Oh, Mama Mia!

Tucked hard into the northwest corner of Broadway and Monument, smack up against the Hopkins medical campus, Mama Mia’s Restaurant stands like a modest lighthouse amid an imposing sea of battleships. When pressed, officials within those imposing medical buildings will confess they once coveted the little restaurant’s teensy slice of land, to prepare for Hopkins' future growth. But the restaurant’s owners were an immigrant family from Greece who held fast to their belief that the restaurant was their ticket to the New World, not a windfall from the next-door neighbors.

Anyway, those neighbors, it turned out, could be won over with cheese steak subs.

Just this past winter, ownership of Mama Mia’s passed into the hands of one very hard-working widow who had been working in the family business since 1998. She doesn’t like to dwell on her establishment’s exposures to the real estate market. "No selling to nobody," says 46-year-old Foula Giannopoulos, "except the family."

According to Giannopoulos, two of her uncles bought the restaurant about 40 years ago, when the decrepit block was broadly in need of attention. Soon, the building’s strategic location became appealing to executives at both Hopkins and the prestigious Kennedy Krieger Institute across the street. But city rules forbade them from initiating offers on any surrounding properties.

"We certainly weren’t banging on doors," says Jack Grinnalds, the School of Medicine’s senior director for facilities management. Grinnalds describes Hopkins' "passive" interest in the property simply in terms of "land banking."

By the early '90s, though, the Maryland Transportation Authority saw the Mama Mia’s corner as a sweet spot that would become part of a new Metro station. But as the new Hopkins stop on the transit system took shape, medical campus executives watched with bemusement as every other property in the row fell to the wrecker's ball—except Mama Mia’s. Suddenly, instead of tearing the restaurant down, workers began reinforcing it. In the end, the surface subway entryway emerged in the shadow of the resilient restaurant.

Soon after that, Mama Mia’s decided to celebrate its survival. It transformed its dingy brick exterior into an alarming mustard yellow with blue accents. Even the most distracted passersby couldn’t miss it. Watching the spectacle from across the street, gray-suited Hopkins administrators smiled at the little restaurant’s pluck.

Today, as the sole owner of Mama Mia’s, Foula Giannopoulos is also smiling. "We ain’t going nowhere," she confirms, as she proudly outlines plans to upgrade her small dining room—new tables and chairs, some snappier décor—along with new offerings like turkey club sandwiches and chicken tenders, and spicier garnishes like jalapeno peppers.

Giannopoulos has actually been a terrific neighbor, Hopkins execs say. She agrees. "I never have a problem," she says. "Eight years, no problems. Everybody loves me."

Ramsey Flynn

From Pythons to Patients

> Ray Robinson, the snake man, in front of the med school dorm and (below) with a former pet.

One thing medical students living in Reed Hall can count on is the dorm’s prominent posting of rules: No toaster ovens, no hot plates or crockpots, and NO PETS. For first-year student Ray Robinson, who at 36 came late to medicine, it’s that last one that’s the bummer. Pets have been Robinson’s weakness since he was a boy. When he was growing up in Los Angeles, Robinson’s older brother used to show up at home with all sorts of reptiles, and Ray would end up taking care of them.  

Later, when Robinson spent 10 years working as a counselor through California’s Department of Mental Health, as a sideline he began breeding reptiles. Pretty soon, the 2,400-square-foot “holding tank” he’d rented was teeming with chameleons, lizards, geckos and snakes—lots of snakes—pythons, boas, colubrids and all sorts of rattlers. Little by little, Robinson began refining his breeding techniques, until some of the offspring he was producing turned out to carry mutations in color and patterns never before seen. Learning there was a market for these one-of-a-kinders, Robinson got businesslike, enrolled in community college to learn a little genetics and launched a reptile and snake-breeding business, Living Proof Reptiles. By then, he’d become what’s known in scientific circles as a herpetoculturist—a reptile authority.

By 1999, Robinson was supplying snakes all over the world to private collectors, zoos and researchers working on serums for snake, spider and scorpion venom. Some of his rattlesnakes were selling for upwards of $2,000. He became the first breeder to produce genetic mutations in a rattlesnake and one type of boa called a Kenyan Sand Boa. That last item sold for $2,500.

