from the - medicine at michiganfor endoscopy,laparoscopy, and endovascular procedures provide...

For decades, the airline industry has used simulation to train andassess the skills of pilots. Beginning in the early 1900s withcontraptions crafted, for example, from two half-sections of abarrel to represent an aircraft’s pitch and roll, simulator flight

training has advanced to sophisticated digital environments that arehighly realistic. Simulations — of staged as well as real disasters, suchas the unforgettable crash of United Airlines flight 232 at Sioux City,Iowa, in 1989 — allow for complete and repeated analysis of whatwent wrong, what could have been done differently, and how morelives could have been saved. These training procedures result in greatersafety for passengers and crew alike.

Medicine now too has embraced simulation for training and assessment. We are in an era when trainees will be taught and willpractice to a level of competency before ever encountering an actualpatient. Our cover story takes us into the Clinical Simulation Lab,where scripted scenarios allow medical students and residents to practice their skills — repeatedly, and with no risk to patients — onlifelike mannequins with bodily functions and symptoms of injury anddisease that are uncannily realistic. Videotapes of training sessions provide an opportunity for students and instructors to analyze, discussand determine ways to improve future performance. Virtual trainersfor endoscopy, laparoscopy, and endovascular procedures provideadditional opportunities to learn and refine skills.

Clinical simulation provides a powerful tool for learning medicine andrepresents both the present and future of medical education. Today’sstudents not only have a familiarity with technology, they have expectations of it. Its value and potential hold huge implications formedical education by creating flexible learning opportunities and ahigh level of skills assessment.

Aviation and medicine are quite different fields, yet they share a similarbottom-line when it comes to training the professionals who workwithin each: to keep people safe, and to be prepared to respond asunexpected events and emergencies arise. Technology offers amazingways to accomplish these goals, and it’s revolutionizing how studentslearn and practice medicine. We’ll explore the larger role of technologyin medical education further in our next issue. Clinical simulation isjust the beginning.

Sincerely,

James O. Woolliscroft, M.D. (Residency 1980)Dean, U-M Medical School

DEANFROM THE

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4 Summer 2007

LETTERS

Animal Research AdvancedKidney TransplantsThe article about animal research in the fall2006 issue (“Myths, Realities, Benefit BeyondMeasure”) was particularly interesting to mebecause at the time of the first kidney trans-plant at the U-M (1964), I was working underDr. Paulette Szadaly, a veterinarian, in theKresge Medical Research Building. We weretesting formulations of radiographic contrastmedia that were being developed for arteriog-raphy. Before doing a transplant, the donor hadto have a renal arteriogram to be sure he orshe had normal kidneys and normal renalartery anatomy. There was no CT, ultrasound orMRI then. We were also testing a new type ofdialysis filter that is now used worldwide — theCordis filter. In the 1960s and ’70s, mostpatients were on dialysis before they couldhave a transplant, so we were working toimprove the efficiency and safety of dialysis.Both the filter and the contrast media weretested on dogs.

Although some medical research doesn’trequire animals, there are many instances whereanimal research is the only way that new med-ical knowledge and treatment can progress.

Phillip B. Shepard (M.D. 1968, Residency 1970)Phnom Penh, [email protected]

Kudos, Memories and a TheoryI have just received and read the spring issueand find that “Class Notes” begins with the1960s. It is yet one more reminder that thoseof us who graduated in the ’50s are slippingfurther into senescence. Nevertheless, I stepforward to congratulate you on the style andcontent of the magazine, as I believe you haveimproved the readability markedly over theyears.

This issue was of special interest as I actuallyknew some of the teachers and colleaguesmentioned. I agree with Dr. Williams about hismemories of Professor Falls (“Letters”). I keptmy notes from his lectures for many yearsbefore finally turning them over to my col-league, Dr. Michael Schermer, a U-M grad andophthalmologist still practicing in Sacramento.Also, it was nice to see Jeremiah Turcotte, a fra-ternity brother and friend who cared for mymother when she required surgery in the ’70sin Ann Arbor.

Finally, I wish to comment on the article aboutidiopathic pulmonary fibrosis, or IPF (“Hope fora Devastating Disease”). My specialty was gen-eral surgery, but pulmonary disease was ofgreat interest to me as an inhabitant of theSacramento Valley for more than 40 years. Inthe last decade I watched three friends suc-cumb to this disease, and all had been lifelongresidents of the valley which is known for itsrice farming and annual burning of the riceresidue prior to the next planting. It has beenmy theory that the small particles of toxicwaste drifting in the smoke were inhaled andfixed in the lungs of these friends for a periodof 70 years. It did not help that all were smok-ers, but I believe that we now have the scien-tific tools to identify these tiny particles andprove the etiology of this illness. These are theramblings of a nearly 50-year medical schoolgraduate, but as my mother (also a U-M grad-uate, in dental hygiene, 1926) succumbed torespiratory failure, this puzzle has continued tointrigue me.

Robert M. Appleman (M.D. 1959)Kamuela, [email protected]

James WoolliscroftNamed Dean ofMedical School

James O. Woolliscroft, M.D. (Residency1980), has been selected dean of the

Medical School for a five-year appoint-ment which began July 1.

Woolliscroft served as executive associatedean since 1999 and was named interimdean last year. An internationally recog-nized medical educator, he has playedmajor roles in medical education at the U-M, and has helped establish standardsfor education and accreditation at anational level for medical student andgraduate medical education.

Woolliscroft joined the U-M faculty in1980 and was selected as the first JosiahMacy Jr. Professor of Medical Education,awarded through a national competition in1996. In January 2001, he became theLyle C. Roll Professor of Medicine, recog-nizing his work in enhancing the practiceof medicine through education. Woolliscroftis also a professor in the Department ofMedical Education.

He was chosen as a fellow of theAssociation of American Medical Colleges’Council of Deans in 2003-04. In 2004,Woolliscroft received the Society of GeneralInternal Medicine’s Career Achievement inMedical Education Award.

—Mary Beth Reilly

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Medicine at Michigan 5

May 23, 2007, 2:08 a.m.Well, this is it. I mean, almost it — to me at least.Today is the last “official” day that I will be withinthe walls of Chelsea High School as a student.I made it. It sounds so lame to say it, but whenI think about how much “making it” means tome, I realize I accomplished the one thing I setmy mind to: graduating with my class. Therewere people who thought I wouldn’t make it to10th grade; there were people who thought Iwouldn’t be able to handle it. Well ... aren’t youglad I’m always right!? I’m kidding, but when itcame to this, I had to be right. I just had to.

This day, along with graduation day,marks the endof a long journey. After having cancer, I was stillfighting and struggling to survive. Survive amongmy fellow classmates as well as survive in the realworld. It’s not that I had doubts, it’s just, well, mylife seems very complicated because of my pastwith cancer. And now with this journey ending,finally, I hope that I can begin life anew.

I’ll be attending Western Michigan University inthe fall, and will no longer be known as the girlwho is trying to survive, trying to graduate withher class because she had cancer. This will bethe first time I will be able to be me, without anobvious past.

Never forget who you are. It’s good advice.But also, I will never forget who I’ve been.Everything I’ve been through has shaped meinto who I am today. And I believe it worked outwell. I am nervous and excited to begin thisnew journey.

I owe a lot of people for accomplishing highschool. And I want to let the world know I couldnot have done it if it weren’t for patient parentssuch as mine. If you only knew the things theydealt with when it came to me. Goodness, I’mnot sure if I want to be a parent now. They nevergave up. They didn’t know what would happenbut that didn’t matter. What mattered was thatI wasn’t allowed to stop trying. It’s the last day

of school but I’m being told to keep studying formy exams even though I’m convinced it doesn’tmatter at this point. My parents don’t want any-thing less for me than my best. And I owe themall of this. All of me being able to graduate.

Parents are the people who raise us, shape us.And my parents have shaped me into a strong,determined, accomplished individual. Simplyput by me to them: THANK YOU.

So here it is, one of the last few entries I willlikely be writing. This CarePage will have tocome to an end eventually. It’s been almostfour years. I’ve got this. I’m healthy.

I’m healthy and graduating. Working full-timeand attending college in the fall!!!! If only youknew all of what that means to me. To hearmyself say it, and to think back, I’m not sure ifthat girl in the hospital could have pictured sucha bright future. But, well, here it is, folks. Here’sthe future. May it bring us all the blessings, loveand much more as we journey through it.

Again, thank you for your support and continu-ing with this CarePage.

~All my love~

Lisa

Medicine at Michigan Updates

Beginning Life AnewIn fall 2005, Lisa Harvey, then 16, graced the cover of Medicine atMichigan representing, as a patient, our story on the Blood and MarrowTransplant Program. Lisa, whose leukemia had returned despitechemotherapy, underwent a bone marrow transplant in 2003.

Lisa has shared her long journey toward recovery with countlessfriends, family and supporters through her CarePage — a free, per-sonal, private Web page provided by C.S. Mott Children’s Hospital.Recently, Lisa, now 18, wrote what is likely one of her final entries onher CarePage, which appears below with her permission.

Lisa Harvey on graduation day with her parents,Nancy and Bill

Team Flu Helps BringHonor to CaliforniaStudents

Nazeela Sabir, Ashleen Kishore andKhanh Nguyen, students at

Sacramento Valley High School inCalifornia, have won second place in thesenior group exhibit category at the annualNational History Day competition — andthey’re thanking a group of U-Mresearchers known as Team Flu.

As we reported in the spring 2007 issue ofMedicine at Michigan, Team Flu, led by U-M Medical School historians HowardMarkel (M.D. 1986), Ph.D., and AlexandraStern, Ph.D., was commissioned by theU.S. government to study the 1918-20influenza pandemic, specifically the fac-tors that reduced its impact in certainareas around the country. Along the way,the team compiled an archive of historicaldocuments and materials related to thepandemic and posted it online. Sabir andher friends consulted with Team Flu anddrew from the archive when constructingtheir project on the pandemic for NationalHistory Day.

“The Team Flu online archive was essentialto our project,” Sabir says. “The theme ofNational History Day this year was‘Triumph and Tragedy,’ and the archiveallowed us to portray the triumph andtragedy of the pandemic in a well-bal-anced manner.”

Khanh Nguyen, Nazeela Sabir and AshleenKishore wearing the medals they received atNational History Day

Photo:AstikaKishore

6 Summer 2007

MOMENTSI N M E D I C I N E A T M I C H I G A N

“The e-mail from the journal was very curt. It said I wasinfringing on their copyright and had to take down thematerial immediately or they’d contact lawyers and sueme. I didn’t want any legal kerfuffle, so I took it down.

“The next day I posted my e-mail conversation with the journal.People in the blog community were outraged that they were trying tobully me with lawyers and being heavy-handed with a student whowas really only trying to bring attention to their journal. I wasn’tslamming them; if anything, I was excited about the research.

“I was so surprised that anyone would think I was doing science a disservice. Science blogs bring pedantic ‘ivory tower’ knowledge to acompletely new audience that would probably never hear about it otherwise. But in the end, I’m glad it happened — and that the entireblogosphere howled.”

—Shelley Batts

Interview by Whitley HillPhotograph by J. Adrian Wylie

Shelley Batts, a native of central Florida and a neuroscience Ph.D. candidate, authors theblog Retrospectacle. In April, she wrote about a paper on fruit antioxidants that hadappeared earlier that month in the Journal of the Science of Food and Agriculture. Sheincluded a table and a graph from the article, and, within two hours, received a stronglyworded cease-and-desist e-mail from the Society of Chemical Industry, publisher of the journal. Batts removed the data, but the incident spread wildly through the science and blogcommunities. Support for Batts poured in from scientists and writers around the world.Two days later, a representative from the society apologized to Batts, calling the incident a“misunderstanding.”

8 Summer 2007

HURONABOVE THEN e w s a n d r e s e a r c h f r o m t h e M e d i c a l S c h o o l

I t looks like heart muscle and beatslike heart muscle, but this small

patch of pulsing cardiac tissue didn’tcome from a living animal. It was cre-ated by researchers in the U-MArtificial Heart Laboratory. Their abilityto grow bioengineered heart musclefrom cardiac cells in the lab repre-sents a major step toward the long-term goal of creating replacementparts for damaged human hearts.

“Tissue engineering is a rapidly evolv-ing field, and cardiovascular tissue isone of the most exciting areas, butalso one of the most challenging,” saysRavi Birla, Ph.D., who directs researchin the Cardiac Surgery Artificial HeartLaboratory. “Although tremendoustechnological challenges remain, weare now at a point where we can engi-neer first-generation prototypes of allcardiovascular structures.”

This means that heart attack survivorscould one day have patches of labo-ratory-grown muscle implanted intheir hearts to replace areas that diedduring the attack. Children born withdefective heart valves could get newones that grow permanently in place,rather than having to be replacedevery few years. And people withclogged or weak blood vessels mightget a “natural” replacement grown in atissue incubator called a bioreactor.

While it will be years before bio-engineered heart muscle can be usedin human beings, U-M scientists havestarted experiments to transplant itinto the hearts of rats with heart attackdamage to see if the new tissue healsthe damage.

Among the hurdles still to be over-come: determining which types of

Bioengineering the Heart,Piece by Piece

Ravi Birla with Louise Hecker, a graduate student in the Section of Cardiac Surgery. Birla and Hecker are seniorauthor and lead author, respectively, on the paper, “Engineering the heart piece by piece: state of the art in cardiactissue engineering,” published in the March 2007 issue of Regenerative Medicine.

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day have patches oflaboratory-grown

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replace areas thatdied during the

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cells hold the most potential andfinding the best way to grow thosecells to form viable cardiac tissuethat is strong, long-lasting and struc-tured, at a cellular level, like naturaltissue.

U-M scientists and biomedical engi-neers work together in the ArtificialHeart Laboratory to compare theeffectiveness of different platformsused to engineer functional heartmuscle. With the right growing condi-tions, they can encourage cardiacmuscle cells to begin producing themolecules they need to communicateand connect with other cells, and togenerate the extracellular matrix orscaffold that supports cells in tissue.

“We’re interested in creating models ofthe different components of the heartone by one,” says Birla. “It’s like build-ing a house — you need to build theseparate pieces first. Once we under-stand how these models can be builtin the lab, then we can work towardbuilding a bioengineered heart.”

The U-M is applying for patent pro-tection on its new bioengineeringtechnology and is looking for a corporate partner to help bring thistechnology to market.

—Kara Gavin and Sally Pobojewski

For an expanded version of thestory:www.med.umich.edu/opm/newspage/2007/enginheart.htm

www.med.umich.edu/opm/newspage/2006/behm.htm

Landmark Gift to the U-M Health System: $50 Million for Cardiovascular Center

In June, the Cardiovascular Center received an extraordinary giftsupporting its innovative model of patient care and emphasizing

and rewarding cooperation, excellence and measurable results ineach area of the center’s operations: clinical care, research andeducation. The benefactor, who wishes to remain anonymous,believes the model could provide a pattern for all types of healthcare facilities in the future.

The donor and the UMHS jointly established benchmarks for cus-tomer satisfaction, collaboration among scientists and physicians,

To repair the damaged heart muscle, U-M researchers take muscle cells from somewhereelse in the animal’s body and remove immature satellite cells from the muscle sample.The satellite cells are placed on a porous biodegradable scaffold to help them grow intothe specific size and shape required.The cells are grown inside a bioreactor that simulates conditions inside the body.

When the tissue-engineered patch isready, researchers implant it over thedamaged heart muscle. As musclecells in the patch grow, they fill in andbecome part of the animal’s heart,restoring its normal pumping ability.

When plaque deposits form insidecoronary blood vessels, they canrestrict the flow of blood to an areaof heart muscle, which can cause a myocardial infarction, or heartattack. Lacking oxygen and nutri-ents from blood, that part of theheart muscle will die (dark area).This weakens the heart’s ability topump blood efficiently.

