Magazine - Eastern Virginia Medical School

ack to09schoolMagazinePAGE 20Harry T. Lesterevms president

newsGRADUATIONWorking together to bring neededchange to the health-care systemshould be the ultimate goal of today’srising physicians, said Paul Farmer,MD, PhD, keynote speaker for Eastern VirginiaMedical School’s 2009 commencement ceremony.“Medical schools call for individual achievement,when what we really need is teamwork,” saidDr. Farmer, an eminent physician and HarvardMedical School professor.As a humanitarian who has won internationalacclaim for his efforts to bring health care to theworld’s poorest countries, Dr. Farmer encouragedgraduates to maintain their enthusiasm forTrimaine Brinkley hugs StudentPrograms Coordinator Vera Pottsbefore walking into the arena forthe commencement ceremony.working collaboratively to help others as theyprepare to face the realities of today’s medical andscientific arena. He applauded the graduates’efforts within the local community and abroad,encouraging them to remain committed toteamwork and service throughout the course oftheir careers.Paul Farmer, MD, PhD, told the Class of 2009 that theywill be the generation that revolutionizes medical care.“The call to service is the hallmark of thisschool,” Dr. Farmer said. “Yours is thegeneration I believe will change medicine –making it more evidence-based, more accessible,more equitable.”The school’s graduation events culminated inthe conferral of degrees, when family andfriends of the 246 graduates celebrated theirachievements. Events in the days leading up tograduation included the commissioning ofphysicians entering the military, a baccalaureateservice honoring all graduates, and banquetssponsored by the physician assistant and medicaldoctorate programs.At the commencement ceremony, PresidentHarry T. Lester noted the move from thetraditional location, Chrysler Hall, to the largerScope Arena. The move was precipitated by thegrowth of the student population.“How do you like our new graduationvenue?” Mr. Lester asked as he welcomed thecrowd. “I think it is pretty nice — and veryappropriate. You see, in my book, EVMSgraduates are all rock stars. …You belong inan arena.”Mr. Lester said he considers the Class of 2009particularly special because the MD studentsbegan their tenure at EVMS the same year hewas named president. He praised their activismand willingness to volunteer their talentsin Hampton Roads and in locations aroundthe globe.“EVMS students are committed to servingothers, demonstrated by your voluntarycommunity service,” Mr. Lester said. “Ourstudents choose the mentoring, the free clinicsand the service projects. That’s the reason I’mso proud to be president of EVMS. That’s thereason I am so proud of you.”MD Class President Nicole Reynolds andGaurav Basu, PhD class representative, offeredthe student responses, thanking the faculty andstaff for helping students achieve their goals.“EVMS has taught us much more thanmedicine; we have been taught humanism andthe importance of service,” Ms. Reynolds said.“My experiences at EVMS have enriched mylife,” Mr. Basu said, noting that he is proudto be a student at a school that encouragesteamwork and strives to improve the health andquality of life of the community it serves byproducing great health professionals andinspiring its students to make a positive impact.This year, the PhD program graduated11 students – the highest number in schoolhistory. “This class includes some verystrong students who I expect to contributeto biomedical research and teaching in a varietyof different ways,” said program directorDr. Earl Godfrey. “They worked hard andI’m very proud of all they’ve accomplished.”Wayne Wilbanks, rector of the EVMS Boardof Visitors, conferred honorary degrees uponDr. Farmer as well as the late William CookeAndrews, MD (accepted by his wife Betsy anddaughter Elizabeth Watts). Dr. Andrews wasan important figure in the establishment of theresidency program in the EVMS Departmentof Obstetrics and Gynecology, and he was anational leader in his specialty.Dr. Farmer, Rector Wayne Wilbanks, and President HarryT. Lester greet David Propert, MD, professor of internalmedicine, shortly before graduation gets underway.For more information about Dr. Farmer and to viewadditional graduation photos, visit us atwww.evms.edu/magazine.Biomedical Sciences PhD graduate Gaurav Basu delivered the student address from the School of Health Professions.4 BTS 2009 WWW.EVMS.EDU NEWS NEWSWWW.EVMS.EDU BTS 2009 5

Faculty and administrators seekStimulus FundsFEDERAL AID WOULD SUPPORT RESEARCH,INFRASTRUCTURE NEEDSResearchers and administrators come together in the school’s temporary “War Room”to discuss grant proposals seeking federal stimulus funds.Eastern Virginia Medical School’sresearchers invest long hours applyingfor vital grants, and recently, the questfor research funding has them burning themidnight oil in record quantities.Scientists and physicians throughout theinstitution are seeking a share of the enormousfederal stimulus funding made available foreducational and biomedical research purposesthrough the American Recovery and ReinvestmentAct. The National Institutes of Health(NIH) alone has an extra $10 billion in grantfunds this year.The school has reacted to the unprecedentedfunding opportunity with its own unprecedentedresponse. EVMS has created a centralizedclearinghouse, dubbed the “War Room,” to helpfaculty and staff identify new fundingopportunities as they become available and tohelp them coordinate and manage thedevelopment of grant proposals.Sentara Healthcare is supporting the effortwith the temporary loan of an employee to staffthe War Room and assist faculty. In addition, theschool has contracted a Washington, DC, grantwritingfirm to help faculty craft submissions.“Grants are the lifeblood of biomedicalresearch,” says Dean and Provost Gerald J. Pepe,PhD. “With a surge in grant support, we canredouble our efforts in important researchareas such as cancer, cardiovascular disease,diabetes and women’s health.”EVMS has applied for 39 grants. Thatincludes everything from requests for researchequipment to multi-million-dollar requests fornew facilities, says William Wasilenko, PhD,associate dean for research.The school also is joining with its hospitalpartners Sentara Healthcare and Children’sHospital of The King’s Daughters and with theUniversity of Virginia to seek funding for healthcareinformation technology.“All of these proposals are competitive. Theyhave to be reviewed by their scientific peers.They have to be competitively scored. ButThe NIH alone has anextra $10 billion in grantfunds this year.we’re very optimistic that by flooding the systemwith grants, we’re going to get some that arejust going to land upright and be funded,”Dr. Wasilenko says.Jerry Nadler, MD, professor and chair ofinternal medicine and one of the many faculty toseize on the funding opportunity, says, “This is aonce-in-a-lifetime opportunity where so muchmoney is being put toward research.”Dr. Nadler, for instance, leads a team thatis seeking a flow cytometer, a state-of-the-artresearch tool that can identify cells and, in theprocess, help researchers understand how diseasecauses inflammation, heart problems, hardeningof the arteries and diabetes. “You can infer what’scausing disease and use that information to testnew therapies,” Dr. Nadler says.Researchers also will use the instrument toperform groundbreaking research of bariatricsurgery, procedures intended to help obesepatients lose weight. Dr. Nadler and his teamwant to understand why bariatric surgerypatients experience a dramatic improvement indiabetes symptoms even before significantweight loss.”We have some ideas we want to test tounderstand how that’s happening,” he says. “Wecan use the flow cytometer to identify specialcomponents in the blood.” The research couldlead to the development of a non-surgicaltherapy that might not help patients lose weightbut could provide other health benefits.Even with the haste demanded by thestimulus-funding deadlines, faculty have beencareful to draft strong submissions. “EverythingI have reviewed has been of outstanding quality,”Dr. Wasilenko says.“The faculty need to be commended for theinitiative they have shown and for theirperseverance,” he continues. “It really has struckme, the quality and talent of the research facultywe have here.”One side benefit of the all-hands-ondeckapproach is a broader awareness campuswideof the scope of EVMS research andpatient-care programs and the potential fornew collaborations. “People are becoming moreaware of what’s going on from one departmentto another,” says Dr. Wasilenko. “And that’s ahealthy thing.”Board of Visitorsappoints new officersJohn Rathbone named EVMS Rectorother new officers are:Maurice Jones, Vice RectorSusan Taylor Hansen, Secretary/TreasurerThe Eastern Virginia Medical School Boardof Visitors voted in three new officers at the June9 annual meeting.John P. Rathbone was unanimously electedrector for fiscal year 2010. The new officersbegan their duties July 1.Mr. Rathbone succeeds Wayne Wilbanks, whostepped down from the board after serving eightyears, three of them as rector.“EVMS is in a strong position to realize the nextstage in its ambitious development goals,” says Mr.Wilbanks. “I am very pleased that individuals ofsuch character and dedication will be spearheadingthis effort. I am confident that they will allbuild upon the school’s impeccable reputation forresearch and scholarship and will continue thegood work being done here at EVMS.”Originally appointed to the board in 2004 bythe EVMS Foundation, Mr. Rathbone is theexecutive vice president of administration forthe Norfolk Southern Corporation, where hehas been employed for nearly 30 years. Mr.Rathbone is also on the boards of the College ofWilliam & Mary Foundation, the Belt RailwayCompany of Chicago and the United Way ofSouth Hampton Roads. He was previously atrustee for the Virginia Stage Company andBethany Hall Home for Alcoholic Women andis a former chapter president of the Institute ofInternal Auditors.Mr. Rathbone holds bachelor’s degreesin history and English from Virginia Techand completed post-baccalaureate studies inaccounting at William & Mary, as well asmanagement training at both Duke andHarvard universities.Maurice Jones, publisher of The Virginian-Pilot, is the new vice rector. Appointed to theboard in 2006, Mr. Jones has worked for theU.S. Treasury Department and the Richmondlaw firm of Hunton & Williams and servedas the deputy chief of staff and commissionerof social services under former Gov. MarkWarner. He is the first black publisher ofLandmark Communications, which makes ThePilot the country’s largest daily newspaper witha black publisher.After graduating at the top of his class fromJohn Rathbone, CPAHampden-Sydney College, Mr. Jones continuedhis studies at Oxford University on a RhodesScholarship and later received a law degree fromthe University of Virginia.A board member since 2003, Susan TaylorHansen has been confirmed for a second term asthe board’s secretary/treasurer. Ms. Hansenspecializes in environmental law as a partnerwith the Portsmouth law firm Cooper, Spong &Davis P.C.In 2004, former Gov. Mark Warner appointedMs. Hansen the at-large member of the VirginiaSoil and Water Conservation Board. She is amember of the Environmental Council of theVirginia State Bar Association and is a formertrustee of the Chesapeake Bay Foundation. Shealso has served as an instructor in environmentallaw at Tidewater Community College and aschair of the Portsmouth Planning Commission.Ms. Hansen received her Bachelor of Artsdegree from the University of Utah andcompleted graduate studies at the AmericanUniversity and University of Utah schoolsof law.6 BTS 2009 WWW.EVMS.EDU NEWS NEWSWWW.EVMS.EDU BTS 2009 7

