Pioneer Medicine in the 21st Century by wuyunyi


     a tio                                                                                               July/August 2006
   du ue

                                             W A S H I N G T O N H O S P I TA L C E N T E R                         vol. 12, no. 6
Gr Iss

                                                                    News for Medical Staff, Residents, Fellows and Alumni

Research                    Pioneer Medicine
                                        in the                                  S     tressed because your labs are late or
                                                                                      there’s a wait for the MRI? Try surgery
                                                                                      near an erupting volcano, taking a his-
                                                                                 tory using primitive sign language or giving an
House Staff                                                                      exam while desert heat sends temperatures
                                 21st Century                                    soaring in your tent. That’s right —your tent.
                                                                                 Every year thousands of physicians and other
                                                          by Melanie Howard      medical personnel travel far from their high
Maryland                                                                         tech hospital havens to provide care to people
Legislative                                                                      in primitive settings that often lack the most
Session                                                                          basic medical facilities. Sometimes, this is in
                                                                                 the wake of a disaster like the December 2004
 . . . . . . . . . 14                                                            tsunami or the October 2005 earthquake in
                                                                                 Pakistan. Sometimes it is in the midst of
                                                                                 armed hostilities, like the conflict in Sudan.
                                                                                  Other times it is simply in an area so unde-
                                                                                     veloped and poor that the medical system
                                                                                        is virtually nonexistent even without a
                                                                                           catastrophe. Often, there is a combi-
                                                                                              nation of all three elements.
                                                                                                 Some doctors take on such a
                                                                                                   mission once in a lifetime,
                                                                                                    for others it becomes an
                                                                                                     abiding passion and even a
                                                                                                      career. They go as part of
                                                                                                        huge humanitarian organ-
                                                                                                        izations such as the Inter-
                                                                                                        national Red Cross and
                                                                                                        Red Crescent or Doctors
                                                                                                        with out Borders, or
                                                                                                       lesser-known programs.
                                                                                                      But no matter how estab-
                                                                                                    lished or well funded the
                                                                                                   mission, they are forced to
                                                                                                live and work under conditions
                                                                                             that do not even remotely resem-
                        Mission Team:
                                                                                          ble the medical environment in
                        From left, nurse                                             which they were trained. Here are the
                        Susan Bowen-Ross,                                        stories of Washington Hospital Center physi-
                        resident Dr. Shana                                       cians who chose to take on the challenge of
                        P. Adams, and                                            practicing “pioneer medicine.”
                        Dr. Jonathan Cosin
                        held gynecological                                                                 continued on page 12
                        clinics in Grenada
                        in the spring.
      Chief Medical Officer

Cultivating the Medical
“Farm System”
by Janis M. Orlowski, MD

       his is a very special issue of Washing-   We currently offer 22 accredited residency    We recruited the physicians through our res-
       ton Hospital Center Physician maga-       and fellowship programs and several for       idency match, we have trained them for sev-
       zine: our annual tribute to the House     which accreditation is not available. The     eral years, and we know their high quality. In
Staff graduates and to those who have            Hospital Center also has integrated pro-      turn, these young physicians know our sys-
excelled in medical research. We celebrate       grams with other sponsoring institutions      tem and the hospital, and they already have
the accomplishments of our special and tal-      whereby house staff may benefit from the      fostered productive relationships with our
ented physician-students, whose work is          varying training opportunities at multiple    staff and our patients. It’s the natural and
highlighted through our annual Research          hospitals.                                    right thing to do.
Day competition and by their many exam-
                                                 As I prepared this column, I once again was   If you are in private practice and would like
ples of living and working our Patient First
                                                 impressed by the massive amount of talent     to talk about recruiting and retaining people
                                                                                                              whom we’ve trained, please
We have a long-standing tradi-                                                                                call me.
tion of educating physicians at
Washington Hospital Center.                                                                                 For inspiration, continue on
Since the graduate medical                We currently offer 22 accredited residency                        to page 6 for an article on this
education program was insti-                                                                                year’s Research Day, a listing
tuted here in 1958, the year the                    and fellowship programs.                                of our graduates and where
Hospital Center opened its                                                                                  they are going (pages 8-9),
doors at 110 Irving Street,                                                                                 snapshots from commence-
thousands of physicians have                                                                                ment (pages 10-11), and a
been trained and have moved on to take care   that we are training at the Hospital Center.                  look at the new house staff. I
of our most vulnerable populations.           And, once again, I want to encourage our guarantee you there are Hall of Fame physi-
                                              employed physicians and our private physi- cians on each of these pages.                    ■
The Accreditation Council for Graduate cians to continue to find opportunities to
Medical Education, which was established in work with our residents and fellows and to
the early 1980s, recently reviewed all of our explore ways to keep them here at the Hos- Dr. Orlowski is senior vice president, Medical
graduate programs. This long and involved pital Center.                                     Affairs, and chief medical officer at Washington
process has given us the opportunity to stop
and reflect on the quality and depth of our   Just as Major League Baseball prepares its up Hospital Center. She can be reached at (202)
                                                                                            877-5284 and
graduate medical programs. Our survey visit and coming ballplayers for “The Show,” or
went well, and we expect to hear our accred- the Big Leagues, so should we take advantage
itation results in the fall.                  of preparing our up-and-coming physicians
                                              for full-time employment right here at our
                                              own hospital working with our own staff
                                              and attending physicians. Our own “farm
                                              system,” or “player development system,” as
                                              with MLB, is a fertile recruiting ground. Not  WASHINGTON HOSPITAL CENTER
                                              only do we save on recruiting costs, but it
                                              simply makes sense.                                      May Statistics
                                                                                                                             2006 2005

  CORRECTION                                                                                     Inpatient Admissions       4,054 3,879

  T  he telephone number for the
     Washington Area Congenital Heart
  Center and Dr. Karen Kuehl, director,
                                                                                                 Outpatient Clinic Visits 8,548 8,513
                                                                                                 ED Visits                  6,410 6,046
  and Dr. George Ruiz, cardiologist, is
  (202) 821-6289. The article on the center
                                                                                                 ED Admissions              1,615 1,576
  was featured on page 3 of the April                                                            Average Daily Census         689      713
  2006 issue of Physician.
                                                                                                 Births                       349      365


Expecting Success:
Excellence in Cardiac Care
Data Gathering, Best Practices in Place

          uch behind-the-scenes and front-      tient, or are being seen by a Unity primary     Hospital Center nine other hospitals were
          line work has gotten underway         care physician.                                 selected to participate. Each of the hospitals
          since Washington Hospital Cen-                                                        chosen has a demonstrated successful track
ter was named last fall as one of ten hospi-    In early April, registration personnel under-   record and commitment to performance
tals nationwide to participate in Expecting     went best practices training to learn how to    improvement, a large minority patient pop-
Success: Excellence in Cardiac Care. This is    sensitively obtain information from patients    ulation, and treat many cardiac patients.
a new national program aimed at reducing        about their ethnic and racial background as     Together, the facilities will participate in a
racial and ethnic disparities in the delivery   well as their language preference. Signs have   collaborative “learning network” to test new
of cardiac care care for African American       been placed at the registration desk alerting   ideas, quantify results, and share lessons
and Latino patients who experience an           patients that these questions will be asked.    learned. Program successes will be shared
acute myocardial infarction or who have         This data has been collected and used for       nationwide throughout the 29-month ini-
congestive heart failure.                       follow-up care.                                 tiative and potentially adopted at hospitals
                                                                                                and medical centers across the country.
Working in conjunction with Unity Health-       Funded by the Robert Wood Johnson
Care physicians, the Hospital Center has        Foundation and coordinated by The George        The Expecting Success program will focus on
launched a Community Demonstration              Washington University Medical Center            a wide range of cardiovascular care inter-
Initiative, which identifies patients who       School of Public Health and Health              ventions that are delivered in both inpatient
have had three or more emergency                Services, the Expecting Success program aims    and outpatient settings, with four key goals:
department visits for heart failure                                                                      To improve cardiovascular care for
in 18 months. Under the new pro-                                                                         African-Americans and Hispanics;
gram, these patients are flagged in
the Azyxxi system when they are                                                                          To develop effective, replicable
registered and are offered enroll-                                                                       quality-improvement   strategies,
ment in the Expecting Success pro-                                                                       models and resources;
gram and follow-up care with a                                                                           To encourage the spread of those
Unity physician.                                                                                         strategies and models to clinical
                                                                                                         areas outside of cardiac care; and
“The goal is to get these patients
the best possible care, teach them                                                                       To share relevant lessons with
the best ways to stay healthy, and                                                                       health care providers and policy-
decrease readmission to the hospi-                                                                       makers nationwide.
tal,” said Elizabeth Wykpisz, RN,
vice president, Washington Heart                                                                     Experts believe that a critical way to
and Vascular Services. “We want to                                                                   address and reduce racial and ethnic
achieve 100 percent compliance                                                                       gaps in treatment is to improve the
with clinical guidelines set out by                                                                  collection and tracking of patient data
the American College of Cardi-                                                                       by race, ethnicity, and spoken lan-
ology and the American Heart                                                                         guage. Evaluate whether specific
Association.”                                                                                        patient populations are not getting the
                                                to develop and test potential solutions to           recommended standard of care; and
Richard Cooke, MD, director of the              well-documented racial and ethnic dispari-      design interventions that will consistently
Hospital Center’s heart failure program,        ties in health care delivery. Though the        improve the quality of care for all patients,
Jacqueline Ennis, PhD, vice president, Out-     Foundation has long been involved in            especially those most at risk of receiving
comes, and Unity HealthCare physician           spearheading and funding research aimed at      lower-quality care.
Jonathan Patrick are the lead team members      documenting such disparities, the intro-
of the project.                                                                                 For more information about the Expecting
                                                duction of Expecting Success marks a signif-    Success program, visit www.expectingsuccess
Wykpisz said sharing electronic medical         icant shift toward identifying specific         .org. Information about the Robert Wood
records will provide “timeless and seamless     solutions.                                      Johnson Foundation’s portfolio of initia-
communication among clinicians,” as the         More than 120 hospitals and health systems      tives to reduce racial and ethnic gaps in
patients’ records can be accessed whether       in the U.S. applied to be pilot sites for the   health care is available at ■
they are in the emergency room, an inpa-        Expecting Success program. Along with the