Realizing he had an affinity for science, Robinson enrolled at UC Davis and started doing biology. Then, with an eye toward a career that would let him work with both people and science, he decided to become a physician and began sending out medical school applications. Last spring, when he received a call from Assistant Dean of Admissions Paul White telling him he’d been accepted by Johns Hopkins, "I withdrew my name from every other school."

 Today, in between classes, studying and running around campus, Robinson still keeps a hand in Living Proof Reptiles. But with a number of tough years to get through in Baltimore, he’s letting his business partner handle the breeding and selling. He’s also downsized the business to concentrate only on California native rattlesnakes. Still, he keeps in touch with clients. And he knows one thing for certain: "Once I’m done with my medical training, I’ll never live without snakes again."

Lydia Levis Bloch

Thrill of the Hunt (scientifically speaking)

> Neuro-researcher Jeff Rothstein describes how well Hopkins plays with others.

The entourage of Hopkins faculty researchers and administrators that arrived in the hushed opulence of Chicago’s Standard Club on an afternoon in early April was a hungry lot. They’d jumped from work to airplane to work again without eating. Hunger of a different sort had pulled them to the Midwest. They wanted warm bodies to fill the new biotech park that’s coming to life adjacent to the medical campus. Why Chicago? The lure was a room thick with industry big shots—a who’s who in pharma, medical device and diagnostics firms.

In just two years, the 282,000-square-foot first building in the Science + Technology Park will be full. Occupying part of the space will be new basic science labs. The remaining 180,000 square feet will house a mix of biotech companies and retail stores. "But at this point," says Helen Montag, special assistant for corporate affairs, "filling the space is like building a shopping mall. Hopkins as a tenant is a great attraction, but we’re searching for a couple more anchors [the equivalent of Nordstrom at the mall]."

"We want both young and more established biotech firms," adds Michael Rosen, liaison for Forest City Enterprises, the park’s developer, "and the right service companies. We’d like one, for example, with the know-how to manage clinical trials." There’s an art to this sort of thing.

 But how to attract tenants? Shepherded by Dean Chi Van Dang and Jill Sorensen, head of technology licensing, these scientists—all sharpies in neuro-research—became the bait. Each spent five minutes at the mike describing his field to an audience of biotech types who’d gathered for BIO2006, the industry’s annual convention. With nearly 20,000 attendees from 62 countries, you couldn’t get a better potential tenant pool.

Neurosurgery chair Henry Brem described tiny, versatile chip-based drug delivery systems in the brain; Radiology’s Jonathan Lewin highlighted the new VASO system that maps a retina’s visual areas. Min Li in Neuroscience explained how the High Throughput Biology Center can pull order from the bewildering mass of data that today’s technology generates. Jeff Rothstein dazzled with an array of services, including animal and tissue models for the major neuro-diseases.

At the cocktail party afterward, business cards fluttered and talk was animated. Finally, at Midway for a 9:30 flight home, came the first clear reward—the airport Ben and Jerry's.

 Marjorie Centofanti

Hi, Ed!

> Ed Miller greeting passersby.

Stroll the medical campus with Ed Miller and you discover one thing right away—the dean/CEO is one friendly guy. Andre Hurst, the president of the University of Geneva in Switzerland—accompanied by three highly placed academic colleagues—found this out on a gorgeous day at the end of March.

After the men had spent a half-hour in Miller’s office discussing potential exchanges between Geneva’s medical school and Hopkins, the dean jumped up and suggested a campus tour. And so, with the 6-foot-6 inch Miller swinging along in the lead, the Europeans wound their way down Broadway, into the Hospital’s original domed building, through the long hallways and then out onto Wolfe Street. All the while, as Miller pointed out the high spots, he was hailing people—and they were hailing him.

“Hi, Ed,” called a woman rushing through the Hospital in a white coat with a stethoscope around her neck.

“Hi, Nancy!” Miller joked. “Slow down.”

“Hi, Ed,” smiled a lady wearing a badge that said “Environmental Services.”

“Gloria, how ya doin’?” asked the dean.

