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And Baby Makes Three

Seven years ago, when Jeremy Berg arrived for an early-evening conference in the director of medicine’s office, the then-31-year-old professor of biophysics and biophysical chemistry created something of a stir. Rather than miss the meeting because he was on dad duty, he simply brought along his son—strapped securely to his back.

“It did raise a few eyebrows,” chuckles Berg, who acknowledges that his new status as Hopkins’ youngest chair gave him the chutzpah to push the boundaries of decades-old decorum. But it also put a face on the career and family juggling act that confronts parents whose work schedules don’t always fit 9-to-5 hours.

One solution Berg—whose wife, Wendie, is director of breast imaging at University of Maryland Medical Center—and others have been espousing for years is a Hopkins child care facility. “A lot of other institutions have on-site child care,” Berg asserts, “and lots of people who apply here factor that into their decision.” Hopkins, in fact, is one of the few academic medical centers that doesn’t offer the benefit. Yale, for example, has maintained a day-care facility for nearly 20 years and now boasts six programs.

The push for campus child care here is by no means new. Committees have been studying the issue for more than 10 years, generating surveys, reviews and reports. But disparate Hospital and University decision-makers have never managed to join forces, and those pushing the cause have found themselves yearning for either a solid yes or no.

Finally, last spring, with the medical faculty calling for a pledge, Dean/CEO Ed Miller announced that he and Hospital President Ron Peterson “are firmly committed to working on a plan to build child care on-site and finding some way to do it.” The facility, he added, would be open to anyone who works on the East Baltimore campus.

The answers to several questions, however, remain murky: How many parents would actually sign up for the facility, and what operating hours would be necessary? How much tuition would people be required and willing to pay? Would they expect extra services like educational programs? This fall, to gather those answers, a committee representing all segments of the campus will spearhead five- to 10-minute phone interviews with a random sample of employees.

As the person in the dean’s office in charge of the effort, Assistant Dean Christine White points out “you can’t just shake trees” for funding. But she adds that the administration hasn’t set a dollar limit that automatically would be considered impossible. “We’re committed to providing on-site child care if there’s any way at all to do it.”

-- —Mary Ann Ayd

Female Empowerment

It was her own grueling bout with breast cancer 11 years ago, when she was in her early 40s, that inspired Baltimorean Harriet Legum to come up with the idea for a forum just for women about matters medical. “I wanted to empower them by helping them know more.”

From that germ has emerged a staggeringly successful autumn landmark: the daylong convention known as A Woman’s Journey at the Sheraton Inner Harbor. Marking its fourth appearance this year, the event, coordinated by Legum and her good friend Mollye Block, also a cancer survivor—with the help of Planning and Marketing and the School of Medicine’s dean’s office—draws more than 1,000 women from as far away as Paris.

For the $40 admission fee ($25 for students), attendees choose four out of 44 seminars. Led by Hopkins faculty (who also eat lunch with the group), these span a lifetime of medical concerns.

Good health is the main thrust. And though such topics as prostate cancer or the current state of gene therapy may not seem female-based, as Block explains, “women tend to make the health care decisions for the

Harriet Legum and Mollye Block, the duennas of the hugely successful A Woman’s Journey.

Harriet Legum and Mollye Block, the duennas of the hugely successful A Woman’s Journey.

entire family. They want to learn.” In the comfort of the single-sex ambiance, participants raise their hands and ask bare-bones questions about subjects as indelicate as dysfunctional sexuality and leaky bladders. They also get demonstrations on how to track health information on the Internet and can purchase books about medical conditions and audiotapes of any of the sessions.

For many, the day is as much about bonding as it is about information-gathering. Dozens of mother-daughter combos turn out, and last year, three generations from one family even chose the get-together for their annual girls-only outing. Women attending range from 18 to 80, with about 60 percent in their 40s and 50s.

So strong has been the response to A Woman’s Journey, several pharmaceutical firms and a University trustee now offer it financial backing.

And several Hopkins physicians who’ve acted as presenters report that they’ve had some eye-openers. Gynecologist Ed Wallach, M.D., was so taken by the depth of the questions about hysterectomy that he’s begun work on an easy-to-understand book on the subject. And psychiatry director Paul McHugh, M.D., who spoke on the “Kevorkian Epidemic,” found the all-female group keenly tuned in. “Women are vitally involved with the people around them,” he says.

A Woman’s Journey gets rolling this year at 9 a.m. on Nov. 21. Call 410-955-8660 for particulars.