A Patch for Damaged Heart Muscle

clinical outcomes, research contributions, and excellence in edu-cation. Of the gift, $25 million will be paid over the next 10 years;another $25 million will be paid when the center meets thebenchmarks. If the center receives the entire $50 million, it will bethe largest gift ever made to the Health System and the second-largest to the U-M.

—Kara Gavin

For more information on the gift and the Cardiovascular Center:www.med.umich.edu/opm/newspage/2007/cvcgift.htm

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10 Summer 2007

HURONABOVE THE

When it comes to ovarian cancer, anyprogress is good news. Since ovarian

cancer produces few or no symptoms dur-ing its early stages, 70 percent of patientsaren’t diagnosed until after the tumor hasgrown or spread to other parts of the body.

Scientists in the Comprehensive CancerCenter are trying to give physicians newdiagnostic and treatment tools to helptheir patients with ovarian cancer. They aretargeting genes responsible for tumor cellsignaling and the growth of new blood ves-sels that feed the growing tumor.Understanding how these genes workcould provide clues to ovarian cancer’sdeadly secrets.

A research team directed by Kathleen R.Cho, M.D., a professor of pathology and ofinternal medicine, is focusing on twodefective cell-signaling pathways that leadto ovarian endometrioid adenocarcinoma,the second most common type of ovariancancer.

“In the last 30 years, we haven’t done a lotto improve the survival of ovarian cancerpatients,” Cho says. “This study has thepotential to improve our understanding ofearly ovarian cancer.”

Researchers in Cho’s lab analyzed genemutations and signaling pathway defectsfound in human ovarian tumor cells, andthen created a strain of genetically engi-neered mice with the same defects to seeif ovarian tumors would develop. In all themice altered to possess both pathwaydefects, ovarian tumors developed rapidlyand often metastasized.

Currently, Cho is using the mice developedin her lab for preclinical testing of a drugcalled Rapamycin to see if it can inhibit thedefective cell-signaling systems involved inovarian endometrioid adenocarcinoma.

Ronald Buckanovich, M.D., Ph.D., an assis-tant professor of internal medicine and ofobstetrics and gynecology, is attacking ovar-ian cancer on a different front. He has iden-tified more than 70 biomarkers that arefound only in the cells of blood vessels run-ning through ovarian tumors. By analyzingthe biomarkers, Buckanovich and other sci-entists were able to identify genes that areactive in tumor vascular cells.

“When these genes are highly expressed,we suspect it may be a sign of a tumorthat’s able to grow blood vessels more effi-ciently and therefore is more aggressive,”Buckanovich says.

If he can prove that these markers are spe-cific to ovarian tumors, Buckanovichbelieves it may be possible to developdrugs that target the blood vessels andstrangle the tumor.

—Nicole Fawcett and Anne Rueter

For an expanded version of the story:www.med.umich.edu/opm/newspage/2007/ovarian.htm

www.med.umich.edu/opm/newspage/2007/ovariancancer.htm

Revealing Ovarian Cancer’s Deadly Secrets

Kathleen Cho and Ronald Buckanovich

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HURONABOVE THE

Researchers at the Comprehensive Cancer Center have devel-oped — and are currently testing in mice — a new technique

that uses magnetic resonance imaging, or MRI, to measure theeffectiveness of chemotherapy for prostate cancer that hasspread to the bones. Currently, physicians have no way to tellwhether or not bone tumors are responding to therapy.

The imaging technique uses special software to track the move-ment of water through cells in the tumor. It was developed byBrian D. Ross, Ph.D., a professor of radiology and of biologicalchemistry, and other scientists in the Cancer Center’s MolecularImaging Program. Tumor cells slow the movement of water, so asthose cells die from the effects of chemotherapy, water diffusionincreases.

Functional diffusion map technology, as the technique isknown, could be used to indicate if a tumor is shrinking,allowing patients to switch to an alternative therapy if atreatment isn’t working.

—Nicole Fawcett

For an expanded version of the story:www.med.umich.edu/opm/newspage/2007/prostatecancer.htm

For patient information on prostate cancer:www.cancer.med.umich.edu/cancertreat/urologiconcology/prostate_cancer.shtml

Is the Chemo Working?

For years, scientists believed that when bacte-ria invade the body, they activate an immune

response by binding to receptors on the surfaceof immune cells called macrophages — thebody’s front-line defense against infection.

Now, a U-M research team led by Gabriel Nunez,M.D., the Paul H. de Kruif Professor of Pathology,has found that invading bacteria also can slipinside macrophages and trigger the immuneresponse by activating a protein called cryopyrinfound in fluid inside the cell. Cryopyrin is impli-cated in the development of several inflamma-

A mouse macrophage (cytoplasm in red,nucleus in blue) infected with bacteria (smallblue elongated bacillus).

This image of a tumor in mouse bone is based on data from magnetic resonanceimaging scans of the bone taken before and after chemotherapy to shrink thetumor. Using software developed at the U-M Cancer Center, scientists can mapthe diffusion of water through cells in the tumor. Green areas indicate portions ofthe tumor that did not respond to chemotherapy.Illustration: Brian D. Ross, Ph.D., U-M Comprehensive Cancer Center

Bacteria Invade Cells, Trigger Immune Response from Within

tory syndromes characterized by recurrent fever,skin rash and arthritis.

This research gives scientists new targets andpathways for future vaccine development, as wellas for drugs designed to block the body’s inflam-matory response in rheumatoid arthritis andsome other autoimmune diseases.

—Anne Rueter

For an expanded version of the story:www.med.umich.edu/opm/newspage/2007/microbes.htm

12 Summer 2007

HURONABOVE THE

Thirty years of experience with a complex surgical procedure called transhiatalesophagectomy has reduced mortality and complications and given the U-M Health

System one of the best patient safety records with the procedure in the country.

First developed by Mark Orringer, M.D., now a professor and head of thoracic surgery, theoperation is used to treat esophageal cancer and other conditions requiring removal ofthe esophagus. Since the U-M procedure does not involve opening the chest to removethe esophagus, it is less difficult for patients and generates fewer complications than atraditional thoracotomy.

Transhiatal esophagectomy was not warmly received by thoracic surgeons when Orringerfirst introduced it, but after 2,000 procedures, U-M’s mortality rate is now just 1 percent,and complication rates have dropped from 32 percent in the early years to between 1percent and 2 percent more recently. “We have the most comprehensive experience withthis operation ever reported,” Orringer says.

—Nicole Fawcett

Skepticism Gives Way to RemarkableResults for Surgical Procedure

Donald Rockefeller enjoys breakfast in his hospital room while visiting with Mark Orringer, who performed Rockefeller’s transhiatal esophagectomy surgery just five days earlier.

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Vaginal Delivery and Organ Prolapse: Is There a Connection?

Some women are encouraged to deliver their babyby an elective Caesarean section, because their

doctors worry that a vaginal delivery will lead, later inlife, to a condition called pelvic organ prolapse.

Prolapse occurs when thebladder, uterus or lowerbowel falls from its nor-mal position in thebody into the vaginalarea. A commoneffect of the conditionis urinary incontinence.Every year, more than200,000 women havesurgery to correct prolapseand other pelvic floor disorders.

Whether vaginal delivery actually causes this conditionhas been hotly debated in the medical community. In arecent study, Medical School researchers found a strongconnection between muscle damage that can occur dur-ing vaginal deliveries and pelvic organ prolapse. Rates ofmuscle injury were particularly high when forceps wereused to assist delivery, according to John O.L. DeLancey,M.D., the Norman F. Miller Professor of Obstetrics andGynecology.

Fifty-five percent of women in the study with prolapsewere found to have major damage to the levator animuscle, which supports the bladder and uterus, com-pared to just 16 percent of women without prolapse.When women were asked to contract their pelvic mus-cles, the muscles were 40 percent weaker in womenwith prolapse.

However, DeLancey cautions against using the findingsto support more elective C-sections. He says studyresults should be used to help identify how women areinjured during vaginal birth in an effort to make it safer.

—Katie Gazella

For an expanded version of the story:www.med.umich.edu/opm/newspage/2007/prolapse.htm

For patient information on pelvic organ prolapse:www.med.umich.edu/1libr/aha/umpelvicpro.htm

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HURONABOVE THE

If a daily dose of extra vitamins could protectyou from noise-induced hearing loss, would

you take it? Scientists at the U-M KresgeHearing Research Institute are convinced thereare lots of people who’d be interested — espe-cially soldiers, musicians, pilots, constructionworkers or anyone who wants to protect theirhearing from the daily din of modern urbansociety.

Josef M. Miller, Ph.D., a professor of otolaryn-gology and former director of the institute, andColleen Le Prell, Ph.D., a former research inves-tigator there, tested a combination of highdoses of vitamins A, C, E and magnesium in apreclinical animal study and found it to be veryeffective at preventing permanent noise-induced hearing loss. The animals had pro-longed, close-range exposure to sounds asloud as a jet engine during take-off.

Convinced that the right combination of antioxi-dants and a vasodilator can effectively preventthis type of noise-induced inner ear damage,

Vitamins to Prevent Hearing Loss?

Photo:ScottGalvin

Josef Miller

The growing national rate of childhood obesity appears to be contributing to early puberty ingirls, according to researchers at the U-M C.S. Mott Children’s Hospital.

“Our study indicates that increased body fatness is associated with earlier onset of puberty,” sayspediatric endocrinologist Joyce Lee, M.D., an assistant professor of pediatrics and communicablediseases and a member of the Child Health Evaluation and Research Unit.

In a study of 354 American girls ages 3 to 12, Lee and the research team found that a body massindex score in the 85th percentile or above in girls as young as age 3, and large increases in scoresbetween age 3 and first grade, were associated with early breast development and menstruation.

According to Lee, early puberty can lead to a higher incidence of behavioral problems, early alco-hol use and sexual intercourse, and increased rates of adult obesity and reproductive cancer.

—Krista Hopson

For an expanded version of the story: www.med.umich.edu/opm/newspage/2007/puberty.htm

Resources for parents with overweight children:www.med.umich.edu/1libr/pa/pa_blobesit_pep.htm

Obesity in Girls Linked to Early Puberty

Miller launched a U-M start-up company calledOtoMedicine to test and market the vitamin-and-magnesium formulation for use in people.

Clinical trials of a hearing-protective tablet orsnack bar are scheduled to begin in Swedenthis summer, according to Miller, co-principalinvestigator with colleagues at the KarolinskaInstitute. The doses of the commonly useddietary supplements to be tested in the clinicalstudy are known to be safe for human con-sumption. If results show that the formulationis effective at preventing hearing loss in peo-ple, Miller says a product could be on the mar-ket within two years.

—Anne Rueter

For an expanded version of the story:www.med.umich.edu/opm/newspage/2007/hearingloss.htm

For patient information about hearing loss:www.med.umich.edu/1libr/aha/aha_noishear_crs.htm Students Award

Pharmaceutical Policy an “A” In 2003, the Health System wasone of the first institutions in theU.S. to limit interactions betweenstaff and pharmaceutical represen-tatives. It was also among the first toeliminate, in 2002, the use of drugsamples in its clinics and hospitals.

Now, the American Medical StudentAssociation has recognized theHealth System for its policy restrict-ing drug representative access. In itsfirst assessment of medical schoolsand affiliated medical centers, onlythe U-M, Stanford University, theUniversity of California-Davis, theUniversity of Pennsylvania and YaleUniversity received an “A” on theassociation’s scorecard.

—Kara Gavin

MEDICAL TRAINING GOES VIRTUAL

REALITYCHECK

14 Summer 2007

BY JAMES TOBINPHOTOS BY MARTIN VLOET

The plastic patient lying on his backin the Clinical Simulation Center at University Hospital may not beamong the living, but he behavesas if he is. His eyelids blink. His

chest rises and falls. And the four doctors hur-rying to his side certainly are acting as if his lifeis at stake.

Overhead, a loudspeaker blurts: “Who do I give a report to? Dr. McGehee? I’m the EMS.I have this 50-year-old, inebriated, combativeguy who, two hours ago, was a restraineddriver in a head-on, car-versus-tree, motor-vehicle accident. He sustained a chest contu-sion, a three-centimeter left scalp lacerationand compound fracture of the left femur. Theairbag did deploy. There were no abdominalinjuries. He has good pulses on the right butno palpable pulses in the left leg.”

The patient needs exploratory surgery on hisleg, the EMS technician on the loudspeakersays, but first the surgeons want him intubated— that is, a tube must be inserted in his throatto prepare him for the ventilator that willbreathe for him during surgery. That’s whatthese four residents in the Department ofFamily Medicine, led by Kassandra McGehee,M.D., a second-year, must do, and fast.

“All right,” McGehee says. “Is he responsive?”

She leans over the mannequin.

“Sir? Sir?”

A new voice, loud and rough, comes throughthe loudspeaker: “Yea-ahh?”

“Hello, sir, we’re going to take care of you,okay?”

“Ahh, great!” the voice bellows. “Hey, canyou give me somethin’ for my leg? My leg iskillin’ me. This is, like, the worst day ever …”

“Yes, we’ll give you something for your leg,”McGehee says. Then, to her colleagues: “Let’s get him stable first.” ä


Residents Scott Kelley, Andrew LeFleur, CarlaZahuranec and Kassandra McGehee tend totheir plastic patient.

16 Summer 2007

Simulation has been part of the training ofphysicians since the first time a cadaver wasopened for inspection. But in recent years, ithas taken a quantum leap. In 2004, whenthe U-M opened its Clinical Simulation

Center, only a few such facilities existed in all theU.S. Now, there are some 500. Taking their cuefrom aviation, and incorporating extraordinary newtechnology, medical educators are making simula-tion a central part of the learning experience. At theU-M, every resident logs time in the Sim Center, asthe lab is called, and many practicing physicians areusing it, too, to keep their skills sharp.

“Airline pilots have been doing this for decades,”says James Cooke, M.D. (Residency 2000), an assis-tant professor of family medicine, whose voicesounds suspiciously like both the efficient EMStechnician and the intoxicated patient just heard inthe Sim Center. “They understand that you have tolearn by doing and practicing. It’s part of how welearn as human beings. We have to actually do thesetasks to learn them.”

And if you can learn on a patient who can’t die, allthe better.

The pioneers in this new era in medical simulationwere anesthesiologists at the Stanford School ofMedicine. In the late 1980s, seeing a need for bettertraining in situations fraught with complexity andunpredictability, they developed a curriculum thatdrew heavily on training techniques designed forflight crews by NASA and the U.S. military. TheStanford educators used the earliest interactivepatient simulators — that is, highly lifelike man-nequins plus the software that runs them. Together,they replicate many features and functions of the

“In three short years, it’s become almost indefensible for a hospital not to do this sortof training, because the face validity of it is

so strong.” —Paul Gauger, M.D.

human body, including its reactions to medications.Teaching units required students to work in teamson operating-room scenarios lasting up to an hour,with debriefing and discussion afterward. Soon, inlaparoscopy and endoscopy, computerized simula-tions showed the enormous potential of virtual real-ity in medical training. By the early 2000s,technology was catching up with the pedagogicalpossibilities of simulation all across the medical dis-ciplines.

“Medicine was 50 years behind in adopting it, butnow it’s taken off like wildfire,” says Paul Gauger,M.D. (Residency 1998), an associate professor ofsurgery. “In three short years, it’s become almostindefensible for a hospital not to do this sort oftraining, because the face validity of it is so strong.”

