By Rob Mitchum

When a doctor pulls a notepad out of his or her white coat, you might expect them to be writing down a drug prescription. But a recently completed contest thrown by the Prizker School of Medicine suggests that physician might be scrawling down a few lines of verse as well. The first annual Pritzker Poetry Contest received an overwhelming response, with more than 80 poetic submissions from Pritzker students, faculty, and residents. Those nominees were whittled down to 11 finalists, and the top entries in two categories were announced last week.

The idea to tease out the poetic side of physicians originated with Rama Jager, an assistant professor of opthamology & visual science with the University of Chicago Medicine. Jager saw a story in the New York Times about similar contests at the Yale and University College London medical schools, and thought that the concept would help students and faculty here express their feelings about their work and their relationships with patients.

With the help of medical students Rebecca Levine and Margaret Nolan and faculty advisor Shalini Reddy, the first Pritzker contest was born in February. Participants could submit a poem in either the rules-free open verse category, or (inspired by another New York Times article), the six-word poem division, a chance to express one’s feelings in highly efficient fashion.

“We wanted to have two different categories, especially since students, residents and doctors are often so busy that an open-form poem can be daunting to take on,” said Nolan, a fourth-year Pritzker student. “6-words can be easier, and yet challenging in other ways as it forces you to distill an experience or thought into so few words. It’s a really fun exercise for anyone to try, though, and we’ll hopefully experiment with other original forms in the coming years.”

The missions of the contest — to “recognize and celebrate the humanistic side of medicine at all levels of medical training and practice” and “foster continued compassion for our patients, enhancing the therapeutic doctor-patient relationship throughout our medical careers” — inspired a flood of replies [pdf]. Generous prize money, which ranged as high as $1,000 for first place in the open poem category, surely didn’t hurt too. Levine said that the final totals doubled the organizers’ original estimate, and gave the panel of 13 judges plenty to work with.

“We thought that there would be around 15 to 20 entries in each category given that this was the first year of the competition and people may not have seen our messages about the competition, have had time to write poems, or be interested in this form of expression,” said Levine, also a fourth-year with Prtizker. “When we received around 40 poems in each category, we were shocked and elated!”

The winning poems, which can be read in full and properly formatted form at the Pritzker website, are a deft blend of medical terms and emotional verse. You may not see the phrase “sinus tachycardia” appear in too many poems published in Granta, but the first prize winner in the open-poem category, H.I.E. by third-year medical student Joshua Williams, weaved that term and other pieces of physician lingo into an artful description of a two-year-old critically ill hospital patient.

You are G-tube, trach-dependent,
deaf, blind, devastated, orphaned,
forgotten,
and two years old today.

You are an incredible teacher.

Second-year Pritzker student Liese Pruitt’s Two Tiny Feet (tied for second) contrasts the bright environment of a delivery ward with a scene of mourning.

sanitized
unyieldingly,
cheerful, a place
for hellos, here
are only good-byes

And first-year Brian Thurber’s Monday Morning Rounds illustrates the all too routine struggle of providing emotional reassurance to patients whose health is declining.

It’s not fair for me to give her a false sense of
security
All the news is bad
Her numbers look worse than they did the day
before
I can’t lie to her
I can’t tell her that everything’s going to be ok
Because it’s not

It’s just not . . .

The transformation of such trying experiences into poetry can help doctors-in-training deal with their emotions and improve their bedside manner going forward, both Levine and Nolan said.

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by Rob Mitchum

Too often, art and science are treated as intellectual adversaries. Educational systems typically route students toward one pole or the other, with the artistic and scientific spheres rarely intersecting by the time one reaches the undergraduate and graduate levels. But for the last two years, the University of Chicago has paved a path between these two fields with the Arts|Science Initiative, which offers grants to collaborations that reach across the traditional boundary lines.

This year’s presentation, which took place in the “performance penthouse” of the brand-new Logan Center for the Arts on the south end of campus, featured six such partnerships formed between scientists and doctors-in-training on one side and artists, sculptors, and filmmakers on the other. The projects covered a wide span of ideas and technologies, from 3-D sculptures based on math theorems to hacked Wii controllers that allow dancers to make music as they move. In each case, the participants raved about how the collaboration allowed them to flex a different part of their mind, approaching familiar topics with a fresh set of eyes and think about new, creative ways to merge the artistic and the scientific.

Trauma Under the Microscope: Collected Perspectives on PTSD

Post-traumatic stress disorder has frequently been in the headlines lately, as tragedies such as the killing of 17 Afghan civilians by a US soldier draws attention to the high incidence of the condition in veterans of war. But the definitions of “trauma” and “PTSD” vary widely from person to person, clouding the issue of what causes the disorder and how it is diagnosed and treated. Many journalists and laypeople misuse the term, or fail to understand that PTSD is caused by a constellation of factors, not a single incident of trauma, said Nicole Baltrushes, a Pritzker School of Medicine student.

So Baltrushes collaborated with Sravana Reddy of the Computer Science program and Carmen Merport of the English Department to create an interactive website on PTSD. Starting with a print flyer, the team asked friends, family, faculty members from several disciplines and health professionals to annotate the flyer based on their understanding of the disorder and its terminology. They then took those notes, plus various multimedia links to poetry, videos, pictures, Facebook posts and other sources, and built an interactive webpage that can be added to and customized by users.