      News & Notes

                                                                  HELICOPTER TRAGEDY
                                                                  L   awrence J. Pietropaulo, president of CJ Systems Aviation
                                                                      Group, and Janis Orlowski, MD, Washington Hospital
                                                                  Center’s chief medical officer, hold a press conference after
                                                                  the crash of a MedSTAR helicopter, which occurred on Tues-
                                                                  day, May 30 on the grounds of the Armed Forces Retirement
                                                                  Home, just blocks from the hospital. The critically ill patient
                                                                  being transported died several hours after the accident, and
                                                                  all three members of the flight crew suffered injuries, from
                                                                  which they are recovering.
                                                                  The flight crew members are pilot Darryl Johnson, 58, of
                                                                  Damascus, Md.; flight nurse Nancy Vanderweele, 39, of Silver
                                                                  Spring, Md., and flight paramedic David Martin, 33, of
                                                                  Haymarket, Va. This is the first incident in MedSTAR Trans-
                                                                  port’s 23-year history. Nearly 40,000 safe medical missions
                                                                  have been flown. The accident is under investigation by the
                                                                  National Transportation Safety Board.

                                 NEW ETHICS TEAM
                                     neka Mokwuyne has been promoted to the
                                                                                          NEW DIABETIC DIETS
                                 N   position of director, Center for Ethics. Mok-
                                 wuyne started as a fellow in the department and
                                 has served in an interim role as director for several
                                                                                          B   eginning June 21, 2006, diabetic
                                                                                              diets will be offered at three
                                                                                          calorie levels and should be ordered
                                 months. She received her master’s degree in philos-      as the following:
                                 ophy with concentrations in ethics and public policy     Low Consistent Carbohydrate
                                 from Howard University and is working on her doc-        (Low CCarb), (1200 – 1600 Calorie
                                 torate in sociology, with concentrations in medical      2 CHO exchanges / meal)
                                 sociology, race, class, and gender inequalities.
                                                                                          Medium Consistent Carbohydrate
                                 Daria Grayer has joined the department this month        (Med CCarb)** replaces the Ccarb
                                 as a bioethicist. Grayer received her undergraduate      diet currently in use (1800 – 2000
                                 degree in philosophy and journalism from Spelman         Calorie), 4 CHO exchanges / meal)
                                 College in Atlanta. As a teaching and research
                                 scholar, Grayer recently completed a master’s            High Consistent Carbohydrate
                                 degree in ethics and public policy, specializing in      (High CCarb) (2200 – 2400 Calorie,
                                 bioethics, at Howard University. Mokwuyne and            6 CHO exchanges / meal)
                                 Grayer may be reached at (202) 877-6211.                 All orders for “CCarb” diets will
Mokwuyne, standing, and Grayer                                                            provide the patient with a medium
                                                                                          CCarb diet, by default. Snacks are
                                                                                          automatically sent at 2 p.m. and
MEDSTAR HEALTH:                                                                           8 p.m. as part of the prescribed
A “BEST PLACE” TO WORK IN WASHINGTON                                                      diabetic diet. The Low, Medium and
                                                                                          High Consistent Carbohydrate diets
            Health has been named one of the region’s top 50 “Best Places to
M edStarthe a survey conducted by theinWashingtonpositive work environment
     Work” in
recognizes    company’s achievements creating a
                                                  Business Journal. The award
                                                                                          are also heart healthy (low fat,
                                                                                          2gm Na). Questions? Contact
                                                                                          Suzanne Lugerner, director, Clinical
that aids in recruitment and retention of employees through a combination of
                                                                                          Nutrition, (202) 877-3403.
employee satisfaction, working conditions and company culture. MedStar Health
was also named a “Best Place to Work” in Baltimore earlier this spring.

                               W A S H I N G T O N                              H O S P I T A L                C E N T E R
                               OFFICE             OF        CONTINUING MEDICAL EDUCATION
                                              J U LY / A U G U S T 2 0 0 6 — H I G H L I G H T S
                            Upcoming CME Events Sponsored by Washington Hospital Center •


PHYSICIAN                  ANESTHESIOLOGY                         MEDICINE                            ORTHOPAEDICS
                           Anesthesiology Clinical                GRAND ROUNDS                        Orthopaedic Grand Rounds
BLOOD-DONOR                Conference                             Weekly, Wednesdays, 12:30 p.m.      Monthly, 1st Monday
                           Weekly, Tuesdays, 7:00 a.m.            True Auditorium                     7:45 a.m. – 9:15 a.m.
SUPER HERO                 Room G-200                             1 AMA PRA Category 1 Credit TM      3 NW Conference Room
                           1 AMA PRA Category 1 Credit TM         (202) 877-3109 or (202) 877-6749    1 AMA PRA Category 1 Credits TM
                           (202) 877-7500                         NRH Medical Grand Rounds            (202) 877-8150
                           CARDIOLOGY/CARDIOVASCULAR              Weekly, Fridays, Noon               OTOLARYNGOLOGY
                           Cardiac Catheterization                NRH Auditorium                      Multidisciplinary Head and Neck
                           Conference                             1 AMA PRA Category 1 Credit TM      Tumor Board Conference
                           Weekly, Wednesdays, 7:30 a.m.          (202) 877-1660                      Weekly, Thursdays, 4:00 – 5:00 p.m.
                           True Auditorium                        NEONATOLOGY                         Siegel Auditorium
                           1 AMA PRA Category 1 Credit TM         Visiting Lecturer Series            1 AMA PRA Category 1 Credit TM
                           (202) 877-8574                         in Perinatal Pediatrics             (202) 877-9403
                           Updates in Cardiovascular              Bi-Monthly, 1st & 2nd Tuesdays      SURGERY
                           Medicine Lecture Series                12:30 p.m.                          General Surgery Orange Team
                           Dates TBD                              5B–3 Conference Room                Teaching Conference and Lecture
                           District, Maryland and Virginia Area   1 AMA PRA Category 1 Credit TM      Weekly, Thursdays, 8:00 a.m.
                           Restaurants                            (202) 877-6527                      General Surgery Conference Room
                           2 AMA PRA Category 1 Credits TM                                            2 AMA PRA Category 1 Credits TM
                           (202) 877-2992                         NEUROSURGERY
                                                                  Neurosurgery Conference             (202) 877-9847
                           Echocardiography Conference            Weekly, Tuesdays, 7:30 a.m.         Surgery Grand Rounds
                           Weekly, Thursdays, 7:45 a.m.           CTEC Board Room–6th Floor           Weekly, Tuesdays, 8:00 a.m.
                           Cath Lab Conference Room (5th Flr)     1 AMA PRA Category 1 Credit TM      True Auditorium

 W   hy Arthur West, MD,
     donates blood:
                           1 AMA PRA Category 1 Credit TM
                           (202) 877-7853
                                                                  (202) 877-5580
                                                                                                      1 AMA PRA Category 1 Credit TM
                                                                                                      (202) 877-6426