Michigan was among the first to organize a simula-tion center shared by multiple departments. Gauger,along with James Woolliscroft, M.D. (Residency1980), who is the Lyle C. Roll Professor ofMedicine and now dean of the Medical School, andLarry D. Gruppen, Ph.D., chair of the Departmentof Medical Education, set up the Clinical SimulationCenter in January 2004 as a cooperative involving15 of the 17 departments in the Medical School.(Only pathology and dermatology, which can dotheir work only with actual human tissue, do notparticipate.) To direct the center, they hired PamelaAndreatta, Ed.D., a Californian with long experi-ence in designing virtual reality training systems.She quickly equipped the center with state-of-the-art interactive mannequins (two adults and a child)and several virtual-reality simulators. She alsobegan working with faculty to develop a broadarray of teaching units.

One of the most active is Cooke, who led the simu-lation ramp-up in the Department of FamilyMedicine. Cooke studied how simulation was usedin other medical schools and surveyed residents,who asked for more training in situations such asrespiratory emergencies, advanced cardiac life sup-port, and rapid intubation for patients in respira-tory distress.


In the Sim Center, the residents are quicklyrunning through their procedures. “Can weget him on the monitor?” McGehee asks.Laura Distel, M.D., a first-year, flips a switch.The monitor overhead blinks on, showing the

patient’s heart rate and oxygen level. The residentsgive lidocaine to stabilize the heart rhythm for sur-gery. The loudspeaker breaks in: “The surgeon wascalling to see if they can get him back to the O.R.”

McGehee says: “Well, he’s stable, so let’s get himintubated. Let’s see. He’s got his lidocaine. Let’s givehim Versed.” This will put the patient to sleep forthe uncomfortable process of having a tube stuckdown his windpipe.

“Hey, doc!” the patient interrupts. “Is that gonnamake my leg feel better? It’s killin’ me!”

“No,” McGehee tells him, “but we’ve got to help you breathe first, and then we’ll take care of your leg second.”

Carla Zahuranec, M.D., a second-year, administersthe drug. The patient’s eyes close.

“Let’s get his head down,” McGehee says. They’re about to intubate.

Scott Kelley, M.D., a second-year standing at thepatient’s head, grasps the chin, opens the mouth. He inserts a laryngoscope to hold the tongue out of the way, then peers inside. He sees the openingsto two narrow tubes, millimeters apart. One is thetrachea, leading to the lungs. The other is the esoph-agus, leading to the stomach. If he places the tubedown the esophagus instead of the trachea, he couldcause cardiac arrest, brain damage, even death. If hepushes it too far down the trachea, only one lungwill work. He can damage the lining of the throat,the vocal cords, the lung itself, even the teeth. Kelleybarely pauses, then inserts the tube.

On the instant, Distel attaches a breathing bag. Shesqueezes it rhythmically to push air into the lungs. “Chest is rising,” she says.

McGehee applies her stethoscope to the chest. Shedetects sounds uncannily like human breathing, if abit mechanical. “Breath sounds, bilateral,” she says.Both lungs are working properly.

“All right,” McGehee calls from below, “we canhave chest X-ray come in.”

“Chest X-ray’s on their way back,” says the loud-speaker. “Can we call for transport to the O.R.?”

“Yes, we can call for transport.”

Up in the booth, unheard by the residents below, Cooke murmurs: “Beautiful. Absolutelybeautiful.” ä

In a typical scenario in the Sim Center, Cooke sits inan elevated control booth, manning a microphoneand a computer. He watches the residents through aone-way window. They can hear his voice playingvarious roles — EMS tech, nurse, clerk, patient —and he clicks his mouse in response to their orders,dispensing digital doses of medicine to the man-nequin. He can let a scenario spin out without inter-fering. Or he can throw curveballs, clicking hismouse to create the kind of unexpected mayhemthat inevitably complicates events in a real-life clinic— a respiratory failure here, a heart attack there.

Cooke and the residents can run through severalscenarios in an afternoon. One week it might be sep-sis, the next week shock, or heart arrhythmia, orcolonoscopy.

Today, it’s the tricky task of rapid intubation. Thisis an ideal skill for the Sim Center, because, asAndreatta says, it’s “low-frequency but high-acu-ity.” That means the average family physician won’toften be called upon to intubate a patient, but whenthe need arises, she has to get it right. Repeatedpractice on a mannequin develops a skill that mightbe long in coming in the real world, simply for lackof practice.

“When the time hits when you need to intubate forthe first time, anxiety is pretty much through theroof,” Cooke says. “It’s an incredibly nerve-rackingway to learn something, and often it’s not necessar-ily the safest for the patient.”

Kassandra McGehee, Scott Kelley and Laura Distelprepare to intubate.

18 Summer 2007

The benefits of simulation in the medicalcurriculum are extending throughoutthe practice of medicine. All boil downto improvements in patient care.Residents are trained more thoroughly

before they work with patients. Faculty members inclinic can spend more time helping residents withcomplex decision-making and less time on basicskills.

These begin with psychomotor skills — the mind-to-muscle actions that must come automatically,even in emergencies. The key to psychomotor devel-opment is repetitive practice. A resident can practiceon a mannequin or a computer program again andagain, with no risk to a human being, until the newskill becomes second nature.

“When you have a physician who knows the basicsand has practiced the moves before they actually

perform the procedures, the benefit is clear,” Gaugersays. “Yes, absolutely, we still need traditional train-ing methods. But that initial, floundering effortdoesn’t need to happen.”

Take a procedure as common as placing a centralline in a patient’s artery. Even a resident with a flaw-less knowledge of anatomy and extensive classroompreparation must develop an instinctive knowledgeof several tactile sensations and manipulative skills— finding the right spot to insert the needle; the pre-cise degree of pressure needed to insert the needleinto the artery without piercing the opposite side;how to hold the needle in place while threading awire through it and inserting a catheter. The tactileskills vary depending on whether the artery isfemoral, jugular or subclavian, and they must beexercised in a sterile, crowded environment. Theopportunities for a resident to try the task are fewand far between, and if he makes a mistake, the con-sequences can be dire.

Yet with simulated skin and arteries astonishinglylike the genuine article, the resident can place a cen-tral line again and again, until it’s as easy and natu-ral as riding a bike.

“When you’re doing this on a patient your firsttime, and it’s cumbersome, there’s all sorts of roomfor problems,” Andreatta says. “So the idea in the

The key to psychomotor development is repetitive practice. A resident can practiceon a mannequin or a computer program again

and again, with no risk to a human being, untilthe new skill becomes second nature.

Before the simulation begins, James Cooke and Christine Kistler (right) orient residents to the equipment available in the Clinical Simulation Center.


Up in the Sim Center booth, Kistler issitting with Cooke as he runs throughthe intubation scenario. She suggeststhat he toss one of those curve balls toher less-experienced colleagues. “Let’s

throw in a tachycardia” — a racing heartbeat.

“Sure,” Cooke says. He slides the mouse and clicks,cutting off the effects of the drug which had put thepatient to sleep.

Below, the residents are thinking their intubatedpatient is ready for surgery. Then, on the monitor,the red digits indicating the heart rate leap.

McGehee sees it instantly. “Heart rate’s 120,” shesays. “He’s tachy.”

Kelley looks down, sees the patient’s eyes are open.

“Oh, he’s awake. That’s why he’s tachy. So let’s givehim some Versed.”

Up in the booth, off-mike, Cooke chuckles. “Onesecond. Very nice.”

The patient’s eyes close. The heart rate drops tosafety.

The voice on the loudspeaker asks: “Doctor, can Isend transport back now?”

“Yes,” McGehee says.

“Okay, they’re on their way right now.”

Kistler descends from the booth, applauding the com-petent performance of her resident colleagues.

Editor’s note: In June, the Clinical SimulationCenter was awarded accreditation as a Level 1Comprehensive Education Institute by theAmerican College of Surgeons, one of only 13 suchinstitutes in the nation.

Sim Center is to do that part before they get to apatient. Let’s make sure that psychomotor skill set isautomated, in a sense — that they have it down pat.Then, when they get to the patient-care environment,they’re not thinking about their skills. They’re think-ing about the patient and the scenario at hand.”

Simulation also allows residents to work out thekinks involved in medical teamwork — who takescharge, who stands where, how to communicatewith maximum efficiency. Because scenarios in theSim Center can be videotaped and recorded, thenreplayed immediately, instructors and residents cango back through the exercise, analyzing what wentright or wrong. Sometimes a scenario is simplystopped in mid-course and started over. Or a mis-take is allowed to play itself out. The “death” of anartificial patient may not be real, but residents say itteaches a powerful lesson.

Many begin Sim Center training with doubts. Afterall, they ask, how much good does it do to treat apatient whom you know, in the back of your mind,is really a machine?

“I was very skeptical when I first went into it,” saysSusan Bettcher, M.D., a second-year resident in fam-ily medicine. “I thought: ‘Is this environment goingto seem realistic?’ But it really is a lot more realisticthan I thought it would be.”

“It can be easy to forget that it’s not a real person,”says Christine Kistler, M.D., a third-year in familymedicine. “You don’t want him to die. It can bereally nerve-racking.”

In fact, says Andreatta, the close observation of fac-ulty, not to mention the videotaping, tends to inducea level of stress in residents comparable to what theygo through in a clinic or hospital with humanpatients.

“It still makes your heart beat a little bit faster,” Distelsays. “You’re being forced to speak in the moment,act on your feet. It’s not a hand-written test.”

James Cooke controls the patient’s actions, provides his voice, and watches the resi-dents’ reactions from the observation room in the Clinical Simulation Center.

James Cooke reviews a recording of the simulation with theresidents involved, and discusses with them what went rightand what went wrong.

20 Summer 2007

Even athletes aren’t spared the decline of muscle mass that accompanies aging

John Faulkner, Ph.D., is livingproof that a lifetime of physicalactivity can deliver big benefits at an advanced age. Faulkner is aprofessor of molecular and inte-

grative physiology and biomedical engi-neering at the U-M Medical School.Now 83 years old, he manages a well-funded research program, supervisesfour graduate students and teaches mus-cle physiology to residents and graduatestudents. Many of his original graduatestudents have retired, but Faulkner justkeeps on going.

When genes for athletic ability werehanded out, Faulkner must have been atthe head of the line. He played footballand basketball in college and has thebroad shoulders and quick step of a manwho works at staying fit. Every day for 47years, Faulkner has been riding a bicycleto and from his office. He also plays ten-nis and works out regularly at the CentralCampus Recreation Building.

His only concession to aging was givingup running. “I have a total knee replace-ment, so I can’t run anymore,” he says.“I ran marathons until my early 60s andused to downhill ski, but it really beat upmy knees, so I had to stop.”

At one time nearly six feet tall, Faulknerhas shrunk to five-feet, nine-inches withage. He sports a neat grey mustache, awide smile and laugh lines around hisbrown eyes. It may take him a bit longerto get up from a chair than it used to, andmost of his thick black hair has long sincedisappeared, but his colleagues say he hasmore energy, passion for his work, andenthusiasm for life than many people halfhis age.

Throughout a long and diverse career asa coach, teacher and scientist, Faulknerhas been fascinated with muscle, espe-cially the effects of aging and exercise onskeletal muscle.

Research by Faulkner and other scien-tists has shown that the decline in muscle

BY SALLY POBOJEWSKI • PHOTOS BY MARIE FROST


mass and strength everyone experienceswith aging is caused largely by the loss ofindividual muscle fibers. Between ages50 and 80, we lose almost half the num-ber of muscle fibers we had in our 20s,according to Faulkner. Even conditionedathletes are not immune.

“No matter how hard you train, there’sa significant decline in muscle mass withage,” he says. “So staying active andbuilding muscle mass when you’re youngis important, because the number ofmuscle fibers you end up with at 70depends on the number you start outwith at 20.”

Understanding what happens to muscle aswe get older is a topic of more than mereacademic interest. With growing numbersof aging baby boomers, sedentary adoles-cents and obese adults, the Americanhealth-care system could face an explo-sion in the number of frail elderly peoplewho need 24-hour care, simply becausetheir muscles have atrophied to the pointwhere they can no longer stand or walk

— or even get out of a chair — withoutassistance.

Physicians call this muscle-wasting con-dition sarcopenia, and it’s the health-carecrisis no one talks about — according toJoseph Metzger, Ph.D., a professor ofphysiology and one of Faulkner’sresearch collaborators. “When physi-cians, scientists and public health expertsthink about morbidity and mortalityassociated with aging, they think aboutheart disease, cancer and Alzheimer’sdisease,” Metzger says. “No one thinksmuch about muscle weakness and theimpact of frailty and falls.”

The news isn’t all bad. U-M researchersare developing and testing new exerciseprotocols designed to help elderly peoplesafely preserve and strengthen the musclefibers they have left. The big problem ishow to motivate everyone, young andold, to get off the couch and start mov-ing before it’s too late. Because after acertain age, once a muscle fiber is gone,it’s gone for good.

Muscle mechanicsOur bodies contain a lot of skeletal mus-cle; it makes up 30 to 40 percent of totalbody mass. Unlike cardiac muscle orsmooth muscle, skeletal muscles areattached to the skeleton and are underour voluntary control. As soon as youhear a ringing telephone, for example,biochemical signals travel from the brain,down the spinal cord and through motorneurons to stimulate the muscles in yourarm and hand to reach for the phone.

Muscle fibers are the basic building blocksof skeletal muscle. Hundreds of musclefibers are bundled together to make asmall muscle in the hand, while hundredsof thousands of fibers make the large,weight-bearing muscles in the thighs.

Under a microscope, skeletal musclefibers look like long cylinders with alter-nating light and dark stripes. The darkstripes are thick filaments of a proteincalled myosin, and the light stripes arethin filaments of a protein called actin. ä

22 Summer 2007

When triggered by nerve impulses, filaments of myosin and actin slideacross each other, making the musclefiber contract.

Under the control of the brain’s centralnervous system, skeletal muscles can“learn” to contract in a specific orderwith great precision. This is what makesit possible for us to dance a waltz, ride abicycle or hit a baseball.

Faulkner uses care with the word “con-traction,” because it implies that mus-cles always get shorter when they areactivated and attempt to contract.Actually, when a muscle is activated, itreacts in one of three ways. The musclecan get shorter, remain the same lengthor get longer, depending on the interac-tion between the force of the contractionand the load on the muscle. These threetypes are known as shortening, isometricand lengthening contractions.

To understand the difference, Faulknersuggests trying this simple experiment inmuscle physiology: Balance a coffee cupon the palm of your hand and lift it off atable. While you lift the cup, note howthe biceps muscle in your upper arm getsshorter to generate more force than theweight of the cup. If you generate anamount of muscle force equal to theweight of the cup (an isometric contrac-tion), the cup will stay level. Now ease upon the amount of force your muscle isgenerating, so you can lower the cupbelow the level of the table, and feel howthe muscle lengthens as it attempts tocontract.

Lengthening contractions, especiallywhen force on the muscle is high — fromactivities like running downhill, loweringa heavy object or catching yourself whenyou fall — are more likely to injure mus-cle, according to Faulkner. Muscleinjuries do not occur during shorteningcontractions (lifting a weight) or duringisometric contractions (pushing against awall).

Because they can injure muscle, lengthen-ing contractions can be dangerous, espe-cially for frail, older people. “Youngpeople can and do injure their musclesfrequently, but young muscle can regen-erate by growing new muscle fibers toheal the damage,” Faulkner says. “Anelderly person can’t regenerate new mus-cle fibers as easily as young people, so thesame level of injury can be permanent.”

In recent research, Faulkner discoveredthat the mechanism of muscle fiber atro-phy in older mice and older peopleappears to be associated with a loss ofmotor units. A motor unit is a group ofmuscle fibers controlled by a singlemotor neuron that projects from a nervecell in the spinal cord. Without stimula-tion from the nervous system, musclefibers lose their ability to contract andthe entire motor unit may atrophy anddie.