The academics marveled at the extent of Miller’s acquaintances. To them, the whole episode seemed distinctly un-Swisslike—less regal than they might have expected.

“I made a tour like this last year at a Japanese university with the president,” one of the academics said later. “When people saw that president passing, they all bowed. Here, they just say, ‘Hi, Ed.’”

Edith Nichols

Talkin’ Trash

Ever worry about where all those red bags of medical waste go? So do we. And with a hospital that produces 40 pounds of trash per bed every day—up to half of which is infectious waste—it’s no wonder officials here are all atwitter over a remarkable new disposal system.

A giant cylindrical device called a “rotoclave” has taken up residence near an Orleans Garage loading dock on the East Baltimore campus. It can chew through 2,600 pounds of medical waste every hour, yielding an inert, mulch-like substance that’s 20 percent of its previous volume, suitable for transport.

The process heats the waste to 270 degrees Fahrenheit, explains Environmental Services Director Todd Gartrell. And he adds that the whole process is designed to soothe the neighbors. “All emissions are vented to a sewer below. A carbon filter removes odors. It’s not noisy. You would never know that all this was going on here.”

It’s a vast improvement over the previous system that had applied chemical and radiation treatments in a process that too often broke down and backed up.

Gartrell is so happy with the new machine that he hopes to target other facilities in the Hopkins network, including Howard County General Hospital, Johns Hopkins Bayview and the outpatient center at Green Spring Station in Baltimore County. But the machine’s great performance is not stopping the Environmental Services team from looking to reduce the volume of waste produced in the first place, by trading disposable products for recyclables. “We’re aiming to get the volume down by 20 percent,” Gattrell says. “If we can do that, we would be very happy.”

Anne Bennett Swingle

Everest of Woodworking

> Gabe Kelen and his masterpiece

What does a rising young physician do with an unplanned year off? For Gabe Kelen, who’s now chair of the Emergency Department here, that year came in 1980 and took on the shape of a harpsichord.

A newly minted M.D. from the University of Toronto at that point, Kelen decided late in the game to focus on emergency medicine, a specialty absent from the Canadian medical landscape at that time. Opting to wait a year for a residency slot at Hopkins, he sought a hobby, anything to absorb his unchained energy. He settled on the idea of constructing a fine musical instrument—a harpsichord. And not just any harpsichord. The young physician—who’d put himself through college playing guitar and singing in coffee houses—cast his nascent woodcrafting ambitions on a “double-manual,” with two layers of keyboards.

To occupy his restless hands, Kelen drafted his craft-smart brother-in-law, and soon the obsessed duo was toiling at all hours, acquiring delicate selects of Sitka spruce, along with exotic tools like hair-thin drill bits. It included “thousands of parts,” said Kelen, fondly recalling the Zenlike state that fell upon him as he carefully fashioned each of the 200 plectra that had to be individually honed to size.

The process lingered into his residency, requiring the better part of three years. And when it came time to play? “That was a different story,” Kelen chuckles. He confesses he never mastered the instrument. Still, it makes for a unique piece and future heirloom, sitting near the piano (which he does play) in the Baltimore County home he shares with his wife and two teen children. He says he looks back on it as his “Everest of woodworking.”

Ramsey Flynn

The Olympian Press

> Superman, M.D., on his way to see a patient

If anyone doubts the power of the press, Robert Seung-bok (“S.B.”) Lee’s story should put that cynicism to rest. Last year, Lee, who was then chief resident in the Department of Physical Medicine and Rehabilitation, earned headline status in two Hopkins Medicine publications—the monthly tabloid Dome and this magazine. A quadriplegic since 1987, Lee had shut down all four of his limbs when he accidentally landed on his chin as he trained for the Korean men’s Olympic gymnastics team. Even so, he went on to complete medical school and a residency, using a wheelchair and a special pen for people with paralyzed arms.

The Dome cover story, “Superman, M.D.,” appeared in February 2005, followed by the Hopkins Medicine piece. Both articles then were posted on the Web—whereupon letters and inquiries about Lee started flowing in from all over the world. A flurry of TV appearances in New York and Baltimore followed, along with features in the Baltimore Sun, the New York Times and Korean papers about the amazing Lee. All that exposure then resulted in a book deal with a Korean publisher.