“The hope is that as more people visit the site, and as more people hear about the site, that there can be a web-based conversation that we start about what is trauma and PTSD, to broaden our understanding,” Baltrushes said. “Because as of yet, we have not the greatest understanding of what these things are, or how to even approach healing of these things on any level.”

Opening

As laboratory imaging technologies improve, science becomes more and more of a visual discipline. In the film “Opening,” Jared Clemens of the Committee on Neurobiology and Marco G. Ferrari of the Department of Visual Art make the connection between scientific videos and the world of film explicit through innovative use of split screens, montage, and audio editing. While original footage featuring neuron-esque trees on the University of Chicago campus runs in the middle of the screen, laboratory videos of actual neurons run on the left side while scenes captured from films such as Elephant Man, The Shining, and Rear Window play on the right. Meanwhile, the audio track alternates between scientific descriptions of the structure and function of the brain and movie dialogue that touches on the nature of the mind.

“This piece originated in a personal interest in the disconnect that exists between much of the public and the sciences,” Clemens said. “I wanted to explore this in a non-traditional way…the structure of the piece is an abstraction of the chaos and dynamics that exist in neural circuits, as well as the chaos that exists between the public and the sciences.”

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Almost everyone has experienced the boredom of sitting through someone’s vacation photos, forcing a wan smile as a friend hands you picture after picture of beaches, museums, and old buildings. But if you’ve been to the same destination as your friend, there’s an allure to seeing how their experience of a particular place compares to your own. Discussing a gelato stand you both visited outside the Uffizi gallery in Florence or debating the merits of ocean-side vs. sound-side in the Outer Banks can bring a friendship closer. But can that communal photo-sharing power be captured and channeled into improving people’s health?

That concept is a novel component of assistant professor of medicine Arshiya Baig’s pilot project to improve diabetes outcomes in the Chicago Latino community, Picture Good Health/Imagínate una Buena Salud. Designed in cooperation with churches in the predominantly Mexican neighborhood of Little Village, Baig’s program offers focus group classes with Latinos diagnosed with diabetes, seeking to improve their diet, exercise, and disease control. At each of the eight weekly sessions, participants go through education, counseling, and activities to help manage their diabetes. But each meeting begins with a novel concept, called “photovoice,” that puts the storytelling potential of photography to use as a stimulant of healthy discussion.

“We thought we would do something fun, so we are giving disposable cameras to everyone in the intervention group, and they get to take photos of their life with diabetes,” Baig said. “Then each class starts off with a conversation around those photos. People can share stories, they can problem solve, and our class leader is trained to facilitate a conversation. It’s probably the most innovative part of the study.”

The concept of photovoice was not created by Baig, but it is typically used by researchers for different purposes. Typically, the idea of giving subjects cameras and asking them to document their situation is used as a “needs assessment” to help design an intervention. For example, one project asked teenagers in an urban area to photograph negative elements in their daily life and community. Researchers or policy makers could then look at those photos to find places where an intervention could make the largest impact, such as cleaning up abandoned buildings or providing more supervision during walks to school.

However, in Picture Good Health, the photovoice method is the intervention. Participants are told only to document things in their life that are relevant to living with diabetes. After the photos are developed, they can choose which ones to share with the group during the first half-hour of each week’s session. The photographer explains what the photo means to him or her, and then the group discusses from there.

Second-year Pritzker medical student Matthew Stutz joined Baig’s project this summer to start analyzing the photovoice component of the focus groups. He found that the participant’s photos covered a wide range of topics, from the obvious (food, diabetes medications) to more general influences such as their home, workplace, neighborhood, and family. A photo of loaves of white and wheat bread might kick off a group discussion of health grocery choices, or a picture of an ashtray could trigger participants to talk about the methods they have used to try and quit smoking. One man shared a picture of a park and said it reminded him of his deceased daughter, inspiring the other participants to talk about family members they had lost - a topic that wouldn’t typically be on the agenda for a diabetes intervention.

“I think of photovoice as an easy mechanism for someone to convey emotions, experiences, losses, gains, without having to verbalize it,” Stutz said. “By having a prop or a mechanism to share, I feel we can gain a lot more ground and depth and conversation.”

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The University of Chicago can fill a couple of classrooms with all of the Nobel Laureates affiliated with the school, from Milton Friedman to Saul Bellow to Barack Obama. After Monday, a third room might have to be opened up, as Pritzker School of Medicine graduate Bruce Beutler became the 86th member of the exclusive club. Beutler, who graduated from our medical school in 1981, was honored with this year’s Nobel Prize in Physiology or Medicine, along with Jules Hoffman and Ralph Steinman. The three scientists were credited with advancements in the field of immunology that have paved the way for new strategies fighting infections, cancer, and other diseases.

“I thought it was possible, but nobody can count on winning the Nobel Prize, so I’m just ecstatic,” Beutler, now at University of Texas Southwestern Medical Center, told the Chicago Tribune.