around campusSemmes to leadnew researchcenterEastern Virginia Medical School has tapped oneof its leading scientists to launch a new researchcenter envisioned as a conduit between scientistsand patients, accelerating new treatments for cancerand disease from the laboratory to the clinic.O. John Semmes, PhD, known internationallyfor his research into identifying cancer at itsearliest stages, will lead the Cancer Biology andInfectious Disease Research Center.“Having a researcher of Dr. Semmes’ caliberspearhead this new center will help EVMS quicklymove to the leading edge of oncology research,”says EVMS Dean and Provost Gerald J. Pepe,PhD. “His strong direction will provide studentswith an exceptional education, contribute to the advancementof cancer detection and treatment, andultimately ensure a healthier community.”His physician collaborators also are excitedabout the appointment.“John Semmes is exceptional at perceivingthe clinical utility and potential applications ofrapidly evolving biotechnologies that benefitour patients while providing us with a sharperunderstanding of the mechanisms of cancer,” saysDonald F. Lynch, MD, chair of urology.This is one of four centers envisioned by DeanPepe as part of a major, multi-year researchinitiative that focuses on health issues where thecommunity has needs and the school has existingstrengths. As a center without walls, this “virtual”center will bring together scientists and physicianswith varied expertise. The goal of this networkof EVMS doctors is to increase funding andresearch opportunities for EVMS faculty andstudents; recruit talented, externally funded researchers;and hasten the translation of laboratoryfindings into clinical trials and treatments.“We must ask ourselves what science can doto help solve clinical questions. We want to doresearch that has an application to disease, that willO. John Semmes, PhD, came to Eastern Virginia Medical School from theUniversity of Virginia. He is a leading scientist in the effort to develop testsfor the early detection of disease, including cancer.make an immediate impact,” Dr. Semmes says.In 2009, the American Cancer Society estimatesthat there will be nearly 1.5 million new cancerdiagnoses in the United States alone, and of those,more than 34,000 will be Virginians. The VirginiaDepartment of Health reports that the Easternregion has the highest rate of age-adjusted cancermortality in the state — 204 deaths per 100,000people each year, second only to heart disease.In an effort to target this menacing epidemic,researchers in the new center will strive to developtools for eliminating the disease, which theAmerican Cancer Society says will affect halfof all U.S. men and a third of all U.S. womenat some point in their lives. They hope to serveas a model for collaborative research programs,throughout the state and the nation, designedto address the critical issues related to cancertreatment and education.At the core of the center is the school’s study ofproteins, a science known as proteomics that wasborn out of scientific efforts to uncover the secretsof the human genome. Dr. Semmes, a professor ofmicrobiology and molecular cell biology and theAnthem Professor for Cancer Research, heads theschool’s George L. Wright Center for BiomedicalProteomics. The school’s investment in clinicalproteomics will yield precise molecular diagnostics,and better diagnostics will in turn lead tobetter and earlier treatment, says Dr. Semmes.Dr. Semmes and his team search blood andtissue samples for proteins that offer telltaleevidence of the earliest forms ofcancer. The Wright Center is oneof a small number of programsnationwide designated by theNational Cancer Institute to searchfor such “biomarkers” of disease(for an in-depth look at his research,see p. 26).“I believe in building from aposition of strength outward,” Dr.Semmes says. In this vein, effortsare already underway to consolidatecancer research among EVMS,community faculty (such as thosein the Department of Urology),Virginia Oncology Associates,Sentara Healthcare and others. “Wecan’t do it alone,” Dr. Semmesexplains. “In order to achieve atruly significant cancer programwe need to tap into the researchand clinical capabilities of the entire HamptonRoads region.”“These are exciting times in cancer research aswe look toward a new paradigm for prediction,detection and treatment,” says Mark Szalwinski,vice president, Cancer Services, Sentara Healthcare.“Knowing a patient’s molecular predictorswill open new possibilities for early detectionof cancer and more individualized therapiesthat may ultimately save more lives. The SentaraCancer Network is excited to be a part ofthis effort.”“Fundamentally, we hope to translate promisingscientific discoveries into more effectiveprevention, diagnosis and treatment options,”says Thomas A. Alberico, MD, of VirginiaOncology Associates. “Together, EVMS,Virginia Oncology Associates and Sentara aremaking great strides in cancer research tobenefit not only the people of Virginia, butcancer patients worldwide.”One of the initial goals for the center is tobe named a Designated Cancer Center by theNational Cancer Institute.Dr. Semmes earned his PhD from GeorgeWashington University and completed postdoctoraltraining at the National Institute of Healthand Johns Hopkins University. He and his teamhave produced over 100 scientific publications.Dr. Semmes serves as scientific advisor for cancerresearch at major medical schools and is on theeditorial boards of cancer-related journals.Biochemistry text formedical students tries new tackFrustrated by existing texts used to teachmedical students about metabolism, MiriamRosenthal, PhD, professor of biochemistry in theDepartment of Physiological Sciences, decided tofix the problem.The new book, “Medical Biochemistry:Human Metabolism in Health and Disease,”which she wrote with an outside colleague, isdesigned to give up-and-coming doctors a moreinsightful guide to metabolic processes than whatcurrently is on library shelves.“We came to the conclusion that the existingtexts didn’t work. They either were clinicallyirrelevant or they were encyclopedic,” says Dr.Rosenthal, who has taught at EVMS for morethan 30 years.She and co-author Robert H. Glew, PhD,professor of biomedical sciences at the UniversityLongtime EVMS community faculty memberDavid M. Pariser, MD, has taken the reins as presidentof the American Academy of Dermatology.The yearlong post makes Dr. Pariser, professor ofdermatology, the leading voice behind the prioritiesof the AAD’s 16,000 members.“My primary role is to advocate for the patientsand advocate for the profession,” he says.In a refrain common across the medical community,Dr. Pariser said the academy’s most pressingissue is the dwindling number of caregivers in itsfield, especially as planned health-care reform bringsthe potential for increased patient loads.“The biggest issue right now in dermatology is theworkforce. There are not enough dermatologists inthe U.S., and they’re scattered disproportionately,”of New Mexico, worked together in recent yearsto co-edit a volume of clinical cases for medicalbiochemistry students. The approach for theirnew textbook “came out of both of us teachingand liking to teach, and we realized it needed anarrative. The idea was to focus on metabolismfor medical students” instead of primarily thechemical processes, says Dr. Rosenthal.The narrative uses clinical examples to demonstratethe importance of chemical pathways – themetabolic processes by which certain substancesinteract within an organism. Other texts she hasused over the years tend to focus so much on thechemical aspects that it becomes harder to connectthat with what a physician might see in apatient. For instance, Dr. Rosenthal says existingtextbooks often overlook the simple fact thatdifferent organs are simultaneously performingPariser leads nation’s largestdermatology organizationhe says, noting that more providers need to workin urban cores instead of less-populated areas.His other priorities include promoting theacademy’s continuing medical education andresearch efforts.Dr. Pariser, whose father, Harry Pariser,MD, helped launch the dermatology programat EVMS, is a prolific publisher and an activemember of his field’s professional organizations.He earned the AAD’s distinguished presidentialcitation in 2000, 2002 and 2004, and he hasbeen among the leaders of more than 90 councils,committees and task forces for the AAD.Dr. Pariser also serves as the secretary/treasurerof the American Dermatological Association,president of the Eastern Virginia DermatologyMiriam Rosenthal, PhDdifferent metabolic functions.“I’m hoping this is something a student wouldactually read,” she says. “It’s similar to the way agood faculty member tries to lecture.”David M. Pariser, MDFoundation, president of the International HyperhidrosisSociety and is past president of the VirginiaDermatological Society. He has authored more than160 publications, including three books.Evan Farmer, MD, former EVMS dean, is theAAD’s vice president.8 SUMMER 2009 WWW.EVMS.EDU AROUND CAMPUS AROUND CAMPUSWWW.EVMS.EDU BTS 2009 9