Lee’s book, “The Miracle Lies Within You,” which debuted in August, sold 25,000 copies the first week, is in its third printing and remains a bestseller in Korea, with translations into Japanese, Chinese and English in the works. Lee has now become a national folk hero in the land of his birth. On one unforgettable day, he  received more than 10,000 e-mails, and a year’s worth of speaking engagements all over the world now dot his calendar. Meanwhile, Hopkins’ mail room was caught a bit off guard by a sudden influx of Korean food and handmade-gift packages addressed to Lee from adoring fans.

One more result of the Hopkins physician’s sudden fame has been an inundation of Korean job offers, including one as vice chair of a new rehab hospital. He’s turned them all down—so far. Most tempting, though, is an offer to become a physician for the Korean Olympic team. “I’ve never been able to abandon my Olympic dreams,” Lee says.

Judy Minkove

Stargazing

The degree of respect a biomedical researcher’s work commands from others in the field used to be something scientists only deduced from hallway conversations or professional meetings. No more. Today, keeping track of who’s who on the laboratory scene has become a science in itself. A Philadelphia-based newsletter called Science Watch uses “unique citation data to provide monthly rankings, interviews and reports on today’s most significant science,” (to quote its own Web site).

Given such precise data-collecting, it was no small thing, then, that Science Watch’s summary of the most frequently cited cancer researchers in the 10 years between 1995 and 2005 placed five researchers from Johns Hopkins Kimmel Cancer Center at the top of its list. Collectively, articles in scientific journals by these Hopkins investigators had been referenced more than 90,000 times in work published by their peers.

Heading the Science Watch list (in place order) were Bert Vogelstein and Kenneth Kinzler, discoverers of the genetic mutations that cause colorectal cancer and inventors of a screening test for the disease; James Herman and Stephen Baylin, leaders in the cutting-edge field of epigenetics, which pinpoints disease-causing genetic changes that take place without affecting the DNA; and David Sidranski, an expert in cancer biomarkers.

Raved Science Watch: “The Kimmel Cancer Center solidifies its stance as a research powerhouse in the field of oncology.”

Edith Nichols

All in a Name

Comparative Medicine has officially changed its departmental name to Molecular and Comparative Pathobiology. A more unwieldy moniker, granted, but one that gives a better idea of what this field is all about. 

Long associated with the clinical care of laboratory animals, Comparative Medicine took a step up in academia’s eyes three years ago when it was elevated to department status. But the confusion over exactly what its faculty did lingered. The new title, Molecular and Comparative Pathobiology, reflects the department's dual focus—looking at the molecular process of animal diseases and comparing the relationship between animal and human disorders. There you have it.

Patrick Gilbert

Lone OB

> Justin Lappen and his new bride, Rachel, on their honeymoon in Thailand in April

Justin Lappen knows all the reasons why a physician might steer away from obstetrics: risk of lawsuits, ungodly malpractice insurance fees and a terrible on-call schedule. And yet he has boldly followed his heart into becoming the only graduate in the School of Medicine’s Class of ’06 to choose Ob/Gyn as a specialty. On July 1, he’ll begin a residency at Northwestern. “The way I figure it,” Lappen teases, “I’ll have a guaranteed business delivering all my colleagues’ children.”

Lappen says the deal was clinched after obstetrics residency program director Jessica Bienstock urged students to visit her service on their own. Lappen couldn’t help himself. “She had me catch a few babies that day,” he says. “There was no turning back.”

On thinking it over, Lappen saw how Ob/Gyn might be the nexus of his three professional passions: surgery, bringing new people into the world and public health. Of course, the malpractice threats still chafe, but he has found encouragement in talking to career-long OBs. “They all said they wouldn’t change their choice of specialty for the world,” he says.

Ramsey Flynn

The Great White-Coat Debate

Ask any five people what one article of clothing symbolizes the M.D. and chances are you’ll get the same answer—the white coat. For more than 100 years, that identifying uniform has spelled doctor. Who’d have guessed, then, that all sorts of physicians actually oppose the wearing of this garment?

