Advancement Officers
Stefan Davis
Pamela Su Perry
J. David Smith, EdD
Feature Writers
Ellen Gullett
Mary Hardin
Kaarta Nemeth
Design & Production
Kaarta Nemeth
David Stahl
Photography & Illustration
Greg Puls
Mardan Photography
Shawn Spence
Sharon Teal
Please submit your comments, letters and requests for a change of address to: Indiana University Medicine Indiana University School of Medicine, 1110 West Michigan Street, LO 401, Indianapolis, IN 46202-5100
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Indiana University Medicine is published four times a year by the Indiana University School of Medicine to inform its alumni, students, faculty and friends about current medical and alumni activities.
© 1997 Trustees of Indiana University
In this issue, we introduce the White Coat Ceremony, a new program at IUSM in which we celebrate with first-year medical students the beginning of the long and arduous journey to becoming a physician. During this passage, both students and faculty are turning increasingly to electronic information resources. On page 8, you'll read about the innovative resource created by five of our students under the direction of Assistant Dean Antoinette Hood, MD.
We also report on two other remarkable new tools for education and patient care. "Regional Anesthesia: An Atlas of Anatomy and Techniques," edited by Professor of Anesthesiology George Sheplock, MD, and colleagues, was named best new book in clinical medicine in 1996 by the American Association of Publishers. Gamma Knife radiosurgery is now in operation in the Indiana Cancer Pavilion through the generous support of the Indiana Lions Cancer Control Fund, the IU Department of Radiation Oncology and Clarian Health.
On another front, a range of important medical issues of women will be addressed through the new National Center for Women's Health at IUSM under the leadership of Assistant Dean Rose Fife, MD. Jane Henney, MD, ('73) our profiled alumna, would likely be encouraged that her alma mater has joined the growing number of medical schools in the country to focus on these issues.
Finally, in our cover article, we share another aspect of the remarkable progress at IUSM towards a comprehensive cancer program encompassing exceptional patient care, outstanding research, and unmatched educational opportunities. Distinguished Professor Larry Einhorn, MD, (res.'74) set the stage when he developed a highly successful drug regimen against testis cancer. With his colleague Distinguished Professor John Donahue, MD, he drew the first of many promising young physicians and scientists to IUSM. One of them, Professor of Medicine Stephen Williams, MD, ('71) director of the IU Cancer Center, remarks on the importance of this program. I hope you will find these stories stimulating and share our pride in the achievements they report.
James W. Edmondson, MD ('69)
Editor-in-Chief
Closing In On Cancer
The new Indiana University Cancer Research Institute, dedicated September 30, marks
another milestone in IUSM's progress toward national leadership in cancer.
PERLjam Is Hot At IUSM
Five medical students spend their summer creating an innovative study aid.
An Inside Look
Award-winning anatomy atlas for anesthesiology students features "X-ray" digital
illustrations - IU's Dr. George Sheplock is a key contributor.
Donning The Future
White Coat Ceremony starts first-year medical students on their way and establishes
a new tradition at IUSM.
Viewpoint
Stephen D. Williams, MD, ('71) comments on the value of cancer research to
IUSM's patient care, research and teaching missions.
News & Notes
Indiana Lions Gamma Knife Center offers radiotherapy's most sophisticated tool
to patients at IU Medical Center, and IUSM wins funding for National Center of
Excellence in Women's Health.
Alumni News
New officers of the IUSM Alumni Association and news from the classes of '47, '55, '56,
'60, '62, '65, '68, '72, '86, '90, '92 and '94.
Alumna Profile
University of New Mexico's Dr. Jane Henney draws from her Indiana roots as she
guides health services in the "Land of Enchantment."
Calendar
It's not too soon to make your plans for Spring Medical Weekend next May -
latecomers may have to compete with Indianapolis 500 race fans for hotel accommodations!
For all of us at IUSM, this is a time of excitement and opportunity. Faculty are opening the doors to new knowledge about cell biology and the human immune system. They are developing needed strategies to attract the best men and women of all races to academic and clinical medicine. And they are building models to improve patient care for people of all geographic, economic and cultural backgrounds.
