outlook upstate
TRANSCRIPT
UpstateUpstate
outlookoutlookVolume 4, Number 2 Spring 2004
News on education, biomedical research and health care at SUNY Upstate Medical University Syracuse, New York
New Dean of Medicine
Intuitive Surgical Robot
New Heights of Spiritual Care
Cancer Crusaders
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19Concussion:A Cautionary TaleConcussion:A Cautionary TalePage 4
As weprogresstoward themilestoneswe’ve set
for SUNY Upstate, theterrain often demandsthat we adjust our route.The recent appointment ofDr. Steven Scheinman asexecutive vice president and dean of theCollege of Medicine represents both amilestone and a course adjustment. I amdelighted with the outcome of the search.Dr. Scheinman is bright, energetic, even-tempered and attentive to detail, yet heworks conceptually and has a clear view of the long road ahead – an essentialperspective as we approach importantintersections in the future development of our institution’s history.
In addition to inspiring celebration, Dr. Scheinman’s appointment hasprompted some introspection on my part.In the 11 years of my presidency, Upstatehas become dramatically more complex, as evidenced by:
• an operating budget that has doubledfrom $325M to $650M per year
• a health care environment that haschanged profoundly
• funding streams which are increasinglyambiguous
• an expanding commitment to collaboration.
Over the course of a decade, thesedevelopments have expanded my role aspresident. On a daily basis, I now amcalled upon to interact:
• with local, state, and national leaders
• with our nation’s academic medicalcenters, through my activities in theAssociation of Academic Health Centers
• with our research colleagues in New York’s promising biotech research corridor
• with our immediate academic neighborson “The Hill’
• with our clinical neighbors next dooron Crouse Avenue
• and with Central New York’s citizens,who are demonstrating unprecedentedgenerosity and support of our work,especially in terms of The CNYChildren’s Hospital at UniversityHospital.
I thoroughly enjoy these interactionsand feel that great good comes of suchclose collaboration and communication.But this shift in my focus necessitatesinternal shifts in responsibility. To a largedegree, I function as chief executive officer,with continued overall responsibility forthe internal activities of Upstate, but withgreater attention to external affairs. Dr. Scheinman essentially functions aschief operating officer for Upstate, as both executive vice president and dean ofmedicine. He is charged, for example, withcoordinating the College of Medicine andUniversity Hospital. This makes sense,given their shared finances and faculty.
On Upstate’s new organizational chart,therefore, the head of the hospital reportsto the executive vice president. Theprovost and vice president of academicaffairs and research reports to the executivevice president on matters related to internalacademic affairs and research – and to thepresident on matters related to SUNY andexternal academic and research relations,such as other academic institutions and theUpstate New York Coalition forBiomedical Research (UNYCoR).Likewise, the vice president for adminis-tration and finance reports to the executivevice president on matters related to financeand space – and to the president onbroader issues such as human resources,infrastructure, and campus security. The vice president for public and govern-mental relations and the vice president for development continue to report to the president.
Of course, these external and internaldistinctions are not crisp and SUNYChancellor Robert King ultimately holdsme accountable for everything at SUNYUpstate. But I am confident that thisalignment will be productive andinvigorating and will enable us to reachmore quickly the important milestones on the road ahead.
–Gregory L. Eastwood MDPresident,
SUNY Upstate Medical University
2 S U N Y U P S T A T E M E D I C A L U N I V E R S I T Y O U T L O O K SPRING 2004
Presidential Perspective
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GregoryEastwood MD
The RoadAheadEn route to ever higher levels
of educational, clinical and
research excellence, SUNY
Upstate has established these
goals for the immediate future:
• Increasedresearch
productivity
• Implemen-tation ofMission- BasedManagementand Funds Flow
• Constructionof the newacademicbuilding
• The CNYChildren’sHospital atUniversityHospital,including a$15 millioncapitalcampaign
• Constructionof parkingfacilities toaccommodatevisitors,employees and students
• Development of the Center for EmergencyPreparedness
• Verticalexpansion ofUniversityHospital’seast wing
• Increaseddiversity of
students,residents,
faculty and staff
• Spacemanagementaccording to
principles and metrics
• Development of research
institutes andclinical centersaround cardio-
vasculardisorders,
cancer,neuro-sciences andorthopedics/
rehabilitation
• Development of productiverelationships
with SUNY ESF,Syracuse
University, the VA Medical
Center and other
institutions
• Increased federal and
state resources to support
SUNY Upstate
• Enhancedvisibility andreputation of
SUNY Upstate – in the region,
state and nation
• Progress toward 750-bed academic
medical center,integrating Crouse
Hospital and University Hospital
The View From the Driver’s Seat
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Table of Contents
S P R I N G 2004
P U B L I S H E RRonald R. Young
Vice President, Public andGovernmental Affairs
E X E C U T I V E E D I T O R SDarryl Geddes
Director, Public and Media Relations
Melanie RichDirector, Marketing and
University CommunicationsE D I T O R - I N - C H I E FDenise Owen Harrigan
A C A D E M I C / R E S E A R C HE D I T O R
Leah CaldwellD E S I G N E RSusan KeeterW R I T E R S
Leah CaldwellDarryl Geddes
Denise Owen HarriganDoretta Royer
Upstate Outlook is published by the Offices
of Public Affairs andCommunications.
SUNY Upstate MedicalUniversity in Syracuse, NY, isan academic medical center
with four colleges – Medicine,Nursing, Health Professions
and Graduate Studies – as wellas an extensive clinical health
care system that includesUniversity Hospital and numer-
ous satellite sites. Affiliatedwith the State University of
New York, SUNY Upstate is oneof Onondaga County's largest
employers. For more information, visit us online
at www.upstate.edu or phoneus at 315-464-4836.
For corrections, story suggestions and
submissions, contact Denise Owen Harrigan, 315-464-4822 or e-mail [email protected] additional copies,
call 315-464-4836.Upstate Outlook offices arelocated at 250 Harrison St.,
Syracuse, NY 13202
On the coverSidelined by concussion for her
winter sports season, KaitlinEnglert is back in action thisspring, after months of treat-ment in University Hospital’s
Concussion ManagementProgram.
Robert MescavagePhotographer
Calling Attention to ConcussionIt’s defined as a mild brain injury, but concussion can derail lives and cause long-term damage.University Hospital’s Concussion Management Program, directed by psychologist Brian RiegerPhD, pays serious attention to this low-profile problem.
By Denise Owen Harrigan Page 4
“Preseasoned” Dean of Medicine Steven Scheinman MD brings a fresh outlook to his new roles as dean and executive vice president.But after 20 years on campus, the former professor of medicine and chief of nephrology also bringsa fine reputation and a seasoned sense of the SUNY Upstate culture.
By Leah Caldwell Page 8
“Doctor” da Vinci Joins Surgical TeamAn anatomically curious but high-functioning surgical robot is now operating at UniversityHospital. Also known as the da Vinci Surgical System®, the robot works hand in hand with thesurgeon, integrating and refining the benefits of minimally invasive and open surgery.
Page 15
New Heights of Spiritual CareThe arrival of SUNY Upstate’s first full-time spiritual care manager, the Rev. Terry Culbertson,heralds increased emphasis on the spiritual dimensions of healing and the launch of excitingeducational initiatives.
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outlookUpstate
Publisher’s Perspective
“The academic difference” is a phrase we often use to distinguish our clinicalenterprise from other local health care resources. But for those not whollyfamiliar with SUNY Upstate’s three interrelated missions – education,research and clinical care – the phrase may not be self-explanatory. Thisissue of Upstate Outlook amplifies the definition of the academic difference.Our feature on concussion, for example, illustrates the multiple resourceswe bring to bear on a challenging medical condition. The most obviousresource is University Hospital’s Concussion Management Program, whichprovides comprehensive clinical care to our community. The lessapparent elements – which create the academic difference – includethe research projects we design with our own experts, with ourultra-advanced research technology (such as the IHP’s research-dedicated functional MRI machine) and with our colleagues atSyracuse University. The more we can learn about concussion, thebetter equipped we are to turn our understanding into education.Education is the reason our institution was founded in 1834, andeducation is at the very heart of the academic difference.