Take Michael Carducci. When seeing patients, the idealistic young oncologist wears normal business attire—typically oxford shirts and ties. To convey his medical expertise, he prefers the subtle cues of a friendly introduction and a modestly displayed badge. He also “sits in the chair the doctor is supposed to sit in,” and makes sure that his desk “never comes between the patient and me.” His goal, he says is “to convey a tone that ‘I’m working with you.’”

Carducci’s no-white-coat credo took root while he was still a chief resident in the early ’90s. He came across studies that questioned whether the distinguishing bright whites could create a barrier in the doctor-patient relationship.

Carducci has company. One of his fellow oncologists, Antonio Wolff, also wears civvies, citing precisely the same rationale. He points out that physicians at the Mayo Clinic are actually forbidden to wear white coats, an edict handed down by a Clinic founder who believed that uniform would make patients uncomfortable and even frightened.

Mike Weisfeldt, director of the Department of Medicine, mentions an illuminating side debate that took place among the 106 members of the house staff in his department. With short white coats the signature of medical students and interns (further down the pecking order from residents), should they also be allowed to wear the elite long white coats? By a narrow margin, the group ratified the restrictions. “I think that indicates how the white coats convey a sense of stature,” Weisfeldt says. He adds that teaching hospitals across the country have been adding “white coat ceremonies” for their incoming students in recent years.

That ceremony, in which new med students are “cloaked” by senior physicians, is spearheaded by the Arnold P. Gold Foundation, which promotes humanism in medicine. The Gold Foundation has no worries about the white coats, creating a barrier with patients. “Any time you put the word doctor in front of your name, you’re introducing a barrier,” says foundation president Sandra Gold. She’s more concerned with wanting med students to reflect on the responsibilities that come with the medical profession.

Luckily, most physicians are allowed their personal preference. Internist Paul Auwaerter, who wears his white coat as a matter of course, is grateful for the latitude. “I don’t know what I’d do without the pockets,” he says.

Ramsey Flynn

The Medicine in Art

> Med students at the BMA

One medical student studies the reclining figure. The man’s eyes are closed, his head thrust back, his right hand hanging limply at his side. “He’s either sleeping or exhausted,” said Rush Chewning as his fellow students looked on. “He’s not dead because he’s got good color. He’s either wounded or out cold.”

“He’s not wounded,” another student says. “He doesn’t appear to be in pain.” Others note the woman at his side. “She has a certain lightness to her face. She seems radiant.” Some study another woman in the painting, her breasts bared. “She’s a little disturbing. Are those fish scales starting at the hip?”

The subjects of this evolving diagnosis are not living people but figures in a painting. The setting is a light-filled gallery at the Baltimore Museum of Art, where on four separate weekend afternoons this spring more than 70 School of Medicine students gathered to observe selected works. Their visits were part of a pilot program to help improve visual observational skills using art as a medium.

The project, developed by Sarah Clever, an assistant professor of general internal medicine, and BMA guide Marcia Gregory—and backed with administrative support from the office of the dean of students—featured three works: a 1938 mask from African Guinea, a painting by American artist Horace Pippin depicting a French village devastated by war, and “Rinaldo and Armida,” the large canvas featuring the slumbering warrior, a 1629 work by Anthony Van Dyck.

Floating an e-mail to the entire student body describing the project, Clever never expected many takers. But within the first hour, she had 25. In all, 83 signed up. Medicine and art are not as disparate as they may seem, Gregory points out. Like the human body, “works of art are complex and require careful analysis.”

The students would be given absolutely no background but, with minimal guidance from Gregory, would interpret the works on their own. Gregory, who is manager of docent and tour programs, knew from experience that the Van Dyck, the only one in the museum’s collection, was well suited for the project. “It’s big, it’s one of our treasures, and I knew we could tease out the story.”

Programs such as this are not new. Yale medical students have attended “clinics” at the Yale Center for British Art in New Haven, and similar courses are in place at Stanford, Cornell and Mount Sinai School of Medicine. Even police officers in New York have sharpened observational skills at the Frick Collection, a Manhattan museum.