In the confusing calculus of the Nobel, Beutler and Hoffman split half of the total award for research on the innate immune system, known as the first line of the body’s defenses against infectious invaders. In the late 1990’s both scientists’ laboratories were looking for immune receptors that respond to signals on the surface of bacteria - Hoffman looking in fruit flies with genetic mutations, Beutler in mice. Within two years of each other, Hoffman discovered a fly mutant named “Toll” involved in the response to an infection, and Beutler found a similar gene in mice for a receptor (named, appropriately, the “Toll-like receptor”) that binds to lipopolysaccharide (LPS), a signal on the surface of bacterial cells.

These findings opened the floodgates to learning about new players in the innate immune system, including the discovery of a dozen more Toll-like receptors that recognize various pathogen signals - what some call “the eyes of the immune system.” Clinically, mutations in these genes can lead to either increased susceptibility to infection (if the innate immune system is too weak) or autoimmune and inflammatory disorders (if the innate immune system is too strong). Drugs that target this system might therefore be promising for the treatment of many different diseases.

“I think the most hopeful line or realm is in inflammatory and autoimmune disease,” Beutler told the Nobel website. “Inflammation is something that evolved to cope with infection, and when we speak of sterile inflammatory diseases like rheumatoid arthritis and autoimmune diseases like lupus, probably some of the same pathways are utilized. It may very well be that by blocking TLR signalling you’ll have very specific therapies for those kinds of diseases.”

Beutler said that he received the news in bed, waking up in the middle of the night and reading an e-mail on his cell phone.

“I was a little bit disbelieving, so I went downstairs to look at my laptop,” Beutler said. “I went to Google News and saw my name there, so I knew it was real.”

At the University of Chicago Medical Center campus, the news quickly spread among former colleagues and teachers of Beutler, as well as scientists that who work in his field.

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Medical students spend the first half of their education learning anatomy and physiology, and the second half applying that knowledge in the hospital. But where in that process do they learn the very important skill of listening and talking to their patients? In the panel discussion that followed yesterday’s announcement of The Bucksbaum Institute for Clinical Excellence, it was clear that even physicians who graduated from medical school decades ago remember exactly when and from whom they learned those important lessons. In some cases, that mentor was sitting just a few feet away, such as when Mark Siegler spoke of his time as a medical student learning from the now 102-year-old Joseph Kirsner.

“The way you learn medicine is by seeing, not by talking. You have to show what good care is about. I learned from studying people like Joe,” Siegler said. “Joe told us that everything was important, [including] science and clinical inquiry, but patients came first, patients were the absolute first priority.”

The Bucksbaum Institute, made possible by a $42 million pledge from The Matthew and Carolyn Bucksbaum Family Foundation, has borrowed that sentiment as its defining principle. Teaching bedside manner may not be as straightforward as teaching biology, but creating a system of mentorship can help experienced physicians pass lessons down to young and aspiring doctors. Perhaps with serendipity, the panel represented that kind of mentorship family tree, with Dr. Siegler seated next to his former trainee Holly Humprey, dean for medical education, and Dr. Humphrey adjacent to current Pritzker 4th-year medical student Rebecca Levine.

[Watch video of yesterday's announcement and panel discussion.]

Each panelist and speaker at the event talked about the doctor-patient relationship as a phenomenon under threat in the modern health care system. Though better tests, treatments, and procedures have saved and extended countless lives, an increased reliance upon technology can interfere with the “old-fashioned” methods of taking a good patient history and answering patients’ questions.

“We were always taught that 90 percent of the diagnosis in medicine was based on what the patient tells you,” said Kenneth Polonsky, dean of the Division of the Biological Sciences and the Pritzker School of Medicine. “There are tendencies on the part of physicians to rely more on technologies than on what the patients tell them, their interactions with patients, and what they learn at the bedside.”

It makes sense then to start with doctors-in-training, and the foundation of the Bucksbaum Institute is the financial support of three to five new medical students a year as Bucksbaum Student Scholars [read more on the Insitute's organization in the FAQ]. Because of the Pritzker School of Medicine’s reputation as a “teacher of teachers,” (30 percent of Pritzker graduates go on to faculty positions at academic medical centers, Humphrey said), the hope is that the emphasis on doctor-patient communication seeded at the University of Chicago will spread around the country.

“This gift allows our medical school to make a very public statement to our students at the time they are applying to medical school and then during their experience in medical school, that the doctor-patient relationship is fundamentally important in the education of a physician,” Humphrey said. “Then, upon graduation, our students populate schools across the country and carry on that Bucksbaum tradition wherever they go.”

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Students might sometimes think that their textbook appeared out of thin air, the accumulated knowledge of a field spontaneously forming into a heavy slab of facts and figures. But textbooks are like any other type of book, with flesh-and-blood authors who labor over the words within and make a million tiny decisions to shape the final product. If you try to include everything, the book will likely be too heavy for even the most determined or muscular students to carry. Cut too much out, and your definitive textbook might be scorned as incomplete and elementary.

In writing her new textbook, professor of neurobiology Peggy Mason helped find the happy middle by starting with a very specific audience in mind: the medical students that she has spent 15 years teaching at the Pritzker School of Medicine. Her completed product, simply named “Medical Neurobiology,” is the first designed with aspiring physicians in mind, teaching med students about the broad influence of the central nervous system. Picking a specific target audience helped Mason make the hard choices about what to include and what to leave out, she said - even if the final 660 pages is heavier than she intended.