                           EMERGENCY MEDICINE                     OB/GYN Grand Rounds                 UROLOGY
   “It is simply one       Emergency Medicine                     Weekly, Tuesdays, 8:00 a.m.         Urology Academic Series
    way I can help.        Grand Rounds                           5B–3 Conference Room                Weekly, Tuesdays, 8:00 a.m.
                           Monthly, Third Thursdays, 7:00 a.m.    1 AMA PRA Category 1 Credit TM      Siegel Auditorium
    I try and donate
                           Emergency Department Conf. Rm.         (202) 877-6054                      1 AMA PRA Category 1 Credit TM
    at least twice         1 AMA PRA Category 1 Credit TM                                             (202) 877-3968
    a year.”               (202) 877-9191                         ONCOLOGY Presented by the
                                                                  Washington Cancer Institute (WCI)
                           Emergency Medicine Continuous
                           Certification (EMCC) Literature         Gastrointestinal Oncology
                           Review                                 Case Presentations
                           Monthly, Last Thursdays, 7:30 a.m.     Bi-Monthly, 2nd & Last Fridays,
                           Emergency Department Conf. Rm.         8:00 a.m. – 10 :00 a.m.
                           1 AMA PRA Category 1 Credit TM         Surgical Classroom – Room G-270
                           (202) 877-9393                         2 AMA PRA Category 1 Credits TM                   Log on to
                                                                  (202) 877-3908             
                           Emergency Medicine Faculty
                                                                  Multidisciplinary Breast Cancer       for CME learning modules, slide
                           Development Series
                           Dates TBD                              Treatment Conference                 library, eGrand Rounds, literature
                           Emergency Department Conf. Room        Weekly, Wednesdays, 7:30 a.m.           update and daily news feed
                           1 AMA PRA Category 1 Credit TM         Siegel Auditorium
                           (202) 877-9393                         1 AMA PRA Category 1 Credit TM
                                                                  (202) 877-7937
                                                                                                             New Era of Medicine
                                                                  OPHTHALMOLOGY Presented by            Conference —2006 Highlights
                                                                  Washington National Eye Center                “Management of
                                                                  Saturday Morning Lecture Series      Hyperglycemia in the Hospital”
                                                                  Weekly, Saturdays, 8:30 a.m.           available as a web module on
     Call                   William M. Steinberg’s Board
                            Review in Gastroenterology—
                                                                  True Auditorium                          SitelMS—Online Learning
                                                                  2.5 AMA PRA Category 1 CreditsTM        Management System. Go to
202-877-5250                  Audio, Video & DVD sets             (202) 877-6159               to register
                             40 AMA PRA Category 1 Credits TM                                          and create your personal account
for an appointment           Call 1-800-283-1997 to order


                              Research Day
                              10 Years Later, a Sophisticated Program

                                    he tenth anniversary of the Washing-                                      This year’s win-          tute. Thirty-eight residents and 16 fellows
                                    ton Hospital Center and MedStar                                           ners featured sea-        submitted posters.
                                    Research Institute’s Research Day                                         soned veterans of
                                                                                                              the competition.          Words of wisdom came from keynote
                              prompted a nostalgic look back to the early
                                                                                                              Naresh       Ahuja,       speaker Hasan Alam, MD, director of
                              days of the program, which featured a trickle
                                                                                                              MD, resident in           research, Division of Trauma, Emergency
                              of excellent submissions that hinted at the
                                                                                                              the Department of         Surgery, and Surgical Critical Care at Massa-
                              robust program to come.
                                                                                                              Surgery, repeated         chusetts General Hospital, and former chief
                              “This research day started with a few dozen                                     his 2005 first-place      resident of surgery at the Hospital Center.
                              posters and has evolved to a high-quality,                                      finish in the resi-       “What is your destination?” asked Alam, who
                              sophisticated program,” said Barbara V.                                         dent oral presen-         encouraged residents to consider research.
                              Howard, PhD, president of MedStar Research                                      tation, and took          “Why do research? I like to say ‘Why not?’ If
                              Institute. “I am very proud of the quality of                                   second place for          you’re not going to do it, who is?” Alam was
                              projects. They bring a great glow to the Hos-       Keynote speaker             his poster presen-        part of a team of researchers at the Uni-
                              pital Center and to MRI.”                           Hasan Alam, MD              tation. Umberto           formed Services University of the Health Sci-
                              For the first time in the history of Research                                   Campia, MD, fel-          ences that developed QuikClot, designed for
                              Day, a second-year medical student from             low, Cardiovascular Research Institute, also          hemorrhage control on the battlefield.
                              Georgetown University, Laura Seiboth, sub-          repeated his 2005 first-place performance for
                                                                                  fellow oral presentations.                            “Right now you have stars in your eyes and
                              mitted her research, “Analysis of the Role of
                                                                                                                                        you have all of the ingredients. You don’t
                              PET/MRI Digital Fusion Images in Detection          Amit Tribrewala, MD, Department of Medi-              know how to get there. It takes planning.”
                              and Management of Recurrent or Persistent           cine, took first place for his poster in the res-
                              Thyroid Cancer,” for consideration in the           ident competition, and Ilan Kedan, MD, Car-           To prepare for their careers, Alam suggested
                              competition. Because of the quality of her          diovascular Disease, took first place in the          that the residents and fellows set goals, find
                              research, it was accepted as the only student       fellow poster presentation.                           good mentors, make friends and cultivate
                              submission. The judging committee was so                                                                  collaborators, make original mistakes and,
                              impressed with her work, it asked her to pres-      Fellows and residents submitted 89 abstract           above all, enjoy their work.                 ■
                              ent as part of the Research Day program.            entries and 55 posters in the competition,
                                                                                  which was judged by physicians from the                                    — Annamarie G. DeCarlo
                                                                                  Hospital Center and MedStar Research Insti-

Research Day Winners 2006
                              RESIDENT ORAL                          FELLOW ORAL                            RESIDENT POSTER                           FELLOW POSTER
                              PRESENTATIONS                          PRESENTATIONS                          PRESENTATIONS                             PRESENTATIONS
                              RESIDENT FIRST PLACE—                  FELLOW FIRST PLACE —                   RESIDENT FIRST PLACE —                    FELLOW FIRST PLACE—
                              $500 PRIZE                             $500 PRIZE                             $250 PRIZE                                $250 PRIZE
                              Naresh Ahuja, MD, Department           Umberto Campia, MD, Cardiovascular     Amit Tibrewala, MD, Department            Ilan Kedan, MD, Cardiovascular Disease
                              of Surgery                             Research Institute                     of Medicine                               “Outcomes and
                                                   “Testing of       “Inflammatory                                               “Size of Myocar-      Treatment of
                                                    Modified          and Vascular                                                dial Necrosis is     American
                                                    Hemostats in a    Abnormalities                                               not the only         Indians Hospi-
                                                    Swine Model of    in Normo-                                                   Mechanism for        talized with
 (photos by Rick Reinhardt)

                                                    Lethal Groin      glycemic                                                    Persistence of ST    Acute Myocar-
                                                    Injury”           Offspring of                                                Segment Eleva-       dial Infarction”
                                                                      Diabetic                                                    tion After Heal-
                                                                      Patients”                                                   ing of Anterior


New House Staff 2006–2007
Welcome, and best wishes to the new house staff members, who begin
their tenure at Washington Hospital Center on July 1, 2006.