“In humans, rats and mice, we see a lossin the number of motor units withaging,” says Faulkner, but the mecha-nism responsible for the loss is unknown.“The big question we’re working on iswhether the nerve dies first or the muscle

fibers die first. Right now, nobodyknows the answer to that question.”

At an age when most scientists are cash-ing their retirement annuity checks,Faulkner is eager to find the answer tothis chicken-and-egg question. He andhis colleagues are starting a newresearch project with Eva Feldman,M.D., Ph.D., who is the Russell N.DeJong Professor of Neurology, todetermine the basic mechanism behindthe degeneration of motor units.

“Building muscle mass

when you’re young is

important, because the

number of muscle fibers

you end up with at 70

depends on the number

you start out with at 20.” —John Faulkner

Faulkner collects data as a runner participates in amaximum oxygen intake test on a treadmill at an alti-tude of 14,000 feet. During the summer of 1966,Faulkner and colleagues ran tests on three groups ofrunners training at different altitudes on Mt. Evans inColorado. The data were published in the Journal ofApplied Physiology, Vol. 24, No. 5, May 1968.

Photo:CourtesyJohn

Faulkner


The mysteries of muscleIn 1960, Faulkner came to the U-MSchool of Education to establish a humanexercise physiology laboratory and teachhuman physiology to physical educationstudents. That’s where he rekindled hisfriendship with Horace Davenport,Ph.D., the legendary chair of the Depart-ment of Physiology who had served onFaulkner’s doctoral committee. In 1965,Davenport invited Faulkner to join theMedical School faculty, an appointmenthe holds to this day. Since then, Faulkner’swisdom, experience and gentle sense ofhumor have influenced generations ofMedical School students and faculty.

“John was a big reason I came toMichigan, so I have a warm place in myheart for him,” says Metzger, who hasworked with Faulkner since joining theU-M faculty in 1991. “He’s a great col-league and a great mentor. I think John isa better scientist now than he was 40years ago. He’s like a fine wine — hereally gets better with age.”

Susan Brooks, Ph.D., an associate pro-fessor of molecular and integrative phys-iology in the Medical School, hasworked with Faulkner since 1985 whenshe came to the U-M as a graduate stu-dent. She is one of 49 former graduatestudents and post-doctoral fellows whobegan their scientific careers inFaulkner’s laboratory.

Her research has contributed to under-standing that muscle injuries have twophases. The initial injury is mechanicaland occurs when a lengthening contrac-tion tears structures, both within andbetween sections of muscle fibers. But thereal damage comes later when signalsfrom damaged fibers trigger an inflamma-tory response, with associated pain andswelling, which can destroy entire sec-tions of muscle. In young animals, thisinflammatory reaction seems somehow tomake the muscle stronger after it heals.But since the mechanical damage and sec-ondary inflammation are more severe inolder animals, what makes young musclestrong can permanently injure old muscle.

Brooks and post-doctoral fellow TimKoh found that controlled passivestretches and isometric contractionsmade mouse muscle more resistant todamage from lengthening contractions.She wants to use what they’ve learned todevelop exercise programs older peoplecan use to safely maintain or increase thesize of the muscle fibers they have left.

“What excites me is the possibility ofdeveloping non-damaging kinds of pro-tocols for the elderly person who wantsto get involved in an exercise program,”says Brooks. “Passive stretch protocolsmay serve as a stepping stone, allowingthem to increase the rigor and intensityof exercise over time.”

To increase muscle mass, athletic trainersknow it’s important to include lengtheningcontractions as part of a progressive resist-ance exercise program. Lengthening con-tractions build muscle mass by increasingthe size and strength of fibers in the mus-cle. Because lengthening contractions alsoincrease the risk of muscle injury, however,they have always been considered too dan-gerous for older people.

But recently, new exercise protocols thatincorporate lengthening contractionshave been developed and are being testedon elderly research subjects. “This kindof training has tremendous potential forolder people,” Faulkner says. “You canget a 10 to 15 percent improvement withshortening contractions alone, but withthese new protocols you can get 30 to 40percent improvement. It’s a huge differ-ence, but you have to be really careful.”

Faulkner is collaborating with JamesAshton-Miller, Ph.D., a U-M professorof biomechanical engineering, and NeilAlexander, M.D., a professor of geron-tology, on a clinical study to test one ofthese new exercise regimens on people intheir 70s. The study uses a leg-pressexercise machine attached to a program-mable motor that regulates the machine’sspeed and the amount of force requiredto complete a 12-week progressive exer-

cise protocol of lengthening and shorten-ing contractions.

When researchers in Faulkner’s labora-tory analyzed the strength of individualmuscle fibers obtained from musclebiopsies of people using the device, theresults were encouraging. They com-pared muscle fibers from people usinglengthening contractions with fibersfrom people using a traditional exerciseprotocol. After 12 weeks, muscle fibersfrom the group using lengthening con-tractions were 35 percent stronger andthey had no injuries.

“Our exercise protocol focuses on build-ing strength and power in musclesinvolved in hip flexion and leg extension,because people with muscle weaknessaround the hips and knees are mostlikely to fall,” says Ashton-Miller.

Faulkner is the study’s “experimentalrabbit,” according to Ashton-Miller.Whenever the exercise apparatus is mod-ified or the protocol changes, Faulkner isthe first person to try it out. He is noweagerly waiting for the arrival of thethird generation training device. “I can’twait to get on it,” he says.

It would be unrealistic to think that every-one in their 80s can match JohnFaulkner’s level of fitness and activity. ButU-M scientists emphasize that exercise,even simple walking, can help nearlyeveryone improve muscle strength.“Doing something is better than doingnothing,” says Ashton-Miller.

T omorrow, John Faulkner will con-tinue to probe the mysteries of mus-cle. There will be new graduate

students to train and more papers towrite. This summer, he’s flying toScotland to attend a retirement party foran old friend and former running partner.

But for now, at the end of a chilly, springday in Ann Arbor, Faulkner heads for thebike rack in front of the BiomedicalScience Research Building. He slips onblack gloves, zips up an electric bluewindbreaker with black stripes, and fas-tens Velcro straps around his pant legs.Then he climbs on his 1981 Peugeotmountain bike and heads across campuson the first leg of the four-mile commutehome.

Web exclusive! Prescription for Exercisewww.medicineatmichigan.org/magazine

Faulkner is the first “older” subject to perform leg exten-sor lengthening contractions on a novel motorized legmuscle training device at the U-M BiomechanicsResearch Laboratory in November 2004.

Photo:James

Ashton-Miller

24 Summer 2007

THESTRONGAPPROACHAt the helm of three hospitals, 40 health centers, a $1.69-billion annual budget anda workforce of 13,500, you might expect to find a highly-pressured executive with acommanding presence of power and authority. But in the whirlwind of daily activity— visible and behind the scenes — CEO Doug Strong is every bit the calm center ofthe storm.


On a gray, blustery Monday morning inMarch, Doug Strong, director andchief executive officer of the Univer-sity of Michigan Hospitals and HealthCenters, and a dozen or so members

of his Senior Management Team are starting theirweek at Arbor Lakes, an office complex on thenortheastern edge of Ann Arbor. This is where thenearly 500 employees of the Medical CenterInformation Technology operation work, designing,monitoring and supporting every computerizedfunction of the Health System, which includes,among other things, every prescription and everytest order from every doctor who practices here.

Visits to these locations have become a regular partof Strong’s and his team’s routine. It helps themknow first-hand what happens in these workplaces,stay ahead of the curve on potential prospects andpitfalls, and try to sustain a human touch in an oper-ation that employs 13,500 people — slightly lessthan the population of Traverse City, Michigan.About 20 percent of the Hospital and Health Centerstaff is off-site from the main medical campus.

Afterward, Strong is scheduled for a working lunchwith his boss, Executive Vice President for MedicalAffairs Robert Kelch, and a candidate for MedicalSchool dean, then a two-hour meeting of theHealth System Executive Group, followed by anhour-and-a-half one-on-one with Chief OperatingOfficer Tony Denton. He won’t get back to hisoffice to check his e-mail, and whatever else hasaccumulated there, until 4:30 that afternoon.

Later in the week, he’ll chair a Senior ManagementTeam retreat focused on goals and objectives,accreditation issues, customer service and referrals.He’ll preside at an Executive Director’s Forumwhere he’ll hear reports on the fiscal year 2008budget plan. And he’ll spend an afternoon at theRoss School of Business, where Health System exec-utives who have completed a six-month leadershipprogram will report on projects as diverse asimproving the psychiatry referral process and assist-ing faculty with research funding gaps.

Strong’s is not a schedule for the shy or sluggish.Eighty standing meetings a year appear on his cal-endar, many of which he chairs. Denton is one of

12 executives who report directly to him, and hemeets semi-annually with each of the departmentchairs and selected physician leaders, and gives atalk almost every week “to any group in the organ-ization that wants to listen to me.”

This doesn’t count his work outside the organiza-tion. He’s involved with the Michigan HospitalAssociation, the University Health SystemConsortium, the Greater Detroit Area HealthCouncil, and the Association of American MedicalColleges’ Council of Teaching Hospitals and HealthSystems. External work takes up about 20 percent ofhis time, but it enables him to contribute Michigan’sexperience to the state and national scenes.

These are some of the ways Strong spends his time;these are some of the issues he has to know about,prioritize, and act upon.

TIME TO THINK AND REFLECTStrong needs a lot of input to do his job. He needsto know finance, personnel, facilities, the regula-tory environment and medical practice, and heneeds to know how social trends might affect themall. And, he needs to keep 13,500 people happy,engaged and feeling secure, even as he prepares forthe vagaries of the future.

Figuring out priorities and policies that will turn allthat potentially bewildering input into output istricky business. It would be easy to get lost or over-whelmed. It would be easy to settle for keeping thelid on. But he sets his sights much higher than that.Strong says his most significant leadership quality islistening, and his most productive time is when he’sreading and thinking. Alone.

“I’ve always tried to reserve time each week forreading and reflection,” he says. “I don’t knowwhat the measure of it is, maybe 10 or 20 percentof my work-time. Every day I scan or read The AnnArbor News, The Wall Street Journal, and The NewYork Times. I read a lot of journals and magazinesrelated to health care. It’s important to be aware ofevents going on around us so we can influence them— Michigan should be an influence in both the stateand nation — but also to see what threats andopportunities there are.” ä

BY JEFF MORTIMER • PHOTOS BY SCOTT GALVIN

26 Summer 2007

While he may not be able to precisely quantify hisreading and thinking time, he knows exactly how itmeasures up otherwise. “I think what I do in thatperiod of time has added the most value to theorganizations I’ve been associated with,” he says.“It allows me to integrate things and frame them inways that perhaps others have not.”

Thus does his solitary work inform his groupdynamic: “I ask a lot of probing questions, andthat’s the result of time to think.”

This is perfectly consistent with his demeanor. Quiet,soft-spoken, almost self-effacing, Strong couldn’t befarther from the flamboyant, commanding CEOstereotype. To a certain extent, it’s just the way he is,but he also sees it as a competitive edge.

“I spend more time listening than talking in mostspheres of my life,” he says. “Part of being a CEO istaking in what you’re hearing from the organization.Part of it is thinking about that and imparting whatyou’ve thought about. I think it’s a fiction when peo-ple view a CEO as all-powerful. There’s a lot to begained by presenting yourself as not being all-power-ful, because it enables others to participate in leadingthe organization. Which, in fact, is what has to hap-pen anyway. It’s never a one-person show.”

He’s serious about listening, and present where he is.He doesn’t carry a pager and, again belying thestereotype, isn’t welded to his cell phone andBlackBerry. “My style in meetings is to not be inter-ruptive,” he says. “I attempt to be focused on what’sgoing on in front of me.”

CONNECTING THE PARTSStrong earned an M.B.A. in health care administra-tion from the Wharton School of the University ofPennsylvania, where he also held several positions atthe School of Medicine. He joined the U-M in 1998as associate vice president for health system financeand strategy, and became chief financial officerbefore assuming his current job. Before coming toAnn Arbor, he served as chief financial officer andassociate dean of the Pritzker School of Medicine andthe Biological Sciences Division at the University ofChicago, associate dean for administration andfinance at the School of Medicine of the StateUniversity of New York at Stony Brook, and associ-ate dean of planning and operations at the SaintLouis University School of Medicine.

“I’m a bit unusual for a hospital leader because of mybackground,” he says. “I’m steeped not in hospitaladministration, but rather in medical school admin-istration. I’m a learner/listener normally, but in thiscontext there’s a lot more reason for me to be listen-ing because I have a lot more learning to do.”

Strong’s original career goal was to be an academichistorian — he also holds a master’s in history fromPenn — and his first foray into health care camewhen it became clear that the employment pickings

were slim in the history arena, and he took a jobdoing survey research for the medical school there.

But his interests always seemed to be one jumpahead of his assignments. “I liked to think beyondthe boundaries of my particular sphere, and I’vebeen blessed to be able to engage in new questionsand different opportunities over time,” he says. “Ilook at the whole of the organization, not just thesegment I’m working on. I like to connect things.I’m an integrator.”

That quality is essential to wringing action from allthose meetings. “The parts need to connect,”Strong says. “We need to see the various parts of anissue, such as patient safety, together in one room— from a nurse perspective, a physician perspec-tive, a financial perspective, a regulatory perspective— and come to an agreement about the overallapproach that we wish to take, then ideally delegateone person in the room to be responsible for carry-ing it forward.”

His administrative background may explain whyhe sees so many core congruencies between leadinga health care system and leading any other kind oflarge, complex organization. “We all are driven bythe connection of many processes,” he says, “andwhat we really need to do is quality work as efficiently as possible, which is common to mostenterprises.”

CREATING COMMON GROUNDCoequal with communicating, listening, and facili-tating implementation is what Strong identifies asthe fourth aspect of leadership: creating a vision, away of looking at where the organization wants tobe at a future point in time, not in all its details, butin a form that can be explained and understood bythe entire organization.

“What I learned in history translated very well toacademic medical centers,” he says. “Critical think-ing, quantitative analysis, reading and writing —are all useful in management, as were learning uni-versity values and the value of universities.”

That training is key to his rapport with physicians,which he counts as perhaps the strongest card in hishand.

“My ability to engage them in mutually beneficialand constructive ways has been important in mycareer,” he says, “and that comes from my ability todevelop quantitative information so that physicians— at their heart, evidence-based scientific people —can deal with real data as they address real prob-lems and move toward constructive resolution.

“Physicians work in academic medical centersbecause they believe in education, patient care andbiomedical research. Because I share the value ofthose missions, there’s a common ground on whichwe can work together.”


Doug Strong isn’t a CEO 24/7. The man whobalances the many components of the

Hospitals and Health Centers also balances his pro-fessional life with time for family and his favoritehobby: gardening. “I’m an amateur,” he says. “Ican’t name a lot of plants, but I’ve learned a fewthings about texture and placement. Sometimes Iget lucky and things turn out well.” The southwestcorner of his home, just off the deck, is whereStrong sees his greatest success.

The son of an insurance executive father and anaccomplished artist mother, Strong played basket-ball and squash through the years before rakes andshovels overtook the hoops and rackets. His inter-est in gardening, learned from his mother, took rootas his children grew older. Brian, the oldest, is a jun-ior in music composition at Grinnell College inIowa, and Kristen, the youngest, a senior in highschool. Middle child Kelsey is an entering freshmanat Lawrence University in Wisconsin. “It’s muchdifferent when they reach this age and become moreindependent. My kids used to occupy a lot more ofmy free time.”

Strong and his wife, Peggy Cavanagh, who teacheslanguage arts at Tappan Middle School in Ann Arbor,

met playing softball in a co-ed grad student league atthe University of Pennsylvania.