In 1986, the IU School of Medicine received $34.6 million in extramural research grants and contracts. In 1996, this figure reached an all-time high of $104.8 million. In 1996 and 1997, we opened two new research and patient care facilities that represent an investment of nearly $45 million dollars. Twenty million of that was through the work of U.S. Congressman John Myers, and $25 million was through the generous contributions of alumni, grateful patients and community organizations. These are truly outstanding accomplishments at a time of keen competition for federal dollars and no state support of research. I believe they are harbingers of your school's entrance into the first tier of medical schools in this country providing both quality medical education and research.
Our residency and fellowship program is now greater than ever with 73 accredited programs and five non-accredited fellowship programs. Residency programs in emergency medicine, emergency medicine/pediatrics and transitional medicine have been added through the consolidation of Riley, IU and Methodist hospitals. Altogether, IUSM sponsors programs in Riley Hospital for Children, Methodist Hospital, Indiana University Hospital, Roudebush VA Medical Center, Wishard Hospital and LaRue Carter. Our mission is to impart a commitment to lifelong learning to the more than 1,970 students, residents and fellows who spend from two to 10 enriching years with us.
As we begin 1998, all of us in the School see exciting challenges and awesome opportunities. Please join us by sharing the news of your experiences in the pages of this magazine, or by attending the annual spring medical weekend in May.
Robert W. Holden, MD ('63)
Dean, Indiana University School of Medicine
The opponent is strong and resilient, with a repertoire of evasive responses. The challengers are skilled and determined to prevail. And the stakes are high: millions of dollars in funding for outstanding performers. The pros? Yes. But this competition is quietly played out in cancer research laboratories across the country and, as of September 30, Indiana University School of Medicine's elite force of researchers is confronting cancer in a new stadium: the $22 million Indiana University Cancer Research Institute.
Inside the five-story, nearly 80,000-square-foot facility, scientific faculty representing eight IUSM departments proceed with their work to understand and control the molecular biology of cancer. Located on the corner of Barnhill Drive and Walnut on the IU Medical Center campus, the Cancer Research Institute is a stone's throw away from the Indiana Cancer Pavilion and Indiana University, Riley, Wishard and VA hospitals, where clinical faculty treat their patients and teach nearly 2,000 students, residents and fellows each year, all while conducting their own research.
Achievements by both basic science and clinical faculty are elevating the School and IU Cancer Center steadily higher within the top ranks of cancer institutions in the country. Already internationally respected for work in blood diseases, bone marrow transplantation, germ cell tumors, pediatric cancer treatment and the treatment of breast, prostate and testis cancers, IU has most recently earned a reputation as a leader in gene therapy. In 1997, its clinical cancer program was ranked 13th in the nation by "US News & World Report's 1997 America's Best Hospitals Guide," the fifth consecutive year it placed among the top 20 programs
The Cancer Research Institute not only brings the majority of the School's basic science researchers in cancer under one roof but also provides fertile ground for campus-wide collaborations. Recent advances in cancer biology, increasing competition for research funding, and a growing emphasis on translational research create the need for physicians and scientific investigators to "close the loop" between bench and bedside. By working closely together, clinical and basic science faculty can target clinical problems to be addressed in the lab, and facilitate the evolution of promising laboratory research into new treatments.
To support this level of research, retain top researchers and recruit talented new investigators to the team, space and equipment are a necessity. But IU's researchers say the most important feature of the new space is that it is shared. "The very point of the building is to bring people together with a topical research focus rather than dividing them by departments," says Theodore G. Gabig, MD, Bruce K. Wiseman Professor of Medicine, professor of biochemistry & molecular biology, and director of adult hematology/oncology. "Physical proximity is crucial in these interactions. By bringing together experts from a range of complementary scientific disciplines and creating a continuous exchange of thoughts, theories, problems and solutions, we will all progress faster."
As scientific knowledge grows ever more complex, a single individual or group may hold only one small piece of the cancer puzzle. Advances that lead to clinical breakthroughs most often result from a series of related discoveries, years in the making. Further, as is the case with HIV and cancer, revelations in one area of scientific inquiry can unexpectedly shed light on another seemingly unrelated area. "Spontaneity and immediacy create some of the greatest thoughts of all time," comments Hal E. Broxmeyer, PhD, chairman and Mary Margaret Walther Professor of Microbiology/Immunology and scientific director of the Walther Oncology Center. "Each person has a different way of attacking a problem; each brings a unique expertise to the total. I don't know why it happens, but just to see a face or have a person right in front of you can make something click. Talking to each other makes a difference, and we do that here in Indiana better than most other places I've seen."