Britt focuses onSurgeonshortageL.D. Britt, MD, MPH, Brickhouseprofessor and chair of surgery, is lending hisvoice to the American College of Surgeons’initiative aimed at curing a critical shortageof surgeons in the U.S.General surgeons play a crucial role inthe health-care team, particularly when itcomes to treating patients with traumaticinjuries or medical emergencies such asappendicitis. A shortage can create backlogsthat limit patients’ access to care, says Dr.Britt, who was elected Chair of the Boardof Regents of the ACS this year.“Most of the trauma centers are staffedby general surgeons,” Dr. Britt said duringan interview with ABC’s Good MorningAmerica Health. “If you have appendicitis,if you have an abdominal obstruction,it’s a general surgeon who’s going toprovide that care, and right now we have amajor shortage.”According to the ACS, three quartersof all U.S. hospitals say there are too fewon-call surgeons to keep their emergencyrooms fully staffed, and the organizationsays there aren’t enough new doctorsbeing trained to replace the one-third ofgeneral surgeons age 55 and over who areconsidering retirement.Barriers such as strict regulations,decreasing reimbursement rates and higheducation costs have stagnated growth inwhat once was among the most soughtafterprofessions in medicine. In March, theACS launched Operation Patient Access totry to regain lost ground, and Dr. Britt saysa few changes could ensure the surgicalworkforce is capable of caring for growingpatient needs.Increasing graduate medical educationfunding to train more surgery residents,easing regulatory hurdles, expandingstudent loan-forgiveness programs andL.D. Britt, MD, MPHimproving health-care provider reimbursementrates are all steps Dr. Britt says wouldclear some of the obstacles facing thesurgical field.“You can have the best insurance in theworld, but if you don’t have access to asurgeon during a surgical emergency, that’sproblematic,” says Dr. Britt, a surgeon withEVMS Health Services. “We’re ringing thebell to tell the public that access to qualitysurgical care is at risk.”PA academy electsThibodeau asboard officerDaniel Thibodeau,MPH, PA-C, assistantprofessor in the Masterof Physician Assistantprogram, was elected inApril as secretary of theboard for the nation’slargest professional organizationfor physicianassistants.Daniel Thibodeau,MPH, PA-CIt is Mr. Thibodeau’ssecond two-year term on the American Academyof Physician Assistants Board of Directors. He previouslyserved as director at large.He says it is exciting to be involved in shaping thefuture of his profession. Physician assistant programshave exploded in popularity across the country,and organizations like the AAPA are backingthe priorities and needs of a segment of the medicalfield that is crucial to effective, economical healthcare.“It’s advocacy in so many different ways — notonly legislation, but things like reimbursement andcontinuing education,” Mr. Thibodeau says of hiswork with the academy.Mr. Thibodeau has been actively engaged withthe AAPA throughout his career. Just recently, hewas among only 40 PAs invited to a summit wherethe academy cemented its opposition to establishinga doctorate for physician assistants as had been donefor nursing. Mr. Thibodeau also will be involved inthe discussion of how physician assistants will fitinto the emerging picture of nationwide health-carereform.Physician assistants differ from nurses in thatphysician assistants are trained to diagnose and treatmedical illnesses and conditions under the supervisionof a doctor, whereas nurses are primarily responsiblefor providing nursing and bedside care –such as monitoring vital signs and administeringmedication. As a result, physician assistants generallyhave more autonomy in making decisions aboutpatient care.To Your HealthAfter the long, cold months of winter,Hampton Roads residents have come outto play.Doctors at Eastern Virginia MedicalSchool say not to rush out to the beach,or even the backyard, without taking amoment to think about sun safety.Antoinette F. Hood, MD, chair of dermatology,warns that smearing on a littlesunscreen may not be enough.“We’ve been indoors for a long time,and suddenly it’s a beautiful day andeveryone rushes out. But they forget howvulnerable they are,” Dr. Hood, an EVMSHealth Services physician, explains.Some hazards of sun exposure includesunburn, aging effects and even skincancer, Dr. Hood says.“Sunburn is painful, but the realdangers of sun exposure come down theroad,” she says. Overexposure to the suncan lead to major health concerns such asskin cancer years after those beach partiesare through.There are plenty of ways to be saferwhile you’re out in the sun, however.First, be aware of the time. UV exposureis highest between 10 a.m. and 2 p.m.,according to Hood.“People are so happy to be outside theymay stay out longer,” she says.A day at the beach is a great getaway,and sunscreen should definitely be in yourbeach bag. But remember, it doesn’t lastforever. Sweat and swimming can washaway that protection before you know it.Dr. Hood recommends reapplyingsunscreen often, perhaps as frequentlyas every two hours.Waterproof sunscreen is agood option if you’re exercising,or can’t reapply that often.Sun SafetyLook for a sunscreen that protectsagainst both UVA and UVB, two wavelengthsof the sun’s ultraviolet light. Also,be aware that those ultraviolet rays areinsidious and can reach you in all sorts ofways. Even sitting under an umbrella orwearing a hat, the sand and the water canreflect the sun’s rays onto your skin.For those with small children, gettingthem to sit still long enough to applysunscreen can be mission impossible.Dr. Hood points parents toward sun-protectiveclothing — shirts, hats, jackets andpants made from material with a tighterweave, to keep out more ultraviolet light.Some clothes are chemically treated tokeep out the sun as well. Sun-protectiveclothes can be a good addition to sunscreen,and work great for adults, too.“They’re comfortable and they workwell,” Dr. Hood says. “It’s not like you’rewearing plastic.”Even a regular cotton long-sleeveT-shirt over your child’s bathing suit canhelp a lot, she adds. “What we preach nowis not just sunscreen, but sun safety andbeing sun smart,”Dr. Hood says.Sunburn is painful,but the real dangers of sunexposure come down theroad.10 BTS 2009 WWW.EVMS.EDU AROUND CAMPUSAROUND CAMPUSWWW.EVMS.EDU BTS 2009 11

THE TEENAGER is one of about twodozen young drivers put behind the virtual wheelfor a study by Eastern Virginia Medical Schoolpediatrics resident LaPrecious Harrold, MD,to see just how distracting today’s mobile gadgetscan be to novice drivers.“Even lower volumes cancause hearing loss withlonger exposure, suchas for an hour or more. ”“Everybody did worse when they had any typeof distraction,” says Dr. Harrold.Cell phones, now a staple for most people, havecome under fire as the most troublesome technologicaldevice for drivers. Headlines describingsometimes-deadly accidents involving distracteddrivers have croppedup around the country,and local andstate governmentshave responded byenacting restrictions— some of them agebased— againsttalking or typingfrom the driver’s seat.More than half ofthe drivers polled ina 2008 AAA surveyadmitted to using aphone behind thewheel. And amongyoung drivers, nearlyhalf confessed totexting from thedriver’s seat.That it’s a distractionto be tappingaway on keys whiletrying to negotiatebusy streets is confirmedby numerousstudies, but it’s beendifficult to quantifyexactly how muchof a diversion it is —especially for teens.“There haven’t reallybeen any studiesWARNING!TEXTING AND DRIVINGMore than half of the driverspolled in a 2008 AAA surveyadmitted to using a phonebehind the wheel. And amongyoung drivers, nearly halfconfessed to texting from thedriver’s seat.focusing in on that age group, and there haven’tbeen any studies focusing on texting while driving,”says Dr. Harrold.The initial goal of the study was to look athow cell phone use affects teenagers’ driving, butDr. Harrold, working with EVMS PediatricsChairman DonaldW. Lewis, MD, onthe study’s design,expanded it to includeMP3 playersand shifted the primaryfocus to texting.Study volunteersdrove through simulatedrural andurban streets filledwith other cars,pedestrians and police.They made thefirst run undistracted,and thenmade subsequentpasses while using acell phone, sending atext message andsearching for songson the MP3 player.The results: Dr.Harrold says everyparticipant’s performancedroppedwhen they were textmessaging or usingthe MP3 player.Many of them alsodrove worse whensimply talking onthe phone.An apple(iPOD) a dayAs if portable MP3 players weren’t enough troublebehind the wheel, their risks are portable, too.The devices have become like mobile entertainmentcenters, getting more complex and capableof providing more elaborate functions. Butusers walking around with earphones on all dayalso should be careful, says Stephanie Moody Antonio,MD, a physician at the EVMS Health ServicesHearing and Balance Center.“There is a significant risk of noise-inducedhearing loss,” says Dr. Moody Antonio, assistantprofessor of otolaryngology-head and necksurgery.Some players can reach volumes of nearly 120decibels — significantly above the 85 decibels atwhich hearing damage can start, according to theNational Institute for Occupational Safety andHealth. Couple that with the fact that many listenersuse headphones like Apple’s “ear buds”that go in the ear canal, and you have the equivalentof noise louder than a rock concert piping outwithin an inch of the eardrum.“Exposure to noise at that volume, even for abrief period, is hazardous to hearing,” Dr. Antoniosays. “Even lower volumes can cause hearingloss with longer exposure, such as for an hour ormore.”The issue first drew attention as players likeApple’s iPod and Microsoft’s Zune exploded inpopularity. Faced with concerns, Apple updated16 BTS 2009 WWW.EVMS.EDU TECH TROUBLESTECH TROUBLESWWW.EVMS.EDU BTS 2009 17