“When I was younger,” he says, “I really enjoyedcooking. Peggy wasn’t a cook. We collaborated a lotand were in a gourmet cooking group together.Now, Peggy is by far the better cook.”

Strong also enjoys movies and theater, and says hispleasure reading falls into the category of the TheNew Republic and the The New Yorker.

Awake at 5 a.m., at his desk by 6:30 facing a 12-hourworkday or more, his family remains with Strong.Framed photos of Peggy and their children adorntables in his office. His mother painted the snowyfarm scene on the wall opposite his desk, and a rich,tapestry-like painting of the Watchung Valley innortheastern New Jersey, tracking its history throughscenes from 1680 to 1840, was created in 1936 byhis great-uncle. It’s the area of the country fromwhich generations of Strongs hail.

In or out of the suit, this CEO seems not to lose hissense of personal priorities, with family holdingstrong at the top of the list.

—Rick Krupinski

Doug Strong with wife, Peggy Cavanagh, and daughter Kristen in their backyard garden.

OUT OF THE SUIT

28 Summer 2007

EACH ONE A

HERO

Tragedy strikes the Transplant Program and

Survival Flight teams as six members are lost

while working to save the life of a patient.

In University Hospital in Ann Arbor, the patient lay prepped and awaitingthe gift of donated organs for a double-lung transplant that could save hislife. In Milwaukee, Wisconsin, the Cessna jet lifted off with six members ofthe U-M transplant team and Survival Flight crew transporting the donorlungs packed in ice for the 45-minute flight to Willow Run Airport outsideYpsilanti. Moments later, the plane had crashed into the waters of LakeMichigan, killing all aboard, and the patient once again was in peril of los-ing his life.

Throughout the Health System, shock and disbelief gradually gave way to great com-munal grief even as other members of the transplant team resumed the urgent searchfor a new pair of donor lungs. Six of our own were suddenly gone. In a field ofendeavor where life and death are confronted every day, the Michigan medical com-munity — indeed, the entire University — tried desperately to accept the unfath-omable, awful truth. And almost immediately, amidst tremendous emotion,memorials to the fallen began.

June 4, 2007, will forever be a dark day in Michigan’s history, and in the personal his-tories of the six stunned families left behind. But underlying the loss remains thenobility of the cause and the individuals themselves: Putting patients first, we do allwe can to save lives. In this extreme case, six were lost in service to others, the ulti-mate sacrifice we more typically associate with those at war, or those who protect ourcommunities from fire, disaster or crime. Even as we grieve their loss, we celebrateand honor the extraordinary dedication, humanism and high ideals embodied bythese six who inspire us to try even harder, to do even more, to save all the lives wehumanly can.

Within days, another set of donor lungs was located, safely transported to UniversityHospital and transplanted into the patient who continues to recover. His progress,and the many physicians, nurses, surgeons and staff who made it possible, stand asour beacon during a long time of deep healing.

Ashburn. Chenault. LaPensee. Spoor. Hoyes. Serra. These names represent the verybest about us, and are forever forged in our hearts and in our history, icons ofMichigan, exemplars of public service, each one a hero to every one of us.

—Rick Krupinski

continued on page 30 ä


•Ashburn

•Chenault

LaPensee•

•Spoor

Serra•

•Hoyes

30 Summer 2007

DAVID ASHBURN, M.D., 35, of Dexter, joined the U-M in 2005 asa resident in pediatric cardiothoracic surgery and planned to begin a fellowship inpediatric cardiovascular surgery in July. Ashburn graduated from Quillen College ofMedicine at East Tennessee State University in 1998 and went on to complete aninternship and residency in general surgery at Wake Forest University. In 2003, he fin-ished a two-year congenital heart surgery fellowship at the University of Toronto. Heserved as chief resident at Wake Forest’s Bowman Gray campus from 2004-05.Ashburn is survived by his wife, Candice, and three children.

RICHARD CHENAULT II, 44, of Ann Arbor, joined the U-M in 1985and served as a transplant donation specialist with the Transplant Program for 10years. In 2006, he received the U.S. Department of Health and Human Services dis-tinguished Medal of Honor for his efforts to increase organ donation at Michigan.He was part of a team that helped achieve an organ donation rate of more than 75percent, establishing the University as one of the leading transplant centers in thenation. Chenualt attended Eastern Michigan University and Spring Arbor College. Heis survived by his wife, Janet, daughter and stepson.

RICK LAPENSEE, 48, of Van Buren Township, joined the U-MTransplant Program as a part-time transplant donation specialist in 2005. He hadserved as an EMT and firefighter for the Ypsilanti Fire Department for 14 years. TheU-M job combined LaPensee’s passions: aviation and helping people. After obtainingan associate’s degree in fire science from Washtenaw Community College, LaPenseegraduated from Eastern Michigan University with a bachelor’s in public safety. Hewas pursuing a master’s degree in emergency management at EMU. LaPensee is sur-vived by his wife of 23 years, Claudia, and two sons.

MARTINUS SPOOR, M.D., 37 and an Ann Arbor resident, wasknown by his colleagues as Mart or Martin. He was a clinical instructor at the U-MMedical School in the Section of Cardiac Surgery. A native of Canada, Spoor receivedhis medical degree from the University of Calgary in 1995, completed his cardiac sur-gery residency and research fellowship at the University of Alberta, and his strategictraining fellowship at the Canadian Institutes for Health Research at the Universityof Alberta. He came to the University of Michigan in 2003 for a heart failure fellow-ship, which he completed in 2005, followed by a critical care fellowship completed in2006. Spoor served many clinical roles at the U-M but was also known for his per-sonality, compassion and humor. He is survived by his wife, Susan, who is also aphysician, and three children.

DENNIS HOYES, 65, was a pilot with Marlin Air Inc. He workedin the insurance industry and as an aviation instructor and professional pilot whoflew executive flights on Beach Jets and King Airs aircrafts. Hoyes flew the SurvivalFlight Cessna periodically during the last 10 years. “Dennis was a great individual,dedicated to flying, with more than 4,000 hours in the air and an excellent trackrecord. He just preferred to fly, and really enjoyed flying for Survival Flight,” says StuDingman, owner of Marlin Air Inc. Hoyes is survived by his wife of 35 years, Vanyce,four children and one stepchild.

WILLIAM SERRA, or Bill as his colleagues called him, age 59, wasMarlin Air’s chief pilot and check airman responsible for ensuring that Marlin Airpilots are proficient in in-house instructing, and for performing instrument flight rulechecks to ensure pilots are skilled in instrument-only landings. With more than12,000 hours of flight as a full-time pilot, including flying DC8s and 747s, Serra hada long track record of achievements including receiving the Air Medal from thePresident of the United States for outstanding achievements while participating in aer-ial flights, and the 1993 Air Force Desert Storm and Desert Shield award as a civilianpilot for supplying materials and ammunition during Desert Storm. Serra is survivedby his wife, Deborah, and three children.

www.med.umich.edu/survival_flight/update/


Twenty years ago, retail pioneer andphilanthropist A. Alfred Taubman lost

a good friend to amyotrophic lateralsclerosis — a horrifying fatal diseasethat’s better known as ALS, or LouGehrig’s disease.

The memory of watching New YorkSenator Jacob Javits slowly succumb tothe nerve-killing condition has never leftTaubman’s mind. That memory has moti-vated him to support ALS research at theUniversity of Michigan Medical Schooland beyond for some time. Now, he hasgreatly increased that support with a new$5 million gift to Michigan. In addition,Taubman will contribute his share of theroyalties from his new book, ThresholdResistance.

The gifts will support ALS studies led byneurologist and researcher Eva Feldman,M.D., Ph.D., who is the Russell N. DeJongProfessor of Neurology and whose lab hasalready received two $1-million gifts fromTaubman. Feldman is considered a nationalleader in ALS treatment and research, andheads the U-M Program for Neurology Researchand Discovery.

Together with a group at the University ofCalifornia, San Diego School of Medicine, ledby Martin Marsala, M.D., associate professor ofanesthesiology, Feldman and her team willwork on several scientific fronts to try to stop orslow the disease. Working at first with animals,then ALS patients, they hope to make quickprogress. Among the weapons they will deployagainst ALS are genetic tools to keep nervecells from dying, new ways of delivering prom-ising drugs and genes directly into nerve cells,and a potential treatment based on injectingstem cells into the spinal cord.

“It’s hard to imagine a more devastating dis-ease than ALS,” says Taubman, “and we havesome of the highest incidence rates in the

country right here in Michigan. Dr. Feldmanand her team are doing miraculous work, andit’s important that they have the resources tobuild on their momentum. I’m not a doctor ora scientist, but I am an optimist who believesin the extraordinary possibilities of modernmedicine.This is important work that must con-tinue.”

Feldman calls the gift a major boost toresearch. “Mr. Taubman’s generous fundingallows us to venture into exciting new territorywith stem cells. It gives our patients great hopethat our new research with our California col-leagues will translate the promise of stem celltechnology into the reality of therapy for ALSpatients.”

—Kara Gavin

For more information on the Taubman gift:www.med.umich.edu/opm/newspage/2007/alsgrant.htm

THE MICHIGAN

Taubman Gift Advances ALS Research

Eva Feldman and Alfred Taubman

DIFFERENCE

Photo: Gregory Fox

G i f t s i n s u p p o r t o f m e d i c i n e a t M i c h i g a n

Audio-Digest FoundationSupports CME ProgramsThe Audio-Digest Foundation has estab-lished an endowment to support continu-ing medical education at the University ofMichigan. The foundation produces CMEprograms for physicians and other health-care professionals in partnership with CMEproviders across the country.

Gift Honors Two Generations ofDarling Family PhysiciansDavid P. Darling, of Berkeley, California,is establishing, through a charitableremainder trust, the Cyrenus G. DarlingSr. and Jr., M.D., Professorship in theDepartment of Surgery. The gift honorsDarling’s father and grandfather, both ofwhom received their medical training atthe University of Michigan. Darling’sfather served on the faculty of theMedical School, and his grandfather wenton to significant roles in medicine in theDetroit area.

Gratitude Prompts Kahn GiftD. Dan Kahn, of Bloomfield Hills, Michi-gan, has made a $1-million gift support-ing capital and construction needs in theCardiovascular Center clinical building.Kahn’s generosity is in gratitude for themedical care provided by Kim Eagle,M.D., to Kahn’s wife, Betty. In recognitionof the gift, the Ambulatory Care receptionarea on level three of the center will benamed the D. Dan Kahn and Betty KahnPatient and Family Reception.

Kligmans Support Cardiac CareThe cardiac surgery staff room is beingfunded through a gift from Gary andKaren Kligman of Bloomfield Hills,Michigan, in gratitude for surgery per-formed on their daughter, Amelia, byEdward Bove, M.D., the Helen F. andMarvin M. Kirsh Professor of CardiacSurgery. In addition, the Kligmans haveincluded the Congenital Heart Program intheir estate plan. ä

32 Summer 2007

DIFFERENCETHE MICHIGAN

Ravitz Foundation Uses PresidentialMatch to Fund New ProfessorshipThe Ravitz Foundation has made a gift of $1 million to establish a professorship in theMedical School. The gift amount will bematched by the University as part of PresidentMary Sue Coleman’s program to help createnew professorships during The MichiganDifference Campaign, completing the $2-mil-lion endowment. The Ravitz Foundation wasestablished as part of the estate of EdwardRavitz, a Kalamazoo native. During a 30-yearperiod, he amassed a fortune as a residentialdeveloper in southeastern Michigan and else-where in the Midwest. The foundation has pre-viously funded, for a renewable term of fiveyears, the Ravitz Professorship in Pediatricsand Communicable Diseases.

George Schnetzer Honors U-MTraining with Scholarship GiftGeorge W. Schnetzer III, M.D. (Residency1972), and Mary H. Lhevine, of Tulsa,Oklahoma, have endowed the George W.Schnetzer III, M.D., and Mary H. LhevineScholarship Fund. The gift honors the impactfaculty and staff had on Schnetzer’s career dur-ing six years of oncology training at the U-M.

Garry Betty’s Legacy forAdrenal Cancer Research

When former EarthLink CEO Garry Betty was diag-nosed with adrenal cancer in late 2006, he was

determined to use his experience to help others and to find a cure. So he established the Garry Betty Foun-dation, which recently made a $400,000 gift to the U-MComprehensive Cancer Center for its adrenal cancer program.

“Throughout his life, Garry was an intense competitor andan eternal optimist who believed in the power of the human spirit,” says Kathy Betty,Garry’s widow.“Those very qualities led Garry to establish the Garry Betty Foundation afterbeing diagnosed. He was determined to not only beat the odds against this rare form ofcancer, but to help others as well.”

Betty, who died on January 2 at the age of 49, joined EarthLink as president and CEO in1996, and took the company from a small regional Internet service provider with fewerthan 100,000 subscribers to a national brand with more than 5 million subscribers.

The first $200,000 of the gift will be used to create the Garry Betty Scholars Program,which will pay for international researchers to come to the U-M for training in adrenalcancer research, enabling them to return to their countries to begin their own programs.

The Comprehensive Cancer Center has one of the top adrenal cancer programs in thecountry, thanks largely to an endowment from former U-M football coach BoSchembechler, whose wife, Millie, died from adrenal cancer in 1992. The U-M also hasone of the only multidisciplinary adrenal cancer treatment programs in the world.

—Nicole Fawcett

For additional information on the Betty gift:www.med.umich.edu/opm/newspage/2007/adrenal.htm

Patricia E. Schemm, of Sarasota, Florida, continues to support the Ferdinand Ripley Schemm Endowed MeritScholarship Fund in memory of her late brother, who performed his surgery residency at the U-M MedicalSchool and was a leading researcher in treatments for edema in the 1940s. The fund supports promisingincoming medical students, and may be renewed by maintaining a “B” average or better. Pictured here areSchemm Scholars Dionesia Adraktas, Sarah Carlson, Tatnai Burnett, Roland Hernandez and Laura Chromy.

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The main entrance lobby of the new CardiovascularCenter is graced dramatically with a beautiful bronzesculpture, commissioned for the space by Doug andLaurie Valassis of Lake Bluff, Illinois. Created byartist Jane DeDecker in her studio in Colorado andentitled “My Heart Is in Your Hand,” the piece evokesthe shape of a heart through the curved elongatedbodies of a man and a woman connected by claspedhands.

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PROFESSORSHIPS RECENTLYINAUGURATED

The Aaron Stern Professorship inPediatric CardiologyAn anonymous gift made to the Medical Schoolafter the death of Aaron M. Stern (M.D. 1945,Residency 1951) in 2003 resulted in a profes-sorship in his honor. On May 2, AssociateProfessor of Pediatrics and CommunicableDiseases Mark W. Russell, M.D., became thefirst Aaron Stern Professor of PediatricCardiology.

The James W. Rae CollegiateProfessorship in Physical Medicineand RehabilitationA pioneer in the field of physical medicine andrehabilitation was honored May 3 with the inau-guration of the James W. Rae CollegiateProfessorship in Physical Medicine andRehabilitation. Rae (M.D. 1943), who chairedPM&R for 30 years, helped install current chairEdward A. Hurvitz, M.D., as the first Rae Professor.

The John A. and Carla S. KleinFamily Research Professorship inThoracic SurgeryLooking for a way to make a difference in the fightagainst esophageal cancer, John A. and Carla S.Klein of Easton,Connecticut, endowed the John A.and Carla S. Klein Family Research Professorshipin Thoracic Surgery. On May 31, Professor ofSurgery and Radiation Oncology David G. Beer,Ph.D., became the first Klein Professor.