Ronald R. Young, PublisherVice President for Public and Governmental Affairs
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When UniversityHospital psychologistBrian Rieger PhDreads the sports page,he’s not just following
his favorite teams. Rieger, director ofUniversity Hospital’s ConcussionManagement Program, is gatheringevidence that sports-related concussionsmerit more serious medical attention andpublic awareness. Rieger has a stack ofsports clippings, and a wealth of personalclinical experience, demonstrating thatconcussion – an injury in which the free-floating brain is shaken inside the skull –can lead to months of miserable symptomsand sometimes serious, long-term brain damage.
That’s why SUNY Upstate MedicalUniversity is focusing its impressiveclinical, educational and research resourceson the issue of concussion. UniversityHospital’s Concussion ManagementProgram, and the CNY Sports ConcussionCenter, which opened this spring in theInstitute for Human Performance (IHP),address the clinical side of concussion, byevaluating and managing concussioninjuries like Kaitlin Englert’s (see page 5).
Elusive SymptomsAs Englert learned when she was hit in
the temple by a volleyball, the symptomsof concussion often worsen in the first 24hours after injury. Most people recoverfrom concussion, but it can take weeks ormonths. According to Rieger, up to 20percent of cases will have symptoms thatpersist for a year or more.
The good news, according to Rieger, is that early education and medicalintervention can help anyone who suffers a concussion.
Voice of ExperienceUniversity Hospital’s Concussion
Management Program was developed bythe Department of Physical Medicine andRehabilitation. “Having operated atraumatic brain injury program for 15years, our department physicians certainlyhave experience in the long-term effects ofbrain injury,” says Robert Weber MD,department chair.
“Often there is little or no relationshipbetween the external injury and the effecton the brain,” he says. “In our experience,there is no such thing as a ‘minor’ braininjury. Any brain injury disrupts your life.”
University Hospital’s ConcussionManagement Program takes a multidisci-plinary approach to concussion treatment,involving physicians, psychologists, a nursecase manager and physical and occupa-tional therapists, as needed.
Focusing an entire medical team on thisunderestimated condition can be veryreassuring to patients. “These are peoplewho have been suffering from severeheadaches, fatigue, inattention, loss ofmemory and other troubling symptoms,”reports Rieger. “The diagnosis often comesas a tremendous relief. The patient will sit in my office and say, ‘You mean I’m not crazy?’”
“This program has certainly made usmore concussion-conscious in theEmergency Department,” says JohnMcCabe MD, chair of emergencymedicine. “In the past, concussionmanagement meant sending seriouslyaltered patients to a neurosurgeon – andsending not-quite-normal patients home,with reassurance that they wouldeventually feel fine.
continued on page 6
4 S U N Y U P S T A T E M E D I C A L U N I V E R S I T Y O U T L O O K SPRING 2004
The Academic Difference
Paying Serious Attention to
SUNY Upstate Marshals Its Forces To Combat an Often Underestimated Condition
ConcussionConcussionConcussion
MYTHSMYTHSMYTHSMYTHSMYTHS
• If you weren’t knocked
out, you didn’t suffer
a concussion
• Everyone gets better
in two weeks
• Once the headache
goes away, everything
will be fine
• If there’s no visible
injury, it can’t
be that bad
• Concussion is a
minor brain injury
with no long-
term effects
• You should play
through the pain, so
get back in the game
Myths
Concussion Crusader:
Psychologist
Brian Rieger PhD
Director, Concussion Management
Program; CNY Sports Concussion Center;
and Rehabilitation Psychology at
University Hospital
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The Academic Difference
Kaitlin Englert, 17, is a reigning
New York state tennis champ,
varsity lacrosse and volleyball
player and dyed-in-the-wool
competitor. So she cringes when
she recounts last winter’s failed
dive after a spiked volleyball. “It
was only practice, but I should have
made that play,” says the
Fayetteville Manlius High School
junior. “I was really embarrassed.”
Embarrassment should have
been the least of Englert’s worries.
The missed volleyball hit the floor,
bounced back and slammed her in
the right temple. A little startled,
she continued to play.There was no
bump on her head – and she hadn’t
blacked out – so concussion didn’t
seem to be a concern.
But by the next day, Englert had
a headache so severe that she went
to her pediatrician, Kathryn Webster
MD at Brighton Pediatrics. Dr.
Webster – noting that Englert also
seemed confused and ultra-
sensitive to light and noise –
referred her to the Concussion
Management Program at University
Hospital.
Director Brian Rieger PhD and
the concussion program staff
conducted a comprehensive
evaluation – including a CT scan
that showed no visible damage.
Rieger diagnosed Englert with a
concussion, or mild traumatic brain
injury (mTBI). As the weeks of
treatment passed, it became
evident that Englert’s mild injury
had major repercussions.The
relentless headache, extreme
fatigue, mental processing problems
and emotional volatility kept
Englert out of school for six weeks
and sidelined from sports for three
months.
“I couldn’t take the light or noise,”
she says. “It felt like everyone was
screaming at me.”
It could have been even more
distressing, without Englert’s
referral to the area’s only
concussion program, where she
received medical attention, physical
and occupational therapy and a
personalized plan for gradual re-
entry into academics and athletics.
To help bring Englert’s teachers up
to speed on her cognitive
difficulties, Rieger sent them
copies of his “Concussion in
the Classroom” manual.
And to test her balance,
vision and reaction time,
Englert’s University
Hospital occupational
therapist Kim Nemi OTR\L
and physical therapist Michelle
Westlake PT tossed Englert
lacrosse balls while she walked on
the treadmill with her lacrosse stick.
By the time lacrosse season
opened in April, Englert was back in
school and back in play. “This was a
very serious injury with a very good
outcome, thanks to the concussion
clinic,” reports Kaitlin’s mother,
Kathleen Englert. “An injury like this
can be overwhelming.There is no
cast or bandage. People on the
outside don’t always understand
what’s happening.”
"Kaitlin was very diligent about
her therapy," reports Paul Trela
FNP, nurse practitioner in the
Concussion Management
Program. "But it's an
invisible injury, and
frustration comes with
the territory."
”It was hard to stay
patient,” admits Kaitlin.
“But as much as I
wanted to play, I
couldn’t risk it.This
wasn’t an injury
you could tape
up.This was
my brain.”
A Mild Brain Injury?
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LEGISLATIONTo address the potentially serious
ramifications of sports concussions,
the New York State Legislature is
considering an amendment to the
Education Law. Proposed Section
916 would establish guidelines –
including written clearance from a
physician – for students returning to
certain sports after concussion.
Proposed by Assemblyman Robert
Sweeney and passed by the
Assembly, the amendment would
also create a system to track the
number and severity of concussions
a student sustains.
Legislation on Concussion
Kaitlin Englert:Lacrosse
midfielder and concussion
patient.
Concussion, continued from page 4
“It’s great to have the ConcussionManagement Program, where patients with minor head trauma can find compre-hensive care,” McCabe says. “It helpspatients determine what they can andcannot do, in terms of going back to work or getting back to sports.”
Broader MissionWhile this clinical component is
essential, education is also imperative.Rieger’s experience is that most people –and some medical professionals – have alimited understanding of concussion. Thelack of information is especially perilouswhen it comes to sports concussions.