BREAST ONCOLOGY                             HEMATOLOGY/ONCOLOGY                        Zone-En Lee, MD, Resident, University of   INTERVENTIONAL
Melody Paulishak, DO, Fellow, Chicago       Eric E. Levy, MD, Resident, Sackler        Maryland School of Medicine                CARDIOLOGY
College of Osteopathic Medicine             School of Medicine in Israel               Ramez Milad, DO, Resident, Arizona         Probal Roy, MD, Fellow, University of
                                            Damian Silbermins, MD, Resident,           College of Osteopathic Medicine Mid-       New South Wales
CARDIAC MRI                                 University of Buenos Aires                 western University
Subodh Joshi, MD, Resident, University                                                 Jennifer Mills, MD, Resident, Louisiana    NEUROINTERVENTIONAL
of Melbourne                                Anish Meerasahib, MD, Fellow, Medical
                                            College of Trivandrum                      State University School of Medicine        RADIOLOGY
CARDIOVASCULAR DISEASE                                                                 Sabrina Newman, MD, Resident, (com-        Johanna Fifi, MD, Fellow, Boston
Sara D. Collins, MD, Fellow, Meharry        INTERNAL MEDICINE                          bined with Dermatology) Georgetown         University
Medical College                             Biju K. Alex, MD, Resident, Medical Col-   University School of Medicine
                                            lege of Virginia, Virginia Commonwealth    Maria Raquel Andrade Nunes, MD, Res-       OBSTETRICS/GYNECOLOGY
Shaila Garg, MD, Fellow, Government         University                                                                            Huong G. Nghiem, MD, Resident, Saint
Medical College, India                                                                 ident, Universidad de Lisboa in Portugal
                                            Jennifer L.Alston, MD, Resident,                                                      George’s University
Katherine Lietz, MD, Fellow, Warsaw                                                    Tinu Oluwo, MD, Resident, Medical
                                            (combined with Dermatology) Medical        College of Virginia, Virginia Common-      Connie Liang, MD, Resident, State
Medical University                          College of Virginia, Virginia Common-                                                 University of New York at Buffalo
                                                                                       wealth University
Dorinna D. Mendoza, MD, Fellow, Weill       wealth University                                                                     School of Medicine
Medical College of Cornell University                                                  Joseph E. Panoff, MD, Resident, Univer-
                                            Bikram Bal, MD, Resident, Christian        sity of Miami School of Medicine           Marcela A. McDonald, MD, Resident,
Hakim Morsli, MD, Fellow, McGill            Medical College, Ludhiana India                                                       Albany Medical College
University                                                                             Derrick Pau, MD, Resident, George
                                            Joseph C. Bonomolo, MD, Resident,          Washington University School of            Karishma Patel, MD, Resident, Univer-
Mohit Rastogi, MD, Fellow, Georgetown       George Washington University School of     Medicine                                   sity of Michigan Medical School
University School of Medicine               Medicine                                                                              Lauren F. Melcher, MD, Resident,
                                                                                       Madhuri Rao, MD, Resident, Bangalore
Aderemi Soyombo, MD, Fellow,                Umberto Campia, MD, Resident, Univer-      Medical College                            University of Tennessee College of
University of Michigan Medical School       sita Cattalica Del Sacro Cuore                                                        Medicine
                                                                                       Beronie Richardson, MD, Resident, New
Shona Velamakanni, MD, Fellow,              Morgana L. Colombo, MD, Resident,          York Medical College
UMDNJ-New Jersey Medical School             (combined with Dermatology), Jefferson                                                OPHTHALMOLOGY
                                            Medical College of Thomas Jefferson        Gerald E. Richmond, Jr., MD, Resident,     Kristin S. Bigge, MD, Resident, Univer-
DERMATOLOGY                                 University                                 Medical University of South Carolina       sity of Pennsylvania School of Medicine
Shabnam Shahabadi, MD, Resident,                                                       College of Medicine                        Jennifer Burka, MD, Resident, George
                                            Stamatina Danielides, MD, Resident,
George Washington University School of      Universita Di Padova                       Elisabeth Sanders, MD, Resident, Boston    Washington University
Medicine                                                                               University                                 David J. Ospital, MD, Resident,
                                            Sonya C. Davis, MD, Resident, Howard
                                            University College of Medicine             Emily Schley, MD, Resident, Eastern        UMDNJ-New Jersey Medical School
ECHOCARDIOGRAPHY                                                                       Virginia Medical School
Vera Nadia Nowaklwskyj, MD, Resident,       Cedric K. Dark, MD, Resident, New York                                                Sunil M. Thadani, MD, Resident,
                                            University School of Medicine              Matthew P. Schreiber, MD, Resident,        George Washington University School
UMDNJ-New Jersey Medical School                                                        Ross University
                                            Atoussa Farough, MD, Resident, Tehran                                                 of Medicine
EMERGENCY MEDICINE                          University of Medical Sciences             Fawad A. Shaheen, MD, Resident,
Nancy Churosh, MD, Resident, Loyola                                                    University of Medicine & Dentistry of      ORAL & MAXILLOFACIAL
                                            Diego M. Gomez, MD, Resident, George       NJ/R.W. Johnson Medical School
University of Chicago                       Washington University School of                                                       SURGERY
Tina M. Ellison, MD, Resident, University   Medicine                                   Young-Rok Shin, MD, Resident, SUNY-        James M. Ryan, DDS, Resident, NYU
of Utah School of Medicine                                                             Downstate College of Medicine              College of Dentistry
                                            Jyoti Gulia, MD, Resident, Maulana Azad
Neil Gulati, MD, Resident, Temple           Medical College                            Inder P. Singh, MD, Resident, Medical      Bonnie M. Arroyo, DDS, Resident,
University School of Medicine                                                          College of Virginia, Virginia Common-      University of Maryland Dental School
                                            Grace Han, MD, Resident, George            wealth University
Kerri L. Layman, MD, Resident, George-      Washington University                                                                 PAIN MANAGEMENT
town University School of Medicine                                                     Amrita K. Sodhi, MD, Resident, Ross
                                            Sara L. Heldt, MD, Resident, Baylor        University                                 Jatinder Narula, MD, Resident, Medical
Maria B. Neuner, MD, Resident, Univer-      College of Medicine                                                                   College of Virginia, Fellow, Virginia
sity of Minnesota-Minneapolis School of                                                Sheela M. Swaminatha, MD, Resident,        Commonwealth University
                                            Aditi Jaidka, MD, Resident, Howard         Georgetown University School of
Medicine                                    University College of Medicine             Medicine                                   PATHOLOGY
Kevin B. Maloy, MD, Resident, George-       Edward W. Jung, MD, Resident, Brown
town University School of Medicine                                                     Keith R. Unger, MD, Resident, University   Ana Lidia Werner Watts, MD, Resident,
                                            Medical College                            of Virginia School of Medicine             Universidade Sao Francisco
Scott R. Osborn, MD, Resident, MCP          Omar K. Khalaf, MD, Resident, George
Hahnemann                                                                              Catherine Vu, MD, Resident, George         Chanda Y. Williams, MD, Resident, East
                                            Washington Univ. School of Medicine        Washington University School of            Tennessee State University College of
Cory A. Wittrock, MD, Resident, Univer-     Laleh Amiri Kordestani, MD, Resident,      Medicine                                   Medicine
sity of Iowa                                Tehran University of Medical Sciences in   Xuezhong Yang, MD, Resident, China
                                            Iran                                       Medical University
GASTROENTEROLOGY                            Sandeep Krishnan, MD, Resident,                                                                      continued on page 9
Dana A. Sloane, MD, Fellow, University      Lokmanya Tilak Municipal Med College
of Maryland

2006 House Graduates
T   he 2006 House Staff graduated on June 10. At this writing
    23 of the 114 graduates have accepted fellowships, residen-
cies, or staff positions at Washington Hospital Center.
                                                                             Michael Sherman, MD, Nephrology
                                                                             Fellowship, Washington Hospital
                                                                                                                    SPECIALTY IN VASCULAR
                                                                                                                    MEDICINE AND PERIPHERAL
                                                                                                                    VASCULAR INTERVENTIONS
                                                                             David Silberstein, MD, Pulmonary       Leonardo C. Clavijo, MD, PhD,
                                                                             & Critical Care Fellowship, TBA        Director of Vascular Medicine &
DEPARTMENT OF                         Teresa Niemiec, MD, Anesthesiology     Rukmani Sivalingam, MD, General        Peripheral Interventions, University
DERMATOLOGY                           Residency, University of Maryland      Medicine Practice, TBA                 of Southern California, Los Angeles
Elena H. Allbritton, MD, Private      Neel Patel, MD, Radiology Residency,   Jina Sohn, MD, Cardiology Fellow-
Practice/Academics, D.C. Area and     University of Chicago                  ship, UMDNJ—Cooper Health
                                                                                                                    SECTION OF
Southern Florida                      Joseph Sobanko, MD, Dermatology                                               ENDOCRINOLOGY
                                                                             Malgorzata Sullivan, MD, Hospital-
David P. Manion, MD, Private          Residency, Washington Hospital                                                Thien-Giang Bach-Huynh, MD,
                                                                             ist, Washington Hospital Center,
Practice, Philadelphia                Center                                                                        Private Practice, Arlington, Va.
Lori S. Whitley, MD, Private          Lynn Venugopalan, MD, Neurology                                               Caroline B Huang, MD, Private
                                                                             Kevin Thompson, MD, Chief
Practice, Los Alamos, New Mexico      Residency, Georgetown University                                              Practice, Arlington, Va.
                                                                             Resident, Department of Medicine,
                                      Hospital                               Washington Hospital Center/Cardiol-
SECTION OF MELANOMA                   Erin Wei, MD, Anesthesiology
                                                                                                                    SECTION OF GASTRO-
                                                                             ogy, TBA
Sara E. Brooks, MD, Combined          Residency, Columbia                                                           ENTEROLOGY
Internal Medicine/Dermatology Resi-                                              Christian                          Jody W. Houston, MD, Private
                                      Heannie Yoo, MD, Anesthesiology
dency, Washington Hospital Center                                            Woods, MD,                             Practice, Dallas, Texas
                                      Residency, University of Virginia
Kimara H. Whisenant, MD,                                                     Infectious Disease                     Melanie L. Jackson, MD, Private
Pathology Residency                   Categorical                                                                   Practice, Annapolis, Md.
                                                                             Fellowship, Wash-
                                      Tameem Alhayya, MD, Hospitalist,
                                      Nephrology Fellowship, Washington      ington Hospital
DEPARTMENT OF INTERNAL                                                       Center
                                                                                                                    SECTION OF HEMATOLOGY/
MEDICINE                              Hospital Center                                                               ONCOLOGY
Preliminary                               Ana Barac,                         SECTION OF CARDIO-                     Huzefa Bahrain, DO, Private Practice,
Hsiong Chen, MD, Neurology                                                   VASCULAR DISEASE                       Baltimore
                                      MD, Research
Residency, University of Chicago                                             Tarek El-Sherif, MD, Private           Sean. Fischer, MD, Private Practice,
                                      Fellowship, CRI
Anna Choo, MD, Physical Medicine                                             Practice                               Santa Monica, Calif.
& Rehabilitation Residency, Emory                                            Aamir Javaid, MD, Interventional       Gurvinder Shaheed, MD, Private
Marianne David, MD, Anesthesia        Betsy Bennet, MD, Endocrinology        Cardiology Fellowship, Washington      Practice, Sacramento, Calif.
Residency, Georgetown University      Fellowship, University of Chicago      Hospital Center
Hospital                                                                     Ilan Kedan, MD, UCLA/Cedar Sinai
                                                                                                                    SECTION OF
                                      Aysha Farooqi, MD, Hospitalist,
Molly Daymont, MD, Neurology                                                 with Private Practice                  INFECTIOUS DISEASES
                                      Washington Hospital Center
Residency, Georgetown University                                                                                    Seemi Andrabi, MD, Part-time
                                      Ramona Goyal, MD, Rheumatology         Alireza Maghsoudi, MD, Brigham
Hospital                                                                                                            Practice
                                      Fellowship, NIH                        & Women’s CT/MRI
Sandra Fernando, MD, Ophthal-                                                                                       Vasilios J. Pyrgos, MD, Research
                                      David Green, MD, Pulmonary &           Benjamin Kleiber, MD, Private
mology Residency, Washington                                                                                        Fellowship
                                      Critical Care Fellowship, Virginia     Practice, Colorado
Hospital Center                       Commonwealth University                Pirooz Mofrad, MD, EP Fellowship,      SECTION OF NEPHROLOGY
Jessica Hoots, MD, Radiology          Peter Kim, MD, Infectious Disease      Stanford
Residency, Georgetown University                                                                                    Shahab Khan, MD, Interventional
                                      Fellowship, Washington Hospital        Neel Patel, MD, Private Practice       Nephrology, Private Practice
Hospital                              Center
Taylor Jordan, MD, Radiology                                                                                        Thibin Santha, MD, Private Practice
                                      Mark Kotlarewsky, MD, Hospitalist,     SPECIALTY IN CARDIAC
Residency, Santa Barbara Cottage      Reading, Pa.                           ELECTROPHYSIOLOGY
Hospital                                                                                                            SECTION OF RHEUMA-
                                      Maria Monge Bonilla, MD, General       Mevan Wijetunga, MD, Private           TOLOGY
Edgar Lai, MD, Radiology Residency,   Medicine, Costa Rica                   Practice, Minnesota
Loma Linda                                                                                                          Ravi D. Acharya, MD, Group Prac-
                                      Irina Raklyar, MD, Rheumatology                                               tice, Camp Hill, Pa.
Bryan Lusk, MD, Ophthalmology                                                SPECIALTY IN CARDIAC MRI
                                      Fellowship, Washington Hospital                                               Florina M. Constantinescu, MD,
Residency, Washington Hospital        Center                                 Gaby Weissman, MD, Private
Center                                                                                                              Assistant Professor, Virginia Com-
                                                                             Practice, Baltimore
                                      Harminder Sandhu, MD, Gastro-                                                 monwealth University, Richmond, Va.
Nathan McGovern, MD, Anesthesia       enterology Research, NIH
Residency, Georgetown University                                             SPECIALTY IN INTER-                    Brian Walitt, MD, MPH, Attending,
Hospital                              Hiral Shah, MD, Chief Resident,        VENTIONAL CARDIOLOGY                   Washington Hospital Center
                                      Department of Medicine/GI Fellow-      William Weiming Chu, MD, PhD,
Zurab Nadareishvili, MD, Neurol-      ship, Washington Hospital Center                                              DEPARTMENT OF
ogy Residency, Georgetown Univer-                                            Multispecialty Practice, Bellingham,
                                                                             Washington                             OBSTETRICS/GYNECOLOGY
sity Hospital                         Minal M. Shah, MD, Hematology/
                                      Oncology Fellowship, Georgetown                                               Christina Bennett-Stewart, MD,
                                      University Hospital                                                           Attending Physician, Providence