-- Kate Ledger

A Once-in-a-Lifetimer

Of centennials marked this year, none spurs warmer memories here than the one honoring the birth of neurophysiologist Philip Bard. The charismatic researcher and teacher directed the Department of Physiology from 1933 to 1964, serving for four years during that time as dean of the School of Medicine. When he died a professor emeritus in 1977, he had published more than 60 scientific papers and won abundant awards in the fields of neurobiology and medicine. He’d also edited two editions of Macleod’s physiology textbook and served as president of the American Physiological Society.

But those who knew Bard remember most a man with an exceptionally uplifting personality, enthralled with science and devoted to teaching. “He was one of those types you meet once or twice in a lifetime,” recalls Vernon Mountcastle, M.D., professor emeritus of neuroscience, who came to Bard in 1946 for a year’s basic science training and was so inspired, he never left. “As soon as you got within six feet of him, you felt the warmth and strength of his character.”

Philip Bard, Director of the Department of Physiology from 1933 to 1964

Harvard-trained Philip Bard came to Hopkins at the age of 34 and stepped right into its ranks. His own research focused on mapping central nervous system mechanisms and was crucial in identifying the hypothalamus as the core of rage, fear and sexual behavior, as well as governing the pituitary gland, regulating body temperature and producing fever.

As director of physiology, he rejuvenated the small department, building an eminent faculty and establishing Hopkins’ premier role in neuro-, cardiac and renal physiology. But research papers produced in physiology didn’t automatically cite Bard as first author, which his daughter Virginia Bard Johnson says epitomized her father’s decency and integrity. “Dad’s sense of fairness required that the one who had done the major part of the work be listed first.”

Today, the Philip Bard Laboratory of Neurophysiology on the Homewood campus (established in 1980 by Mountcastle, who succeeded Bard as director), is a central fixture of the Mind-Brain Institute. And this centennial birthday kicks off a three-year campaign looking to endow physiology’s top job through the Philip Bard Director’s Fund. “It will link us to training that influenced generations,” says current director William Agnew, Ph.D.

As 31 classes of Hopkins students passed through Bard’s domain, Mountcastle describes how the never-critical professor worked alongside them at the lab table, shunning “cookbook” experiments and encouraging them to trust their observations. “He also gave his faculty total freedom and inspired confidence; we knew we were touched in our careers.”

-- KL

Spinal Chords

Bruce Wasserman is profoundly absorbed with the brain. Day after day, the postdoctoral fellow in neuroradiology meets patients with brutal medical conditions like epilepsy, brain tumors and aneurysms, then pores over their MRIs and CT scans to get to the root of their problems. It can, he says, get tough. “There are days when I feel like I’ve been beaten over the head and flogged.”

Times like these, Wasserman escapes to the Steinway grand piano in Hurd Hall. With its steeply sloped floor, high ceiling and superb acoustics, the Hospital’s cavernous auditorium—generally used for medical lectures or momentous meetings—is a perfect place to practice, he says. “You feel like you’re performing in a concert hall.”

He’s played since the age of 6, growing up in Newburgh, N.Y. As a teen, he studied with Robert Guralnik, a noted pianist

Neuroradiologist Bruce Wasserman rechannels his emotions.

Neuroradiologist Bruce Wasserman rechannels his emotions.

who concertized throughout Europe and America dressed up as famous historical performers like Franz Liszt or Mozart. Wasserman stuck to the piano even after he’d graduated in 1986 from Rensselaer Polytechnic Institute and headed for his M.D. at the University of Rochester. There, during his first year of medical school, he took music composition classes at the university’s esteemed Eastman School of Music, and played a public recital. Straight through his radiology residency at Harvard’s Mount Auburn Hospital and his first postdoctoral fellowship at Case Western, the young physician kept finding available pianos that allowed him to snatch a moment here, a moment there to spend with Chopin, Bach and the like.

“Sitting at the piano is a different world for me,” he reflects. “I’ve left the medical world and entered the musical one. It’s a great release, a way of channeling my emotions into some other medium. I become unaware of what’s around me. If I’m hungry or tired, and start playing the piano, all those desires are muffled.”

These days, in hastily grabbed sessions in Hurd Hall, Wasserman’s been working on Chopin’s Premiere Ballade, “one of my all-time favorite pieces.” Passersby stop in often, he says, especially when they hear another Chopin composition, the famous Polonaise. “That draws the most numbers. People seem to like it.”