Collaboration also means a more efficient scientific process which, in turn, allows scientists to cover more ground and move more rapidly to a clinically applicable result. "A lot of ideas sound promising, but a researcher can waste years circling around the one study that will prove or disprove it," Dr. Gabig points out. "You must do the conclusive experiment as fast as you can so you can either take your hypothesis to the next testable level or eliminate it and move on. The critical thing is that everyone is more effective when they're not working in a vacuum."
In the past 20 years, huge strides have been made in cancer biology. Despite more than 100 types of cancer identified to date and wide variation in their specific genetic material, all cancers appear to have a similar molecular process, characterized by genetic mutations which permit tumor cells to arise, grow and spread. Each new discovery about this complex process offers opportunities to explore anticancer strategies. One of the most exciting of these is gene therapy, whereby investigators attempt to reprogram or correct the errant genetic events affecting cancerous cells.
The promise of the first gene therapy studies in the 1980s led the National Institutes of Health (NIH) to pave the way for large-scale comparative studies, to standardize methodology and to provide broad access to reliable gene vectors, the protein envelopes used to transport manipulated genetic material into the cells. At IU, researchers in the Herman B Wells Center were awarded two large NIH grants to pursue basic research in gene therapy of genetic diseases. Then, in late 1995, the National Center for Research Resources, NIH, created three National Gene Vector Laboratories to review and select worthwhile gene therapy protocols, produce the vectors needed, and then distribute them to multiple centers for trials. The creation of these labs ensures that all investigators in a particular protocol start with the same material and that the vectors they use meet rigid standards both for efficacy and purity (freedom from unwanted viruses or pathogens). Indiana University was one of the sites selected and was awarded $4 million to fund its laboratory. The Indiana University National Gene Vector Laboratory, directed by Kenneth Cornetta, MD, associate professor of medicine, of medical and molecular genetics, and of microbiology/immunology, and director of adult bone marrow transplantation, is responsible for producing retrovirus vectors and for coordinating the NIH effort. (Dr. Cornetta helped develop the first application of retroviruses at NIH earlier in his career.) The two other national gene vector labs, at the University of Michigan and the University of Pennsylvania, produce plasmid vectors and adenovirus vectors, respectively.
IUSM's research "track record," especially in the basic biology of viral vectors and genetic diseases, and Dr. Cornetta's international reputation in vector safety were instrumental in winning the NIH laboratory designation. Numerous pre-clinical gene therapy efforts involving many different investigators are under way at IUSM, and three gene therapy treatments which have proven effective in animal studies have been approved by the FDA and are beginning Phase I safety trials (the first phase of clinical trials). Two of these approved studies target cancer.
The ultimate goal of both these cancer studies is to augment the ability of the blood-producing stem cells in the patient's bone marrow to withstand the toxic effects of chemotherapy. If the stem cells can be strengthened in this way, the patient should be able to tolerate more poten doses of chemotherapy, resulting in a higher "kill" of tumor cells. This approach is being tested in adults with testis cancer through a Phase I safety trial conducted by Rafat Abonour, MD, assistant professor of medicine, with Dr. Cornetta and Lawrence Einhorn, MD, (res.'74) distinguished professor of medicine. In this trial, blood stem cells will be harvested from the patient, a drug resistance gene called MDR will be placed into the stem cells by means of a vector, and the genetically altered stem cells will be given back to patients before they undergo chemotherapy. The chemotherapy drug used in the study is etoposide (VP-16).
The same sequence of events will occur in a pediatric Phase I safety trial using a drug resistance gene called MGMT. This study is directed by David A. Williams, MD, ('79) the Freida and Albrecht Kipp Professor of Pediatrics and investigator of the Howard Hughes Medical Institute and IU's Herman B Wells Center for Pediatric Research. Dr. Williams and colleagues including Edward Dropcho, MD, professor of neurology, Regina Jakacki, MD, assistant professor of pediatrics, and James Croop, MD, PhD, associate professor of pediatrics, developed the MGMT viral vector which codes for overexpression of the protein MGMT. This protein repairs the DNA damage caused by the BCNU or chloroethylnitrosourea class of chemotherapy drugs, which has been shown to be effecive as a single agent in the treatment of children with brain tumors.