“I think it’s actually the only textbook completely aimed at the medical students,” Mason said. “I did a few things because of that that no other textbook does.”

For starters, Mason chose not to interpret “medical neurobiology” as simply “neurology.” Only a small percentage of medical students will eventually choose to train as neurologists, but the other 97 percent also need to be familiar with the central nervous system, she said. Knowing the anatomy and function of the brain, spinal cord, and nerve pathways can help everyone from future neonatologists measuring infants’ reflexes to future pulmonologists treating asthma to future geriatricians looking for the warning signs of dementia or motor deficits.

Another important decision came to Mason after a dinner with four medical students who gave her insight into the overwhelming workload of an aspiring doctor.

“All of a sudden I just realized that the immensity of the knowledge base that they need to acquire in two years,” Mason said. “It made me think anew about what we were teaching them, and I decided that as entertaining as it may be for us to talk about the newest, greatest research, it’s a disservice to them. They don’t have the time; they need the body of information that they need clinically and not the extraneous stuff. So I tried to cut out as much as I could.”

Mason kept the page count down by restricting the coverage wherever possible to topics of clinical relevance, leaving out popular neuroscience textbook subjects such as the fundamentals of smell and leech swimming (a common model for the neurobiology of locomotion). Instead, she focused on the anatomical regions where patients are most likely to suffer lesions that cause symptoms, and the neurotransmitter imbalances that cause behavioral changes. Pop-out boxes describe the clinical manifestations physicians are likely to see, such as the pupil constriction and droopy eyelid of Horner syndrome, which indicates damage to a specific pathway from the brain to the eye.

But to really help important neurobiology topics take up permanent residence in the minds of medical students, Mason deployed an armory of inventive examples and metaphors to make the text both enjoyable to read and memorable.

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Medical school isn’t cheap. Today, medical students graduate with an average debt over $155,000, and the need to pay off those mortgage-sized loans drives many a young doctor away from more modestly compensated but sorely needed fields such as primary care and family medicine. To alleviate this financial pressure, many organizations have started scholarships to help with the med school tuition bill, rewarding scholastic achievements and commitments to work in underserved populations. The American Medical Association’s Physicians of Tomorrow program is one such effort, and this week’s announcement of the 2011 recipients [pdf] carried a heavy Pritzker School of Medicine presence.

Two of the 18 (11 percent, but who’s counting) fourth-year medical students receiving the $10,000 scholarship were from the University of Chicago’s medical school. Laura Blinkhorn (left) and Maggie Moore (right) are the two very impressive Pritzker students among the recipients, each with very impressive biographies already built in their young careers. Blinkhorn has done work with South Side neighborhoods as part of the Pritzker Summer Service Partnership, works with the Washington Park Free Children’s Clinic, and is planning to spend 3 months of the next year doing a clinical rotation in the African country of Gabon. Moore volunteered at the Maria Shelter Clinic for Women and Children and the South Side “Girls on the Run” program, and somehow finds time to write poetry about her medical experiences. Because of poems such as “Cadaver Memorial” and a collection called “A Third Year’s Life in Lyrics,” Moore was given the Johnson F. Hammond, MD Scholarships supporting medical journalism by the AMA. Congrats!

New Furniture for Molecular Engineering

When you are building a new house, you’re gonna need some furniture. The same thing goes for building a new research institute - before you can fill it with people, you need somewhere for them to sit. The University of Chicago’s Institute for Molecular Engineering, which was born in December and acquired a leader in March, has this week announced four named professorships made possible by anonymous donations. The funded positions give the institute the power to recruit prominent researchers to help realize the institute’s unique vision blending biology, chemistry, and physics.

“The big job in front of us is to bring together people with expertise in broadly applicable areas of enabling technology, such as synthesis of new materials, biological engineering, new ways of doing computing and quantum information science,” said Matthew Tirrell, the founding Pritzker Director of the Institute for Molecular Engineering and senior scientist at Argonne.

Elsewhere…

The San Diego Union-Tribune Keith Darcé wrote an excellent overview of the Earth Microbiome Project, the global study of the world’s bacterial populations that has previously been featured on the blog. Our own Jack Gilbert is featured (he mentions their current project swabbing bacteria from the animals of the San Diego Zoo), and an interesting hunt for bacteria able to survive in high-salt conditions is also explained.

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By John Easton

At 1:30 pm, on Monday, December 12, at its Annual Meeting and Exposition in San Diego, The American Society of Hematology will recognize Janet Rowley of the University of Chicago Medical Center, and Brian Druker of Oregon Health & Science University, with the 2011 Ernest Beutler Lecture and Prize for their significant advances in the diagnosis and treatment of chronic myeloid leukemia (CML), a cancer of the blood characterized by an overproduction of white blood cells.

This is a great honor - and a storage problem.

Rowley has received many prizes over the course of her career: the Lasker Award, the Gruber Genetics Prize and the American Association for Cancer Research Award for Lifetime Achievement. President Jimmy Carter appointed her to the National Cancer Advisory Board. President Bill Clinton awarded her the National Medal of Science. George W. Bush selected her for his President’s Council on Bioethics. She stood with President Barack Obama when he signed the stem cell research bill and she returned to the Obama White to accept the Presidential Medal of Freedom. Then she moved to a new office with a better view, but less shelf space.