“If an injured athlete returns to playbefore the symptoms are fully apparent –or before the concussion has healed – therisk of severe, permanent damage dramat-ically increases,” says Rieger, whose missionis raising awareness about concussion.
“One of the first steps is to dispel themyths,” he says. “There is a commonmisconception that only a blackoutindicates serious risk. But there is a lot ofresearch indicating that loss ofconsciousness does not necessarily meanthe concussion is more or less severe.”
Topic du jourMillions of Americans suffer a
concussion every year, but only about300,000 are sports-related. “Your garden-variety concussion is caused by a caraccident. Falls and assaults also cause farmore concussions than sports,” concedesRieger. “But sports injuries have highervisibility.
“On professional football teams, this is the topic du jour,” he adds. Concussionresearch has prompted the first football
helmet redesign in 25 years. And a recentstudy in the American Journal of SportsMedicine reported that 10 percent of highschool athletes playing contact sports sufferconcussions every season.
“We’re taking advantage of this publicityto help make our case about concussion,”says Rieger.
Sideline DebateSports-related concussions also deserve
extra attention because there can bepressure – from a variety of sources – to return injured athletes to the game.“Coaches and trainers aren’t alwaysknowledgeable about the potentialconsequences,” Rieger says. “And in theheat of the game, players aren’t alwaysforthcoming about symptoms.”
Orthopedist Dwight Webster MD, chiefof the Sports Medicine Section in theDepartment of Orthopedic Surgery, isgrateful for Rieger’s words of caution aboutconcussion. “He is a tremendous resourcefor our residents and physicians,” saysWebster. “Concussions initially can bevery subtle and difficult to diagnose. Forthose of us who deal with musculoskeletalinjuries, concussions can be a little outsideour realm of expertise.
“Dr. Rieger also helps educate the highschool athletic trainers who work with ourprogram,” Webster adds. “These trainersare the athlete’s advocates. It is critical that they understand the subtleties ofconcussion.”
Medical MentionRieger is pleased to see growing
awareness of concussion and sportsconcussion, especially in the medicalcommunity. The first internationalconference on sports concussion was held
in 2001 in Vienna. “It recommended thatathletes who appear to suffer a concussionshould automatically be removed from playfor at least 24 hours,” Rieger reports. “It’stoo difficult, at that point, to determine ifthey’ll be OK. At the high school level,there is absolutely no excuse not to takethe athlete out.”
“When in doubt, sit them out,” Riegeradds. “That’s the current catch-phrase forgood concussion management in sports.Our Concussion Management Program isglad to see the athlete and take responsi-bility for the decision.”
Spreading the Word For more than a year, Rieger and his
colleagues have been on the local speakers’circuit, promoting concussion awareness –especially among coaches, trainers, schoolnurses, parents and players.
They are also working on a program tooffer preseason cognitive testing to localhigh school and college athletes, who cantake the test online. These computerizedtests (created by HeadMinder and fundedby University Hospital’s Department ofPhysical Medicine and Rehabilitation)provide a baseline for measuring recoveryafter a concussion. “When an injuredathlete regains the original level ofcognitive function, that’s a green light forreturn to play.” Rieger explains. “These are the same kinds of tests used by theNational Football League and other professional sports.”
Orange ConnectionSyracuse University and Onondaga
Community College athletes have alreadytaken the HeadMinder tests, in collabo-ration with the Concussion ManagementProgram. Timothy Neal, head athletictrainer at SU, jumped at the chance to
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The Academic Difference
S U N Y U P S T A T E M E D I C A L U N I V E R S I T Y O U T L O O K
From McAllister TW. et al. Differential working memory load effects after mild traumatic brain injury. Neuroimage. 14(5):1004-12, 2001 Nov.
fMRI: Working Memory Load Effects After mTBIfMRI: Normal Working Memory Load Effects
Visual Proof: The brain under siege by concussion (right) works muchharder than the normal brain (left) to complete the same task.
offer his players the computerized testing.“The impact of severe or repeatedconcussions on a student athlete’sacademics is a major concern for us,” says Neal. “Did you ever think of wherethe term ‘dumb jock’ comes from? It may be related to concussions earlier in the athlete’s life.
“In my 27 years at SU, I’ve seen six orseven dozen concussions, including four orfive career-ending head injuries,” Nealreports. “We’re already pretty conservativewhen it comes to head injuries. We treatSU athletes like our own sons anddaughters. But it’s great to have Head-Minder’s objective measures. We’recommitted to this testing and to findingout all we can about the long-term impactof concussion.”
The Research ComponentRieger’s ultimate research interest is the
impact of concussion on academic – notathletic – performance. “Concussion in theclassroom is a very underexplored area,” he reports. “There is a lot of informationabout academic problems after brain injurybut almost nothing that is focused specif-ically on concussion.”
Last winter, Rieger tailored one of hispopular concussion workshops to specialeducation teachers in the Syracuse CitySchool District. “Concussion is an invisibleinjury that often leads to academic andsocial problems,” he told the teachers.
“For students with concussion, fatigue isthe number-one problem,” he says.“Concussion causes chemical changes thatlead to an energy crisis in the brain. The student has to work much harder toaccomplish what once came easily. In the wake of a concussion, you often findpoor cognitive and organizational skillslayered on top of good intellect andlanguage skills.”
Collaborative ResearchRieger’s research partner is Lawrence
Lewandowski PhD, Meredith Professor of Teaching Excellence in SyracuseUniversity’s Department of Psychology.The two psychologists are using data fromthe HeadMinder tests to investigate whichmeasures – such as reading speed – are sensitive to concussion.
“Until recently, the diagnostic measuresfor concussion have been pretty crude,”Lewandowski reports. “The testing oftenconsists of the doctor telling the patient,‘Follow my finger.’ The bottom line is thatvery little is documented about concussion,and what people think they know might be myth.”
Lewandowski and Rieger plan to usetheir current research as a springboard to amajor funded study. In collaboration withUpstate’s Department of Neurosurgery,they also hope to use the IHP’s world-classfunctional magnetic resonance imaging(fMRI) equipment to capture dramaticimages of a brain under siege byconcussion. (see page 6)
Rieger hopes that the research willultimately help students struggling withthe cognitive effects of concussion. “Thereare about 15 sets of guidelines for return toplay after concussion,” he notes, “but thereare no guidelines for return to school.”
–Denise Owen Harrigan
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The Academic Difference
Collaborating on Concussion:Timothy Neal, left, head athletic trainer at Syracuse University, workswith the University Hospital Concussion Management Program to establish the baseline cognitivefunction of SU athletes, using the computerized HeadMinder program. “Concussion is becomingan ever more urgent issue,” says Neal. “Athletes today are bigger, stronger and faster. When theycollide on the field and fall at your feet, the ground shakes.”
“When in doubt, sit them out. That’s the current catch phrase for good
concussion management in sports.”–Brian Rieger PhD, Director
Concussion Management Program,University Hospital
Before and After: Sample computerized test ofcognitive function performed one day post-injury. After 14 days, the same patient’s testshowed normal (green) function.
Simple Reaction Time
Complex Reaction Time
Processing Speed Index
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Over the course of more thana year, Steven ScheinmanMD developed an inter-esting perspective onSUNY Upstate — from
the eyes of candidates for the dean ofmedicine position.
“Hearing how the candidates viewed our problems and strengths got meinvolved in thinking how we could bemore successful,” he says.
As the outside search flagged,Scheinman’s interest in the position grew.He was urged by many colleagues towithdraw from the search to apply for theposition himself. “I was ready to roll up mysleeves and try to fix what might be
holding us back.” He now holds theposition and is approaching his new jobwith high degree of excitement, and headds, a bit of trepidation.