The George A. Dean, M.D., Chair inFamily MedicineContinuing his lifelong service to family medi-cine, George A. Dean, M.D., established theGeorge A. Dean, M.D., Chair in Family Medicine.Dean helped create the Department of FamilyMedicine in 1978. On June 13, departmentchair Thomas L. Schwenk (M.D. 1975) wasinstalled as the first holder of the Dean Chair.

The Holtom-Garrett FamilyProfessorship in NeurologyAfter providing steadfast care for his first wife,Marilyn Holtom Garrett, during her 25-year strug-gle with multiple sclerosis, Richard T. Garrett andhis second wife, Marjorie Deutsch Garrett,endowed a professorship in Marilyn’s memory.On June 20, Benjamin M. Segal, M.D., becamethe first Holtom-Garrett Professor of Neurology.

LIVES LIVED

Ed Meader, Longtime U-MSupporter, dies at 97The generous philanthropy of Edwin “Ed” andMary Meader has benefited the University ofMichigan in many important ways and manyareas across the University. Ed Meader’s deathon February 1 at his home in Kalamazoo was agreat loss to Michigan and a variety of other wor-thy causes he and his wife supported over theyears, particularly in the Kalamazoo area.

Meader earned a bachelor’s degree at the U-Min 1933, and later a master’s in geography fromWayne State University where he then taught thegeography of northern Africa and the Middle Eastas a part-time avocation. Meader’s Army ä

Aaron and Nell Stern Arleen and James Rae Carla and John Klein

George and Vivian Dean

Richard and Marjorie Garrett

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34 Summer 2007


service in World War II forthe Office of StrategicServices included a longassignment in Ghana andnorth Africa. He marriedMary Upjohn in 1965after the death of his firstwife, and they enjoyed 42years of marriage until thetime of his death.

Meader served as a member and sometimespresident of the Harold and Grace UpjohnFoundation for more than 30 years. In recentyears, Ed and Mary Meader have devotedthemselves to philanthropy, most of which hasbeen done very quietly.At Michigan, the RachelUpjohn Depression Center, the Kellogg EyeCenter and the Kelsey Archaeological Museumare among the causes the Meaders supported.The Meaders’ generosity continues a family tra-dition of philanthropy started by MaryMeader’s grandfather, William E. Upjohn, whoearned his medical degree from Michigan andwent on to found the Upjohn Company, a majorpharmaceutical firm.

Ophthalmology Pioneer andScholarship Benefactor WilliamMyers Dies at 65William D. Myers (M.D. 1966), a founder anddirector of the Michigan Eyecare Institute ofSouthfield, Dearborn and Livonia, and a strongsupporter of Medical School scholarships, diedon January 15 at age 65.

A pioneer in ophthalmol-ogy, in the 1970s Myerswas one of the first in theU.S. to use surgical tech-niques for vision correc-tion, and in the late ’80s, before LASIK wasapproved by the FDA, heperformed the surgery inWindsor, Canada. He

developed the Nova Curve Lens for use incataract surgery and co-invented, with hisbrother, Terry Myers, D.D.S., the first workabledental laser.

Myers’ wife, Irene, an alumna of the U-MSchool of Art & Design, which the couple alsogenerously supports, describes her husband’sphilanthropic concept as “personal.”

“If a snapping turtle was attempting to crossthe road and would surely be crushed by an

oncoming car, Bill would carefully pick it upand carry it across the road to safety,” IreneMyers recalls. “When he admired a particularart student’s work, he commissioned a workfrom the student for his office. His support ofscholarships was in the same vein — simply toassist someone along the way.”

Jane Von Voigtlander SupportedChildren’s and Women’s HospitalJane E. Von Voigtlander of Ann Arbor, a gener-ous supporter of the new U-M C.S. MottChildren’s and Women’s Hospital in the U-MHealth System, died January 19. She was 62.

With her daughter, Gwen,Von Voigtlander madea $2 million gift supporting construction of thenew hospital in honor of Ted Von Voigtlander, aco-founder of Discount Tire and Jane’s hus-band for nearly 25 years until his death in1999.Their life and the gift were profiled in thespring 2006 issue of Medicine at Michigan.Survived by her daughter and three grandchil-dren, Jane said of her generosity, “When youhave grandchildren, you want to know thatgreat research is being done to help all chil-dren,” and that she and Gwen, as well as Ted’sson, were happy about “this gift and what itwill mean for Ted’s memory and for the futureof children’s medicine at Michigan.”

Looking down from a mezzanine, visitors to the new Cardiovascular Center have a unique view of the five-story circular atrium, and the garden it contains. The atrium gar-den is one of the many areas within the CVC that was funded by a private gift.

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1950sHenry Poore, M.D. (Residency 1959), has pub-lished the book Lessons Remembered: Memoirsof an Audacious Country Doctor (available atwww.docpoore.com). In the book, he recalls hischildhood in Bristol, Tennessee and Bristol,Virginia, his career as a physician in Virginia andArizona, his work with the Navajos, his travels(both for pleasure and as a medical missionary)and more. Poore and his wife, Nina, divide theirtime between Arizona and Virginia and enjoy rais-ing cattle on their ranch and spending time withtheir seven children and 14 grandchildren.

1960sH. Otto Kaak (M.D. 1964,Residency 1972), a professorof psychiatry and of pediatricsat the University of KentuckyCollege of Medicine, was hon-ored in January when a bene-factor endowed a chair at thatuniversity in his honor. The H.Otto Kaak Endowed Chair in

Early Childhood Mental Health will support thework of a researcher in the Comprehensive Assess-ment and Training Services Clinic in the Universityof Kentucky College of Social Work. Kaak is a prin-cipal investigator at the clinic, holds a joint facultyappointment in the College of Social Work, and isa founding member of the Kentucky AttachmentProject, which educates, advocates and providestraining for professionals working with childrenwho have attachment disorders.

Richard S. Panush (M.D.1967), professor and chair ofthe Department of Medicine at Saint Barnabas MedicalCenter, is president-elect of theAssociation of Chiefs and Chairsof Medicine. Prior to his currentposition, Panush was professorand chief of the Division of

Alumni:Update your classmates!Send class notes to:Medicine at Michigan, 301 E. Liberty St.,Suite 400, Ann Arbor, MI 48104-2251;[email protected]; or submit online atwww.medicineatmichigan.org/classnotes

NOTESCLASS

Clinical Immunology,Allergy and Rheumatology atthe University of Florida College of Medicine. Heand his wife, Rena, have three children, two grand-children and two dogs, and reside in FlorhamPark, New Jersey.

1970sDouglas Kirkpatrick, M.D.(Residency 1975), has beenelected president of the Ameri-can College of Obstetriciansand Gynecologists (ACOG). Histerm began in May. Kirkpatrickis an assistant clinical profes-sor of obstetrics and gynecol-ogy at the University of Colorado

Health Sciences Center and resides in Denver. Hehas been an ACOG fellow since 1980, served asvice president of the organization and as chair ofthe Grievance Committee and the Council ofDistrict Chairs, chaired the group’s District VIII andColorado Section, and received the 2003Outstanding District Service Award and the 1990Wyeth Pharmaceuticals Section Award.

Robert Willix (M.D. 1975) hasopened Cenegenics MedicalInstitute at the Boca RatonResort & Club in Boca Raton,Florida. The institute providespatients with hormone therapy,nutrition and exercise regimensin an effort to decrease theeffects of aging. Willix is CEO of

the institute, which is headquartered in Las Vegas,Nevada, and has a third U.S. location inCharleston, South Carolina, as well as internationalpresences in South Korea, Japan and China. Heresides in Boca Raton.

1990sJoel L. Young, M.D. (Residency1993), medical director of theRochester Center for BehavioralMedicine in Rochester Hills,Michigan, has authored thebook ADHD Grown Up: A Guideto Adolescent and Adult ADHD.A psychiatrist and neurologist,Young is a diplomate of the

American Board of Adolescent Psychiatry and fre-quently writes about mental health issues. He andhis wife, Mindy, have three children.

Lives LivedSaroja Adusumilli, M.D. (Resi-dency 2000), clinical assistantprofessor in the U-M MedicalSchool Department of Radiol-ogy, died March 3 at the age of36 from injuries sustained in acar accident. The accidentoccurred while she was return-ing from giving four talks at a

University-sponsored continuing medical educa-tion conference in Arizona.Adusumilli received hermedical degree from the Case Western ReserveSchool of Medicine and, following her residency atthe U-M, completed a fellowship at the Universityof Pennsylvania. She joined the U-M faculty in2002, and soon became a well-respected author-ity on magnetic resonance imaging and a memberof the abdominal imaging group in the depart-ment. A valued mentor to residents and fellows,Adusumilli was associate director of the radiologyresidency program at the time of her death.

Robert F. Barnett Jr., M.D.(Residency 1961), died Feb-ruary 13 at age 78. Barnettcompleted an internship atHenry Ford Hospital in Detroitand, after three years of servicein the Navy, worked for one yearwith the Los Angeles HealthDepartment before returning to

the U-M for a radiology residency. Barnett spentone year as an instructor in the U-M Departmentof Radiology, then joined a radiology practice inPetoskey, Michigan. In 1962, he moved toCadillac, Michigan, and practiced radiology atMercy Hospital and Medical Art until he retired in1990. Barnett also served as director of theCadillac State Bank for 20 years, and was instru-mental in its merger with NBD. He was known forhis encyclopedic knowledge of history, specificallythe battles of World War II and the game of base-ball. He loved show tunes and playing chess, andhe was a devoted fan of the Pittsburgh Pirates andMichigan football. Barnett is survived by his wife,Elizabeth, four children and four grandsons.

Franklin Ray Black (M.D. 1941) of Reno, Nevada,died on May 3 at the age of 91. A retired surgeonand U.S. Army veteran who served in World War II,he is survived by his wife, Rita, four children and28 grandchildren, great-grandchildren and great-great-grandchildren. ä

U p d a t e s o n M e d i c a l S c h o o l a l u m n i

36 Summer 2007

NOTESCLASS

Frank R. Ellis (M.D. 1943,Residency 1954) died March22 in Scottsdale, Arizona. Hewas 91. Ellis was a U-M MedicalSchool student and a memberof the Michigan National Guardwhen he was commissioned asa second lieutenant in theMedical Administrative Corps,

Officers Reserve Corps of the U.S. Army. Heremained dedicated to the military throughout hislife and served in France during World War II. Duringhis career, he served as clinical pathologist andassistant director of pathology at Wayne CountyGeneral Hospital in Eloise, Michigan, and served invarious roles at many Red Cross facilities aroundthe country. In 1984 he retired to Arvada, Colorado,where he spent time restoring vintage vehicles. In1999 he moved to Scottsdale where he continuedto work on cars and participated in numerous autoclubs and shows. He is survived by his wife,Gertrude, four children, seven grandchildren andthree great-grandchildren.

Francis A. Gress, M.D. (Residency 1950), diedDecember 8, 2006. He was 86. Gress received hisbachelor’s degree from Lehigh University and hismedical degree from Jefferson Medical Collegebefore completing a residency in pediatrics at theU-M. He was in private practice and was associatedwith St. Luke’s Hospital in Bethlehem,Pennsylvania,from 1951-86, and served as an Army physicianduring World War II. In addition to his medicalcareer, Gress served as a lay eucharistic minister atMethodius Catholic Church in Bethlehem. Heenjoyed traveling with his wife, Virginia, in theirAirstream trailer and had served as president andtreasurer of the Penn Lehigh Unit of the Wally ByamCaravan Club International — an association ofAirstream enthusiasts. Gress was preceded indeath by his first wife, Mary R. Mervan Gress, and issurvived by Virginia, three children, four stepchil-dren, five grandchildren and six stepgrandchildren.

Herbert J. Hazledine (M.D. 1943, Residency1945), 92, died on March 28.After completing hismedical training, Hazledine served in the U.S.ArmyMedical Corps from 1950-52, then continued hissurgical training for two years at the Mayo Clinic inMinnesota. He then returned to his home in PortHuron, Michigan, to establish a new practice,Surgical Associates. During his career he served aschief of staff and chief of surgery at Port HuronHospital and Mercy Hospital, was a member of thePort Huron Hospital Board of Directors and presi-dent of the St. Clair County Medical Society. Healso served on his local school board and wasactive in the St. Clair County community and the

First Congregational Church. In 1981 he retired toFlorida where he enjoyed golfing and being close tonature, often watching the alligators in the pondbehind his house. Hazledine was preceded indeath by his first wife, Tine, in 1964, his secondwife, Betty, in 1966, and a son, Thomas. He is sur-vived by two daughters, a daughter-in-law, fivegrandchildren and seven great-grandchildren.

Rose H. Parker Kahn (M.D.1940, Residency 1942) diedon May 21 at the age of 91. Inaddition to her medical degree,Kahn held a master’s degree inpublic health from the U-M,and served as a faculty mem-ber in the Department ofInternal Medicine and per-

formed nuclear medicine research at the U-M formany years. A member of the recovering commu-nity in Washtenaw County, Kahn helped many oth-ers struggling with addiction. She enjoyedspending summers on Surveyor’s Island, nearDrummond Island in Michigan’s eastern UpperPenninsula, where she documented the life cycleof the monarch butterfly, gardened and tookwalks. She was preceded in death in 1985 by herhusband, renowned U-M neurosurgeon Edgar A.Kahn (M.D. 1924, Residency 1926). She is sur-vived by one son, three daughters, eight grand-children and several great-grandchildren.

Barbara Ruth Rennick (M.D. 1950), of ChapelHill, North Carolina, died December 14, 2006. Shewas 87. Rennick began her career as an educatorat the State University of New York Medical Schoolin Syracuse. She was a research fellow at OxfordUniversity in England for one year, then returned toteaching at Mount Holyoke College in SouthHadley, Massachusetts, and then at the StateUniversity of New York Medical School in Buffalo.While at Buffalo, she performed research fundedby the National Institutes of Health and served aschair of pharmacology for four years. Rennick

retired to Punta Gorda, Florida, and eventually relo-cated to Chapel Hill. She was active in the Leagueof Women Voters and the Spafford HistoricalSociety, and served on the Mental HealthFoundation Board in Chapel Hill. She is survived byher sister and six nieces and nephews.

Samuel I. Roth (M.D. 1949) of Woodland Hills,California, died February 25. He was 84. Roth spe-cialized in internal medicine and was an assistantclinical professor of medicine at UCLA. He was anactive environmentalist and co-founder of the LosAngeles, California, chapter of Physicians for SocialResponsibility. In 1989 he chaired a symposium inLos Angeles to educate others about the impor-tance of preserving the rainforests of Brazil in aneffort to counter the greenhouse effect.

David J. Young (M.D. 1952)died on May 23 from complica-tions of Parkinson’s disease,which he battled for nearlythree decades. He was 78. Theyoungest member of the Classof 1952,Young also was rankedfirst in the class, academically.He was one of the original

board-certified internists at Providence Hospital inDetroit and Southfield, Michigan. He is survived byhis wife, Phyllis, and three children — a U-MMedical School professor, a nurse and a psychia-trist — all trained at the University of Michigan.

In the nextI S S U Eof Medicine at Michigan: Partnering withAfrican-American churches in service tothe community … the ever-expandingreach of technology in medical education… cilia and the secrets they keep.

E-news to keepalumni informedTo receive your bimonthly e-news-letter, go to the Alumni Directoryat www.medicineatmichigan.org/alumni and add or update youre-mail address, or contact MaryMorency in the Office of Medi-cal Development and AlumniRelations at [email protected] or (734) 998-7584.


NOTESCLASS

Full DisclosureThe influential Steve Nissen

The e-mail was one of many Steve Nissen(M.D. 1978) routinely receives in a day. This

one, however, was anything but routine. It saidthat Time magazine had named him one of the100 most influential people of 2007.

Nissen thought it was a joke. A friend musthave sent it.