CAUTION!TEXTING ANDCONSTANT USEOF DIGITSthe iPod software in 2006 to limit the maximumvolume to 100 decibels. Dr Antonio says that isstill loud enough to cause damage, and nationalguidelines suggest listening at that level is safe foronly 15 minutes.Since most people don’t carry a decibel gauge,Dr. Antonio says there are other ways to tell whenthe tunes need to be turned down.If others around you can hear the music fromyour earphones or you have to remove theearphones to hear someone talk, it’s too loud,Dr. Antonio explains. “If you have new fullnessor ringing in the ear immediately after you stopthe music, you have suffered some noise damage.”A Wii BitPainfulThe Nintendo Wii is the gaming system forthe masses — the one that people who havenever cared about video games want to try.They are lured by its billing as the systemthat gets people up and moving. But for somepeople, it’s got them moving straight to thedoctor’s office.Horror stories about Wii injuries aboundon the Internet. Photos show people withblack eyes, cuts, bruises and limbs inslings — injuries they say came fromplaying the system. Nintendo Inc. haseven sent out e-mails remindingpeople to use the wrist tether thatcomes with the Wii controllersand play in areas withenough room for swingingarms.However, AntonioQuidgley-Nevares,MD, an EVMSHealth Servicesphysician andassistant professorof physicalmedicine and rehabilitation, says the problemshe has seen are similar to what happenswhen someone takes up a new sport withouttraining first: strained joints, pulled muscles,hyperextensions — all the symptoms of aweekend warrior.“The issue is that they play it for 10 hours”right out of the box, he says.Most of the patients he’s seen with Wiirelatedproblems — “Wii-itis” — arepeople who don’t normally play sportsor video games. They simply like theidea of a more physically engaginggame and charge right in withoutconsidering their physicalcondition or the potentialfor injury.Many of the gameson Wii are modeledon everyday sportssuch as tennis, andplayers try to dothe same thing inthe virtual worldthat would berequired on a real court, swinging the remote likethey would a real racket. Since the remotes arelighter, the arms swing with more force and canstrain muscles and joints.“You don’t have to do the whole motion,” Dr.Quidgley-Nevares says. A simple flick of thewrist is sufficient, but even that can lead to painif continued for hours on end.To truly protect against Wii-itis, though, hesays players should train like they would for anyother sport. If someone isn’t physically active,they should start slowly. Play for an hour at atime, and then take a break. Be sure to stretch,and if it hurts, stop playing.BlackBerryThumbThe opposable thumb may give primates theability to do many things other species cannot,but hammering away on the keys of a PDA(personal digital assistant) such as the Black-Berry is not one of those things.“Your thumb is not really meant to be pushing.It’s meant to stabilize things in your hand,”says Dr. Quidgley-Nevares.A little thumb thumping can be harmless, butconstant use of those digits for an activity towhich they are not suitedcan lead to pain. Withthe rise of textingas a modern formof communicationand theubiquity ofPDAs inthe business world, thumbs are getting abusedlike never before. It’s common enough to haveearned the tongue-in-cheek medical moniker“BlackBerry thumb.”A little thumb thumpingcan be harmless, butconstant use of thosedigits for an activity towhich they are not suitedcan lead to pain.“Instead of a 30-second phone call, they’retexting” or typing an e-mail from their phone,says Dr. Quidgley-Nevares. “When you’re doing30 or 40 or 50 of those things a day, that’s whenyou get problems.”It really comes down to a repetitive stressinjury, he says. Do most any motion enoughtimes in a row and with enough force, and itprobably will hurt. Unlike pain from othertech toys like the Wii, there’s no way aroundBlackBerry thumb other than curtailingthe use of that tiny keyboard. Many wirelesscompanies have a way to send a textmessage through the computer, whichmeans the sender can type normally.If all else fails, Dr. Quidgley-Nevares says,spare your thumb some agony by using thatcell phone for its original purpose — making aquick phone call.18 BTS 2009 WWW.EVMS.EDU TECH TROUBLESTECH TROUBLESWWW.EVMS.EDU BTS 2009 19

ArchitecttheofPROGRESSWhen themedical schoolwas ailing,HARRY T.LESTERwas “just whatthe doctorordered.”20BTS 2009 WWW.EVMS.EDU HARRY T. LESTERHARRY T. LESTER WWW.EVMS.EDU BTS 2009 21caption

A BLUEPRINTIn four years as president of Eastern Virginia Medical School, “You’ve got to do it every day,” says President Lester of the deliveryHarry T. Lester has led the school through a dramatic reversal role. “It doesn’t matter if it’s raining. It doesn’t matter if it’s cold. Itof fortunes.doesn’t matter if it’s hot. And people expect their paper to be in a certainOnce unsure about its financial future and hamstrung by place.”accreditation concerns, EVMS today is on solid financial footing He acquired his strong work ethic and values like honesty andand poised for historic growth in student enrollment.integrity from his father, a minister, and his mother who worked in theAfter stepping into the role of president for what was supposed to be national office of their denomination. “I had a wonderful opportunityonly a few months, Mr. Lester has become the medical school’s most to see really good people in action,” he says.persuasive spokesperson and its most effective advocate.He earned a degree in business administration from Rollins CollegeHis tenure has beenin Winter Park, Fla. Uponmarked by improvedgraduation, Mr. Lesterrelationships with keyspent three years as anpartners, a substantialofficer in the U.S. Navy, aincrease in resources, androle that would eventuallya recommitment to thebring him to Hamptonschool’s fundamentalRoads.mission – to improve theDuring Mr. Lester’shealth of the people ofsuccessful 30-yearHampton Roads.career as a commercial“Harry Lester is exactlyreal estate broker, hewhat the doctor ordered,”was active in varioussays Deborah DiCroce,community activitiespresident of Tidewaterranging from the boardsCommunity College. “Hisof the Chrysler Museumbusiness acumen, combinedto the Chesapeake Baywith the respect he enjoysFoundation. In 2000, heacross the multiple levelsjoined the EVMS Boardof government andof Visitors (BOV). Fivecommunity, has made himyears later, he was Rectora most strategic leader for— the leader of the BOVEVMS.”As an affable leader whoseeks consensus, he hasbrought a new focus to theschool as well as a determination to make EVMS the best it can be. So forthose who know him, it’s no surprise that he wants to finish what he started.His intent is to take the medical school to a new level of excellence —and he’ll be turning to the entire community to lend a hand.Baptism by fireGov. Timothy M. Kaine, with President Lester at right, talks with EVMS faculty andstudents in early 2007 during his visit to campus, a testament to the school’sstrengthening relationship with state leaders.A North Carolina native, Mr. Lester learned some of life’s mostimportant lessons delivering morning newspapers.For several years, the future naval officer, commercial real estate brokerand medical school president would rise before the sun to make hisrounds on his bicycle. Regardless of the weather, he faithfully deliveredthe Greensboro Daily News to 85 homes. The experience taught him thevalue of money and responsibility and the importance of customer service.— when the president ofthe school decided to stepdown.Mr. Lester filled thevacancy on a temporary basis, but it quickly became evident he was theright person at the right time.A review of the school by the Liaison Committee on MedicalEducation (LCME) had found that while the school was doing a goodjob in its educational role, it faced serious financial and organizationalchallenges. The LCME review panel reported that the school neededadditional funding resources to ensure its long-term viability, and it citedother deficiencies, including the need for a better working relationshipbetween the dean and the president.In response, Mr. Lester and the Board of Visitors hired a consultingfirm with health-care expertise. EVMS board members workedalongside President Lester and members of senior management to assessthe school’s policies and practices and make the necessary changes. “Therewere a lot of business-oriented things we needed to do,” Mr. Lester recalls.FOR SUCCESSAt the same time, President Lester focused on building andstrengthening relationships with strategic partners. He convincedthen-Gov. Mark Warner to include $4.2 million in additional statefunding for the school on an annual basis. He met with leaders atthree of the school’s partner teaching hospitals and negotiatedincreases totaling $4.6 million in their annual support of the medicalschool. He also forged a new agreement with a key partner, SentaraHealthcare.Sentara hospitals serve as primary teaching sites for EVMS studentsand medical residents.As part of the agreement,Sentara agreed to provideEVMS $25 million overfive years in operatingfunds and support forthe training of residents.The school and Sentarahave continued to workclosely across a numberneeds. Governor Kaine’s proposal included $59 million for EVMSfor construction of a new building.President Lester then organized local support for the school in thelegislature. He spent countless hours on the phone talking strategy andtraveled to Richmond regularly to press the school’s case.Ultimately the General Assembly supported the governor’s plan andapproved $59 million for EVMS.Mr. Lester attributes the school’s turn of fortune in large part tofaculty, staff and students. “None of this would have been possiblewithout their undyingdedication to our centralmission. I am fortunateto work with talentedindividuals who share acommitment to makingHampton Roads and theworld a healthier place.”He also is quickto credit the variousof fronts.“Harry Lester hasdone an outstanding jobas president of EVMS inmoving the institutionforward,” says DaveBernd, CEO of Sentara.Those developments– all within PresidentLester’s first year –represented a dramaticindividuals andturnaround for theschool and put it on firmfinancial ground.With guidance from theconsultant, the school better defined the distinct roles for the president andthe dean. At the urging of the faculty, Mr. Lester appointed a veteranscientist to the post of dean. Since then, President Lester and Dean andProvost Gerald J. Pepe, PhD, have developed an effective workingrelationship that has drawn praise from members of the board andfaculty.Two years ago, as the nation’s medical leaders began to realize thecountry was not producing enough physicians, EVMS took action.The school put forward plans for an $80 million building project toprovide space for the school to increase its enrollment by 30 percent.The building also includes desperately needed research space.President Lester asked Gov. Tim Kaine to include funds for thebuilding in a state bond package. It was a long shot; the state hadprovided only $1 million previously for EVMS infrastructurePresident Lester is a consensus builder who welcomes input from a broad spectrum ofpartners. Above, he chats with EVMS Foundation Trustee Bruce Bradley, left, InternalMedicine Chair Jerry Nadler, MD, and Trustee Robin Ray.organizations thatsupport the school inword and deed, frommembers of the Boardof Visitors and theFoundation Board ofTrustees, to area businessand civic leaders,lawmakers, governmentleaders and countlessdonors.“We have been blessedwith great friendswho understand andappreciate the school’s importance to the community,” he says.A commitment to excellenceWith stable finances, productive relationships with its key partnersand a new building about to rise from the ground, some have suggestedit’s an opportune time for the president to leave.“My really good friends tell me I should quit now because things areworking well and something bad could happen tomorrow,” Mr. Lester says.He disagrees. In fact, in June the Board of Visitors enthusiasticallyendorsed a three-year extension of his contract.“He has a clear vision for the growth of EVMS to meet the loomingshortage of doctors facing this country,” says EVMS Rector John Rathbone.“We are fortunate to have Harry’s enthusiasm and leadership.”22BTS 2009 WWW.EVMS.EDU HARRY T. LESTERHARRY T. LESTER WWW.EVMS.EDU BTS 2009 23