                                                                                                                        NEW HOUSE STAFF
                                                                                                                        from page 7

C. Vivia Liang, MD, Kaiser                DEPARTMENT OF                          Tedia Tessema, MD, Trauma Fellow-      PODIATRIC SURGERY
Permanente, Virginia                      PHYSICAL MEDICINE AND                  ship, University of Miami              Rhonda S. Cornell, DPM, Resident,
Kimberly L. Matchett, MD,                 REHABILITATION                         Kimberly Yee, MD, Colon and            Temple University School of Podiatric
Eauclaire Cooperative Health Center,                                             Rectal Surgery Residency, Washington   Medicine
                                          Mehul J. Desai, MD, MPH, Pain
South Carolina                            Fellowship, Thomas Jefferson Univer-   Hospital Center                        Ryan H. Fitzgerald, DPM, Resident,
                                          sity Hospital, Philadelphia                                                   Barry University School of Podiatric
LaKeischa Webb-McMillan, MD,                                                     Section of Surgical Critical Care      Medicine & Surgery
Plans Pending                             Jatinder Narula, MD, Pain Fellow-      James H. Street, III, MD, Attending    Judith Olkaba, DPM, Resident,
                                          ship, Washington Hospital Center       Surgeon, Department of Surgery,        Temple University School of Podiatric
DEPARTMENT OF                                                                    Washington Hospital Center
                                          Lane Peterson, DO, Interventional                                             Medicine
OPHTHALMOLOGY                             Spine/Pain Fellowship                  Section of Transplant                  Mariam Popal, DPM, Resident,
Lauren Zoe Gavaris, MD, Oculo-                                                   Jesse Garcia, MD, Attending            Temple University School of Podiatric
plastics Fellowship, Kreiger Eye Insti-   Section of Pain
                                          Management                             Surgeon, Department of Surgery,        Medicine
tute, Sinai Hospital of Baltimore                                                Section of Vascular Access, Washing-
Brad P. Novey, MD, Private Practice           Robert Long,                       ton Hospital Center                    SURGERY
Rosaliz M. Portela, MD, Vitreo-           MD, Private Prac-                                                             Brian H. Campbell, MD, Resident,
                                                                                 Vandad Raofi, MD, Plans Pending        University of Pittsburgh School of
retinal Fellowship, Yale University       tice, Minneapolis
                                                                                 Section of Breast Oncology             Medicine
   Michael Eric                           DEPARTMENT                             Danielle M. Duchini, DO, Compre-       Gregory A. Dawkins, MD, Resident,
                                          OF PODIATRIC SURGERY                   hensive Breast Center, Erie, Pa.       Howard University College of Medi-
MD, Private                               Alison J. Garten, DPM, Private         Section of Colon and Rectal
                                          Practice, Washington D.C. area         Surgery                                Andrew J. Erickson, MD, Resident,
                                                                                 Alexander Matthew, MD, Private         University of Pittsburgh School of
                                          Elizabeth Grey Bass, DPM, Coastal                                             Medicine
                                          Carolina Foot and Ankle Care, New      Practice
                                                                                                                        Carlos O. Geigel, MD, Resident,
                                          Bern, North Carolina                   Section of Vascular Surgery            University of Puerto Rico School of
DEPARTMENT OF ORAL AND                                                           Niten Singh, MD, Attending Physi-
MAXILLOFACIAL SURGERY                                                                                                   Medicine
                                          DEPARTMENT OF SURGERY                  cian, Madigan Army Medical Center,
I-Ling Chen, DDS, Private Practice                                                                                      Mackenzie D. Hay, MD, Resident,
                                          Preliminary                            Tacoma, Washington                     University of Illinois College of
Lance Smagalski, DDS, Air Force           Edward Bridges, MD, Flight                                                    Medicine
                                          Surgeon, U.S. Air Force                DEPARTMENT OF UROLOGY
                                                                                                                        Hallie R. Huls, MD, Resident, Wright
DEPARTMENT OF                             Mazen J. El-Sayed, MD, Emergency       Eric Diner, MD, Private Practice,      State University Boonshoft School of
ORTHOPAEDIC SURGERY                       Residency, University of Maryland,     St. Petersburg, Fla.                   Medicine
Susan Lai, MD, Spine Fellowship,          Medical Center, Baltimore                                                     Hal Brooks Hooper, MD, Resident,
Sinai Hospital                                                                   MEDSTAR RESEARCH
                                          Corey D. Finch, MD, Plans Pending                                             Medical University of South Carolina
                                                                                 INSTITUTE                              College of Medicine
Matthew Levine, MD, Sports                Michael Isaacson, MD, Urology
Fellowship, Duke University                                                      Umberto Campia, MD, Internal           Tareq Kheirbek, MD, Resident,
                                          Residency, Washington Hospital         Medicine Residency, Washington
Jesse McCarron, MD, Shoulder &            Center                                                                        University of Damascus
                                                                                 Hospital Center
Elbow Fellowship, Cleveland Clinic                                                                                      Kevin S. Persaud, MD, Resident,
                                          Kenneth Park, MD, Plans Pending        Tamir Pritch, MD, Israel               Howard University College of
Jeff Schulman, MD, Trauma Fellow-         Julio Sokolich, MD, Surgical Resi-                                            Medicine
ship, Maryland Shock Trauma                                                      Tristan Donabo Yan, MD, Surgical
                                          dency, Methodist Hospital of Dallas    Research Training, Sydney, Australia   Natalie E. Ruff, MD, Resident, Loma
DEPARTMENT OF                             Stella Tort, MD, OB/Gyn Residency,     Li Zhang, MD, Cardiac Surgery          Linda University School of Medicine
OTOLARYNGOLOGY                            University of Texas-Houston            Fellowship, North America              Jeffrey W. Shupp, MD, Resident,
                                          Jeffrey Watson, MD, Orthopaedic                                               Medical College of Virginia, Virginia
Natalie Earl, MD, Private Practice,
                                          Surgery Residency, University of MD-                                          Commonwealth University
Feldman ENT Group
                                          Baltimore                                                                     David W. Switzer, MD, Resident,
Paul Garlich, MD, Reconstructive                                                       STAY IN TOUCH!                   Georgetown University School of
Surgery Fellowship, Cincinnati, Ohio      Seol Yang, MD, Plans Pending                                                  Medicine
                                                                                      Please send us your new
Emmerich Yoder, MD, Plans Pending         Categorical                                mailing address, email and         Terral Goode, MD, Resident, Medical
                                          Lana Bijelic, MD, Surgical Oncology        phone number so we can             College of Virginia, Virginia
DEPARTMENT OF                             Fellowship, Washington Hospital              stay in touch with you.          Commonwealth University
PATHOLOGY                                 Center                                  Richard G. Highstead, MD, Resident,
Maria B. Braman, MD, Surgical Pathol-     Craig Louisy, MD, Laparoscopic                                                University of Texas Medical School at
                                                                                    Graduate Medical Education,         Galveston
ogy Fellowship, University of Michigan,   Fellowship, Providence Hospital,                Room 6A-126
Ann Arbor                                 Washington, D.C.                                                              Tariq M. Ibrahim Kath, MD,
                                                                                    Washington Hospital Center          Resident, University of Minnesota-
                                          Rony Ramia, MD, Surgical Critical
                                                                                      110 Irving Street, NW             Minneapolis School of Medicine
                                          Care Residency, Washington Hospital        Washington, D.C. 20010
                                                                                           (202) 877-7204


                                        The Joy of                                       Dr. Cecilia
                                        Graduation                                       Monge Bonilla,
                                                                                         Internal Medi-
                                                                                         cine, second
                                                                                         from left, with
                                                                                         her family

                                                                 Dr. Charles L. Rice,
                                                                 president, Uni-
                                                                 formed Services
                                                                 University of the
                                                                 Health Sciences,
                                                                 delivered the
                                                                 keynote address.

