] • Or log on to our Web site:
http://rwjms.umdnj.edu/alumni
Benjamin F. Crabtree:
Social Science Evolves into
Practice Jazz
How Her
Garden Grows
— Continued from Page 29
Medicine Research Network, which includes
90 practices in 20 of 21 New Jersey counties
and represents more than 200 physicians and
500,000 patients. The network is currently
recruiting practices for the five-year SCOPE
project, for which the NCI recently awarded
nearly $2 million in direct costs. SCOPE will
work with practices to incorporate cancer
screenings, particularly for colorectal cancer.
The anthropologist in Dr. Crabtree combines
an understanding of human cultures with a
mastery of the tools of social science. With the
creation and development of the division of
research, he has nurtured a wide, informed
network of people whose shared aim is to
improve the quality of primary care. Many
have benefited — above all, the patients cared
for in practices that have evolved through the
MAP/RAP process. In addition, Dr. Crabtree’s
RWJMS colleagues, along with their academic
and primary care collaborators, are better
equipped to handle the challenges of delivering
excellent primary care. M
Rapid HIV/AIDS Testing Initiative
Hailed as Model Program
“We know that 50 percent of the time,
HIV/AIDS is transmitted within the first six
months of infection, that more infections occur
early on, and that most people do not know
they are infected within this first six months,”
reports Dr. Martin. “If we can reduce this time
in half, we can reduce the number of HIV
infections by nearly 25 percent.”
Dr. Cadoff and Dr. Martin have the distinct privilege of creating and helping to sustain a program that will save lives throughout New Jersey. And now that the Rapid
HIV/AIDS Program they created has won a
national award, other states may begin to
emulate this model program that has had so
much success. M
village of Kakamega, 250 miles
northwest of Nairobi. Staffed
by year-round health workers,
and volunteer physicians from
the United States who travel
there for three weeks to three
months each year, the clinic
focuses its care on women and
children. Education and prevention are objectives that
begin with teaching women the
importance of boiling water,
eating vegetables, and drinking
milk. Care extends to the availability of screening mammograms and Pap smears, programs to reduce pregnancyrelated fatalities, and, most
critically, education to combat
mother-to-child transmission
of HIV, the AIDS virus.
“In Africa, when you treat
women, you are really treating
the country,” Dr. Kilibwa explains. “It is the women who
do most of the work. They are
the ones who hold the community together.”
Dr. Kilibwa’s program benefits from her successful efforts,
not only in recruiting physicians and other health care
workers to volunteer at the
clinic, but in getting donations
of refurbished equipment,
including an MRI scanner. She
succeeded in raising $250,000
last year, directed toward medications and salaries for yearround staff. On weekends, she
can be found campaigning for
funds to reach the 2006 goal of
$950,000. Her own participation, including the cost of her
yearly travel to Africa, remains
a volunteer commitment.
What does she get out of all
this? The answer lies in small
rewards that pay big dividends.
“I once gave a group of
women money so they could
grow vegetables for their families,” Dr. Kilibwa says. “When
I went back the following year,
they had learned to irrigate the
area, and had grown more
than they needed.”
She adds that the women
sold what was left over and expanded the vegetable garden,
creating a micro-credit program
in which they loan money to
other women to plant their own
gardens. In a year’s time, the
original group of five women
had become 18 and was still
growing.
Her eyes open wide with
delight as she explains, “The
creativity of these village
people is amazing. They are
smart and pragmatic. They just
need to be empowered.” She
pauses briefly before confiding, “I can hardly wait to go
back and see how much their
enterprise has grown since last
year.”
In 2007, a group of RWJMS
physicians will travel to
Kakamega with Dr. Kilibwa.
By then, her new clinic will be
treating 500 patients a day.