Q&AwithPresident LesterWe spoke with President Lesterabout his plans and aspirationsfor the future.How has your perception ofthe medical school changedsince you became involvedwith EVMS?I used to think EVMS was simply a place totrain doctors. And we do have a talented andcompassionate student body that is second tonone. But I now know that EVMS is muchmore than just an institution of higher learning.Our teaching doctors also see patients —120,000 a year — in our medical school officesand in hospitals across the region. They provideextraordinary care, some of it unique inHampton Roads, and they do it without regardto a patient’s ability to pay. We have a talentedcorps of researchers — including scientistsand physicians – who are busy developingtomorrow’s treatments today. And our schoolisn’t limited to students studying to be doctors.Our students also include those studying inthe health professions, as well as newly minteddoctors — also called residents — who needadditional training to attain licensure, andveteran physicians who require continuingmedical education. We do three things:Teaching. Discovering. Caring. And we excelin every category.What will be your focusover the next three years?We’re in good shape. But now I want us tobe in great shape. My objectives fall into fivegeneral areas:One: Improve our relationship with the state.For 35 years, EVMS has been a bargain forthe state, compared to its investment in theother state-owned medical schools. The statehas stepped up its support for EVMS andwe are grateful, but we believe it is time tolevel the funding. The people we serve — aquarter of the state’s population — deservenothing less.Two: Construct a new building &Three: Launch a capital campaign. Thepeople of Hampton Roads were extremelygenerous a generation ago when theyestablished this medical school in responseto a physician shortage. With anotherphysician shortage looming, we need toappeal to the generosity of the people ofHampton Roads once again.We have committed to construct a newbuilding so that we can increasethe number of physician andphysician assistants that we train.The state has given us $59 milliontoward this $80 million project. Weneed the community to help fundthe difference and to pay for theadditional faculty we will need.We also must build our endowmentto support our operations, and it’svital that we increase student aid inthe form of scholarships.Four: Update our operatingagreement with Sentara Healthcare.Unlike most medical schools, we donot own a hospital, so our hospitalpartners are among our mostimportant allies. We couldn’t functionwithout them, but likewise, localhospitals are equally dependent on us.For instance, working withSentara we have made great stridesthat neither of us could have achievedalone, such as the recruitment ofnationally known scientists like Dr.Jerry Nadler, a specialist in the linkbetween diabetes and heart disease.Sentara is our largest and most generoushospital partner. They’ve been incrediblysupportive. We wouldn’t have the potentialthat we have were it not for Sentara being arobust, well-managed company. Dr. Nadlerand other EVMS researchers bring theincreasing promise of translational research,where lab discoveries are translated intotreatment that will ultimately benefit thepatient.Five: Complete our long-range planning.We are in the midst of a year-long processto create a strategic plan that will betransformational. We’re not just fiddlingwith the margins. We’re working on takingEVMS to the next level with the state’s helpand with the help of our hospital partners.As a part of that discussion, we wantto be at the forefront in understandinghealth-care reform. We will evaluate the“President Lester hasa clear vision forthe growth of EVMSto meet the looming shortageof doctors facing this country.We are fortunate to haveHarry’s enthusiasmand leadership.”EVMS Rector John Rathbonechallenges and the opportunities arisingfrom health-care reform both internally andin cooperation with our partners.Where does your motivationcome from?I like to work on things that I reallybelieve in, and I don’t mind a little challenge,like figuring out how to find new money,encouraging good business practices andkeeping the school focused on our mission.What are you most proud ofin your time at EVMS?First on my list is the day we signed anaffiliation agreement with Sentara. A closesecond is when Mark Warner believed in usenough to say EVMS has gotten it togetherand agreed to recommend an increase in theschool’s annual state appropriation by $4.2million. We had figured out those were theimportant things we had to do and wegot them done.What do you hope yourlegacy will be?I’m not worried about legacy. It’s noton my list. I hope I will have made thisa better place. That’s all. I don’t get upin the morning thinking about how I’mgoing to be looked at after I’m gone.Work hard while I’m here. Do the bestI can. Get out of the way.What do you enjoy mostabout your job?The best part is working with somany really smart people. I meetwith students on a regular basis and Iam continually impressed with theirmotivations. They feel compelled tohelp others regardless of the obstaclesthat modern medicine imposes. I’malso impressed with our residents.We attract some of the nation’s topphysicians to our campus to learn andpractice their craft.Our faculty are fantastic. I’ve never meta more dedicated group of individuals.They’re saving lives. They’re makingsick people well. They’re making newdiscoveries. They are training the healthcareworkers of tomorrow. It’s a great placeto work. Smart people doing good things —what’s not to like? It’s a wonderful job.24BTS 2009 WWW.EVMS.EDU HARRY T. LESTERHARRY T. LESTER WWW.EVMS.EDU BTS 2009 25

Seeking Cancer’sFingerprintUndigested controlTrypsin digestionLaboratory successes could lead theway to the development of better testsJohn Semmes, PhD, right, director of the proteomics center,tours the center with Sudhir Srivastava, PhD, from theNational Cancer Institute.Urologic oncologist Raymond S. Lance, MD,has seen the panic when he tells men they haveprostate cancer but can’t say with certaintyhow serious it is.“Unfortunately, at this time, we don’t havegreat tools,” Dr. Lance explains.One in six men will eventually be confrontedby the prostate cancer dilemma: Should I wait andhope mine is the usual slow-growing variety notlikely to be lethal? Or should I try to prevent thecancer from spreading by removing or irradiatingmy prostate, with the risk of incontinence andimpotence?Sophisticated imaging techniquesallow scientists to visualizecancer. (above and below)26BTS 2009WWW.EVMS.EDUPROTEOMICSPROTEOMICSWWW.EVMS.EDU BTS 200927

The vast majority opt for radical treatments,Dr. Lance says, and up to 40 percent ofpatients find out later that they could havesafely waited.Research currently underway at the EasternVirginia Medical School George L. WrightJr. Center for Biomedical Proteomics holdspromise for helping men make better medicaldecisions. Scientists working in the labs inLewis Hall have located a protein in prostatebiopsy tissue that not only confirms whether aperson has cancer, but also could differentiatebetween mild and aggressive forms of thedisease. Scientists refer to such a protein as a“marker,” or chemical signpost.The techniques refined in the study ofprostate cancer may someday be applied tobreast, bladder, colon and kidney cancers,according to O. John Semmes, PhD, thecenter’s director and primary investigator inthe prostate cancer marker study.So far, PSA tests appear to be no better thanthose binoculars. They have detected cancerssooner, but they may not have extended thelives of most men tested. The PSA test alsomisses up to a quarter of cancers and is proneto false positives, which often lead to painfulbiopsies. And a PSA can’t distinguish betweenmild and aggressive cancers. For those whohave the slower-progressing form of prostatecancer, the surgery or radiation promptedby high PSA readings may needlessly reducequality of life.“We don’t need any more early detectionmarkers — we have PSA,” said Sudhir“I’m pretty hopeful in the next five years youmay have this kind of biomarker to tell doctorswhether to do a biopsy or not do a biopsy andwait,” Dr. Srivastava adds.A prostate biopsy can be painful, withneedles often inserted through the rectum toget samples. A biopsy also can leave scar tissuethat might make removal of the prostate moredifficult later.The prostate is a spongy, walnut-sized organin front of the rectum between the bladder andthe penis. The urethra, which carries urine andsperm, runs through it. The prostate makes themilky alkaline fluid in semen. Just millimetersProteomics lab supervisor Lisa Cazares,PhD, and postdoctoral fellow Cindy Guo,PhD, prepare samples for testing.IN SEARCH OF A BETTER TESTProstate cancer is the most common non-skincancer in this country. According to the ProstateCancer Foundation, more than 186,000 Americanmen were diagnosed and 28,000 died from thedisease last year. That equates to a new case every2.5 minutes and three deaths every hour in theU.S. alone.In 1986, the Food and Drug Administrationapproved a blood test known as PSA (prostatespecificantigen) to measure the effectivenessof cancer treatments. EVMS scientists helpedvalidate the usefulness of PSA, and it wasapproved as a general screening aid for prostatecancer in 1994. Soon, doctors were routinelyordering it in older men and catching the diseasemuch earlier.But recent research indicates that earlydetection using PSA and digital rectal examshasn’t really improved survival rates. Theexplanation may be something researchers calllead-time bias. Dr. Semmes, the school’s AnthemProfessor for Cancer Research, uses a silent-filmstaple to explain. If you give binoculars to adamsel tied to a railroad track, she can detect anoncoming train much earlier. But if she can’t getoff the track, her life expectancy doesn’t improve.Urologist Ray Lance, MD, spends one day a week in the proteomics center to lend aphysician’s perspective to the research.Srivastava, PhD, MPH, chief of the CancerBiomarkers Research Group in the Divisionof Cancer Prevention at the National CancerInstitute. “We need to ferret out PSA-detectedcancers that are likely to progress or not likelyto progress.”Dr. Srivastava heads the NCI’s EarlyDetection Research Network, which includesthe EVMS Biomarker Discovery Lab. He saysthe EVMS marker studies “are very exciting.I think [Dr. Semmes] has picked up on theright approach.”away on either side are delicate nerve bundlesthat control erections. The sphincter musclethat prevents urine from leaking is located onits border with the bladder.It’s a crowded neighborhood, and removingthe prostate involves precise surgery,sometimes done with robotic arms under highmagnification. There is a significant chance thata nerve will be nicked or the sphincter stretched,with potency and continence affected.Still, 90 percent of those diagnosed withprostate cancer wind up choosing to have28BTS 2009WWW.EVMS.EDUPROTEOMICSPROTEOMICSWWW.EVMS.EDU BTS 200929