“Most medical school deans last two-and-one-half years on the job. I’m hopingto beat that,” he says with a smile. “Deanjobs anywhere are complex in their issuesand scope, even when you don’t have ahospital.” The complexities at SUNYUpstate include state regulations for boththe colleges and hospital, and navigatingrelationships with the medical marketplace.
As a professor of medicine and chief ofthe Nephrology Division, Scheinmancomes to the position with a distinguishedinternational reputation for his research on
kidney stone disease, two current NIHgrants, an active lab and a specializedclinical practice. His recent awards includebeing named by the SUNY ChancellorRobert King as one of New York State’smost important and innovative scientistsand SUNY Upstate’s President’s Award forExcellence in Research. He lectures tomedical students through the Program inMedical Humanities.
As dean, Scheinman will oversee SUNYUpstate’s academic, clinical and researchenterprises which include 600 medicalstudents, 480 faculty from 18 clinical andfive basic science departments and afunded research budget that will top $34 million in 2004.
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It’s Academic
“Introducing”Steven Scheinman MD Executive Vice President & Dean of the College of Medicine
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It’s Academic
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How does this dean of
medicine position differ
from its predecessors?
The dean of medicine responsi-bilities were expanded toinclude an executive vicepresident role —in particular
to make reporting relationships moreefficient. In effect, as Dr. Eastwood hasexplained it, the president is the CEO, the dean is the COO. That means I will be overseeing the inside operation,including finance and space, while thepresident will develop relations withoutside constituencies such as SUNY,government agencies and others essential to our development.
What is the advantage of
being an Upstate insider?
Do you see yourself that
way?
I have a love for this place andhave been here 20 years, whichby definition makes me aninsider. But I also have an
outsider’s view of our problems andchallenges. Like many people here, I haveinterests and colleagues that span manyinstitutions, which keeps me in touch withnew ideas. I think I understand andsupport Upstate while being open tocomments about how we need to grow orimprove.
What have you observed
during your 20 years here
that will help you in your
new position?
The faculty here are talented,devoted to what they do andreally care about this placedoing well. Throughout the
campus, there is a real sense of all threecomponents of our medical university —education, research, patient care —although they are not always given thesame attention.
I support the desire held by many here forgreater faculty and staff development, andin making Upstate an attractive place tocome and be successful.
In general, I would say Upstate employeeshave a shared sense of mission but see thatwe haven’t always used resources to ourbest advantage.
You mention resources.
What is your take on
that?
First, our state resources are awonderful asset — you canequate the $50 million wereceive from SUNY to income
from a $1 billion endowment at a privateschool. I would like to see it used todevelop planned programs, rather thanpatch problems. But the state makes ithard to do such planning. However, ourinstitutes are tangible evidence of howplans can succeed.
Second, I will be implementing Mission-Based Management, but I can’t take creditfor it. Skeptics call it a substitute forleadership, but MBM is basically a tool to gather information. Once we have theinformation, we must make appropriatedecisions. That’s where leadership comes in.
Most of our dollars are tied up in salarylines, so it’s not flexible money. Therefore,any change will have to be gradual.
How would you describe
your management style?
I hope my management stylewill empower people. I am notautocratic and feel that peopledo better when decisions arenot simply imposed. If there is
an unpopular decision, I hope thatemployees understand how the decisionwas made. I plan to build consensuswhenever possible, but I won’t deliberateforever on an issue.
Why is it important for
our university to
embrace the missions of
research, education and
patient care?
Research expands ourknowledge and our ability toimprove the care of patients.
Research informs our education mission,and there is ample documentation thatpatient care at a research institution is ofhigher quality. Education of newphysicians and other caregivers is a centralobligation of all healers and contributes toa higher quality of patient care at teachinginstitutions. Patient care, the purpose forwhich we train new physicians and developnew treatments, is a central mission. Amedical university at which all threemissions are not fully developed is notcomplete.
–Leah Caldwell
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Questions and Answers with Dean Scheinman
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It’s Academic
SUNY Upstate’s new academic building, scheduled to open in 2006, connects to Weiskotten Hall at left. Above: final rendering of the exterior; below: clinical skills classroom space. Holt Architects PC, Ithaca.
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Clinical TeachingAnchors NewAcademic Building
A state-of-the-art clinical teaching suitewill occupy the entire ground level of thenew five-story academic building,scheduled to open in the fall of 2006.
The clinical teaching suite, with 22exam rooms, will utilize actors – known asstandardized patients – to simulate diseasesymptoms. These carefully stagedsimulations help medical students developexamination, interviewing and diagnosticskills.
Ninety five percent of US medicalschools – including SUNY Upstate –currently use actors in clinical training.Upstate’s new clinical skills teaching areawill dramatically improve the faculty’sability to observe, evaluate and guide thestudents’ interaction with actors. It willalso help students prepare for the clinical
reasoning exam recently added to the USMLE Step 2 licensing exam.
“Students learn by doing,” notes Sara JoGrethlein MD, director for the Practice ofMedicine course. “Students will be betterable to take abstract knowledge and applyit in a real situation, yet one where theycan make a mistake and try again.”
The new academic building will alsoprovide needed classrooms, small grouplearning space and program-related officesThe building program has been developedby a committee representing students andthe Colleges of Medicine, HealthProfessions, Nursing and Graduate Studies.
The project is heartily supported by theCollege of Medicine Alumni, according toDirector Carole Novick. “The originalstate funding did not cover all neededteaching space, and our alumni are makingit happen,” she reports. “To purchase state-of-the art equipment for the new building,we are also launching a fundraisingcampaign, with naming opportunities.”
Program Courts Future Nurses
With the demand fornurses reachingnew heights, theSUNY UpstateCollege of Nursing
is courting high school students with a novel approach to a bachelor’s degreein nursing.
The new 2+2 bachelor’s degree pro-gram—currently one-of-a-kind in theregion – invites future nurses to applyto Upstate at the same time they applyto their associate degree program. (Asan upper-division nursing college,Upstate only enrolls nurses who havetheir RN.) Students accepted byUpstate are then guaranteed a spot fortheir junior and senior years of college.At that point they can enroll full-timein the College of Nursing or work as anurse while taking courses.
“We hope this will make it easier forstudents to consider a bachelor’s degreefrom day one,” says College of NursingDean Elvira Szigeti PhD, RN. “Furthereducation is rewarding in itself, andthere is terrific opportunity and jobsecurity in this profession.”
A nurse with a bachelor’s degreeearns a median salary of $46,500 and ismore likely to be promoted to manage-ment. Nationwide, nursing opportuni-ties outrank most other areas ofemployment. In New York State alone,the number of available nursing positions is expected to reach 17,000by 2005. For more information on how to become a nurse, visitwww.upstate.edu/con
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SPRING 2004
Need to KnowTo assess the educational needs of
nurses, SUNY Upstate’s College ofNursing recently conducted a demo-graphic survey of RNs and learned thatmore than half of its respondents intendto seek further education, particularlybachelor’s and master’s degrees. And 83percent are interested in workshops andconferences, according to Barbara Black,College of Nursing continuing educa-tion director (pictured above).
The respondents were from a randomsampling of 26,000 registered nurseslicensed to practice in New York State.
It's A MatchOn March 18, 152 fourth-year students
from SUNY Upstate’s College of Medicinelearned where they will spend theirresidency years as they pursue their chosenspecialty.
This annual rite of passage, known asMatch Day, was established in 1952 by theNational Resident Matching Program ofthe Association of American MedicalColleges. The matching program providesan orderly and fair way to match thepreferences of applicants with those of theresidency programs that offer the training.
At Upstate Medical University, 100percent of the fourth-year medical studentsreceived residency appointments.Nationwide, 93 percent of all US medicalgraduates matched to a residency program.