If these attempts are successful, they could eventually be combined with related pharmacological work in which Dr. Williams and Dr. Cornetta are collaborating with Leonard C. Erickson, PhD, professor of pharmacology and toxicology, IU Cancer Center's associate director for basic science research, and an internationally known expert in DNA repair. The goal of Dr. Erickson's study is to attack the problem from the opposite direction: making tumor cells less resistant to chemotherapy.
"A number of years ago, we identified the unique DNA repair process that blocks the lethal damage of BCNU drugs in a large number of tumor cells." Dr. Erickson explains. "In the last few years, we have developed biochemical strategies for inhibiting this DNA repair system. Our long-term plan is to combine both approaches: to make bone marrow more resistant and tumor cells less resistant to DNA-damaging chemotherapy drugs. Patients will receive a pretreatment drug that turns off their tumor cells' ability to repair chemotherapy- induced DNA damage and will receive the drug-resistance gene that makes their normal tissue (bone marrow) resistant to chemotherapy."
Results from the first gene therapy trials at IUSM may be published as early as 1999. Meanwhile, for IU's researchers and clinicians who daily see cancer's toll on human life, the advances these trials represent are uplifting, needing only time and money to fulfill their promise. "Since the beginning of the war on cancer in 1972, the NIH budget has grown from approximately $2.5 billion to around $12.8 billion," says Dr. Erickson, who has served on NIH study sections, which review and select grant proposals for funding, since 1990. "That sounds like a five-fold increase, but adjusted for inflation, funding growth has remained absolutely flat for the last 25 years. At the same time, the number of cancer researchers is at an all-time high, so there is simply less to go around and the success rate for grants has gotten lower and lower in the last year and a half. In the old days, the NIH study sections tried to identify the 10 percent that shouldn't be funded; now they're trying to identify the 15 to 20 percent that should be funded."
In 1996, more than $105 million in extramural research funding has been generated by IUSM researchers. About $25 million of this has been for cancer research activities. The strengths of IUSM faculty and the collaborative environment of the new Cancer Research Institute are expected to make a difference as the School continues to compete for this funding.
"We have much more grant support now because of how well everyone is interacting," Dr. Broxmeyer says. "The interdisciplinary setting makes it easier to collaborate and to recruit first-rate people who can be highly interactive with a number of different departments and sectors on campus. You cannot do this without the money, but money is not the ultimate goal.
"The goal is knowledge that will translate into better health. Ten years ago, cancer was an initiative at Indiana University, and look how far we've come. Five years ago, gene transfer and gene therapy was an initiative, and we've come very far. We're here to accelerate the research from the lab to the clinic as soon as possible because the ultimate aim is to do better medicine."
IU Cancer Center's clinical programs bring the most promising new treatments to
cancer patients and return valuable feedback to IUSM's basic science researchers. Below,
a few of many exciting approaches being studied.
The Bone Marrow Transplantation Program
Stem cell selection, immuno-therapy, gene therapy and the use of alternate donors for
leukemia, lymphoma, thymoma, and brain, breast and testicular cancers.
The Breast Care and Research Center
New drugs and biologic therapies for breast cancer. Premenopausal bone loss related to
breast cancer. Heritable breast cancer.
GI Oncology Program
Combined chemotherapy and radiation therapy for pancreatic cancer. Adjuvant monoclonal
antibody treatment for colorectal cancer.
The GU Oncology Program
New chemotherapy drugs and biologics for metastatic prostate, bladder and kidney cancer.
GYN Oncology Program
New drug regimens and radiation techniques in gynecologic cancer. Studies of mechanisms
in ovarian cancer growth.
The Head and Neck Oncology Program
Combinations of chemotherapy and radiation, ultrasound-guided fine needle aspiration to
improve detection and staging of head and neck malignancies.
The Pediatric
Hematology/Oncology Program
Chemotherapy resistance, stem cell biology and gene therapy for children with cancer,
congenital blood diseases and immune system disorders.
The Melanoma Program
PET scan staging. Detection through blood markers. Adjuvant ganglioside vaccination
therapy vs high-dose interferon treatment. Isolation limb perfusion and adjuvant vaccine
therapy for resectable Stage IV disease.
The Neuro-oncology Program
New pharmaceutical treatments for brain tumors. MGMT gene therapy trial (please see story)
for adults with brain tumors.