                                                                                                                                                  Graduates Dr. Mark Kotlarewsky,
                                                                                                                                                  Internal Medicine, and Dr. Craig
                                                                                                                                                  Louisy, Surgery

                                                    Dr. Erwin Brun, graduate Dr. Maria
                                                    Braman, Pathology, and Dr. Thomas
                                                    Godwin, chair, Department of

                                                                                                 Graduate Dr. Jody Houston,
                                                                                                 Gastroenterology, right, with wife
                                                                                                 Dr. Kathryn Mandal and son Kiran

                                                                                                                                Left, Dr. Florina Constantinescu, Rheumatology,
                                                                                                                                with her mother, Maria Constantinescu, and
(Photos by Leslie Kossoff, LK Photos)

                                         Dr. Christian
                                         Surgery, and
                                         surgical resi-
                                         dent Dr. Brian

                                        – 10 –
                       Dr. Margo
                       Smith, section
                       director, Infec-
                       tious Diseases,
                       and graduate
                       Dr. Vasilios

                                                                                           Dr. Michael
                                                                                           right, with
                                                                                           his parents

                                                    Seated, Graduate
                                                    Dr. Gosia Sullivan,
                                                    Internal Medicine,      Dr. John Kirkpatrick, chair, Department of
                                                    with her husband        Surgery, with graduate Dr. Tedla Tessema,
                                                    Neil; standing, grad-   MD, Surgery, and Dr. Lisa Boyle
                                                    uate Dr. Rukmani
                                                    Internal Medicine,
                                                    her husband Ganesh
                                                    Letchumanan, and
                                                    graduate Dr. Mark
                                                    Internal Medicine

Dr. Mahmood Abedi, gastroenterology graduate
Dr. Melanie Jackson, and Dr. Michael Gold

                                                                                        Dr. Paul Sugar-
                                                                                        baker and Dr.
                                                                                        Tristan D. Yan,
                                                                                        GI Oncology/
                                                                                        Pathology fellow

                                    Dr. Kimberly                                                      Otolaryngology
                                    Yee, Surgery,                                                     graduate Dr.
                                    left, and her                                                     Emmerich Yoder
                                    mother                                                            and Dr. Kenneth
                                                                                                      Burman, section

                                                                                                                 – 11 –

continued from page 1

Jonathan Cosin, MD, Shana P.                      During their week’s stay, Cosin, Adams, and      Patients spoke 19 different languages and
Adams, MD, and Susan Bowen-                       Bowen-Ross saw hundreds of patients, held        White remembers that on rounds, translators
Ross, RN, Clinical Manager—                       five clinics at hospitals and regional health    often outnumbered doctors. But as exotic as
                                                  centers, and performed four radical hysterec-    this world was compared to that of Char-
Gynecologic Oncology                              tomies and one trachelectomy (surgical           lottesville, Virginia, it was nothing compared
Twice the size of Washington, D.C. with           removal of the cervix). They brought specu-      to White’s month pursuing an elective in
about one-quarter of the population, the          lums and educational materials with them,        tropical diseases.
beautiful Caribbean island of Grenada has         but found that the clinics had adequate sup-
had its share of tragedies since it attained      plies for most needs. “One clinic didn’t have    “Once a week we would fly out to the Darian
independence from Great Britain more than         running water the morning we were there,”        jungle between the Canal Zone and South
30 years ago. The government was seized by a      Cosin added.                                     America. It was totally rural at the time and
Marxist military council in 1983. Hurricane                                                        the Trans America Highway had not been
Ivan paid a visit in September 2004, killing 39   Most problems were related to disorganiza-       built.” White’s mission was to do epidemio-
people and causing damage to more than 85         tion, he said, although the team found the       logical studies on the route of Yellow Fever
percent of buildings. Hurricane Emily struck      local people easy to work with. “We received     and hold clinics in the jungle villages. “The
the island less than one year later.              a lot of cooperation from the local gynecol-     natives were wearing body paint, loin cloths
                                                  ogists, both with identifying patients and       and the kids ran around in nothing. It was
One tragedy, however, is not hit-or-miss in       helping us work within their system. When        really like going back to the Stone Age,” he
this second-smallest independent nation in        issues arose, we just went with the flow.”       remembers.
the Western Hemisphere. It is persistent: the     Improved screening, health education, and
lack of preventive gynecologic health care.       patient empowerment would go a long way          Because the villages were so isolated, the clin-
                                                  to improving gynecological health care on        ics and the process of obtaining blood sam-
It didn’t take much for nurse Susan Bowen-                                                         ples for the study were “a great social event.”
Ross, clinical manager, Washington Cancer         the island.
                                                                                                   They were also a challenge. “The Indians did
Institute, to persuade Jonathan Cosin, MD,        For now, Cosin is awaiting pathology reports     not speak English or Spanish, but their own
section director of gynecologic oncology, to      to determine whether some patients need          unique language. You had minimal transla-
embark on a mission trip to her native            follow-up treatments. “We hope to make this      tion, and most conversation was in sign lan-
Grenada recently to hold clinics and educate      a regular trip and go back from time to time     guage. You sort of have to show them what to
residents there about gynecologic health. She     as the need arise.”                              do. If you want them to take a deep breath,
knew, first-hand, about the dearth of quality                                                      you take a deep breath.”
preventive care. They recruited ob-gyn resi-
dent Shana P. Adams, MD, and the trio spent       Robert L. White, MD, Radiation                   All this took place in sort of a town hall —an
a week in St. George in the spring.               Oncology                                         open-air pavilion that unlike the villagers’
                                                  “Radiation oncology is so very, very high        huts had both a floor and a tin roof. “You
“Grenada has limited resources and patients       tech,” says Robert L. White, radiation oncol-    realize when you are in a situation like that
do not have access to care,” said Cosin. “We      ogy. “It’s such a contrast to the experience I   that you can’t rely on X-rays, CT scans, MRI
treated women who saw a gynecologist regu-        had in Panama.”                                  scans or sophisticated blood tests. You listen
larly, but had never had a mammogram or a                                                          to symptoms, examine the patient, and come
Pap test. The cervical cancer rate there is two   White was just finishing up medical school at    up with the diagnosis and treatment. And it
to two-and-a-half times what it is in D.C.”       the University of Virginia, contemplating his    worked 95 percent of the time.
                                                  next move, when a friend going into ophthal-
As a result, he said, the incidence of cervical   mology told him about a year-long general        White remembers a child who was about six
cancer and other gynecological disorders in       medical training program in Panama. Think-       years old, so sick he had to be carried to the
Grenada is high. Patients with cervical cancer    ing this might add some spice to pre-spe-        pavilion on his father’s back. He had malnu-
have one option for radiation therapy, he         cialty training; White signed on and headed      trition due to a bad lung infection and wasn’t
said: traveling to another country, the closest   out for Gorgas Hospital in what was then the     getting enough fluids. “He was really close to
being Trinidad, which many people cannot          Canal Zone.                                      death,” White says. White and his team put
afford. “We saw several patients who had                                                           the boy on a really strong antibiotic, and a
been diagnosed several years ago with cervi-      The largest hospital in the world during         week later, he was taking fluids and eating.
cal cancer and were never able to get treat-      WWII, Gorgas provided care for all the U.S.      “He made a full recovery, and if we hadn’t
ment, so they just slowly die.”                   military and civilian personnel in the Canal     been there to intervene, he would have died.”
                                                  Zone as well as crew members or passengers
                                                  on ships passing through the Panama Canal.