Qualified African doctors will
begin work there as a result of
the equipment she has been
able to secure. Fees from paying patients will help supplement the cost of care for the
poor. American physicians will
provide refresher courses for
local doctors, adding proof
that sometimes a global project
with far-flung implications
begins on a modest scale, when
one person cares enough. M
L a s t
STUDENTS ON
A MISSION
pediatrics and assistant dean for
student affairs, says, “The students
can’t help but develop more sensitivity to patients when they are confronted by this kind of need. Global
health experiences can contribute in
a seminal manner to the development of humanistic physicians.
“When they see patients walking
great distances, and then waiting
hours to receive the limited care that
is available, they realize medicine is
a calling, not just a profession.”
Dr. Mehne agrees, adding that he
hopes resources can be found to
provide even more global student
experiences. “It affects a student’s
medical education, and well beyond
that,” he says. “It benefits his or her
ultimate knowledge, perspective,
and performance of the practice of
medicine.” M
pay b a c k
where it
counts
many of the students benefiting
from his scholarships. At his suggestion, students write a complete
report of their foreign experiences,
and these reports are put on the
RWJMS Web site in the hope that
they may inspire others to seek
foreign study as well.
“Health care is my passion, and
I’m committed to everything good
global health represents,” he says.
“The scholarship is my way of furthering that commitment, and giving
something back for the education I
received at RWJMS. I encourage all
alumni to consider projects of this
nature that enhance the social conscience of medical students.” M
Charles J.
Gatt, Jr., MD ’89:
At Home, On the
Field and in the Lab
P a g e
continued from page 52
cates, we will develop an infrastructure
whereby ideas, insights, and discoveries
generated through basic scientific
inquiry are brought, more rapidly and
he recipient of the RWJMS
Volunteer Faculty Award in
2003, Dr. Gatt currently is funded
by the National Institutes of
Health (NIH) and the National
Aeronautics and Space Administration, and is co-investigator with
Nicola C. Partridge, PhD, professor
and chair, Department of Physiology and Biophysics, in an NIHfunded osteoarthritis research
project. He has authored numerous publications, and has served
on the editorial boards of the
American Journal of Sports Medicine and the Journal of Bone and
Joint Surgery.
Although he says he has regrettably little time to participate in
sports himself these days, Dr. Gatt
has been a player since youth. He
ran competitively in college and
medical school, completing 80 to
100 miles a week. His commitment to his chosen sub-specialty is
reflected not only in his clinical
and research activities, but in his
personal enjoyment of the game
— almost any game. This is evident when he talks of the importance of injury prevention.
“Today, there is much more
interest in the amateur athlete
than ever before,” he says. “For
instance, we conduct pre-season
training that includes techniques
for skiers in how to prevent knee
injuries, and classes that teach
simple exercises that can prevent
the kind of shoulder injury that
keeps golfers off the course.”
With his varied responsibilities,
Dr. Gatt may not have much time
to be part of the game these days.
But he certainly hasn’t strayed far
from the action. M
T
effectively, to the treatment and prevention of human disease.
In the historical approach to translational research, academic centers have
been the vast providers of new ideas.
Often the translational application of
these discoveries has been an afterthought, rather than a driver, of the
research approach. In this scenario, for
every basic discovery that found a medical application, scores more lay by the
roadside, due to a lack of market value
or a variety of other barriers. In our new
vision, all the stakeholders will take part
throughout the process, from discovery
to cure. We will work as teams, determining needs, directing research to fulfill
those needs, and cooperating to anticipate and remove the traditional impediments to success. Importantly, as part of
the process, we will train the teams of
the future, so that what seems novel and
innovative to us today will be common
practice for the next generation.
In the words of Elias A. Zerhouni,
MD, director of the NIH: “We are the
edge of science, and to provoke a change
be a provocateur, not the manager of the
status quo. It’s extremely hard. The key
thing, though, is if you don’t have a
framework for a vision, nobody moves
in a really new direction. Today there are
genuinely new opportunities, but the
new science will require interdisciplinary
collaborations. That will be key.”