The Thoracic Oncology Program
Chemotherapy, radiotherapy and transesophageal ultrasonography for lung, esophageal
and primary mediastinal cancers.
The IU Cancer Research Institute nurtures collaboration among scientists
in IU Cancer Center's five key basic science research groups.
The Herman B Wells
Center for Pediatric Research
David Williams, MD
Established through funding by the James Whitcomb Riley Memorial Association.
Focuses on the genetic causes of severe and chronic diseases in children and on
developing new therapies for childhood illnesses, including cancer.
The Adult
Hematology/Oncology Laboratories
Theodore Gabig, MD
An interdepartmental effort with a number of translational research projects in breast,
prostate and testicular cancer. Has received regular funding support from the Indiana
Order of the Elks for nearly 40 years.
Walther Oncology Center
Hal Broxmeyer, PhD
A joint venture of the IU School of Medicine and the Walther Cancer Institute focusing
on cancer research. Its 23 investigators have contributed to groundbreaking achievements
in blood stem cell biology, cord blood transplantation, and cytokine (growth factor)
production and action.
The IU National Gene Vector Laboratory
Kenneth Cornetta, MD
IU's core vector production facility, and one of only three NIH-designated Gene Vector
Laboratories in the country. Produces retrovirus vectors and is the coordinating center for
the NIH effort.
The Experimental Therapeutics Program
Leonard Erickson, PhD
A new area at IU Cancer Center focusing on cell cycle control, signal transduction,
programmed cell death, mechanisms and control of drug resistance and new drug
development.
PERLjam contains more than 500 slide images used in the IU histology and pathology courses, 150 dermatology and dermatopathology images, a laboratory medicine tutorial, and a bibliography of medical web pages from other colleges and universities. The web page also provides links to other national medical sites such as the National Medical Library and the National Institutes of Health (NIH).
The project was named PERLjam after the Pathology Education Resources Laboratory. PERLjam's main advantage is that students can access the slides any time, not just during scheduled lab hours. Since 1996, when Dean Robert W. Holden, MD, ('63) created the Medical Student Computer Task Force, the group has been charged with integrating electronic information and computer technology into the medical education curriculum. The purpose is to prepare students for the increasing applications of computer and Internet technology to the practice of medicine. The Fall 1997 class is the first class required to have personal computers.
"Patients are coming to their physicians with information they have found on the Internet. It's critical that our students be knowledgeable of how to use the Internet and cognizant of the information it holds," says Dean Holden.
Computer Task Force Chair Antoinette Hood, MD, has led the group in the integration of electronic technology and medical education. "We realized that the students would have expectations of us as well," Dr. Hood says. "So our goal was to create a tool that would not only help students learn course material, but also introduce them to how computer and Internet technology can apply to medicine."
Last summer Team PERL was born. Five medical students who had just completed their first year were chosen for Team PERL because of their experience in web page and graphic design. The students spent their vacation working in a tiny computer lab in the basement of the Van Nuys Medical Science Building. Their original task was to create a CD-ROM and web page with only the slides from the systemic and general pathology courses. PERLjam grew into a much larger project, however, explains student Bradley Orris. "We completed the pathology slides fairly quickly, so we also included the histology and dermatology course slides, the laboratory medicine section and the bibliography," he says.
The images are of the actual slides used in each class and are organized in the same manner as the course laboratory manual, making the CD-ROM and web page easy to use. Each slide has multiple versions that include magnified or diagrammed images. The laboratory medicine section outlines the steps to be performed with basic laboratory tests and displays pictures of the necessary supplies. Team PERL browsed and evaluated other medical school web sites to create the bibliography. The sites are organized by course, such as anatomy and pathology, and are ranked by their usefulness as study guides.
Dean Hawley, MD, ('79) course director for the systemic pathology course, and John Paulsrud, PhD, system administrator for pathology, served as faculty liaisons for the PERLjam project. Dr. Hawley says that the project has been overwhelmingly well-received based on student feedback and by the number of visits to the web site. He attributes the success of PERLjam to its student creators and their first-hand knowledge of the type of resource deemed valuable by students.
"This was to be an introductory year for integrating computer resources into the histology and pathology courses," says Dr. Hawley, "but the students have really latched on to and mastered the technology. Even the second-year students, who aren't required to have computer access, are using PERLjam as an educational resource."