Nearly half will enter the primary carespecialties comprised of internal medicine(23 percent); pediatrics (16 percent);family practice (5.3 percent); combined medicine/pediatrics (2.6 percent); and
obstetrics and gynecology (2 percent). Eighteen percent will pursue surgicalspecialties, five percent will train inpsychiatry and four percent in emergencymedicine.
While SUNY Upstate medical graduateswill go to 26 different states, 55 percenthave decided to remain in New York.Thirty graduates will remain in Syracuse:21 at University Hospital and nine at St.Joseph’s Hospital Health Center.
In addition to matching its students toprograms throughout the country, SUNYUpstate has also filled its own 110 specialtyand subspecialty residency positions,according to William Grant EdD,associate dean for graduate medicaleducation. “The fact that we filled all theopenings in our own teaching hospital —even in the primary care programs wherethere was less of an interest at the nationallevel — is highly significant and speaks tothe quality of our programs,” he notes.
–It’s Academic compiled from reports by
Leah Caldwell and Doretta Royer
1 1
It’s Academic
Match Day! Graduating Upstate
medical students,
from left, Emmy Gilles
of Huntington will
go to North Shore
University Hospital
on Long Island;
Donna Thomas of
New York City will
got to Columbia
University Medical
Center in New York;
and Kim Gilbert of
Syracuse will go to
Robert Wood Johnson
University Hospital in
New Brunswick, NJ.
All will pursue
residencies in
internal medicine.
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1 2 S U N Y U P S T A T E M E D I C A L U N I V E R S I T Y O U T L O O K SPRING 2004
It’s Academic
New PT DoctorateEagerly Embraced
SUNY Upstate’s new transitionaldoctoral program in physical therapy (T-DPT) promptly filled its first class with 25licensed physical therapists (PTs) who areeager for the advanced degree andappreciative of the program’s flexibleweekend format.
Upstate’s College of Health Professionswill also welcome its first PT doctoralstudents in June. These students, who wantto become physical therapists, will enterthe three-year DPT program with abachelor’s degree.
The College of Health Professionspreviously offered a master’s degree inphysical therapy. Elevating the program to
the doctoral level permits the expansion ofkey curriculum areas, including theapplication of evidence-based practice andcritical thinking skills.
“These are ambitious programs that will enhance the PTs’ capabilities asdiagnosticians and practitioners,” saysPamela Gramet PT, PhD, chair of the Physical Therapy Department. “Inmany states, physical therapists practiceautonomously, in a direct-access environ-ment. Both Upstate DPT programsprepare graduates for this opportunity.”
Upstate’s addition of DPT programs –for both licensed PTs and those wishing to enter the field – is in line with the vision of the American Physical TherapyAssociation. It predicts that, by the year2020, most physical therapy services willbe provided by doctors of physical therapy.
Takes PrizeThis year, SUNY Upstate's Mini Med
course sold out the day it was advertised,enrolling more than 100 students, ages 15 to 74. The popular course also took tophonors in a SUNY-wide competition forbest special event. The competition wassponsored by the SUNY Council forUniversity Affairs and Development(SUNY CUAD).
Mini Med offers a behind-the-sceneslook at health career education. More thanone dozen Upstate teaching professionals— including physicians, nurses, scientistsand researchers — share their insights over six Wednesday evenings. “We ask our professors to present a lecture that has a big impact on Upstate students,”reports Mini Med coordinator LeahCaldwell, assistant director for universitycommunications.
“Some participants are exploring theircareer options, but most are just fascinatedby medicine,” Caldwell notes. “For thoseinterested in one of Upstate’s four colleges,we offered on-the-spot admissioncounseling one night.”
Mini Med is supported by aneducational grant from the PfizerCorporation, and will run again in fall2004 at University Hospital’s OasisHealthLink Learning Center inShoppingTown mall. To be placed on the mailing list, please e-mail [email protected] or call (315) 464-4835.
MedQuest: Summer Program for High Schoolers
While Mini Med attracts students of allages, SUNY Upstate is hosting a summerprogram for area students who are entering10th and 11th grades and are interested inhealth and medical careers. MedQuest is aweek-long resident camp, cosponsored bythe Central New York Area HealthEducation Center.
Jim Vossler, associate dean for theCollege of Health Professions, issupervising the content and says the
program offers a combination of lecturematerial and hands-on experiences.“Participants will also see demonstrationsof sophisticated medical equipment, suchas imaging and trauma care,” Vossler says.
Activities range from taking healthassessments to learning how to put oncasts. Each participant will also gain CPRand automated external defibrillator (AED)certification. Only 20 students are acceptedinto the program, and they will besupervised by staff at all times.
To download a brochure or application,please visit www.cnyahec.org or call 607-756-1090. MedQuest runs July 16-20,with applications due May 28.
Physical therapy students practice water therapy techniques in the Institute for Human Performance pool.
Mini Med
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SPRING 2004 S U N Y U P S T A T E M E D I C A L U N I V E R S I T Y O U T L O O K 1 3
Clinically Speaking
The president ofthe NationalAssociation ofWomenSurgeons has
been named chief of the newVascular Surgery Section in UniversityHospital’s Department of Surgery. VivianGahtan MD, formerly an attendingsurgeon at Yale New Haven Hospital,brings advanced expertise in treating
carotid artery disease, aortic aneurysmdisease, lower extremity arterial insuffi-ciency and varicose veins. She offers bothopen and endovascular approaches to manyprocedures.
Gahtan says she was attracted to vascularsurgery by the intricacy of the surgicalprocedures and the long-term nature of thepatient relationships. “In contrast to atrauma surgeon,” she explains, “a vascularsurgeon often follows a patient for life. Ialso like the fact that most of what we doas vascular surgeons is palliative – we lessenthe burdens of aging, prolong a patient’sfunction and improve the quality of life.”
Gahtan’s previous appointments includechief of peripheral vascular surgery withthe VA Connecticut Health Care System.She will continue her affiliation the VA
Healthcare Network in Syracuse. She willalso continue her clinical research intovascular reconstruction outcomes and basicresearch into vascular smooth muscle cellmigration and other topics. To date, shehas published close to 100 journal articles,book chapters and abstracts.
Gahtan is president of the NationalAssociation of Women Surgeons, a highlyregarded national group established in1981 by Upstate’s Patricia Numann MD.
The connection ultimately led toGahtan’s recruitment to Upstate. “Lastyear, I called Dr. Numann inquiring aboutthe group’s history,” Dr. Gahtan explains.“The next day I received a recruiting callfrom her colleague, Surgery Chair PaulCunningham.”
NNeeww VVaassccuullaarrSSuurrggeerryy CChhiieeff
Vivian Gahtan MD
Because there can be noconclusion to a medicaleducation, grand rounds play acritical role in delivering thelatest insights to community
and attending physicians, as well as residents, medical students, nurses and
other medical professionals. As CentralNew York’s only academic medical center,SUNY Upstate is epicenter of continuing medical education, with its 19 clinicaldepartments offering various grand roundspresentations.
The Department of Pediatrics offersweekly grand rounds on Wednesdaymornings at 9:15 am. The April 7 sessionpictured at right, featured Richard CantorMD, director of University Hospital’sdedicated Pediatric EmergencyDepartment. Cantor drew a typicallyrobust crowd.
“It’s the best pediatric education in theregion,” reports Kathleen Shefner MD, apediatrician in private practice. Shefnerrecently relocated to Syracuse fromSouthern California, where distance – andtraffic – prohibited her from attending
grand rounds.
For a schedule of grand rounds at SUNYUpstate, go to www.upstate.edu/ calendar
Pediatric Grand Rounds: Among those present,at left, pediatrician Hans Hartenstein MD, whohas been attending for the past 50 years; pedi-atrician Kathleen Shefner MD, who recentlymoved to Syracuse; and Hasra Phillip, a third-year SUNY Upstate medical student fromQueens.