M
— Kathleen W. Scotto, PhD,
Professor of Pharmacology and
Senior Associate Dean for Research
LAST
P
A
G
E
From the Bench to the Trench —
A Vision for Innovative Health Care
To the individual who devotes his or her life to science, nothing can give more happiness than
when the results immediately find practical application. There are not two sciences. There is science and
the application of science and these two are linked as the fruit is to the tree.
— Louis Pasteur, 1871
In
the autumn of 2005, the National Institutes of Health
group of basic scientists, our dedicated and tireless group of
(NIH) established funding for a new initiative with the purpose
clinical researchers, and their genuine commitment to translat-
of transforming the application of scientific discoveries to new
ing the findings of the former to the practice of the latter. In
and better health care. The goal of
addition, what distinguishes us
this initiative, termed the Clinical
from other medical schools around
and Translational Science Award
the country, and provides us with
(CTSA), is to finance the develop-
invaluable partnerships as we trans-
ment of integrated, multi-discipli-
form our clinical translational enter-
nary academic homes that have the
prise, is our unique environment.
consolidated resources to “1) cap-
New Jersey holds a distinctive posi-
tivate, advance, and nurture a cadre
tion in the nation with respect to its
of well-trained multi- and inter-
population, its technology-based
disciplinary investigators and re-
industry, and its highly regarded
search teams; 2) create an incuba-
scientific and health-related institu-
tor for innovative research tools
tions.
and information technologies; and
In September 2006, RWJMS and
3) synergize multi-disciplinary and
its partners were awarded a CTSA
interdisciplinary clinical and trans-
Planning Grant. Taking advantage
STEVE HOCKSTEIN
lational research and researchers to
catalyze the application of new
knowledge and techniques to clini-
of the strength of our research and
our environment, we have developed a vision for the transforma-
cal practice at the front lines of patient care” (http://
tion of health care discovery and delivery in our state. In part-
grants.nih.gov/grants/guide/rfa-files/RFA-RM-06-002.html).
nership with the State of New Jersey, other academic institu-
For UMDNJ-Robert Wood Johnson Medical School, both
tions, our local pharmaceutical and biotechnology industries,
the timing and the vision of the NIH-CTSA program could not
our hospital partners, and our community health care advo-
have been better. We are proud of our strong and renowned
B
Y
K
A
T
H
L
E
E
N
W .
C o n t i n u e d
S
C
O
T
T
O
,
o n
P a g e
P
H
5 1
D
S A V E
T H E
D A T E
Alumni
R E U N I O N
W E E K E N D
OCTOBER 12
1 4, 2 0 0 7
S at u r d ay, O c tob e r 1 3
Gala Dinner Dance
The Heldrich, New Brunswick
Honoring the following anniversary classes:
35th: 1971, 1972 ■ 30th: 1976, 1977
25th: 1981, 1982 ■ 20th: 1986, 1987
15th: 1991, 1992 ■ 10th: 1996, 1997
5th: 2001, 2002
Sunday, October 14
Alumni Brunch ■ The Heldrich
Distinguished
Alumni Award:
Please send nominations to Roberta Ribner
at: [email protected]
For additional information, please contact:
Roberta Ribner, Coordinator, Alumni Affairs, 732-235-6310
or email: [email protected]
For updates on plans for the Alumni Reunion Weekend, please check the
Alumni Association Web site: http://rwjms.umdnj.edu/alumni
When you need advanced medical care,
TRUST A LEADER WITH A NATIONAL REPUTATION.
ONE ROBERT WOOD JOHNSON PLACE, NEW BRUNSWICK, NJ 08901
732-937-8521
www.rwjuh.edu
Non-Profit Org.
U.S. Postage
P A I D
Piscataway, NJ
Permit No. 44
125 Paterson Street • Suite 1400
New Brunswick, New Jersey 08903-0019

Robert Wood Johnson Medicine • Spring 07

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