Initially 1,200 copies of the CD-ROM were produced and distributed to first- and second-year students and the teaching faculty. "We hope that student interest in computer technology will encourage the faculty to integrate it more into the curriculum," says Orris.
Besides PERLjam, other computer- and Internet-based resources are being integrated into the curriculum. David Allman, PhD, ('58) who teaches the first-year problem-based learning course, "Concepts in Health and Disease," uses a laptop computer in class to do Internet literature searches. An interactive dermatology web page is now on line, soon to be followed by a pathology web page. Students will be able to work through case problems from a patient's presentation of symptoms to the actual diagnosis. The interactive program will allow students to order tests and treatments, but also will give them an accounting of the cost of each test or medication. At the end of the case, the student will learn if he or she ordered the right test(s) and prescribed the correct course of treatment.
Modern biomedical research is very difficult. There is unprecedented competition for extramural research support. In spite of this competition, support for our cancer researchers has increased nearly 30 percent in the last four years and now totals nearly $25 million annually. This funding is important for many reasons. First, the intellectual climate that allows and benefits from this support also fosters the educational environment of our students and clinical and research post-doctoral trainees. Successful laboratory and clinical researchers are also the best teachers, and the institutional culture thus created becomes a challenging and rich place for learning. A vigorous cancer research program also fosters the interdisciplinary research that directly benefits patient care. Promising laboratory observations and discoveries can be promptly and thoroughly evaluated in the clinic. The battle against cancer is a difficult one, but innovation ultimately makes patients better. The time is at hand when our rapidly improving understanding of the fundamental biology of cancer will translate into better treatment and prevention. Finally, from a purely business point of view, extramural research support is a valuable source of revenue that helps pay for goods and services in Indiana, not an insignificant benefit.
In summary, while in some ways there is concern about what lies ahead for the practice of medicine, there are also many positives. I believe that the cancer research, education and patient care programs of the IU School of Medicine and the IU Cancer Center have a great future and are an outstanding resource for practicing physicians and citizens of Indiana and beyond.
Indiana Lions Gamma
Knife Truly Offers Surgery
Without A Scalpel
It is a miracle of medicine and research.
It also exemplifies how philanthropic contributions can improve
the lives of many.
It is the Leksell Gamma Knife and on September 8, IU physicians used it to treat an acoustic neuroma tumor that was affecting Ann Weifenbach of Indianapolis. She was the first patient treated with the Gamma Knife at the IU Cancer Center. But the high-tech equipment was so much in demand that physicians treated five more patients the inaugural week. Since then, the Gamma Knife has been used to treat several patients each week.
The Gamma Knife was brought to Indiana through the dedication and efforts of several IU School of Medicine faculty members and a pledge of $1 million by the Lions Cancer Control Fund of Indiana, Inc. The cost of the entire project was $4.2 million which included the expense of constructing a special underground space to house the Gamma Knife and its Cobalt 60 sources.
The Indiana Lions Gamma Knife at Indiana University Hospital of Clarian Health is the only one in Indiana and currently one of 30 being used in the U.S. It is effective in treating benign and malignant tumors of the brain, along with vascular malformations and facial pain conditions such as trigeminal neuralgia. No incision is involved. The Gamma Knife performs its miracles through the use of gamma ray beams.
Those who extol the wonders of the Gamma Knife say it is the most accurate and precise way to deliver a very high dose of radiation to small areas in and around the brain with minimal damage to surrounding normal tissue. Robert Timmerman, MD, and Thomas Witt, MD, co-directors of the Indiana Lions Gamma Knife Center, say the Gamma Knife emits gamma ray beams and focuses them on a specific point. It is accurate to within a fraction of one millimeter. Both the dosage and the area of convergence can be closely controlled, making it possible to channel radiation to the depths of the brain and areas that would be difficult to reach surgically without harming other tissue or damaging nerves.
Another plus for patients is that they usually can return home the day of the treatment
and often return to work within days. There is no lengthy hospital stay associated with the
Gamma Knife procedure because patients receive only a mild sedative and the procedure
is non-invasive.
The 300-pound collimator helmet allows precise delineation of the
area of the brain to be treated. The helmet is one of several used with the Gamma Knife.
The helmet apertures create beams which vary in diameter from four to18 millimeters.