GET THE PICTUREHistologyStroma Glands Overlaym/zDr. Semmes meets with proteomics center staff and representatives from otherdepartments who assist with the cancer research.Through their research to identify the “fingerprint” of cancer, EVMS scientists have discovered chemical clues that help guide their search.At left above is a section of prostate tissue. The succeeding images demonstrate how, through an analysis of the proteins present in thetissue, scientists can pinpoint the location of a cancer within tissue. Scientists and physicians working side by side hope to translate thisunderstanding into simple tests that one day may be used to identify aggressive cancer in its earliest stages when it is most susceptibleto treatment.the organ removed or treated with radiation,Dr. Lance says.“People are torn between the side effectsof treatment and missing a window ofopportunity to be cured,” says Dr. Lance,a board-certified surgeon with Urology ofVirginia who has performed more than 100robotic prostate surgeries.Dr. Lance, the Paul F. SchellhammerProfessor of Cancer Research at EVMS, is partof the team trying to develop better tools todetect prostate cancer.“Like CSI, when you go to a crime scene,the bad guy leaves some kind of fingerprint,”he says. “We think, in cancers, that there also isa molecular lineup of bad guys.”A POTENTIAL BREAKTHROUGHFor more than a decade, EVMS scientistshave been sifting through the hundreds ofthousands of proteins in blood and trying toidentify the few that are present only whenthere is disease.There’s great promise in such research,known as proteomics. Proteins form the skin,hair, muscles, ligaments and cartilage that giveus shape. They are also the enzymes, hormones,antibodies and hemoglobin necessary for life.It’s estimated that there are between one andtwo million proteins in the human body.Initially, EVMS researchers hunted forcancer markers in a cache of blood samplesdrawn over the years from healthy andsick men. A continuing partnership withUrology of Virginia, the practice that formsthe backbone of the school’s Department ofUrology, provided the samples and detaileddata on how each disease had progressed.The lab experienced a breakthrough recentlywhen it narrowed the search by switching totissue samples taken during prostate biopsies atSentara Norfolk General Hospital.“Blood is like a jungle,” Dr. Semmesexplains, “and you are looking for one leaf.”Techniques honed on blood testing wereapplied to the biopsy tissues. A machineknown as a mass spectrometer helps scientistslearn what proteins are present and in whatquantities.That is only the beginning of the work,though, according to Lisa H. Cazares, PhD, apost-doctoral fellow at the center. Dr. Cazareshad started working on the protein studies atEVMS as a lab assistant, then obtained herdoctorate in biomedical sciences at EVMS andis now one of the principal investigators in themarker research.Dr. Cazares says it took another six monthsto identify the potential marker, a protein calledMEKK2 which was previously identified asinvolved in prostate cancer development.“It was a logical hit,” Dr. Semmes says.“I would be surprised if this lone proteinturned out to become a biomarker,” he says,“pleasantly surprised, but not floored.”Unlike the PSA test, which only measures abody’s reaction, or antigen, to something, theyhad found a component of cancerous tissueitself that was behaving as a signal, he says.The research, eventually involving tissue from85 patients, also shows MEKK2 can determinehow aggressive the cancer is, with the level ofthe protein dropping as the risk increases.THE NEED FOR COLLABORATIONStill, it’s a long way from lab discovery toclinical marker, says Dr. Semmes. Only a smallpercentage of such finds wind up being usefulin the field. Follow-up testing is expensiveand often requires a partnership with abioengineering company or the medical testindustry. That’s one reason EVMS has appliedfor a patent on the marker test. This way, Dr.Semmes says, a partner company can be certainwhom they will be dealing with.Other proteins in their research seem tobe potential markers and need to be furtheridentified, he says.Eventually, he hopes the EVMS proteins canbe combined with markers from collaboratorsaround the world into a prostate cancer screeningpanel that would increase the reliability of the tests.NCI’s Dr. Srivastava praises EVMS forsharing its expertise with other researchers.“John is very collaborative, very open,” he says.“You need people like him to move the fieldforward.”Once such a panel of markers is developed,Dr. Semmes says, pathologists could eitherhave their own testing equipment on siteor ship specimens to labs such as EVMSto determine the protein profile. Theywould then be able to pair the moleculardata with their own experience with tumorslides to come to a conclusion on a cancer’saggressiveness.“If you can tell a 60-year-old man, ‘You don’thave an aggressive phenotype,’” Dr. Cazaressays, “he’s going to feel good.”As for Dr. Srivastava’s dream of a test thatcan eliminate the need for some biopsies, theEVMS team is working toward that as well,looking for marker proteins in the fluidssqueezed out when a doctor examines aprostate in a digital rectal exam. That fluid,which bathes the prostate, is present in a simpleand painless urine sample taken right after theprocedure, Dr. Semmes says.“So far, the results we are seeing areextremely promising,” Dr. Lance says.Proteins can change function when theychange shape, and other EVMS researcherswill look at how and why they might mutatewhen they are involved in cancer.“We’re really interested in knowing, ifthere is cancer, what proteins are messedup,” Dr. Cazares explains. “What proteinspossibly contribute to the start andprogression of cancer? If you know whatit is, you can target it for therapy – knock itout, fix it, or knock it in, depending on howit’s messed up.”As the search narrows for cancer’s molecularfingerprints, EVMS scientists are learningmore and more about the disease. Theirdiscoveries may one day give physicians andtheir patients the upper hand in the ongoingbattle against an ingenious and lethal foe.30BTS 2009WWW.EVMS.EDUPROTEOMICSPROTEOMICSWWW.EVMS.EDU BTS 200931