He’s also been practicing with first-year medical student Melinda Hakim, a violinist, working on a Brahms piece that Hakim would like to perform at some point. “I’d be up for it, but I don’t know when we’ll be ready,” Wasserman says. “We’ve practiced several times, but it’s hard because of our schedules.”

Wasserman’s fellowship ends next year, and he still doesn’t know what his next move will be. He’ll probably end up in an academic setting, he says, because he gets a lot of pleasure out of research and teaching. “Friends say I’d go crazy in private practice.” Music also will doubtless continue to play a large role in his life, and he dreams of buying a grand piano. “But it’ll be a while before I can afford it.”

-- Bruce Goldfarb

Off-the-Wall Idea

To cool off reader’s brains during the dog days of summer, University President Bill Brody, M.D., proposed some off-the-wall ideas for improving the nation’s health care system in his column in the medical campus newsletter Change. Here’s his first suggestion: “Now that Congress has eliminated the land bank subsidies to pay farmers for not planting wheat, “I thought perhaps we could try applying that concept to health care. Why not create a physician bank to eliminate the surplus of doctors? We could pay them for not practicing medicine. After all, even though physicians’ salaries account for less than 20 percent of health care costs, they are responsible for generating more than 80 percent of health care expenditures. Mothballing physicians would clearly reduce health care expenditures.”

Into the Trash with Latex Gloves

Hopkins Hospital and clinics are ridding themselves of a fixture—the ubiquitous latex examination glove—and replacing it with a vinyl model. The rubber gloves, the very items recommended early in the century to protect hospital workers from infection, it appears, are themselves a public health threat. Huge amounts of latex now in the environment have dramatically increased the number of people allergic to the substance.

“While there are not a lot of problems,” Edward Bernacki, M.D., M.P.H., chairman of a Hospital task force that spent months studying the problem, worries that “the potential for a catastrophic event is there.”

Living proof of that possibility is Corneil Dockett, an asphalt layer from Lancaster, Pa., who arrived at the Hospital for neck surgery last fall well aware that when he wore rubber gloves, his hands itched, and when he blew up a balloon, his lips swelled. “I knew something was wrong,” Dockett remembers. “I just didn’t know it was latex.”

While receiving anesthesia, however, Dockett was unwittingly subjected to huge doses of latex when lines and tubes were inserted into his mouth, neck and bladder by gloved clinicians. Then, as his blood pressure began to plummet and his lips and mouth began to swell, doctors and nurses who rushed into the OR all pulled on gloves made of latex.

Immunologist Robert Hamilton with a culprit rubber glove.

Immunologist Robert Hamilton with a culprit rubber glove.

Furiously searching for the root of Dockett’s problem, anesthesiologist Lynette Mark, M.D., began calculating the potential effects of the drugs he was receiving and concluded the culprit had to be the latex. Sure enough, as soon as the substance was removed, the patient began to recover (he was treated with epinephrine and fluids). Dockett has no memory of the incident, but Mark will never forget it: “It was the single most profound anaphylactic reaction I’ve ever seen.”

Finding a substitute for latex, a compound derived from the sap of the South American rubber tree, has been no easy task. So thin it barely impairs the sense of touch, so elastic it can stretch to five times its length, the substance is impermeable, durable and affordable. Hopkins, however, has finally settled on a synthetic powdered vinyl glove, a decision task force member immunologist Robert Hamilton, Ph.D., says “should solve 99 percent of the problem.”

-- Anne Bennett Swingle

Beating the Odds Big Time

Few decisions upset a doctor more than having to save a child’s life with a treatment that will blight the youngster’s future. For Wilmer Eye Institute Director Morton F. Goldberg, M.D., the case he would never forget was Cara Dunne, a 1-year-old girl he diagnosed in the early ’70s with a hereditary cancer of the eyes called a retinoblastoma that can lead to other malignancies.

Goldberg, who was practicing ophthalmology in Chicago at the time, made the normal call to remove both of Cara’s eyes after chemotherapy and radiotherapy failed. But he was devastated: “Here’s this impoverished little blind girl with nothing to look forward to,” he recalls thinking.

Over the years, the ophthalmologist and the girl lost contact. Then, on a summer night in 1992, Goldberg was lying in bed at his home in suburban Baltimore and flipping though Harvard’s alumni magazine, when he came across a story about an undergraduate who’d been named a first marshal of the graduating class. She was from Chicago; she was blind; and her name was Cara Dunne. “I sat bolt upright in bed and couldn’t sleep the rest of the night!” Goldberg recalls.