April 2004 Department of Pediatrics grandrounds, featuring Richard Cantor MD, directorof University Hospital’s dedicated PediatricEmergency Department.
The Academic Difference:
The Ritual of Grand Rounds
Sign of the Times:Surgery Grand RoundsGo OnlineDepartment of Surgery grand
rounds are now digitally recorded
and available online.
“Eight to nine o’clock on
Wednesday morning is when we
offer grand rounds, but it’s also
prime time for surgeons to be in
the operating room,” reports
surgeon Patricia Numann MD of
the Department of Surgery. “Now
you can go to our website and
download surgery grand rounds to
your computer. It’s as if you are
sitting there.”
To access surgery ground rounds
online, go to
http://www.upstate.edu/surgery/
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The CNY Gamma KnifeCenter at University Hospitalrecently celebrated its fifthanniversary, treated its1,000th patient and installed
a new cobalt radiation source and majorsystem upgrade.
The new system – Leksell GammaKnife® C – shortens treatment time andincreases target conformity. The system'ssignature component is its AutomaticPositioning SystemTM, which sets the headframe coordinates and repositions thepatient for each stage of treatment.Previously, at least two staff members hadto enter the treatment room for eachposition adjustment. The automation saves approximately one hour per patient.
The Gamma Knife C has a greatercapacity to conform treatment to complextarget shapes, thus increasing accuracy.
The Leksell Gamma Plan®, the newtreatment planning system, digitallytransfers treatment parameters from theoperator’s console to the AutomaticPositioning System, optimizing speed andensuring data integrity. This state-of-the-artsoftware permits real-time dose calculationyet retains the option of manual individu-alization of treatment planning.
In the past five years, high demand hasprompted the CNY Gamma Knife Centerto expand its services from two to five daysper week. Seven neurosurgeons, sixradiation oncologists, three physicists andseven nurses work in teams to plan anddeliver Gamma Knife treatments atUniversity Hospital, one of 83 GammaKnife sites in the United States.
The list of conditions successfullytreated by the Gamma Knife is alsoexpanding. Traditionally used to combat
inoperable orinaccessible braintumors, arteriovenous malfor-mations (AVMs) and acousticneuromas, the Gamma Knife now showspromise for treating epilepsy and otherconditions which involve highly functional– and very high risk – regions of the brain.
Lisa Mitchell RN of the Gamma KnifeCenter recently presented at a nationalconference of Gamma Knife adminis-trators. Her presentation was titled“Communicating the Value ofRadiosurgery to Patients.”
According to Mitchell, “Our center isdeveloping a strong reputation in theGamma Knife world, based on ourpresence at national functions, our volumeand our willingness to share expertise withnew Gamma Knife centers.”
–Denise Owen Harrigan
“Surgery Without A Scalpel”
The Gamma Knife, widely
considered the world’s most
sophisticated neurosurgical device,
delivers powerful doses of radiation
to inaccessible or inoperable brain
lesions.The treatment involves no
incision, minimal discomfort and
greatly reduced risk for the patient,
yet attacks its target with
unparalleled precision.
Widely known as “surgery
without a scalpel,” the Gamma
Knife “blades” are actually beams
of gamma radiation, programmed
to bombard lesions only at the
point of intersection. Before they
intersect, however, these beams
pass harmlessly through the skull
and healthy tissue.
1 4 S U N Y U P S T A T E M E D I C A L U N I V E R S I T Y O U T L O O K SPRING 2004
Surgically Speaking
Gamma Knife Gets Upgrade
Good to Go
Thanks to treatment at the
CNY Gamma Knife Center, 10-year-old
Katie is back in action after being
sidelined for two years by an inoperable
tumor behind her left eye.The rare
condition–diagnosed as schwannoma
of the third nerve – was expected
to eventually paralyze Katie’s eye.
Her family was told there were no
surgical options, but University
Hospital’s Charles Hodge MD,
chair of the Department of
Neurosurgery, suggested
Gamma Knife radiosurgery.
Only six weeks after her
“surgery without a scalpel,”
Katie’s symptoms were improving.
Conditions Treated with the Leksell Gamma Knife in the U.S.
Vascular DiseasesAVM 8,080Aneurysm 18Other Vascular 293Total 8,391
Benign TumorsAcoustic Neuroma 5,789Meningioma 8,740Pituitary 2,838Pineal 207Craniopharyngioma 250Hemangioblastoma 314Chordoma 246Trigeminal Neuroma 307Schwannoma 488Other Benign Tumors 471Total 19,650
Malignant TumorsMetastasis 21,515Glial Tumors 6,758Chondrosarcoma 86Glomus Tumor 247Ocular Melanoma 56NPH Carcinoma 249Hemangiopericytoma 250Other Malignant Tumors 694Total 29,855Total Tumors 49,505
Functional TargetsIntractable Pain Targets 233Trigeminal Nerve 8,441Parkinsonian Targets 332Psychoneurosis Targets 33Epilepsy Targets 45Other Functional Targets 356Total 9,440Total Indications 67,336
* 71 sites reporting
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Clinically Speaking
Asurgical robot that integratesthe best features of minimallyinvasive and open surgery isnow operating at UniversityHospital. The da Vinci
Surgical System® was added this year to thehospital’s arsenal of advanced surgicaltechnology, at a cost of more than $1million.
The investment made sense to UniversityHospital because it offers clear advantagesto patients.
“The da Vinci system reduces the size ofthe surgical incision, the length of stay,postoperative pain and risk of infection,”reports Charles Lutz MD, the firstUniversity Hospital surgeon to operatewith the new system. “For the patient, itmeans a faster, more comfortable return tonormal activity.”
For the surgeon, the da Vinci systemretains – and even enhances – theadvantages of open surgery, includingdirect 3-D visualization, full range ofmotion and an intuitive sense of control.
Lutz, who is fellowship trained incardiac surgery and has completed specialtraining with the da Vinci system, is mostimpressed by the robot’s dexterity andprecision. “This device does things thesurgeon’s hands cannot physically do,” heexplains.
“It makes the right and left handambidextrous. It eliminates any tremor. Itscales back delicate hand movements to aneven more precise level. It allows us toperform more complex procedures throughpencil-sized incisions.
“And it never gets tired,” adds Lutz.
The robotic system also allows thesurgeon to operate with natural hand-eyecoordination while seated at a console fivefeet from the patient. The instrument’smovements at the patient mimic thesurgeon’s hand movements at the console.When the surgeon turns the controlsclockwise, the robot’s instruments turnclockwise. Standard laparoscopic surgery iscounter-intuitive, with the surgeonworking from a mirror image of theoperating field.
Initially available for mitral valve repair,mammary artery harvesting and coronaryartery bypass, the da Vinci system willeventually be used for gastric bypasssurgery, prostatectomy and variouspediatric procedures performed byUniversity Hospital surgeons.
University Hospital’s da Vinci system isone of only 210 available in the UnitedStates, Europe and Japan. It was the firstsurgical robot system to be judged safe andeffective by the US Food and DrugAdministration.
–Denise Owen Harrigan
The da Vinci SurgicalSystem: How It Works
A The surgeon, who works ata console several feet fromthe patient, views the high-resolution, 3-D surgicalfield on the console screen.
B With hands and wristsnaturally positioned, thesurgeon manipulatesinstrument controlspositioned below thedisplay screen.
C InSite® vision softwareseamlessly transmits thesurgeon’s hand, wrist andfinger movements to theultra-sensitive EndoWrist®instruments positionedinside the robotic arms.