NewassociationunitesHealthProfessionsAlumniIn mid-April, alumni representatives joinedfaculty and school administrators for the inauguralgathering of the EVMS Health ProfessionsAlumni Association. The organization complementsthe existing MD Alumni Associationand represents a connection for the nearly 1,500graduates of the 11 EVMS health professionsprograms.The establishment of this new alumniassociation is an important milestone for thegraduates and for the School of HealthProfessions, says C. Donald Combs, PhD, viceprovost for planning and health professions. Dr.Combs sees the health professions alumni ascrucial to fulfilling the school’s education andcommunity service missions.“EVMS needs their knowledge and theirefforts,” Dr. Combs says. “The Health ProfessionsAlumni Association is a very important mechanismto making that happen.”Aaron A. Lambert, MPH (’07), is presidentof the new alumni association. Speaking onbehalf of its newly installed Board of Trustees,Mr. Lambert said the organization will benefitthe school by fostering relationships amongalumni, students and faculty.“Our new association represents the beginningof what I’m hoping will be a strong andcollaborative effort towards growing the healthBradford N. Boyette, MPAprofessions programs, providing the opportunityto network among fellow alumni and workingwith the students, faculty and EVMS communityto help us continue to succeed,” Mr. Lambert says.Mr. Lambert, a resident of Chesapeake, holds aBS in environmental science from Old DominionUniversity and is pursuing an MBA from theMason School of Business at the College ofWilliam and Mary. He manages claims operationsin Georgia and Virginia for the AMERIGROUPCorporation, a managed health-care company.Other members of the board include:President-Elect Rita M. Fickenscher, MPA(’01). A resident of Virginia Beach, she holds aBS in medical technology from Kent StateUniversity. Mrs. Finkenscher actively supportsEVMS, organizing annual receptions for MPAalumni, coordinating alumni fundraisingactivities and helping to interview and educateMPA students. One of her three sons, Ben, is a2005 EVMS MD graduate and a board memberof the EVMS Medical Alumni Association. Sheis chief physician assistant with EmergencyPhysicians of Tidewater.Bradford N. Boyette, MPA (’02). AChesapeake native now living in Virginia Beach,Mr. Boyette holds an undergraduate degree inmusic from Old Dominion University. APaulette Brown, MPARita M. Fickenscher, MPAKerry A. Kruk, ATR-BC Aaron A. Lambert, MPHTaegen L. McGowan, MPH Kerry L. Walls, MPHmember of the EVMS community faculty, heworks full-time in general surgery for SouthsideSurgical Group and part-time with EmergencyPhysicians of Tidewater.Paulette Brown, MPA (’04). Ms. Brown, aresident of Chesapeake, holds an undergraduatedegree in business administration from LibertyUniversity. She works with the 1st FighterWing, NASA Family Practice Clinic, at LangleyAir Force Base in Hampton.Kerry A. Kruk, ATR-BC (’04). Ms. Kruk,a resident of Norfolk, holds a BA ininterdisciplinary natural sciences, biology andchemistry from Lawrence University inAppleton, Wis. She works for the City of VirginiaBeach as a counselor at the Recovery Center, adetoxification and crisis stabilization center,and serves as art therapy adjunct faculty.Taegen L. McGowan, MPH (’07). Ms.McGowan lives in Newington, Conn. She holdsan associate’s degree from the College of DuPageand an undergraduate degree in biology fromBarat College. She works as a program assistantin the school of medicine at the University ofConnecticut Health Center.Kerry L. Walls, MPH (’06). Ms. Walls lives inPortsmouth and holds a BS in finance fromVirginia Tech. She is an operations analyst withAMERIGROUP Corporation.EVMS an “exceptional opportunity”for ’76 alumWhen Marcus L. Martin, MD, was growing upin Covington, Va., a small community of less than10,000, fellow students at the all-black high schoolhe attended called him “Dr. Martin.” He evencarried a bag around with the title scribbled on it.But a career in medicine was a distant dream atthe time.Dr. Martin got his start at the WESTVACOpaper mill in Covington. He went to North CarolinaState University on a pulp, paper and chemicalengineering scholarship. Upon graduation, hewas offered a job at WESTVACO as a productionchemical engineer, and it was while working therethat Dr. Martin heard about the plans to open amedical school in southeastern Virginia.“I always had it in the back of my mind that Iwanted to become a doctor and provide care to people,”Dr. Martin says. “In the paper industry I wassupplying care and assessment to machinery.”But in 1972, caustic paper pulp spilled from anormally closed pipe and injured several of hiscoworkers. He had left work only a few minutesbefore the accident, and that close call cemented thenagging feeling that he wanted to do somethingelse with his life; he realized he wanted to help patients— not machines.At that time, Eastern Virginia Medical Schoolwas planning its first academic year — the goal itssupporters had dreamt of for nearly a decade.“It was an incredibly visionary effort on the partof Norfolk and the citizens of the Tidewater area,”Dr. Martin says. “People realized you had areas likeRichmond and Charlottesville where the numberof practicing physicians was much greater. Pullingtogether a medical school was an incredible feat atthat time.”Dr. Martin said he applied to EVMS because hedidn’t have anything to lose, and he had heard arumor that the school was accepting many peoplefrom Virginia.“I didn’t have any advisers or mentors telling memy chances would not be good,” Dr. Martin says. “Ihad no clue that I would be accepted. I had no reasonto believe that I would be accepted.”But he was. Dr. Martin entered EVMS as one of24 in the firstclass of medicalstudents acceptedfrom more than1,700 applicants.“It was anexceptional opportunityand itMarcus L. Martin, MDcertainly was a career-defining moment,” he says.“I took it and never looked back.”After his acceptance, Dr. Martin cracked openhis books. His engineering background gave himan easy grasp of many of the science classes, but hehad to study often to memorize for his neuroanatomyclass, he says.“My classmates and I were all very close,” he says.“We spent many evenings studying together inSmith-Rogers Hall and watching kung fu movies.”The long hours spent studying paid off. Hereceived the school’s first Outstanding Student inInternal Medicine award.“During an awards banquet, Dean Manningrecognized my academic accomplishments andpresented me with a lifetime subscription tothe New England Journal of Medicine,” Dr. Martinexplains. “I still receive the [journal] on aregular basis.”Despite his recognition as a superlative student,Dr. Martin is missing from the graduation photographof the Class of ’76.“I was the first in my family to become a doctor,so graduation was a great time for the family tocelebrate. I missed the photo of the class in ourcaps and gowns because I was so involved withfamily following graduation,” he says. “AlthoughI was unhappy about not being in the photo, itwas truly one of the best days of my life.”Dr. Martin graduated at 28 years old and begana career that took him across the country in variouspositions from New York City to New Mexico toCincinnati.“But I always wanted to come back to Virginia,”he says.Dr. Martin currently lives in Charlottesville withhis wife, Donna. A professor at the University ofannualdean’s awardscontinued from page 13in developing the Master of PhysicianAssistant Program’s pharmacology curriculum,and he fills multiple roles withinthe Department of Family and CommunityMedicine, such as consulting for the seniorcare clinic, making hospital rounds withresidents and working with third-yearmedical students.“Dr. Lynch has been of great helpduring the family medicine clerkship bothin a role as didactic instructor, group facilitator,and as collaborator in curriculumdevelopment and educational research,”says a colleague. “His well-thought-outcontributions have substantially raisedthe educational value of the clerkshiprotation.”A highly regarded professional in hisfield, Dr. Lynch was invited to give threepresentations at the annual meetingof the American Academy of PhysicianAssistants in 2008 and was also an invitedpresenter at the national meetings of theAmerican Medical Directors Associationand the Society for Teachers of FamilyMedicine in both 2008 and 2009.Prior to beginning his tenure as anassociate professor with EVMS in 2006,Dr. Lynch served as an assistant professorat Virginia Commonwealth University’sSchool of Pharmacy in Richmond. Heholds a doctor of pharmacy degree fromthe University of Arkansas for MedicalSciences.Dr. Lynch lives in Virginia Beach.Virginia, Dr. Martin is also assistant dean of theSchool of Medicine and previously served as chairof the Department of Emergency Medicine.He remembers his experience at EVMS fondly.“I’d be remiss if I didn’t say I thought the educationalenvironment was exceptional and that the relationshipsamong students were the best that I canrecall in any of my academic studies.”32 BTS 2009 WWW.EVMS.EDU ALUMNI ALUMNIWWW.EVMS.EDU BTS 2009 33