The IU School of Medcine is one of six schools awarded funding this year by the Department of Health and Human Services for a National Center of Excellence in Women's Health.
Center director, Rose Fife, MD, assistant dean and professor of medicine, notes that an integrated, multi-pronged approach to Hoosier women's health problems is needed and this award will help achieve that goal. Mortality rates due to breast and lung cancer in Indianapolis women were twice the national average in 1995, and Indiana ranks second in the U.S. in prevalence of smoking among women. In addition, Indiana's 1994 infant mortality rate was eleventh among all states. In Indianapolis, the 1995 mortality rate among Black infants was 15.6 percent -- well above state and national levels.
Dr. Fife's proposal is to assess women's health needs and current efforts in the state to address those needs, and to develop a coordinated national resource center consisting of programs to provide comprehensive women's health care, education for both the public and for health care professionals, and research into women's health issues. "We can do this only through a collaborative effort," says Dr. Fife, "which will involve IUSM and the other IU health schools, the Indiana State Department of Health, and community organizations that focus on issues affecting women's health."
Center goals also will address issues within IUSM. Improvement in the recruitment and retention of female students and faculty, advancement of female faculty, and the development of culturally appropriate and sensitive programs in medical education have been emphasized in the proposal.
Donning The Future
There wasn't much chitchat among members of the Class of 2001 as they began their first day together in August. Nervousness and anticipation filled the auditorium as the students waited for the opening orientation event to begin. They knew the "White Coat Ceremony" was the first item on the agenda, but they had little idea how it would unite them as they embarked on a four-year journey.
Dean Robert W. Holden, MD, greeted the newest class of IU medical students and charged them to care for their patients, even when it becomes impossible to cure them. Richard Gunderman, MD, PhD, assistant professor in the Department of Radiology, supported Dean Holden's charge by recounting the tragic circumstances of a former young patient who was beyond medical repair. This fragile child simply needed to feel care and support during his last days. Dr. Gunderman encouraged students to remember their obligations as human beings while carrying out their duties as physicians.
Just as students were beginning to realize the hefty responsibility they were about to undertake, it was time to make their commitment official with the donning of their white medical jackets and the recitation of the Hippocratic Oath. One by one, as their names were read, they filed onto the stage to receive their jackets. Then the Class of 2001 pledged to serve their profession and patients responsibly and faithfully.
First-year medical student Aislinn Vaughan enjoyed the symbolic experience. "I liked reciting the oath at the beginning of my medical career because it put everything into perspective and gave me a goal to work toward. It also meant a lot to see our class together for the first time, united in one place," she says.
The White Coat Ceremony is a relatively new concept, but one many medical schools around the country are employing. The ceremony helps identify the characteristics of the complete doctor by encouraging a balance of scientific excellence and compassionate patient care. The idea was created by the Arnold P. Gold Foundation, which supports innovative programs and projects that foster humanism in medicine. The White Coat Ceremony was initiated at the College of Physicians & Surgeons of Columbia University in 1993. IUSM held its first White Coat Ceremony in 1996.
Tim Steiner, another first-year student, described the experience as a rite of passage. "It made everything feel real. After months of wading through the testing, application and interview process, I finally felt like I was truly on my way to becoming a doctor."
Like every medical school class before them, the Class of 2001 has a long road to travel. The hope of the School's leadership is to set them off on the right foot.
An Inside Look
Anesthesiology Students
Get X-ray Vision with New Anatomy Text
It's not as far from the operating room to a publishing house as one might think. Just ask
George Sheplock, MD, co-author of the book that was honored as the best new clinical
medicine textbook of the year in 1996 by the Association of American Publishers, Inc.
Dr. Sheplock, assistant professor in the Department of Anesthesia, illustrated "Regional Anesthesia: An Atlas of Anatomy and Techniques." There were nearly 30 contributing authors to the book, including Dr. Sheplock's fellow editors, who are faculty members at the Department of Anesthesia at Pennsylvania State University College of Medicine. The book was published by Mosby-Year Book, Inc.
What makes this book unique is the three-dimensional illustrations, which give the reader "X-ray vision." Dr. Sheplock used vivid digitized photos that depict views of external anatomy. Using image editing software on a personal computer system, he superimposed these images over a second photo that exposes the underlying structures of nerves, bone, muscles and ligaments.