– 12 –
                                                                                                            Left to right: Jonathan Cosin, MD;
                                                                                                            Robert L. White, MD; Minal Nagda,
                                                                                                            MD; and Yuri Millo, MD

“We get so used to relying on technology           “The people were totally different, beyond         them were waiting— to have their debilitat-
that…the art of medicine has become sec-           their medical condition,” she recalls.“Most of     ing deformities corrected.
ondary to the science,” says White. “Doctors       them didn’t have much insight into the med-
after a while, I think they tend to get jaded.     ical problems they were having. It was very        “I had a flashlight I put on my forehead,
You forget about human contact and listen-         hard to try and explain what was going on.         because from time to time there were no
ing to your patients. An experience like this      But they are very simple and very humble           lights, and we performed surgeries from 6
teaches you that it’s not just mechanics, its      and they will listen to you and totally trust      a.m. to 8 p.m. The surgeries took longer [than
human touch, feeling emotion and caring.           the doctors.”                                      they would here] and we tried to have mini-
That’s all part of it.”                                                                               mal or no bleeding using chemical cautery.”
                                                   Because of an illness, Nagda was unable to go
                                                   when an earthquake struck the area in 2001,        After hours the experience was interesting as
Minal Nagda, MD, resident                          but heard from her colleagues that the small       well. “When we went back to the hotel it was
For five years, Minal Nagda, a resident in the     hospital had completely collapsed and that         really impressive to watch the lava go down
Department of Medicine, trained as a               the patients, many already in poor condition,      the mountain. One day, they took us to a city
pathologist in her native India, spending          were suffering from psychological and physi-       covered in lava [from a previous eruption.]
several weeks a year on an outreach mission        cal trauma, dehydration, and diarrhea.             Only the church steeple is left.” At first Millo
in a remote collection of villages near the                                                           was worried, “because it was flowing pretty
Pakistani border. A nonprofit group in             “I got a deep satisfaction when I was out          fast and I don’t run so fast.” But he said after
Mumbai (Bombay) sent 80 to 100 specialists         there working,” she says. “It was only a few       a few days he and the other doctors got used
as well as nurses and other staff volunteers to    days, but the amount of work we did and the        to it.
Bachau, the central village, to diagnose, treat,   feedback we got from patients was amazing.
                                                   It made me feel like a real doctor.”               “We really were able to help the kids, nobody
and perform tests and surgeries on villagers
                                                                                                      was harmed and even without having any
who might otherwise wait months or years
                                                                                                      fancy devices, everything came out well.”
for treatment.                                     Yuri Millo, MD, plastic surgeon
                                                   Since 1994, Yuri Millo has traveled once or        He especially remembers the case of an 18-
The main three-story hospital was the site of
                                                   twice a year to locations as diverse as Roma-      year-old boy who had spent his whole life
most surgeries, but a tent camp was set up
                                                   nia, Kenya and Cambodia with Operation             hidden away in his parents hut because “in
outside the small, primitive building for out-
                                                   Smile, a U.S.-based nonprofit that in more         their culture, having a cleft lip is like a curse.”
patient visits.“We would get a lot of support,
                                                   than 23 years has performed free surgeries on      A photographer returned with him after the
like free medications and machines for
                                                   more than 90,000 children worldwide, pri-          surgery — a three- to four-day walk—and
blood tests, and we would bring our own
                                                   marily to correct cleft palate and related         took photos as he was accepted into his com-
equipment like endoscopes.” Accommoda-
                                                   defects. In 2001, he ventured to Legaspi, a        munity for the first time. Millo was able to
tions were in nearby hotels and a big kitchen
                                                   remote seaside town in the Philippines about       see them afterward. “It was wonderful. That
on the tent campus provided meals for the
                                                   600 miles south of Manila.                         is the kind of rewarding things that happen.”
staff and patients.
                                                   “It’s a beautiful place with only two prob-        He has had similar experiences in other
“But still, it was really hard for me, the
                                                   lems. First they had a really basic facility       locales, including last year in Phnom Penh.
weather was very hot and dry, water was
                                                   that’s just walls that they considered a hospi-    Although it is Cambodia’s capital city, the
scarce and there was no indoor plumbing,”
                                                   tal, and second, 15 miles away there was a         medical facilities are virtually nonexistent,
recalls Nagda. Despite the equipment the
                                                   volcano that had just decided to erupt,” says      the infrastructure destroyed during the anti-
organization brought, “There were a lot of
                                                   Millo, with perfect comic timing. Although         intellectual terror campaign of the Khmer
tests we were doing manually, and blood col-
                                                   Operation Smile brings most of the equip-          Rouge. Millo operated on orphans whose
lection was done outside in a tent.” The con-
                                                   ment they need for surgery such as monitors        families had been casualties of those mas-
dition of patients was also far different from
                                                   and intubation supplies “we are relying on         sacres, again without electricity. “You have to
what she saw in Bombay and would later see
                                                   the place to have electricity. And with the        rely on your basic medical skills. You are
here. People would come in with “huge
                                                   eruption and ashes falling all over the city the   really looking at your patient and not at a
masses” and she would do a preliminary
                                                   mayor decided to evacuate, and electricity         fancy monitor. If you use basic skills and the
diagnosis and send samples for special tests
                                                   was something that was random.”                    right judgment, you do good work. Technol-
like tissue diagnosis to Bombay and a team
would return later with results. “The prob-
                                                                                                      ogy is nice, but it is an add on.”           ■
                                                   The team decided to go forward with the sur-
lems seemed so often to be in the end stage,       geries because this might be the only chance
it was a real challenge for the surgeons.”         in a decade or two for these children—400 of       Annamarie G. DeCarlo contributed to
                                                                                                      this article.

                                                                                                                                                 – 13 –

Maryland Legislative Session 2006:
A Retrospective
by Michael Rogers, Executive Vice President, Corporate Services, MedStar Health

The Maryland General Assembly ended the           Good Samaritan Hospital was approved
90-day session having considered over 2,882       to receive $500,000 from the state capital
bills. The session was dominated by parti-        budget to partially fund a $1.5 million
san acrimony and positioning between the          assisted living facility to be developed on
Republican-controlled executive branch            its East Baltimore campus.
and the Democratic-controlled legislature
in anticipation of the upcoming election          The MedStar Research Institute lobbied
cycle.                                            for state funding for stem cell research      Michael
                                                  and specifically for the inclusion of fund-   Rogers,
In terms of health care legislation, MedStar                                                    executive vice
                                                  ing for adult stem cell research. Both pro-   president,
Health monitored over 197 health-related          visions passed.                               Corporate
bills or bills that could have directly                                                         Services,
impacted MedStar facilities. The results were                                                   MedStar
favorable when measured against our 2006        Regulation Reforms                              Health
Legislative Priorities.                         The legislature enacted several regulatory
                                                reforms that MedStar Health supported,
Coverage and Access                                                                             Medical Malpractice Reform
Key legislation to expand health care cover-      Increasing the capital threshold for cer-
                                                                                                MedStar Health was less successful this
age and access passed this session including      tificate of need review to $10 million for
                                                  hospitals and implementing other              year in its goal to obtain stronger malprac-
legislation to:                                                                                 tice reforms. Fifteen medical liability
                                                  changes so that it will streamline the cer-
   Expand Medicaid coverage for legal immi-       tificate of need review process.              reforms were introduced, including a bill
   grant-pregnant women and children                                                            that MedStar helped draft and supported,
                                                  Prohibiting insurers from insisting on        which focused on structured settlements.
   Reduce the reliance on the Medicaid hos-       “Most Favored Nation” contractual pro-        However, all of the malpractice reform
   pital day limits (by $20 million) to           visions, which prohibited providers from      bills died at the close of session.
   achieve Medicaid budget reduction as           contracting with another insurer for a
   adopted in 2005                                lower reimbursement rate.                     District of Columbia
   Appropriated $26 million to establish a                                                      The major health care legislative matters that
                                                  Requiring the Maryland Insurance
   primary care program for individuals                                                         have dominated the current legislative ses-
                                                  Administration to adopt regulation
   below 116 percent of the Federal Poverty                                                     sion in the District have centered on Mayor
                                                  establishing network adequacy standards
   Level                                                                                        Anthony Williams’ proposal to establish the
                                                  for insurers by 2007.
                                                                                                National Capital Medical Center, a partner-
                                                MedStar Health worked to defeat or kill sev-    ship with Howard University and, medical
Government Capital and                          eral “reform” bills that we opposed, which      malpractice reform legislation.
Programs Grants                                 would have:
MedStar Health was successful in achieving                                                      National Capital Medical Center
several of its key priorities to expand state     Eliminated the certificate of need pro-
                                                  gram and abolished the hospital rate-set-     (NCMC)
funding for MedStar facilities.
                                                  ting system in Maryland.                      Legislation to implement the agreement
   The Maryland Trauma Physician                                                                between the District and Howard University
   Uncompensated Care Fund was amended            Bypassed the certificate of need process to   to develop a $400 million hospital on the old
   to make Curtis Hand Center physicians’         approve a new open-heart program in           DC General Hospital site in Southeast Wash-
   uncompensated care and physician on-           Maryland at Anne Arundel Medical              ington was introduced. But after two years of
   call costs eligible for reimbursement from     Center.                                       promoting the partnership, Mayor Williams,
   the Fund. The Curtis Hand Center at            Granted a wavier to non-open heart sur-       in an abrupt turnaround, announced plans
   Union Memorial Hospital will receive a         gery hospitals to participate in the          in April to re-evaluate the options for use of
   grant of $300,000 in fiscal year 2007.         Atlantic C-PORT elective angioplasty          the proposed $200 million slated for the
                                                  research study and perform elective           NCMC. Yielding to intense pressures to
                                                  angioplasty without surgical back up.         reconsider the Howard Plan, the mayor