Rowley has long been known for brilliant insights, intellectual rigor, and relentless tenacity, but never for extreme neatness. “Her filing system involved piles,” said MaryBeth Neilly, a senior research technician who works with her. When preparing for the move, “we found awards all over the place,” she said. “We knew we needed a place to put them, and that her office was not that place.”

Thus was born the shrine. “Once we moved, but before we unpacked, we ordered a display case,” said Neilly. She and Rowley sorted through the honors and picked the cream of the crop; those that were the most significant, or that looked really cool. Lots of them, some of the trophies, most of the plaques and the vast majority of honorary doctorates, were transported - lovingly, but in bulk - to the University archives.

The display case soon filled to capacity. “There’s a lot of crystal in there, a lot of shiny metal,” Neilly said, such as the National Cancer Institute’s Rosalind E. Franklin Award for Women in Cancer Research, a big carved glass bowl, or the National Medal of Science, a golden medallion.

A few favorites - for reasons aesthetic or sentimental - wound up in Rowley’s office, including the Lasker, the Presidential Medal of Freedom, a large, twisting crystal chromosome from the Jeffrey M. Trent Lectureship in Cancer Research, and a bronze sculpture from the Leukemia and Lymphoma Society. A few more are at Rowley’s house. Two made of a particularly valuable soft, shiny heavy metal, stay at a local bank. The exact positioning of the Beutler Prize has not yet been determined.

Elsewhere…

Vijay S. Dayal, a longtime fixture of the Medical Center’s otolaryngology department, passed away last week at the age of 74. A head-and-neck surgeon and expert on hearing and balance, Dayal was also known as a skilled inventor, obtaining patents for an artificial voice box and a customized “rotating chair” used to test dizziness and balance. “Testing in the chair is not uncomfortable for the patient,” Dayal said in 1991. “It’s like a mild ride on a merry-go-round and it provides us with information we cannot get any other way.” You can read another obituary for Dr. Dayal at the Chicago Tribune.

What’s it like to be a medical student? Pritzker first-year Akash Parekh narrates a day in his life for US News & World Report. Spoiler alert: there’s not much free time, or sleep.

If parents refuse vaccinations for their child, should pediatricians be allowed to refuse to take them as a patient? That interesting ethical question was the subject of an article by the Chicago Tribune’s Deborah Shelton.

The new Scientific American blog network officially launched this week, and provides a new home to many of my favorite science bloggers. For a taste, check out Lucas Brouwers’ post on the evolution of E. coli, and this interview with John Boswell of Symphony of Science (best known for the Carl Sagan autotune track “A Glorious Dawn”).

Popular Mechanics typically offers step-by-step guides for changing your oil or building a bookcase. But in a recent feature they seriously upped the instructional ante with an “Extreme How-To” - How to Perform Open Heart Surgery. The expert chosen to guide their readers through this don’t-try-this-at-home process was Medical Center cardiac and thoracic surgeons Jai Raman and Shahab Akhter who helped develop a new technique in heart surgery called the “wrap procedure.” The surgeons do a great job of explaining how the surgery has changed over the years, particularly in the materials used for repairing the heart and sternum after surgery to speed recovery and decrease scarring. “You’ve got to get comfortable putting stitches into a beating heart,” is just some of the sage advice that Raman offers in the piece.

The end of the academic year always brings a bounty of teaching honors, voted on by medical students, residents, and faculty peers. For the 2010-2011 year, more than two dozen awards were handed out by the Pritzker School of Medicine, the Biological Sciences Division, and departments of the Medical Center. For an awards roundup from both sides of campus, visit this article at the University of Chicago News Site.

The pediatric cancer patients at Comer were treated to a celebrity visit last weekend, though their parents and staff may have recognized her more by voice than by sight. Delilah, the easy listening disc jockey known for her “Love Someone” radio dedications, visited families at Comer before making 3-year-old leukemia patient Atia Lutarewych her “Brave Child of the Week.” You can listen to her segment on the visit here [mp3].

Another inspiring story of pediatric cancer was told in the Chicago Tribune this week, focusing on 6-year-old neuroblastoma patient Theofanis Yianas. After Theo’s hair fell out from chemotherapy treatment, 30 friends and family members shaved their heads in solidarity with the young boy. Theo’s doctor, professor of pediatrics Susan Cohn, comments on the importance of support in a patient’s recovery.

What did St. Vitus’ Dance - the 14th century outbreak of weeks and months-long uncontrolled dancing across Europe - have to do with mirror neurons in the brain? UChicago psychologist John Cacioppo weighs in on this fascinating phenomenon for ABC News.

An interesting plan to create “mystery shoppers” for assessing the primary care shortage in the United States was revealed in the New York Times on Sunday, then disappeared by Tuesday after doctors bristled about “snooping.” The survey, which would have been conducted by the University of Chicago National Opinion Research Center, shows how far the administration will go to collect data on the current health care system…and how stiff the medical field’s resistance can be to being measured.

More Honors for Shubin

In 1863, in the midst of the Civil War, Abraham Lincoln signed an order creating the National Academy of Sciences, an organization bringing together the country’s most esteemed scientists to “investigate, examine, experiment, and report upon any subject of science or art.” From the original 50 members, the group has blossomed to 2,100 today, with roughly 200 of those Nobel Laureates. Any club with a 10 percent Nobel ratio is pretty exclusive, so being elected to the Academy’s lifetime membership is a thrilling honor for a scientist.