“You don’t expect to end up on a list like thatif you practice medicine and write researchpapers,” he says. Nissen chairs the Departmentof Cardiovascular Medicine at Cleveland Clinic,which he joined in 1992.

It was no joke. Time magazine included Nissenon the list in the section “Scientists andThinkers,” along with the likes of geneticistCraig Venter and political activist and formerVice President Al Gore. Internationally knownfor his research into reducing the progressionof coronary artery disease, Nissen, a formerpresident of the American College ofCardiology, has dedicated his career to betterunderstanding the biology of heart disease. Hehelped pioneer intravascular ultrasound, a typeof high-resolution imaging technology that canbe threaded through blood vessels into thebeating heart, which has been the basis for hisresearch during the last decade.

An activist since his U-M undergrad daysprotesting the Vietnam War, Nissen today alsois well-known as an outspoken and crediblevoice on public health and policy matters. Herecently testified before Congress on drugsafety and FDA reform, calling for majorchanges in drug development and post-mar-keting surveillance. And since he doesn’taccept honoraria from industry, he’s emergedas a highly credible media resource.

In 2001, Nissen was one of the first to showthat COX-2 inhibitors increase the chance ofheart attack. In May of this year, he publisheda paper in the New England Journal ofMedicine on a blockbuster drug for diabetes.His research showed that people who take the

drug, which reduces blood sugar, are 43 per-cent more likely to have a heart attack thanpatients who take a placebo or another dia-betes medication. “I had some concernsbased on the clinical trial data, and I tend topursue those scientific questions,” he says.

While many heralded this research, not every-one was happy with the results. A public rela-tions officer from GlaxoSmithKline, maker ofthe drug, sent an e-mail to several journalistsquestioning the validity of Nissen’s study. Thiskind of reaction comes with his work, yetNissen doesn’t let the negatives stop him.

“I believe that providers and patients have aright to know all of the findings about therapies

— positive and negative. The value of full dis-closure almost always outweighs the risks ofnot disclosing such findings,” he explains.

The official GlaxoSmithKline response is that it“strongly disagrees” with Nissen’s results.

Nissen also researches the efficacy of choles-terol drugs using intravascular ultrasound. In astudy published in 2004 in the Journal of theAmerican Medical Association, he discoveredthat statins were more effective in reducingcholesterol and plaques in coronary arteries ifdoctors used an aggressive dose of the treat-ment.

Currently, Nissen is involved in clinical trials forthe weight loss drug rimonabant, and he’sworking on a comparative study of arthritisdrugs for patients at high risk for cardiovascu-lar disease. He is the principal investigator forseveral large intravascular ultrasound athero-sclerosis trials.

While he enjoys a relatively quiet life in north-ern Ohio, Nissen doesn’t hesitate to speak upwhen necessary. And when he does, peopleeverywhere tend to listen.

—Meghan Holohan

Steve Nissen in the cardiology catheterization lab at Cleveland Clinic

Photo: Greg Ruffing/Redux

“I believe that providers and patientshave a right to know all of the findingsabout therapies — positive and nega-tive. The value of full disclosurealmost always outweighs the risks ofnot disclosing such findings.”

—Steve Nissen

38 Summer 2007

Acentury-and-a-quarter ago, doctors didn’tknow much about how the human body

works. The world’s best scientists didn’t under-stand how the body converts food into energy,how blood pressure is regulated or how thebrain and body interact. Basic informationtaught to high school biology students todaywas still a mystery when Henry Sewall, Ph.D.,the U-M’s first professor of physiology, came tothe U-M Medical School in 1882.

Since then, many generations of gifted teach-ers and scientists have made the study ofphysiology an integral part of every U-M med-ical student’s education. Over the course of itshistory, U-M physiologists have made impor-tant contributions to understanding how differ-ent organs in the body work together, how the

Grand Tradition — Bold Future125 Years of physiology at Michigan

BACKLOOKINGM i l e s t o n e s t h a t m a d e m e d i c i n e a t M i c h i g a n

In the early 1900s, U-M students studied physiology in the department’s laboratory in the C.C. Little Building onthe main campus. Warren P. Lombard, M.D., is the bearded man to the left of the wall clock. After receiving theirtraining at Michigan, prominent U-M alumni like Carl Wiggers (M.D. 1906) and Detlev Bronk, Ph.D., made impor-tant contributions to physiology research and became department chairs, deans and presidents at other majoruniversities.

body adjusts to changes in its environment,and how genes function in the context of theentire cell, organ and organ system in a livinganimal or person.

Virtually everything about physiology atMichigan has changed over the years — eventhe name of the department. It’s now called theDepartment of Molecular and IntegrativePhysiology. Instead of just one faculty member,the department has 50. Today’s researchersare using genetically engineered mice andother animal models to learn about human

diseases like muscular dystrophy, cardiomy-opathy, pancreatitis, obesity and diabetes.

This September, many of the department’s cur-rent and former graduate students, fellows andfaculty will gather in Ann Arbor to celebrate thedepartment’s 125th anniversary and attend ascientific symposium that will emphasize phys-iology’s contribution to contemporary biomed-ical research.

—Sally Pobojewski

From 1956-78, Horace Davenport, Ph.D., wasprofessor and chair of the U-M Department ofPhysiology. He focused his considerable tal-ent and energy on teaching, recruiting out-standing scientists and graduate students,writing textbooks and starting a new careeras a medical historian. During his many yearsat Michigan, Davenport taught physiology toabout 3,000 medical students.

Warren P. Lombard was a professor of physiol-ogy from 1892-1923. He developed the firstU-M laboratory courses in physiologydesigned for the needs of medical students.Under Lombard’s direction, students learnedphysiology by monitoring blood pressure,knee jerk reflexes, muscle fatigue and pulserates on each other and in research animals.

Recruited to the U-M in 1882, Henry Sewallwas the Medical School’s first professor ofphysiology. He was a distinguished scholarand the first person in the United States toreceive a doctorate in physiology. While at theU-M, he injected pigeons with rattlesnakevenom to demonstrate, for the first time, theprinciple of antitoxin production. The historyof physiology as an academic discipline andas an integral part of research and educationin the Medical School started with Sewall.


Today’s scientists use research animals, like these rats in the department’s Centerfor Integrative Genomics, to study complex interactions between genes, an organ-ism and its environment. Using a rotating device called a rota-rod, these rats arebeing tested for balance and coordination.

U-M physiologists haveplayed leadership roles

in the discipline’s main professionalorganization, the American Physiological Society,

since it was founded in 1887. Four of 28 charter members of APScame from the University of Michigan. During the organization’s 120-yearhistory, more than 10 percent of its presidents have been from the U-M.William Henry Howell, M.D., the U-M’s second professor of physiology, wasone of several prestigious scientists with papers published in the first(1898) issue of the American Journal of Physiology.

Photo: Courtesy of the Center for Integrative Genomics

40 Summer 2007

Amana Akhtar and DerekNarendra, members of theClass of 2009, are among42 medical and dental students selected to partici-pate in the Howard HughesMedical Institute-NationalInstitutes of Health Re-search Scholars Program.They will live for a year on

the NIH campus in Bethesda, Maryland, conduct-ing research in NIH laboratories. Medical studentsLia Gracey (Class of 2010) and Kyle Viani (Classof 2009) were among 69 students named HHMIMedical Fellows, receiving support for a year offull-time research at an institution of their choice.Students will pursue a diverse range of researchprojects in fields such as immunology, neuro-science, cell and molecular biology, developmen-tal biology and genetics. The Research Scholarsand Medical Fellows programs are part of a largereffort by HHMI to integrate basic research andclinical experience.

Amy Alderman, M.D. (Resi-dency 2004), an assistant pro-fessor in the Section of PlasticSurgery, has been selected for the Robert Wood Johnson Foundation Physician FacultyScholars Program Class of2010. Intended to strengthenthe leadership and academic

productivity of junior medical school faculty whoare dedicated to improving health and health care,the program provides support for three years ofresearch, as well as national and local mentorship.

The American Academy ofOtolaryngology-Head and NeckSurgery Foundation will presentCarol Bradford (M.D. 1986,Residency 1992), professor ofotolaryngology, with its Dis-tinguished Service Award at thefoundation’s annual meeting in

LIMELIGHTIN THEF a c u l t y a n d s t u d e n t h o n o r s a n d a c c o l a d e s

David BloomChairs UrologyDavid A. Bloom, M.D., the JackLapides Professor of Urology,became chair of the Departmentof Urology March 1.

A widely-recognized authority in the field of pediatric urology, Bloom joinedthe U-M faculty in 1984. He became the first Lapides Professor in 2002.During his time at Michigan, he has published more than 150 papers and50 book chapters, and has served on the editorial boards of the Journal ofPediatric Urology, the British Journal of Urology, Urology, ContemporaryUrology, and the Journal of Endourology, and has been a consultant forStedman’s Medical Dictionary since 1992. In 2006, U-M supporters Brianand Mary Campbell honored Bloom by establishing a professorship in hisname.

Bloom earned his medical degree from the State University of New York atBuffalo in 1971.After serving an internship in surgery at UCLA, he completedresidencies in general surgery and urology, both at UCLA, in addition to a fel-lowship in pediatric urology at the Institute of Urology of the University ofLondon. He was named associate professor and chief of pediatric urology atWalter Reed Army Medical Center in 1983.

Bloom has held memberships and offices in 26 professional societies,including chair of the American Academy of Pediatrics, Section on Urology;historian for the Society for Pediatric Urology; and historian for the AmericanAssociation of Genitourinary Surgeons. He also is a trustee of the AmericanBoard of Urology.

Bloom, who stepped down as associate dean for faculty affairs in theMedical School in order to accommodate his new role as chair, succeedsJames E. Montie (M.D. 1971), the Valassis Professor of Urologic Oncology,who is concentrating on research on the quality of care for patients with uro-logic cancer.


Akhtar Narendra

Gracey


Ginsburg Elected toNational Academy ofSciencesDavid Ginsburg, M.D., the James V. Neel DistinguishedUniversity Professor, Warner Lambert/Parke-DavisProfessor of Medicine and professor of internal medi-cine and of human genetics, has been elected to theNational Academy of Sciences in recognition of distin-guished and continuing achievements in originalresearch. Election to the academy is one of the highesthonors bestowed upon scientists.

Ginsburg is the former chief of medical genetics in the Department of InternalMedicine, a past-president of the American Society for Clinical Investigation, and amember of the Institute of Medicine of the National Academy of Sciences, as well asof the American Academy of Arts and Sciences. He also holds an appointment as aninvestigator with the Howard Hughes Medical Institute. Ginsburg’s groundbreakingresearch has generated novel insights into the molecular mechanisms underlying life-threatening bleeding disorders.

The election of 72 new members for 2007 brings the total number of active membersof the academy to 2,025.

September. The award recognizes volunteer contri-butions to the academy and its foundation. In2006, Bradford was elected into the CollegiumOto-Rhino-Laryngologicum Amicitiae Sacrum, aninternational association with members from 50countries.

Sally A. Camper, Ph.D., chair ofthe Department of HumanGenetics, the James V. NeelCollegiate Professor of HumanGenetics and a professor in theDepartment of Internal Medi-cine, received the 2007 Roy O.Greep Award from the Endo-crine Society for outstanding

contributions to research in endocrinology. TheEndocrine Society is an international body with13,000 members from more than 85 countries.

William F. Chandler (M.D.1971, Residency 1977), pro-fessor of internal medicine and of neurology, was recentlyappointed the Richard C.Schneider Professor of Neuro-surgery for a five-year term.Chandler also serves as co-director of the Pituitary and

Neuroendocrine Center.

The American Association forCancer Research recentlyselected the research team ofArul Chinnaiyan (M.D. andPh.D. 1999), the S.P. HicksCollegiate Professor of Path-ology and professor of urology,for its inaugural Team ScienceAward. Chinnaiyan’s team won

the award for its landmark discovery that prostatecancer harbors gene fusions which may cause thedisease.

Marci Lesperance (M.D. 1988,Residency 1994), associateprofessor of otolaryngology,recently was honored by theAmerican Academy of Otolaryn-gology-Head and Neck SurgeryFoundation for her work withthe foundation, and wasappointed chair of the acad-

emy’s Pediatric Otolaryngology Education AdvisoryCommittee, which provides continuing medical edu-

America’s Top Docsfor MenThe April issue of Men’s Health listed six U-Mphysicians among the top doctors in theirfields in the U.S.

Chosen by the magazine were John Greden,M.D., professor of psychiatry and executivedirector of the Depression Center, for top psy-chiatrists; William Herman, M.D. (Residency1982), professor of internal medicine anddirector of the Michigan Diabetes Researchand Training Center, for top endocrinologists;Dana Alan Ohl (M.D. 1982, Residency 1987),

professor of urology and co-director of the Center for Fertility and Sexuality, for topurologists; Chung Owyang, M.D., professor of internal medicine and director of theDigestive Health Center, for top gastroenterologists; Thomas Schwenk (M.D. 1975),professor and chair of family medicine, for top sports-medicine specialists; and AlanWeder, M.D., professor of internal medicine and co-director of the Vascular MedicineProgram, for top cardiologists/internists.

The magazine ranked the physicians with the most prestige among their peers as away to encourage men to seek better health care.


Photo: Peter Smith Photography

42 Summer 2007

cation and standards of care for pediatric otolaryn-gologists in the U.S. and internationally.

Howard Markel (M.D. 1986),Ph.D., the George E. WantzDistinguished Professor of theHistory of Medicine, professorof pediatrics and communica-ble diseases and director of theCenter for the History of Medi-cine, has been named one ofeight contributing writers to the

Journal of the American Medical Association.Markel’s charge is to write frequent essays exploringthe interactions of medicine, society and culture.

The American Thoracic Societyrecently honored Marc Peters-Golden, M.D., with an award forscientific accomplishment, rec-ognizing his career-long commit-ment and contributions to basicand clinical research. Peters-Golden, who studies how lipidmolecules are involved in inflam-

mation and other body processes, is a professor ofinternal medicine and director of the FellowshipProgram in Pulmonary and Critical Care Medicine.

Anand Swaroop, Ph.D., theHarold F. Falls Collegiate Pro-fessor of Ophthalmology andVisual Sciences and professorof human genetics, received theBoard of Directors Award forOutstanding Research Achieve-ment from the FoundationFighting Blindness. The award

recognizes his discovery of the gene CEP290,associated with retinal degeneration in mice.

The Institute of Medicine selected Denise G. Tate,Ph.D., professor of physical medicine and rehabili-tation, to serve on a committee to evaluate medicaldisability compensation for veterans. Also servingon the committee was Sid Gilman, M.D., formerchair of Neurology and current director of the

LIMELIGHTIN THE

Michigan Alzheimer’s Disease Research Center. Thecommittee’s report was prepared at the request ofthe Veterans’ Disability Benefits Commission andcalled for updating the system for evaluating veter-ans and their disabilities, giving special focus toconditions such as traumatic brain injury.

Scott Tomlins, a Ph.D. candidate in pathology,and Omer Yilmaz, a Ph.D. candidate in cellularand molecular biology, are among 12 graduatestudents from North America and Asia chosen toreceive the 2007 Harold M. Weintraub GraduateStudent Award sponsored by the Basic SciencesDivision of the Fred Hutchinson Cancer ResearchCenter. Nominations were solicited internationally.Winners were selected based on the quality, orig-inality and significance of their work.

continued from page 41

Edited by Richard H. Cohan, M.D., professor ofradiology; and Stuart G. Silverman, M.D.: CTUrography: An Atlas. Lippincott Williams &Wilkins, 2007.

Edited by Steven M. Donn, M.D., professor ofpediatrics and communicable diseases, directorof neonatal-perinatal medicine; and Thomas E. Wiswell, M.D.: Clinics in Perinatology:Surfactant and Mechanical Ventilation, volume34, number 1. Saunders, March 2007.