                                                                                                                       continued on page 16

– 14 –
  Spotlight On…

Yuri Millo, MD

                                                                                                                                                   (Courtesy Photo)

        uri Millo, MD, the director of SiTEL (Simulation and
        Training Environment Lab) at the ER One Institute
        Washington Hospital Center has a theory on why his
program, which trains staff through simulations to respond to
mega-disasters like terrorist attacks, will ultimately improve
the care for all ER patients.
“Every day is a small disaster in an emergency room, which you
will see if you visit in the evening,” says Millo in a cheerful tone.
“By building a response to major disasters, we learn to take care
of more patients and use technology to make patient care bet-
ter—we’ll spend more time on patient care and less time
retrieving data.”
Responding to disaster comes naturally to Millo, who as a col-
lege student and paramedic served on Israeli Air Force Rescue           Dr. Yuri Millo carries a patient who has undergone corrective
                                                                        surgery for a cleft palate.
Teams. Later, as a physician, he commanded one of the teams
that swooped into enemy territory in helicopters to rescue and
treat injured pilots. “I can only talk about what’s unclassified,”      They have two children, a son Amit, 11 and daughter Inbar, 13.
says Millo nonchalantly. “It’s really a combination of trauma
                                                                        Dr. Millo’s relationship with Operation Smile began in 1994,
care and combat activity.”
                                                                        when the organization launched a mission to the Gaza Strip
Millo was born in 1962 in Yassi, Romania, under the repressive          during a very violent period. Bill Magee, MD, the organization’s
communist regime. “It was communist, but we had a very                  founder, called Millo and told him his U.S. volunteer physicians
strong Jewish background,” which ultimately led his parents,            felt uncomfortable and had backed out, yet the Palestinian
both physicians, to immigrate to Israel when Millo was just six         patients were still anxiously awaiting the critical surgeries on
years old. He was too young to grasp the cruelty and anti-Semi-         cleft lips and palates.
tism prevalent in the country at the time. “I didn’t realize it
                                                                        “Can you help us with Israeli plastic surgeons?” Magee asked.
because I was so young but something was probably there in the
                                                                        And Millo rounded up some fellow doctors and made the dan-
air because I don’t remember that place.”
                                                                        gerous journey to Nablus. “The funny thing was, at that point
Israel, on the other hand, was young Millo’s idea of paradise.          the Palestinian Authority wouldn’t let Palestinians come to be
“Israel absorbs Jewish immigrants very smoothly, so the transi-         treated in Israeli hospitals. So we went there, and the kids [with
tion was very easy for us,” he recalls. “It was very nice. You feel     deformities] were taken care of.” Millo still goes on one mission
this sense of freedom as a kid. I did whatever I wanted.”               each year with Operation Smile.

In fact, the freewheeling Millo was having such a good time he          Millo came to Washington Hospital Center because of his wife.
wanted it to continue into adulthood. “I wanted to open a pub,”         He had started the Internet Academy for Continuing Medical
he confesses. “That is until I finished my military service, then I     Education with a relative who was a computer engineer in 2001
grew up a little bit and wanted a stable future, so I thought ‘Let’s    to allow busy physicians to take CME courses online. His wife was
do medical school, I like to help people.’” He admits, however,         working at Washington Hospital Center and living in Bethesda
that family legacy also influenced his choice. “Both my parents         with the children, while Millo split his time between here and his
are physicians, so, unfortunately I had no escape,” he jokes.           practice in Israel. Corin introduced him to Mark Smith, MD,
                                                                        chair, Department of Emergency Medicine, and the two men dis-
After serving in the conflict zone in the Lebanon war, Millo            covered they had a similar vision for using technology to improve
chose to go to university in Italy and medical school in Florence.      emergency medical care. Millo started SiTEL in 2003.
He was originally set on specializing in neurosurgery, but the
beauty of Italian art, particularly sculpture, led him to plastic       Now that he commutes to Washington rather than Jerusalem,
surgery.“And, I finished school, which isn’t always done in Italy,”     Millo has had time to get a “wonderful dog,” Daisy, an Australian
he laughs.                                                              Shepherd/Labrador mix who recently added seven new mem-
                                                                        bers to the Millo family, and to play some tennis.“I tried to golf,”
Returning to Israel he did an internship at Chaim Sheba Med-            he says. “But it’s just not my type of personality. I like things to
ical Center in Tel Aviv and a general surgery residency at Shaare       move fast.”                                                       ■
Zedek Medical Center in Jerusalem. In 1987, he married his wife,
Corin, a fellow physician and Romanian immigrant to Israel.                                                            — Melanie Howard
                                                                                                                                          – 15 –
     Insider                                                                                       CONTACT                    INFORMATION
                                                                                                                James S. Jelinek, MD
                                                                                                                 Editor • (202) 877-6088
                                                                                                                   Margo Smith, MD
                                                                                                            Associate Editor • (202) 877-7164
MARYLAND LEGISLATURE                                                                                
continued from page 15                                                                                   Annamarie G. DeCarlo, ABC
                                                                                                           Managing Editor • (202) 877-3118

                                                                                                   Washington Hospital Center Physician is an
                                                                                                   informative monthly publication for all the members of the
                                                                                                   Washington Hospital Center Medical and Dental Staff. It is a
                                                                                                   forum to report news of interest to the medical staff, disseminate
                                                                                                   information about what is going on in the hospital, introduce new
appointed a task force to re-examine the          notice of intent to sue, and require manda-      providers and profile current ones, exchange ideas and opinions
NCMC project as well as other options for         tory mediation.                                  about subjects of interest and controversy, and recognize the
                                                                                                   professional and personal accomplishments of our practitioners.
how best to address the health care needs in                                                       Its overall goal is to help foster and celebrate a sense of commu-
Southeast Washington. Led by Department           2006 Elections                                   nity among the broad diversity of the Hospital Center physician
                                                                                                   membership. The newsletter is published by the editorial services
of Health Director Gregg Pane, the taskforce                                                       division of Public Affairs for the Office of Medical Affairs.
                                                  Major elections will be held in Maryland
is expected to issue a report in July. In addi-                                                    MISSION—Washington Hospital Center, a valued member of
                                                  and the District of Columbia this fall with      MedStar Health, is dedicated to delivering exceptional patient
tion to myself, the taskforce members                                                              first health care. We provide the region with the highest quality
                                                  potential major changes in personnel and
include: Dr. M. Joy Drass, president of Med-                                                       and latest medical advances through excellence in patient care,
                                                  policy directions expected.                      education and research.
Star Health’s George-                                                                              Washington Hospital Center, a private, not-for-profit hospital,
town University Hos-                                                    In Maryland, the           does not discriminate on grounds of race, religion, color, gender,
                                                                                                   physical handicap, national origin or sexual preference.
pital, among other                                                      incumbent Repub-
health care experts.          MedStar Health was                        lican Gov. Robert
                                                                                                   Visit the hospital’s Web page at:

                             successful in achieving                    Ehrlich stands for
Medical                                                                 re-election. In the           James F. Caldas, President, Washington Hospital Center
Malpractice                     several of its key                      District of Colum-                               Richard A. Weiss
                                                                                                        Chairman of the Board, Washington Hospital Center
On the medical mal-                priorities.                          bia, there will be a
                                                                        change at the chief
                                                                                                             John P. McDaniel, CEO, MedStar Health
practice front, The                                                                                        James Jelinek, MD                  Editorial Board
Council Committee                                                       executive level, as                       Editor                          Members
on Health and the Committee on the Judi-          two-term mayor Anthony Williams has                      Margo Smith, MD                 David Downing, MD
ciary have conducted hearings on proposed         announced his retirement.                                  Associate Editor                Jeffrey Dubin, MD
                                                                                                    Annamarie G. DeCarlo, ABC                Cheryl Iglesia, MD
medical malpractice reforms proposed by a         When the elections are over, the District will            Managing Editor                Stephen Peterson, MD
task force appointed by Councilmember             elect a new mayor, new council chairman               Jean Wilhelmsen-Exter               Michael Pistole, MD
David Catania, co-chaired by DCHA Presi-                                                                     Graphic Design
                                                  and three new council members. In Mary-              Frederick C. Finelli, MD
                                                                                                                                           Marc Schlosberg, MD
dent Robert Malson, and trial lawyer and          land, a large turnover in the legislature can                 President,                   Thomas Stahl, MD
former Councilmember William Lightfoot.                                                                Medical and Dental Staff              Guy Weigold, MD
                                                  be expected. All 188 members of the Mary-                                                   Larry White, MD
The Committee on the Judiciary has                                                                      Janis M. Orlowski, MD
                                                  land General Assembly are up for re-elec-               Senior Vice President
advanced legislation that will require 90-day     tion this year.                            ■         and Chief Medical Officer            Contributing Writers
                                                                                                               Lisa Wyatt                    Melanie Howard
                                                                                                   Sr. Vice President, Public Affairs
                                                                                                             Christine Vinh
                                                                                                           Asst. Vice President
                                                                                                   Medical Affairs/Quality Resources

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              Washington, DC 20010

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