This week, evolutionary biologist Neil Shubin was the latest UChicago scientist given the honor of NAS membership, part of this year’s class of 72 new members and 18 “foreign associates.” Shubin becomes the 40th current member of the NAS located at the University of Chicago, and joins Medical Center faculty such as Janet Rowley, Martin Weigert, Donald Steiner, Bernard Roizman, Robert Haselkorn, and David Jablonski, who was elected last year (Fermilab director and professor of physics Pier Oddone was also elected in this year’s class). Election is no simple matter - each new member must pass a 10-step process [pdf] and be voted in to the academy by their potential peers.

Shubin is most famous for the discovery of the pivotal fossil named Tiktaalik roseae, a transitional species between ancient fish and the first limbed creatures to walk the land. But Shubin’s research is more than just fossil-hunting, as he studies the genetic programs that control development of limbs in the embryos of species such as sharks and salamanders. On the blog, we recently featured a paper by Shubin and former graduate student Andrew Gillis, where the embryos of strange creatures called holocephalons revealed some of the earliest steps in limb evolution.

In all likelihood, Shubin’s election was helped by his scientific communication skills as well. From his book about the discovery of Tiktaalik and the story of human evolution, Your Inner Fish: A Journey Through the 3.5-Billion-Year History of the Human Body, to his appearances as a correspondent on WTTW, to his anatomy teaching duties at Pritzker Medical School, Shubin has proven himself eager to educate the public at large about science. Appropriately enough, a second honor announced for Shubin this week was the Distinguished Service Award for Enhancing Education through Biological Research from the National Association of Biology Teachers. Once again, he finds himself in good company, as previous recipients include James Watson, Stephen Jay Gould, and Richard Dawkins.

“I am deeply honored to receive the NABT Distinguished Service Award. In an age where the ideas and tools of biology are increasingly playing a role in our lives, it is a deep honor to be recognized by those who are at the front lines of educating the next generation,” Shubin said.

The Science of Killing Bin Laden

A news story as big as the killing of Osama Bin Laden spares no beats, and there were plenty of science stories written this week in the aftermath of Sunday night’s surprise news. The most direct scientific angle was in the identification of the terrorist leader’s body, a step U.S. officials wanted to prove beyond a doubt before going public with the news. Like many of the events surrounding the raid, many of the details remain classified. But that hasn’t stopped science writers from writing explainers on how biometrics and DNA matching likely would have been used to make sure the Navy SEALS really had killed Bin Laden. President Obama himself confirmed that DNA testing was used to confirm they had the right body, but one fascinating mystery is where the DNA used to make the comparison was gathered. Nature blog The Great Beyond describes the candidates - from Bin Laden’s half-brothers and half-sister to one of his purported 26 children - and talks a bit about the recent history of using DNA identification techniques in criminal matters, including one crook busted by DNA he left on a slice of pizza.

Elsewhere…

The creation of new drugs, and the death of old drugs - Medical Center researchers commented on both sides of the pharmaceutical life cycle in newspaper stories this week. In the New York Times blog Fixes, reporter David Bornstein looks at the “valley of death” in developing new drugs for less-than-common diseases, and focused on the Myelin Repair Foundation and researchers such as Brian Popko (who we have featured twice). Then yesterday, the Chicago Tribune’s Bruce Japsen wrote about the upcoming patent expirations on the popular drugs Plavix, Lipitor, and Actos, and talks to our Caleb Alexander about the implications for health care.

How do you make a new species in the lab? It’s easier if you find a lizard species that is entirely female and can reproduce by cloning. Ed Yong at Not Exactly Rocket Science describes genome mash-ups, asexual reproduction, and the trickiness of species-naming in this great post.

A retired nurse and research coordinator at the Medical Center talks with Dawn Turner Trice about her experiences working with a small rural clinic in Ghana.

Photo by Bruce Powell

Yesterday wasn’t just St. Patrick’s Day for fourth-year medical students around the country - it was also Match Day, the tense and celebratory day when aspiring doctors learn the residency program where they will spend their next 3-7 years. At the Pritzker School of Medicine, green-clad students and supporters absolutely packed the hospital’s Billings Auditorium for the big event Thursday morning, cheering their peers as they were called one by one at random to collect their match envelope. In a local tradition, it literally pays to go last, as students throw into an informal prize pot for whoever has to wait and squirm the longest to pick up their envelope (second-to-last gets a Hershey bar as consolation). In the video below, you can see some of that process - including the outcry when the last envelopes are miscounted - followed by the amazing tension-release of the countdown and unison envelope opening.

The numbers from the day are just as exciting as the video. At Pritzker (recently ranked #12 among medical schools by US News and World Report), 110 students were matched in 24 specialties at 46 institutions, including 23 students who will stay with us here at the Medical Center. The most popular specialties for Pritzker students were internal medicine (25% of the class), general surgery (11%), and pediatrics (11%). Nationally, trends continued to shift for the second consecutive year toward primary care specialties such as internal medicine, family medicine, and pediatrics, according to the National Residency Matching Program, a step in the right direction to meet some of the increased demand for primary care doctors expected in the wake of health care reform. MedPageToday’s Kristina Fiore breaks down the numbers.