With her cycling partner at the Paralympic Games, Cara Dunne accepts her medal, 20 years after her eyes were removed.

With her cycling partner at the Paralympic Games, Cara Dunne accepts her medal, 20 years after her eyes were removed.

Goldberg finally tracked down the family and caught up with the girl whose future he thought he’d ruined. As a student, Cara had graduated magna cum laude from Harvard and earned a law degree from UCLA. As an athlete, she’d won medals in cycling at the 1996 Paralympic Games and a bunch of gold medals for skiing. She’d also endured and beaten a lengthy battle with osteosarcoma, a rare bone cancer, in her face.

Last November, after 22 years, Goldberg met his former patient in an encounter so moving “it gave me the shivers.” “Long time, no see!” Cara exclaimed as she marched into his office. On hand to record the reunion for millions of Americans was ABC-TV’s “20/20.”

Now, Wilmer has established a Cara Dunne Fund that will support research into childhood eye diseases. Goldberg, meanwhile, has come to relish the chance to share his patient’s story with medical students and residents. His message stresses that it pays to instill hope in young patients facing uphill struggles in life. The case, he believes, also shows the inestimable value of supportive families—Cara’s encouraged their blind daughter academically, taught her to ski and stood by her through devastating illness—and strong social-support networks.“Don’t ever give up on a child who’s allegedly disabled,” Goldberg instructs students. “They’re liable to develop skills no able person can match.”

-- Jim Duffy

Neighborhood Clean-up

Aiming to transform 41 square blocks in the Baltimore neighborhood known as the Middle East, Hopkins is taking part in a $44 million plan spearheaded by the Historic East Baltimore Community Action Coalition to acquire and demolish or renovate hundreds of crumbling residential and commercial buildings.

The prickliest part of the job is freeing up the substandard properties immediately north of Hopkins. Some Hopkins and Kennedy Krieger people live in the neighborhood, and some elderly folks have lived there for 30 or 40 years. “But we deal with everyone on a case-by-case basis in a sensitive, humane way,” says Jack Grinnalds of the facilities department, who’s in charge of the acquisition end. “We help them relocate and move; sometimes we help with first-month deposits.” Right now, he’s in the process of acquiring 100 houses, 75 of which are occupied.

Slated for a segment of the new, open space are two community centers—one with badly needed playgrounds. And the area closest to Hopkins will offer new surface parking—600 spaces in all—to give employees more affordable, nearby places to leave their cars.

-- ABS

By George, It’s Back!

Sporting a meticulous new paint job, the historic marker proclaiming that Broadway is a section of the General’s Highway has returned to its decades-old spot on the lawn in front of the Marburg Building. The sign had become nearly illegible over the years, but thanks to Cecil Boblitz, a retired Bethlehem Steel worker who’s been volunteering his time over the last four years to refurbish markers around the state, passersby now can read that George Washington passed this way during his journey from New York to Annapolis to resign as commander in chief of the first American Army.

Shown here with his wife, Margaret, who’s worked in the Hospital’s admitting office for 28 years, Boblitz has been a history buff since childhood. “I remember coming to Hopkins with my mother when I was about 10,” he says. “What always stuck in my mind was the beautiful statue of Jesus, the smell of ether and the historic marker that said something about Washington.”

A spiffed up historical marker in front of the Hospital lets everyone know that George Washington passed this way.

A spiffed up historical marker in front of the Hospital lets everyone know that George Washington passed this way.

News from Town Hall

Mourning the increasing amounts of capital being poured into maintenance of Hopkins’ aging buildings, Dean/CEO Edward Miller noted at the last Johns Hopkins Medicine town meeting the “real need” for a critical care tower, to be built adjacent to the new Cancer Center, a new children’s facility, as well as a research tower to prepare Hopkins for the 21st century.

Hospital President Ronald Peterson announced that on the financial front “our cost controls are paying off.” Whereas two years ago Hopkins stood 35 percent pricier than its Beltway competitors, that margin now has been reduced to 23 percent. Furthermore, Hopkins’ prices are only 1 percent higher than other city hospitals, a remarkable feat considering its additional cost burdens for teaching and research.

With Hopkins’ volumes up 3 percent (they’re down 2 percent statewide), Peterson sees a “less onerous” future for the medical center. “We’ll still have to manage costs, but to a lesser degree.”