By Thomas R. Gest, M.D., Ph.D., associate pro-fessor of anatomical sciences and medical edu-cation: Clemente’s Anatomy Flash Cards.Lippincott Williams & Wilkins, 2008. Also,edited by Thomas R. Gest; Jennifer K.Brueckner, Ph.D.; Stephen W. Carmichael, Ph.D.;Noelle A. Granger, Ph.D.; John T. Hansen, Ph.D.;and Anil H. Walji, M.D., Ph.D.: Atlas of HumanAnatomy, fourth edition. Saunders, 2006.

PRINTIN Books and journals written or edited by Medical School faculty

Bina Valsangkar, a medicalstudent in the Class of 2009,has been awarded a prestigiousReynolds Foundation Fellowshipwhich will enable her to pursuea master’s degree in publichealth at the Harvard School ofPublic Health. The fellowshipseeks to accelerate the prepa-

ration of a new generation of public leaders whocan bring the insights of entrepreneurship andmanagement to bear on social problems.

The Michigan College ofEmergency Physicians’ Board ofDirectors has named EdwardWalton, M.D., assistant profes-sor of emergency medicine, asthe 2007 Emergency Physicianof the Year. The award recog-nizes clinicians of unusual meritwho are outstanding emergency

physician role models, maintain high professionalstandards and clinical orientation, and are active incommunity service and education.

Tate Gilman

Tomlins Yilmaz


LIMELIGHTIN THE

Hearing ResearchPioneer MerleLawrence DiesMerle Lawrence, Ph.D., founder of the KresgeHearing Research Institute and professor emeri-tus of otolaryngology, physiology and psychol-ogy, died on January 29 at the age of 91.

Recruited to Michigan in 1952 by Dean AlbertFurstenberg (M.D. 1915) to set up a laboratoryfor physiological acoustics, Lawrence obtainedfunds from the Kresge Foundation to build afacility devoted to research on the ear andhearing. He directed the Kresge HearingResearch Institute from 1961-83.

Lawrence earned a doctorate degree fromPrinceton University in 1941, then became aNaval aviator during World War II. After joining aNaval squadron in the South Pacific, his planewas struck by enemy fire and Lawrence waswounded. He was awarded the Silver Star Medaland the Purple Heart, among other military honors. Lawrence received numerous academic

Michigan’s ContinuingMedical EducationProgram

Pelvic surgery ... multidisciplinarybreast cancer management ...advances in psychiatry ... these arebut a few of the upcoming topics inthe U-M Continuing Medical Edu-cation program.

For information on course content,dates and locations, visit the Depart-ment of Medical Education Web siteat www.med.umich.edu/meded, call(734) 763-1400 or (800) 800-0666, or e-mail [email protected].

By Gary B. Huffnagle, M.D., Ph.D., professor ofinternal medicine and of microbiology andimmunology; and Sarah Wernick, Ph.D.: TheProbiotics Revolution: The Definitive Guide toSafe, Natural Health Solutions Using Probioticand Prebiotic Foods and Supplements. BantamBooks, 2007.

Edited by Theodore S. Lawrence, M.D., Ph.D.,chair and professor of radiation oncology;Vincent T. DeVita Jr., M.D. (Residency 1963);and Steven A Rosenberg, M.D.: The CancerJournal: The Journal of Principles & Practice of

Oncology, volume 13, number 1. LippincottWilliams & Wilkins, January/February 2007.Also, edited by Theodore S. Lawrence; NicholasJ. Petrelli, M.D.; Benjamin D. Li, M.D.; and JamesM. Galvin, D.Sc.: Journal of Clinical Oncology,volume 25, number 8. American Society ofClinical Oncology, March 2007.

Edited by Paul H. Park (M.D. 1998, Residency2005), assistant professor of neurosurgery; K. Lewandrowski; M.J. Yaszemski; R.F. McLain;and D.J. Trantolo: Spinal Reconstruction:Clinical Examples of Applied Basic Science,

Biomechanics, and Engineering. InformaHealthcare USA, 2007.

Edited by Linda S. Polley (M.D. 1991, Residency1995), associate professor of anesthesiology;and David Wlody, M.D.: International Anesthe-siology Clinics: Obstetric Anesthesia, volume 45,number 1. Lippincott Williams & Wilkins, 2007.

By Raymond W. Ruddon (Ph.D. 1964, M.D.1967), professor emeritus of pharmacology:Cancer Biology, fourth edition. Oxford UniversityPress, 2007.

and professional honors as well, includingawards from the American Academy ofOphthalmology and Otolaryngology, theAssociation for Research in Otolaryngology, theAmerican Otological Society and the AmericanAcademy of Audiology.

He is survived by his wife of 64 years, Bobbie,as well as three children, five grandchildren,and nine great-grandchildren. Memorial contri-butions may be made to the Merle LawrenceResearch Fund, U-M Kresge Hearing ResearchInstitute, 1301 E. Ann Street, Ann Arbor,Michigan, 48109-0506.

CorrectionOn page 41 of the spring 2007issue, we identified Medical Schoolfaculty member Marilyn Roubidoux,M.D., as an associate professor ofradiology. Roubidoux is, in fact, a pro-fessor of radiology. Our apologies.

42 Summer 2007

cation and standards of care for pediatric otolaryn-gologists in the U.S. and internationally.

Howard Markel (M.D. 1986),Ph.D., the George E. WantzDistinguished Professor of theHistory of Medicine, professorof pediatrics and communica-ble diseases and director of theCenter for the History of Medi-cine, has been named one ofeight contributing writers to the

Journal of the American Medical Association.Markel’s charge is to write frequent essays exploringthe interactions of medicine, society and culture.

The American Thoracic Societyrecently honored Marc Peters-Golden, M.D., with an award forscientific accomplishment, rec-ognizing his career-long commit-ment and contributions to basicand clinical research. Peters-Golden, who studies how lipidmolecules are involved in inflam-

mation and other body processes, is a professor ofinternal medicine and director of the FellowshipProgram in Pulmonary and Critical Care Medicine.

Anand Swaroop, Ph.D., theHarold F. Falls Collegiate Pro-fessor of Ophthalmology andVisual Sciences and professorof human genetics, received theBoard of Directors Award forOutstanding Research Achieve-ment from the FoundationFighting Blindness. The award

recognizes his discovery of the gene CEP290,associated with retinal degeneration in mice.

The Institute of Medicine selected Denise G. Tate,Ph.D., professor of physical medicine and rehabili-tation, to serve on a committee to evaluate medicaldisability compensation for veterans. Also servingon the committee was Sid Gilman, M.D., formerchair of Neurology and current director of the

LIMELIGHTIN THE

Michigan Alzheimer’s Disease Research Center. Thecommittee’s report was prepared at the request ofthe Veterans’ Disability Benefits Commission andcalled for updating the system for evaluating veter-ans and their disabilities, giving special focus toconditions such as traumatic brain injury.

Scott Tomlins, a Ph.D. candidate in pathology,and Omer Yilmaz, a Ph.D. candidate in cellularand molecular biology, are among 12 graduatestudents from North America and Asia chosen toreceive the 2007 Harold M. Weintraub GraduateStudent Award sponsored by the Basic SciencesDivision of the Fred Hutchinson Cancer ResearchCenter. Nominations were solicited internationally.Winners were selected based on the quality, orig-inality and significance of their work.

continued from page 41

Edited by Richard H. Cohan, M.D., professor ofradiology; and Stuart G. Silverman, M.D.: CTUrography: An Atlas. Lippincott Williams &Wilkins, 2007.

Edited by Steven M. Donn, M.D., professor ofpediatrics and communicable diseases, directorof neonatal-perinatal medicine; and Thomas E. Wiswell, M.D.: Clinics in Perinatology:Surfactant and Mechanical Ventilation, volume34, number 1. Saunders, March 2007.

By Thomas R. Gest, M.D., Ph.D., associate pro-fessor of anatomical sciences and medical edu-cation: Clemente’s Anatomy Flash Cards.Lippincott Williams & Wilkins, 2008. Also,edited by Thomas R. Gest; Jennifer K.Brueckner, Ph.D.; Stephen W. Carmichael, Ph.D.;Noelle A. Granger, Ph.D.; John T. Hansen, Ph.D.;and Anil H. Walji, M.D., Ph.D.: Atlas of HumanAnatomy, fourth edition. Saunders, 2006.

PRINTIN Books and journals written or edited by Medical School faculty

Bina Valsangkar, a medicalstudent in the Class of 2009,has been awarded a prestigiousReynolds Foundation Fellowshipwhich will enable her to pursuea master’s degree in publichealth at the Harvard School ofPublic Health. The fellowshipseeks to accelerate the prepa-

ration of a new generation of public leaders whocan bring the insights of entrepreneurship andmanagement to bear on social problems.

The Michigan College ofEmergency Physicians’ Board ofDirectors has named EdwardWalton, M.D., assistant profes-sor of emergency medicine, asthe 2007 Emergency Physicianof the Year. The award recog-nizes clinicians of unusual meritwho are outstanding emergency

physician role models, maintain high professionalstandards and clinical orientation, and are active incommunity service and education.

Tate Gilman

Tomlins Yilmaz


LIMELIGHTIN THE

Hearing ResearchPioneer MerleLawrence DiesMerle Lawrence, Ph.D., founder of the KresgeHearing Research Institute and professor emeri-tus of otolaryngology, physiology and psychol-ogy, died on January 29 at the age of 91.

Recruited to Michigan in 1952 by Dean AlbertFurstenberg (M.D. 1915) to set up a laboratoryfor physiological acoustics, Lawrence obtainedfunds from the Kresge Foundation to build afacility devoted to research on the ear andhearing. He directed the Kresge HearingResearch Institute from 1961-83.

Lawrence earned a doctorate degree fromPrinceton University in 1941, then became aNaval aviator during World War II. After joining aNaval squadron in the South Pacific, his planewas struck by enemy fire and Lawrence waswounded. He was awarded the Silver Star Medaland the Purple Heart, among other military honors. Lawrence received numerous academic

Michigan’s ContinuingMedical EducationProgram

Pelvic surgery ... multidisciplinarybreast cancer management ...advances in psychiatry ... these arebut a few of the upcoming topics inthe U-M Continuing Medical Edu-cation program.

For information on course content,dates and locations, visit the Depart-ment of Medical Education Web siteat www.med.umich.edu/meded, call(734) 763-1400 or (800) 800-0666, or e-mail [email protected].

By Gary B. Huffnagle, M.D., Ph.D., professor ofinternal medicine and of microbiology andimmunology; and Sarah Wernick, Ph.D.: TheProbiotics Revolution: The Definitive Guide toSafe, Natural Health Solutions Using Probioticand Prebiotic Foods and Supplements. BantamBooks, 2007.

Edited by Theodore S. Lawrence, M.D., Ph.D.,chair and professor of radiation oncology;Vincent T. DeVita Jr., M.D. (Residency 1963);and Steven A Rosenberg, M.D.: The CancerJournal: The Journal of Principles & Practice of

Oncology, volume 13, number 1. LippincottWilliams & Wilkins, January/February 2007.Also, edited by Theodore S. Lawrence; NicholasJ. Petrelli, M.D.; Benjamin D. Li, M.D.; and JamesM. Galvin, D.Sc.: Journal of Clinical Oncology,volume 25, number 8. American Society ofClinical Oncology, March 2007.

Edited by Paul H. Park (M.D. 1998, Residency2005), assistant professor of neurosurgery; K. Lewandrowski; M.J. Yaszemski; R.F. McLain;and D.J. Trantolo: Spinal Reconstruction:Clinical Examples of Applied Basic Science,

Biomechanics, and Engineering. InformaHealthcare USA, 2007.

Edited by Linda S. Polley (M.D. 1991, Residency1995), associate professor of anesthesiology;and David Wlody, M.D.: International Anesthe-siology Clinics: Obstetric Anesthesia, volume 45,number 1. Lippincott Williams & Wilkins, 2007.

By Raymond W. Ruddon (Ph.D. 1964, M.D.1967), professor emeritus of pharmacology:Cancer Biology, fourth edition. Oxford UniversityPress, 2007.

and professional honors as well, includingawards from the American Academy ofOphthalmology and Otolaryngology, theAssociation for Research in Otolaryngology, theAmerican Otological Society and the AmericanAcademy of Audiology.

He is survived by his wife of 64 years, Bobbie,as well as three children, five grandchildren,and nine great-grandchildren. Memorial contri-butions may be made to the Merle LawrenceResearch Fund, U-M Kresge Hearing ResearchInstitute, 1301 E. Ann Street, Ann Arbor,Michigan, 48109-0506.

CorrectionOn page 41 of the spring 2007issue, we identified Medical Schoolfaculty member Marilyn Roubidoux,M.D., as an associate professor ofradiology. Roubidoux is, in fact, a pro-fessor of radiology. Our apologies.

44 Summer 2007

All of us in the U-M Health System will remember June 4,2007, with sadness as well as with a deep sense of respect.The loss of our Survival Flight and Transplant Program colleagues — six courageous men doing the jobs they did

for patients — is a loss from which it will take us a long time to heal.

People outside our environment sometimes believe that, because wedeal with life and death every day, we somehow harden and growaccustomed to it. Anyone who knows us knows that couldn’t be further from the truth. In fact, we are as devastated by loss as anyone,and we mourn as deeply and painfully as everyone mourns.

What sets us apart is that even when disaster strikes, we don’t let anything diminish our efforts because our commitment to our missionis so very strong. Working through our tears, even while suffering atremendous blow, we continue: someone needs us, so we help. It’s what we do — not the best we can under the circumstances, but thevery best we can, period.

Our hearts and hopes go out to the families affected by this horribleevent. We will commemorate the fallen by commissioning a work ofart to stand prominently in the Health System as a constant reminderof the indelible mark these men have made upon our institution.Endowments in their names will be established for each of the six families to designate as they wish as permanent memorials to their losthusbands and fathers.

Despite the tragic and untimely loss of these six men, their strong senseof team lives on in the Health System and will not change. We continueto offer hope and healing to patients and their families. And we all havebeen reminded once again just how precious life is. Cherish it well.

Sincerely,

Robert P. Kelch (M.D. 1967, Residency 1970)U-M Executive Vice President for Medical Affairs CEO, U-M Health System

EVPMAFROM THEE X E C U T I V E V I C E P R E S I D E N T F O R M E D I C A L A F F A I R S

Phot

o: M

artin

Vlo

et

After alumni Fred and Jean Holland became doctors, they never lost sight of the finan-cial challenges medical students face, and always hoped to find a way to help. WhenFred died of a brain tumor in 1997 at age 46, Jean recalled their plans, and, with herfive sons, honored her late husband by establishing the Frederick Richard Holland,M.D., Endowed Medical Scholarship.

“He loved people and firmly believed he was put on Earth to help them,” says Jean.“I’m sure he would have looked upon the recipients of this scholarship as his adoptedsons and daughters.” Jean shares this view. “I think they know I truly care about them,believe in them, and am thrilled to see them joining this marvelous profession,” she says.

Your scholarship gift can help make the Michigan Difference. Every gift, of every amount, strengthensthe ability of the Medical School to attract outstanding students and to lighten their financial burdenas they pursue careers of distinction and service in the Michigan tradition.

For more information about how you can help support medical students at Michigan, contact B.J. Bessat (734) 998-7705 or [email protected].

Jean Holland Extends Her Familythrough Student Support

T H E M I C H I G A N D I F F E R E N C E

Jean Holland with Holland scholarship recipient Jennifer Velander (M.D. 2007)

Photo: Lin Jones

from the - medicine at michiganfor endoscopy,laparoscopy, and endovascular procedures provide...

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