Podcast 0.3: Transplants, Rock-Paper-Scissors Ecology, and More

We have settled on a name for our young research podcast: Bench to Bedside. However, we are still keeping the training wheels on as we work out the technical kinks and explore the best ways to deliver audio versions of our latest research and medical stories. Please enjoy the third installment of our podcast, featuring a recent coast-to-coast kidney transplant chain that involved the Medical Center, how Rock-Paper-Scissors can explain biodiversity, the fight against indoor air pollution in Nigeria, and the new numbers on the eating disorders epidemic in the United States. As always, we would love to hear feedback on what we’re doing right and wrong at robert.mitchum@uchospitals.edu or dianna.douglas@uchospitals.edu.

Bench to Bedside Episode #0.3 by robmitchum

Elsewhere…

Some people keep ant farms, some people keep multiple flasks of bacteria growing for 13 years (and counting) to study evolution. Ed Yong writes about experiments from Michigan State University that show “tortoise” bacteria can beat out “hare” bacteria over the long run. (And if you’re a science communicator of any sort, do listen to Ed and Carl Zimmer’s “Death to Obfuscation” session from January’s Science Online meeting)

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As discussed previously on ScienceLife, the microbiome is the ecosystem of billions of bacterial organisms living inside our bodies, influencing us in as-yet-undetermined ways. Most efforts to study the microbiome thus far have focused on how gut bacteria affect digestion and disease, but a paper this week in PNAS reveals a surprising new power for those microorganisms: the ability to shape sexual preference. Okay, so far it’s only been observed in fruit flies, but as Ed Yong at Discover Magazine’s Not Exactly Rocket Science explains, it’s still a remarkable example of how a change in diet can alter an organism’s behavior in unforeseen ways.

The relationship between science and films, Carl Zimmer writes in this week’s Nature, has largely been a one-way street. Science gives Hollywood the technology to make pictures move, talk, and appear to throw things at you (in the case of the recent 3D boom), but returns the favor by portraying scientists as mad, geeky, or both. Zimmer’s column was inspired by hosting the recent Imagine Science Film Festival, a New York event that showcases short films with scientific inspiration. And while Zimmer is skeptical about the use of Hollywood film to promote science - Citizen Kane “would not have been a masterpiece if Orson Welles had kept asking himself ‘Does this make journalism accessible to a broader audience?’,” Zimmer writes - he comes slightly around after seeing films portraying the sensory phenomenon of synaesthesia and the comedic adventures of a Norwegian cryonics laboratory.

Bad news: a new projection by former University of Chicago faculty member Nicholas Christakis predicts that 42 percent of Americans will be obese by the year 2050. Good news: the obesity rate will plateau at that ghastly figure; as the authors write, “While not great, this is a much more optimistic estimate than 100%.” As our own Elbert Huang calculated last year, that plateau will still mean billions more in health care costs to treat chronic diseases associated with obesity, such as diabetes and heart disease.

The health care reform measures passed last year, should they survive the new Republican-led House, put a greater emphasis on primary care and preventive medicine. But the question of who will provide that primary care remains unanswered, as Joanna Broder wrote in the Chicago Tribune this week. Broder leads her article with Pritzker School of Medicine graduate Nina Vergari Rogers, currently working at the Chicago Family Health Center as part of the University of Chicago Medical Center’s REACH program. Doctors enrolled in REACH can receive $40,000 a year toward their medical school loans - a serious incentive, given that the lower salaries paid to primary care physicians mean their expenses exceed their earnings for the first 3-5 years after residency.

Covering medical research for the University of Chicago, one hears a lot about racial health disparities and the efforts to narrow those gaps. But some statistics still pack a punch, and Otis Webb Brawley’s talk at the University of Chicago last Thursday contained several left hooks. The five-year risk of death after diagnosis with breast cancer is almost twice as high for black women as for white women - but 30 years ago, the risk was nearly equal. An uninsured patient with stage 1 colon cancer is more likely to die from their disease than an insured patient with the more-dangerous stage 2 colon cancer. Obesity in children has risen five-fold since 1970, and obesity is expected to pass cancer as the #1 cause of cancer by the year 2030…if it hasn’t already.

In Brawley’s role as chief medical and scientific officer for the American Cancer Society, it’s his job to use these statistics to make clear arguments to scientists, physicians, politicians, and laypeople about what must be done to reduce cancer disparities. But Brawley’s talk for the Bowman Society Lecture Series (named for retired professor, and former teacher of Brawley at the Pritzker School of Medicine, James Bowman), was distinctly not about just throwing money at the problem. His central philosophy was “equal treatment yields equal outcomes among equal patients” - but sometimes, deciding what that equal treatment should be is the hard part.

Brawley took care to set his talk in the context of spiraling health care costs in the United States, showing the now-familiar graph plotting our highest-in-the-world health care spending against the country’s mediocre life expectancy. Racial disparities could explain part of those poor returns on US health care spending, but Brawley put the focus on “faith-based medicine” - not health care based on religion, but care (and associated spending) based on assumptions about what works rather than hard evidence. As an example, Brawley cited the practice of chest X-ray screening, considered by physicians in the 1960’s to be a necessary routine procedure for the detection of cardiopulmonary disease. But clinical trials found that these screens caused more harm than good, through increased rates of lung cancer and over-diagnosis.