D Through 1-CM ports, theinstruments immediatelyexecute the commands.Each instrument has aspecific mission – such asclamping, suturing orsevering – and is designedwith seven degrees ofmotion to precisely mimicthe surgeon’s dexterity.
E At the patient’s side, thesurgical team prepares theports, installs and changesinstruments and supervisesthe robotic arms.
F The InSite Vision System –also visible on thesurgeon’s display –enhances, refines andoptimizes 3-D images ofthe operative field.
Intuitive Surgical RobotOffers Best of Both Worlds
A B
F
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The da Vinci Team:
From left, Patricia Kuntz RN, patient service manager; Stephen Downey CCP,perfusionist; Charles Lutz MD, cardio-thoracic surgeon; and David Downey PA-C, physician assistant.
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SPRING 2004
Integrating more
spiritual care into
the continuum of
care is the goal of
Rev. Terry Culbertson
and her team.
Often the first words the Rev. Terry Culbertson hearsat a patient’s bedside are, “I don’t go to church verymuch.” But church
attendance – or religious affiliation – are of little concern to Culbertson, who isSUNY Upstate’s new spiritual care managerand represents the changing face ofspiritual care in a clinical setting.
Until about 10 years ago, Culbertsonadmits, spirituality was almost synonymouswith religion. Today, she says, “It’s muchbroader than religious affiliation, althoughit can include worship, prayer and sacredtext. Spirituality is anything – from our
inner resilience to the creative arts – thathelps us think about ourselves as morethan flesh and bones.
“Nurturing spirituality in the hospitalsetting is especially important,” Culbertsonbelieves. “Many clinical studies demon-strate that something larger than us affectsour health and well-being. Spiritualityhelps patients cope, transcend and grow.
“The body, mind and spirit are allaffected by illness, yet spirituality has nothistorically been at the interdisciplinarytable,” she adds. “My commitment is tomore fully integrate our discipline into our continuum of care.”
Spiritually Speaking
1 6
New Heights of Spiritual Care
S U N Y U P S T A T E M E D I C A L U N I V E R S I T Y O U T L O O K
The staff and volunteers of University Hospital’s Spiritual Care team: Kneeling, clockwise from left: Rev. Terry Ruth Culbertson; Rev. Alfred Bebel; Kathy Ball (Roman Catholic Diocesan chaplain);* Rev. Jerald Shave and Rev. Louise Tallman-Shepard. Standing, from left: Violeta Cuenca;* Rev. Luciano Plaza;* Shirley Hermann,* Helen Filipsack,* William Billingham DDS,* Rev. W. John Hottenstein,* Elder James Rudisell,* Patricia Hottenstein* and Pastor Marilyn Plaza.* *spiritual care volunteers.
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Strong TraditionWhile Culbertson plans to take her
discipline to new heights, she admiresUniversity Hospital’s strong tradition ofspiritual care. In recent decades, that carehas been delivered by two dedicated, part-time chaplains, the Rev. Alfred Bebel andthe Rev. Gerald Shave, plus a cadre ofvolunteer chaplains from many denomi-nations.
Culbertson is the first person, however,to focus full-time on spiritual care. “I havethe luxury of a larger vision,” she says,“because I share my daily patient dutieswith Father Bebel, Reverend Shave andChaplain Ball. We have a wonderfulpediatric chaplain, the Rev. LouiseShepard, on board as well, partially fundedthrough a one-year Children’s MiracleNetwork grant.”
Since Culbertson assumed her new rolelast fall, she has organized a choir that singsat the patient’s bedside and twice-weeklymeditation sessions in the hospital chapel –among other healing additions. But the“larger vision” to which she refers largelyinvolves educational initiatives.
This summer, University Hospitalbecomes the sole Central New York site tooffer a nationally accredited trainingprogram through the Association ofClinical Pastoral Education (ACPE).Culbertson, who recently completed arigorous, five-year ACPE supervisoryprogram to provide this training, will soonwelcome six seminarians and clergy. Eachwill spend 400 hours on UniversityHospital units and in the classroom,“learning to care for the sick and sufferingpatient,” Culbertson explains.
“Nothing in the seminary prepares youto work with patients, although manydenominations require this experience forordination or chaplaincy certification. Thelack of such a training site in Syracuse hasleft a big hole for a long time,” she says.
Raising Awareness In Medical School
For the first time this year, 154 first-yearSUNY Upstate medical students are alsofocusing more closely on the spiritualdimension, in a Practice of Medicinecurriculum requirement that culminateswith each student accompanying achaplain on institutional rounds.
“We want the medical students torecognize that faith often plays a role in thehealing process,” Culbertson explains, “andto understand that faith may be thepatient’s greatest strength.”
Culbertson recruited 29 volunteerchaplain-mentors for the course (which isfunded by a grant from the John D.Templeton Foundation). “One of ourgoals,” she confides, “is to have thechaplains available as a source of supportfor the students, because medical schoolcan be very stressful.”
Culbertson – whose most previousposition was director of pastoral care forthe Interreligious Council of Central NewYork – has served for the past four years asthe College of Medicine’s course directorfor spirituality. The opportunity to expandthis educational role attracted Culbertsonto University Hospital’s newly createdposition of spiritual care manager.
“How do you increase the institution’sopenness to spiritual care?” she asks. “Youchange it through education. Patients todayare demanding that we pay more attentionto spiritual care, just as they oncedemanded that we change the labor-and-delivery culture.”
Patient as TeacherWhile Culbertson is passionate about
education, she is no less committed todirect patient care. She considers it ablessing to work with patients.
“The chaplain’s role is not to preach orproselytize,” she explains. “It’s not so muchabout what we say. Our role is to be withpatients and to listen to them. I often saythat the patient is the teacher – we sit atthe feet of the patient to learn.
“In the midst of tremendous suffering,patients and families often ask, ‘Whatpurpose does this have?’” Culbertsoncontinues. “I believe that this will to findmeaning is the strongest drive in our lives,even stronger than hunger. Sometimespatients need our help finding thatmeaning, that spark of hope. I’ve seenmany people go through devastating illness– and even through the end of life – and inthe process they grow, prevail and find joy– while profoundly enriching the lives ofothers.”
–Denise Owen Harrigan
Spiritually Speaking
The Path to thePatient’sBedside
When Terry Culbertson first
heard the voice that called
her to the ministry, her
response was “You must be
kidding me.”The Baltimore native
was very shy – certainly not a
woman who wanted to stand up
and preach. She had already earned
a college degree – in art and
psychology – and was working as a
graphic designer. And she was
raised in the Church of God, a
Protestant tradition, she says,
“which is not doctrinal and doesn’t
require seminary.”
On the other hand, Culbertson felt
closely connected to her God. As a
child, she had suffered from
rheumatoid arthritis. She had deep
compassion for others who
struggle and often felt only God
knows the extent of our suffering.
So in her mid-20s, Culbertson
followed her new vocation to Drew
Theological School in Madison, NJ,
and ultimately to clinical
internships and residencies.
“I could never imagine myself
preaching,” she says. “But when I
learned about clinical pastoral care,
I could imagine myself in that role,
because it wasn’t about me. It was
about the patient.”
The process of preparing for that
role was surprisingly painful,
however. “In order to help patients,
you have to understand your own
history, your own weaknesses and
strengths,’ she explains. “You have
to explore those areas in group
training, with the eyes of your
peers on you.”
It’s a process that never ends,
Culbertson has learned. “You are
always growing and learning –
from self-exploration and from
your patients,” she says.
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SPRING 2004
The Central New YorkChildren’s Hospital atUniversity Hospital is steadily moving towardgroundbreaking. A prominent
architectural firm has been selected, the design process is well underway andcommunity support exceeds expectations.