Dr. Sheplock first employed this three-dimensional look at the human anatomy" in a teaching tool computer program he developed called "Brachial Plexus Blocks." In that program, the "anesthesiologist" can test his accuracy on a virtual patient who does not hesitate to holler when the needle is inserted in the wrong location. "Hey, that hurts! Why did you stick me there?" says the program as the student attempts to develop his accuracy.
Now an enthusiastic advocate of courseware, Dr. Sheplock is helping develop a CD-ROM package that provides anesthesiologists with detailed instructions, along with simulations and graphics, for setting up and checking their equipment.
His hard-bound project has 311 pages, containing more than 300 of Dr. Sheplock's computer-enhanced images. And, as might be expected, this project will not live in textbook form alone. It was released as a CD-ROM in December 1997. Dr. Sheplock said that version includes quick-time virtual reality images, giving users further opportunity to explore the unique world of anesthesia as it relates to the human form.
Please send your submissions for Alumni News to Alumni Relations, 850 West
Michigan St., Suite 241, Indianapolis, IN 46202-5198 Fax: (317) 274-5064
e-mail: ssdavis@wpo.iupui.edu
Editor's Comments
We learned as the magazine went to press that our featured alumna, Dr. Jane Henney, will be
recognized as a Distinguished Alumna this May during Spring Medical Weekend.
Apologies to M.E. Hodes, MD, PhD, who was incorrectly identified as D.E. Hodes, MD, PhD, in the cover story of our fall issue, and also to P. Michael Conneally who is a PhD rather than an MD.
Also, Dennis Beck, MD, says his wife was quite surprised to see Lisa Holbrook, MD, identified as his wife in the caption to the Match Day photo on page 8. We apologize for the error. Dr. Holbrook is now a family practice resident at Good Samaritan Regional in Phoenix.
As a child, Jane Henney's roots were firmly planted in Woodburn, Indiana where she grew up. When the time came for her to extend her education, she followed in her father's and uncle's footsteps and attended a liberal arts college near her home. "My time at Manchester College was rewarding," says Jane E. Henney, MD, ('73) who joined the University of New Mexico (UNM) in 1994 as vice president for health sciences. "I was looking for a school with a strong program in the sciences and Manchester had a great track record." As she progressed through her studies as a biology major, she tutored male students whose sights were set on medical school. In the process, Jane Henney realized that her childhood dream of becoming a physician was just as real a possibility for her. Her determination was reinforced by a family friend who saw opportunity in clinical trials during her battle with breast cancer. "She was a very adventuresome and independent woman," Dr. Henney recalls. "She believed in me and that I could make a difference in medicine."
Dr. Henney entered the IU School of Medicine at a time when students were challenging the establishment. Her experience with the Student American Medical Association was the beginning of her engagement with national policy making. After her internship and residency in internal medicine, and a fellowship in medical oncology, she joined the National Cancer Institute, the largest of the National Institutes of Health's (NIH) institutes, and quickly advanced to deputy director. Today, she continues her relationship with NIH as a member of the Advisory Committee to its director, Harold Varmus, MD.
As a vice president at UNM, Dr. Henney focuses on guiding its colleges, schools, and hospitals toward tomorrow. "Over the centuries, New Mexico's enchanting landscapes have attracted many peoples. Because of this, the state has no majority population, which makes developing health care to meet the needs of the people in this state very exciting." The service and education missions of the Health Sciences Center strongly affect rural communities statewide, where the center extends its emphasis on interdisciplinary education. Community outreach is one of several areas where the partnership of the School of Medicine, Colleges of Nursing and Pharmacy, and the Allied Health Programs, together with the UNM hospitals, positions the institution at the forefront of change in health education.
When Dr. Henney graduated from IUSM, there were only 11 other women in her class. Today, the IUSM student body is nearly 40 percent women; at UNM, it is 60 percent women, and the UNM medical school ranks first in the nation for the number of women in senior leadership positions. "Whether in the clinic, administration or classroom, women are capable leaders," she says.
As for her personal life, Dr. Henney still visits her family in Indiana, though not as frequently as she'd like. "My younger brother practices family medicine (Frederic Alan Henney, '80) in Monticello, and my nephew (Jeremy Henney) entered IU this fall as a freshman," says Dr. Henney, who recognizes that growing up in a small town in Indiana keeps her perspective true, as she works to meet the health care needs of those who live in New Mexico.