“We did all those things because we thought we were doing the right thing, but we didn’t do rigorous assessment before we started doing them,” Brawley said. “So I ask the question: are we willing to be scientific and accept scientific realities? There are things that we do that add to the incredible cost of health care, but make no difference in outcome.”

That tough talk should apply equally to the problem of reducing health disparities in minority populations, Brawley emphasized. While some pursue the genetic risk factors that may explain disparate rates of disease in minorities, Brawley argued that socioeconomic factors were a much bigger target for intervention. A 1998 study that compared the breast cancer mortality gap in the general population versus women in the U.S. military medical system (who receive free health insurance and easier access to hospital care) found that the gap was still there, but almost two-thirds smaller. The other third could be genetics, Brawley conceded, but the more significant - and, in his view, easier to fix - factors were social and economic.

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One typically thinks of a high school science project as something involving frog dissection or baking soda and volcanoes. Less often do you see high school students presenting posters on communication between medical residents and patients who leave the hospital against medical advice. But the Training Early Achievers for Careers in Health Program, or TEACH, prepares students for a future in medicine and research with the real, undiluted deal, a summer studying an important aspect of hospital operations.

Since 2004, more than 70 students from the University of Chicago Collegiate Scholars Program have willingly traded a significant portion of their summer break to assist on a TEACH project. Groups of high school students are connected with an UChicago undergraduate, a student from the Pritzker School of Medicine, and a faculty advisor to tackle a research topic. At the end of the summer, those research projects are presented by the high schoolers in a poster session attended by physicians and social scientists.

This year’s session, held in early August, grouped the students into four research “teams”: Team Sleep, Team ESM Pain, Team AMA, and Team Handoffs. But this was no summer camp three-legged race; their posters covered topics that appear frequently in the highest-profile medical journals and conferences.

Tenika Walker, working with undergraduate student Arshiya Fazal, presented on the effects of hospital sleep - or lack thereof - on the blood pressure of inpatients. With the noisy overnight environment of the hospital ward and occasional late-night and early-morning tests, patients in the hospital slept an average of 2 hours less each night compared to at home. The sleep loss led to more than just baggy eyes, as the study found that 10 percent less sleep raised blood pressure by an average of roughly 3 mm/Hg.

“The hospital is supposed to be a place of healing, but unfortunately sometimes it’s not,” Walker said. “In the future, we hope to inspire hospitals to consider patient’s sleep.”

Where patients may benefit from fewer interruptions during the night, another poster focused on the frequency of contact with physicians, nurses, and other staff members during the daytime. To do so, they used an “experience sampling method,” a method of measuring a patient’s experience in the hospital. Throughout the day, researchers William Bernstein, Zikra Mohideen, Andres Nicodemus, and Ethalle Thompson would stop by patients’ rooms and ask who was with them. They found that the most frequent visitors were family members, with nurses close behind and physicians a rare sighting (though the students suggested the timing of their sample may have missed early-morning doctor rounds).

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Welcome to Dr. Polonsky

Today’s big news on campus is the announcement of Kenneth S. Polonsky, our new dean and executive vice president of medical affairs. The position puts Polonsky, an endocrinologist and diabetes researcher, at the helm of our Biological Sciences Division, the Pritzker School of Medicine, and the University of Chicago Medical Center. Polonsky was most recently chair of medicine at Washington University in St. Louis, but before that he was a faculty member at the University of Chicago from 1981 to 1999.

As such, Friday morning’s announcement event felt more like a homecoming than an introduction, with many faculty members cheerfully reuniting with Polonsky and his wife Lydia, a former math teacher at the University of Chicago Laboratory Schools. In his first remarks to the University community, Polonsky admitted to feeling a little “intimidated and nervous,” but excited about the future of the Medical Center and BSD.

“It really does feel right,” Polonsky said. “I do really think that we have an opportunity to continue a spectacular tradition. I have retained the utmost respect for the University of Chicago broadly, but particularly for the medical school and the biological sciences division. When I walk around this campus, I see all these buildings, including the new hospital, that weren’t here in 1999. I thought we were pretty great then, so I think that we have an enormous potential to be even better, and I hope to facilitate that.”

Polonsky will begin his new duties on October 1st, when our current interim dean and CEO, Everett Vokes, will step back to his prior role as chair of medicine. University of Chicago President Robert J. Zimmer also had kind words for Vokes, saying that he “took on this role at a challenging moment for this enterprise, and I think everybody recognizes the absolutely extraordinary job that he’s done.”

You can watch video of today’s ceremony here.

Feed the World with Science

In the year 2050, the world population is estimated to pass 9 billion people, nearly a 50 percent increase over today’s number. Among many concerns with that growing population is whether all those new people will be able to be fed; after all, an estimated 1 billion people today do not get enough food for minimum energy requirements. The journal Nature devotes a big chunk of this week’s issue to the question of food’s future, and perhaps surprisingly, there’s no panic amid the fancy graphics and editorials. The percentage of hungry people has dropped over the last few decades (with a slight rebound due to the current economic crisis), food production is growing at a faster pace than the population, and productivity can be lifted even further through the spread of existing technology.

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