Karlsberger Companies, a nationallyrecognized healthcare planning and designfirm, has been selected as the architect forUniversity Hospital’s entire $99 millionvertical expansion project, which will becrowned by the CNY Children’s Hospital.King and King Associates of Manlius willserve as associate architect.
An award-winning specialist in thedevelopment of children’s healthcare spaces,Karlsberger has worked with 10 of the top25 children’s hospitals as ranked by U.S.News and World Report.
Among the current clients of the 75-year-old firm are The Children’s Hospitalof Philadelphia; Children’s NationalMedical Center in Washington, DC; AllChildren’s Hospital in St. Petersburg, Fla.;and Children’s Hospital of Austin, Tex.
Karlsberger Companies is based in Columbus, Ohio, with offices in New York, NY; Birmingham, Ala.; and West Palm Beach, Fla.
Family-Focused“Karlsberger will tailor the leading
trends in health care design to the uniqueneeds of University Hospital,” according toGregory C. Mare, AIA, the firm’s principal-in-charge. Increasing the family’s presencein the caregiving process is a key mandateto the architects (see sidebar at right).
“Our design and development work will address issues that are keenlyimportant to University Hospital,including family-centered environments for adults and children, contemporaryeducational space for the next generation
of healthcare professionals; and better efficiencies for the hospital,” Mare reports.
The Children's Hospital will increase the space dedicated to pediatricmedicine at University Hospital from18,000 to 87,000 square feet. Thechildren’s “hospital within a hospital”will feature 50 private patient rooms,family sleep and dining areas as well asplayrooms, a family resource center andperformance space, among other amenities.
Ambitious Undertaking,Generous Support
Construction costs for the entire verticalexpansion of the east wing are estimated at $92 million. Adjustments for inflationand interim interest expense are expectedto increase the cost to $99.8 million.University Hospital was authorized to finance the construction throughbonding when Gov. Pataki and thelegislature approved bonding legislationearlier this year.
The Children’s Hospital will haveunique equipment, programmatic andenvironmental needs and will feature aseparate Children’s Hospital entrance onIrving Avenue. These expenses will befunded through a $15 million community-wide capital campaign. Mary Ann Shaw,chair of the Children’s Hospital Campaigncommittee, reports that $7.55 million hasbeen pledged to date. SUNY Upstateemployees, including medical staff andfaculty, have committed close to $1.1million. The Upstate Medical Foundation’sannual Gala in December raised more than$220,000, and the Rosamond GiffordCommunity Foundation recentlyannounced a $250,000 gift to theChildren’s Hospital.
“Our community is rallying behind this project in ways not often experiencedin Syracuse or Central New York,” reports Shaw.
–Darryl Geddes
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Support Systems
CNY Children’sHospital Takes Major Strides Forward
The Changing Faceof Hospital DesignA University Hospital Committee of
more than 20 members – including
administrators, physicians, nurses,
parents and highly committed
citizens – has been meeting for
months to guide the design of the
new children’s hospital. Among the
priorities they have communicated
to the architects are mandates for:
• More family-centered care, with
sleeping, dining, bath, recreation
and communication amenities
for families
• More decentralized care delivery –
e.g., smaller staff stations placed
closer to patient rooms
• More consideration of privacy,
per new HIPPA regulations –
and out of respect to patients
and families
• More “normal” environmental
elements, including art, music,
lighting – even performance
space
• More attention to scale, to make
the hospital experience less
overwhelming for children.
S U N Y U P S T A T E M E D I C A L U N I V E R S I T Y O U T L O O K
Making the Case
for a children's hospital at University Hospitalis the mission of a 24-page case statementwith voices of support from parents, com-munity leaders and medical professionals. The award-winning publication was designedby Kathleen Carnes and her colleagues in the Department of Marketing andCommunications.
SPRING 2004 S U N Y U P S T A T E M E D I C A L U N I V E R S I T Y O U T L O O K
Carol M. BaldwinBaldwin became a cancer activist after
a grueling personal encounter with
breast cancer. In the early 1990s, after
a double mastectomy at University
Hospital, she reached out to other
women struggling with the disease
and became a catalyst for the
Syracuse Chapter of the Susan G.
Komen Breast Cancer Foundation. Her
belief that funds raised locally should support local
research inspired the formation of the Carol M. Baldwin
Breast Cancer Research Fund.Through its Long Island
and Central New York chapters, the organization has
awarded more than $2.5 million in research grants.
SUNY Upstate researchers have to date received close to
$450,000 from Baldwin’s organization, including $50,000
for an annual lecture series on the latest advances in
breast cancer research.
Baldwin is integrally involved in the fund’s activities,
from major galas and golf tournaments to scores of
grassroots fundraisers. Baldwin’s six children –
Elizabeth, Jane, Alec, William, Stephen and Daniel –
serve on the foundation’s board and are very active
in its work.
Brian J. Druker MDProfessor of medicine and director
of the Leukemia Center at Oregon
Health and Science University in
Portland, Druker committed early in
his career to combining direct
patient care with cancer-related
bench research.
While investigating the molecular
abnormalities of chronic myelogenous leukemia (CML),
Druker and his colleagues identified the proteins that
trigger CML’s wild proliferation of red blood cells.
He then identified BCR/ABL, a mutant protein, as an
ideal target for drug intervention and worked with a
pharmaceutical company to inhibit BCR/ABL.Their
subsequent development of Gleevec, or ST1-571, has
proved to be the most effective CML treatment in
history.The drug was FDA-approved in 2001 and has
been administered to more than 50,000 CML patients
worldwide. According to Druker, 75 percent of his
patients treated with Gleevec are alive and doing
“unbelievably well” five years later.
Gleevec has been a commercial as well as clinical
success, inspiring other pharmaceutical companies to
invest in “designer” drugs like Gleevec – highly specific
drugs that are reverse engineered to disrupt abnormal
molecular processes.
1 9
Support Systems
Two prominent leaders in the crusade to eradicate cancer will be awarded honorary degrees at SUNY Upstate’s 2004 convocation on May 16.Oncologist Brian J. Druker MD of Oregon Health and Science University, the primary
investigator behind the revolutionary cancer drug Gleevec®, will receive the doctor of science degree.
Carol M. Baldwin of Syracuse, who has raised more than $2.5 million dollars through the Carol M. Baldwin Breast Cancer Research Fund, will receive the doctor of humane letters degree.
Both recipients are considered kindred spirits of SUNY Upstate,which has made cancer one of its four pillars of excellence. Lastyear, University Hospital earned elite accreditation from theAmerican College of Surgeons Commission on Cancer. Thedistinction is awarded to only one in four cancer centersnationwide. In the rigorous accreditation process, UniversityHospital earned the highest possible score and received specialcommendation for its clinical trials program.
SUNY Upstate also has a robust basic research program, withdozens of scientists conducting cancer-related studies. Close to$400,000 of its research support has come through the Carol M.Baldwin Breast Cancer Research Fund. A number of Upstate’scancer research studies share share common ground with themolecular research of Druker.
Honorary Degrees Applaud Cancer Crusaders
“We’re finding breastcancer earlier, but we’restill finding it. Withoutmoney for research, wewon’t find a cure.”
“Having a direct, dailyconnection to patientsmakes my research evenmore urgent.”–Carol Baldwin –Brian Druger MD
Foot Note
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Why Would You Go Anywhere Else?
University Hospital’s 2004 TV advertising campaign, created with thelaborious technique known as microcinematography, takes an out-of-the box approach to promoting the hospital’s clinical services. Thecampaign highlights breakthrough cancer care, high-tech neurosurgery,minimally invasive cardiovascular surgery and pediatric specialties unique
in Central New York. The campaign, which also includes print and radio ads, underscoresthe academic edge which SUNY Upstate’s education and research enterprises add to the clinical care available at University Hospital.