Making a gift of a giftTributes honor designee and help EVMSphilanthropyWhen a friend’s birthday rolls around, orsomeone in her family has something to celebrate,Selma Graber doesn’t head to the mall tolook for gifts.Instead, she makes a donation to Eastern VirginiaMedical School in the person’s name.“I just have a special feeling about EVMS,”she says. “They’re a tremendous asset to thecommunity and they’ve helped so many people.”Among them is her son, Mark, a 1981 EVMSgraduate. He now practices medicine in Iowa,has written three books and travels around theworld as a volunteer physician.“My son has done amazing things, and Iblame EVMS for all his accomplishments,” Mrs.Graber says with a laugh.Mrs. Graber’s husband, Stanley Graber, MD,and daughter are optometrists, so supporting themedical school comes naturally to her.“It honors them, and it helps the school,” sheexplains. “EVMS is a fantastic facility. I’ve beenmaking donations for years, and will continuefor years to come.”Honor donations and memorial donations —gifts made in recognition of another person —are a popular method of giving to EVMS,according to the school’s director of development,Ryan Martin.“Memorial and honor donations are a way toshow appreciation of another person — eithersomeone who has passed away or in honor of abirthday or anniversary. Some make a gift asthanks for something someone else has done,”Mr. Martin says.Memorial donations, those made in honor ofsomeone who has died, evoke powerful feelingsWomen-only fishingtournament Lures Money forEVMS Breast Cancer ResearchThe 7th annual Wine, Women & Fishingladies-only tournament, hosted by theChesapeake Bay Wine Classic Foundation,kicked off Sunday, Aug. 16.Under blue skies, 165 lady anglers on29 teams set a tournament record, reelingin 33 white marlin and sailfish.The team aboard the Triflin claimedthe first place trophy. The VictoryLap took second place, and the SeaWolf’s team took third place honors.The first-ever Junior Angler Award wentto Hunter Bayne of the Sniper. Annein those who give, Mr. Martin says. Some peopleget a sense of closure and peace.“The person they loved has died because ofsome disease or problem, and the school is workingon that problem,” he says. “It’s part of thehealing process. They feel powerless, and this isa way to continue the fight.”Mr. Martin says the popularity of these giftsshows that EVMS holds a special place in thecommunity, that people in Hampton Roads feela strong connection to the school.“There’s a sense of pride and support,” hesays. “There’s a kind of ‘let’s help each other out’attitude. This is a community gem, and peoplewant to preserve that crown jewel.”For more information about how to make a gift to EVMS,please visit www.evms.edu/magazine.Black of Triflin won the Top LadyAngler Award.To date the charitable event has donatedmore than $100,000 for breast cancer researchat Eastern Virginia Medical School.The day of fishing concluded at TheView at Rudee Inlet with dinner, dancingand live music.Sponsorship opportunities for the2010 tournament are available. For information,contact Tournament DirectorPaige Ray at (757) 572-6592 or visitwww.evms.edu/magazine. Continued on page 39Maurice Young, MD, keeps pictures on his wall of the children he’s helped deliver.Partnership translatesinto lower debts and better accessStudent loan debt is a reality for most collegegraduates, but students graduating from medicalschools might shoulder $200,000 or more.In order to help pay off their loans and gainfinancial security, many go on to residencies andspecialties that are high-paying but often locatedin large metropolitan areas. That is why EVMS,through the L.D. Britt, MD, Scholarship, teamedup with the Obici Healthcare Foundation to offera grant of loan forgiveness to two graduates ormembers of the school’s community faculty.William E. Russell, EdD, deputy superintendentof Chesapeake City Public Schools, isa founding member of the L.D. Britt, MD,Scholarship Committee, which administers theloan-forgiveness grants.Dr. Russell happened to hear about the ObiciFoundation grants by chance and realized thefoundation supported many of the same things asthe Britt Scholarship.“This grant is a prime example of how theObici Foundation is carrying out the wishes ofthe founder of the hospital in expanding medicalservices in that area,” Dr. Russell says.The first recipients are Patricia McNulty, MD,and Maurice Young, MD.“Having the opportunity to serve in thiscapacity and receive the support of the [program]is truly a blessing to me and my family,” Dr.Young says. “My student loans total almost$200,000 with accrued interest. Relief from sucha financial burden will only make things easierfor me to focus on patient care and provide themedical needs of this community.”The school and the foundation have placedconditions on the grant that they hope willimprove access to quality care in the regions ofHampton Roads that need it the most. Recipientsof the grant must agree to practice in the ObiciHealthcare Foundation service area for at leastfour years, over which time they receive $120,000to pay down their student debt.“One of the problems that we are encounteringas a nation is access to health care, particularly inrural areas like Suffolk, Isle of Wight County andFranklin where there’s not a big concentration ofphysicians,” says Ryan Martin, director ofdevelopment at EVMS. He notes that there is amuch higher prevalence of underserved andindigent patients in those areas.Cassandra Barksdale, PhD, is an elementaryschool principal in Chesapeake and sits on thecommittee that selected recipients of the grant.“We were looking for someone that had theprofessional attributes to become a goodphysician, but most importantly we were lookingfor someone with a strong commitment to thecommunity. Someone that would give us manyyears and give back in terms of service,” she says.Dr. Young, formerly an active-duty Air Forceobstetrics and gynecology physician at LangleyAir Force Base, started working in Franklin as alocums tenens physician — a doctor who worksfor a practice temporarily.“I have become so committed to my work herein Franklin that I have resigned my regularofficer commission in order to practice full-timewith a group of two ob-gyn physicians,” he says.“The city of Franklin will be my new home,and I am dedicated to serving the needs of thefolks here.”The grant is generally restricted to minoritiesby race or gender, Mr. Martin says.“Part of the reason for this goes back to accessto care — generally those populations areminorities,” he says. “And research suggests thata minority community member is likely to goto another minority person and seek out careand trust.”The smooth start has already led to interest inexpanding the grant opportunity. “The programis really starting off successfully, and we’re able tosee how the recipients are already helping to serveunderserved and indigent populations,” Mr.Martin says. “Obici has been incredibly generousand open to future partnerships and possibilities.”Dr. Young, who received his grant from theprogram last year, practices with Ob-GynPhysicians Inc. in Franklin.34 BTS 2009 WWW.EVMS.EDU PHILANTHROPYPHILANTHROPYWWW.EVMS.EDU BTS 2009 35

35th anniversaryWhat a difference 50 years makes. The future site of the EasternVirginia Medical Center (below) consisted of Norfolk General Hospital andlittle else in this photo taken in the late 1950s. By the 1990s, the complex(bottom) had grown substantially and Eastern Virginia Medical School wasan integral part. The latest aerial view (main photo), taken in the fall of2008, shows the initial work on an expanded staff parking garage in thelower right of the frame. The parking lot adjoining that construction is thefuture site of the new EVMS education and research building. EVMS willbreak ground on the new facility this fall.EVMSthen & now19591993 200836 BTS 2009 WWW.EVMS.EDUWWW.EVMS.EDU BTS 2009 37

Runners step up forEVMS Trauma RunCavish Tournamenta driving successupcomingState of the School andGroundbreaking – Sept. 17More than 200 people turned out for theinaugural Eastern Virginia Medical SchoolTrauma: Run for Your Life 5K held May 23.Scott F. Reed, MD, an associate professor ofsurgery and EVMS Health Services surgeon,organized the event as a way to raise awarenessabout the risks of traumatic injury.“It was great that somany people cameout on a Saturdaymorning to runand learn about preventing trauma,” saysDr. Reed. “We learned a lot this year and arereally looking forward to doing the run againnext year.”Representatives of the Norfolk and VirginiaBeach Emergency Medical Services, LifeNetHealth, Sentara Healthcare and the EVMSDepartment of Pathology and Anatomy hosteda family-friendly health fair to educate attendeesabout different ways to prevent accidents andavoid injuries.Most trauma deaths result from car accidentsor falls, Dr. Reed says. Burns account forthe majority of children’s trauma injuriesat Sentara Norfolk General Hospital(SNGH), where EVMS surgeons staffthe region’s only Level 1 trauma center. In ayear, the surgeons there will care for nearly 2,100trauma patients.“It's truly a disease,” Dr. Reed says. “As wetalk about prevention in heart disease andprevention in everything else, we need to starttalking about prevention in trauma. It’s not justan accident.”Patrick Hunt of Virginia Beach was therace’s overall winner, completing the 3.1 milesin 15:14.42. Meredith Faulkner, MD, whograduated May 16 with a medical degree fromEVMS, was the women’s winner with a timeof 19:31.75.For additional photos of the event and links torace results, visit us at www.evms.edu/magazine.Overall race winner Patrick Hunt leads morethan 200 other runners across the start ofthe inaugural EVMS Run for Your Life 5K.Even the weather knows agood cause. A brilliant spring sunin a cloudless sky greeted morethan 130 golfers who turned outto support diabetes treatment andresearch at Eastern VirginiaMedical School during the11th annual Mike Cavish GolfTournament.The tournament is heldannually in memory of Mr.Cavish, a restaurateur andcommunity activist. He was an ardentsupporter of diabetes research, and in thewake of his death, members of the localcommunity took up the cause in his place.The daylong celebration of Mr. Cavish’smemory and the cause he fervently supportedGolfers helped raise $33,000 fordiabetes research at EVMS.women-only fishingCalling on Vintners, Collectorsand ConnoisseursThe Chesapeake Bay Wine ClassicFoundation will also host the 19th annualGrand Auction on November 14, 2009; aportion of the proceeds will benefitEastern Virginia Medical School.As the largest and most successfulauction of its kind in the mid-Atlanticregion, this celebration of wine attractshundreds of enthusiasts from across theUnited States. Held each year at Eleanorand Bob Stanton’s Bayville Farm estate,the event features award-winning localraised a total of $33,000.That tally shows that evenin a cloudy economy, thecommunity recognizes theimportance of diabetes careat EVMS.Proceeds from the eventbenefit the EVMS StrelitzDiabetes Center’s efforts toexplore new treatments andcontinue the battle againstdiabetes’ devastating effects.With the prevalence of diabetes on therise in Hampton Roads and across thecountry, such support is more criticalthan ever as EVMS physicians andscientists increase the number of toolsavailable to fight the disease.continued from page 34chefs, exceptional wine from around theworld and a spirited auction featuring rarewines, trips, exclusive wine dinners andautomobiles.Event coordinators are currentlyseeking donations of wine for individuallots from private collectors as well asbusinesses. Please consider donatingcollectible wines from your cellar tobenefit Eastern Virginia Medical School.A premier event in Hampton Roads,The Chesapeake Bay Wine ClassicGrand Auction sells out every year.Contact Jennie Capps for information atwineclassic@cox.net.President Harry T. Lester and Dean and ProvostGerald J. Pepe, PhD, will talk in detail about the latestnews from EVMS and how the medical school is positioningitself to face the challenges and opportunitiesahead. The event will include a groundbreaking for thenew research and education facility to be constructedbehind Lewis Hall.The address and ceremony will be held in McCombsAuditorium in Lewis Hall and begins at 5:30 p.m. It isopen to the public.Donor Appreciation Reception– Oct. 7Eastern Virginia Medical School invites its supportersto campus the evening of Wednesday, Oct. 7,for a reception in appreciation of their generouscontributions to the school. It is those contributionsthat enable EVMS to continue pursuing the missionsfor which it was founded — helping people live healthierlives in Hampton Roads and beyond. The event willbe held in the Brickell Medical Sciences Library atriumbeginning at 6 p.m.Britt Scholarship Dinner– Oct. 22The 14th annual L.D. Britt, MD, Scholarship FundDinner begins at 7 p.m. Oct. 22 at the Norfolk WatersideMarriott. The scholarship aims to encourage moreminorities to pursue medical careers by removing thebarrier of medical school tuition.The keynote speaker is Haile T. Debas, MD, DeanEmeritus at UCSF and Executive Director of UCSF GlobalHealth Sciences.For more information about the scholarship, go tohttp://www.evms.edu/students/fin-aid/britt.htmlTell us what you thinkTake a short survey to let us knowwhat you think of EVMS Magazineand qualify for a chance to wina $25 Visa gift card. Visitwww.evms.edu/magazine andclick on the survey link.38 BTS 2009 WWW.EVMS.EDUWWW.EVMS.EDU BTS 2009 39

P.O. Box 1980Norfolk, VA 23501-1980Address Service RequestedTeaching. Discovering. Caring.