Clever hopes the pilot program will continue in the fall. Evaluations were uniformly positive. “Translating images into words is challenging,” one student wrote. “However, it’s a very useful skill for physicians-to-be.”

Anne Bennett Swingle

Neuroscience's Act II

With a neuroscience department and its namesake director already widely considered the best in their field, what was Hopkins to do for an encore?

Lasker-award-winning Solomon Snyder—the only chair the Hopkins neuroscience department has ever known—was stepping down, prompting a global search for a worthy successor. But as sometimes happens with departments that possess a magnetic reputation for attracting big talents, the perfect fit emerged from within: Richard L. Huganir, a world-renowned authority on neuron-to-neuron brain functions who has been on the Hopkins faculty since 1988.

Huganir’s scientific credentials are impeccable and impressive. He’s a Howard Hughes scholar and a member of the American Academy of Sciences and has authored or co-authored more than 180 scientific articles and reviews. What’s more, “he has the vision to take the department into what is quickly becoming a new Golden Age of neuroscience,” says Dean/CEO Edward D. Miller.

One part of this vision has to do with Huganir’s commitment to foster the careers of women and under-represented minorities within the neurosciences.

A professor of neuroscience since 1993, Huganir is acclaimed for shedding light on what goes on when nerve cells in the brain communicate. His work on the makeup and activity of proteins and other brain chemicals has profound implications for the treatment of such neurological diseases and movement disorders as Lou Gehrig’s disease, stroke and dementia.

Huganir has also served as director of the department’s graduate program, chair of the National Institute of Neurological Disease and Stroke’s board of scientific counselors, and treasurer of the Society of Neuroscience.

Huganir obtained an undergraduate degree in biochemistry from Vassar, then earned a Ph.D. in biochemistry, as well as molecular and cell biology, from Cornell. He did postdoctoral work at Yale and Rockefeller universities.

Neil A. Grauer

Bennett and Bayview: The Next Chapter

Richard Bennett ’82 came naturally to his affinity for older people: He practically grew up in a nursing home. Since 1937, his family has operated a small Northwest Baltimore elder care facility, and he was raised on the grounds.

Bennett, now a nationally recognized gerontologist, was recently appointed executive vice president and chief operating officer of Johns Hopkins Bayview Medical Center, where Hopkins’ Division of Geriatrics is among the biggest draws. His early experience, he says, is going to serve him well. “I grew up watching compassionate care being delivered and also observing the business of health care.”

Bennett has a stellar reputation in both fields. Serving since 1997 as executive medical director of the Johns Hopkins Geriatric Center (now the Care Center), he led an array of clinical programs that have become national models. He also directed the center’s fellowship training program, overseeing one of the largest groups of clinical and research geriatrics fellows in the nation. In 2003, he was appointed vice president of medical affairs at Bayview and the next year was elevated to senior vice president of medical affairs.

A pure Baltimore product, Bennett headed straight for gerontology when he graduated from the School of Medicine in 1982. After a residency and fellowship at Hopkins, he joined the faculty in 1989 and quickly made his mark with landmark research on such afflictions of the elderly as post-antibiotic diarrhea and pressure ulcers (bed sores). He also developed approaches for older people to live at home and “age in the community,” as services and medical treatment are delivered by outside providers.

Neil A. Grauer

The Maven of Scientific Marketing

A certain buzz always surrounds the arrival of a new vice president for Hopkins Medicine.  So when word got out early this year that Dalal Haldeman, a health care executive from the Cleveland Clinic, had been named VP for Marketing and Communications, people were all ears to know her thinking.

Haldeman, it turns out, comes to marketing via a distinctly scientific pathway. She grew up in Lebanon, studied biology and chemistry at the American University of Beirut and became Lebanon’s first Ph.D. in food science after earning her doctorate from Penn State. She became a marketing pro almost accidentally. Living in Pittsburgh in the late 1980s, she was an assistant professor at Pitt when Metro Health Care in Cleveland recruited her to lead its 250-person clinical nutrition division. When the CEO there noticed her penchant for building patient satisfaction through service, he tapped her to head up the system’s quality improvement effort. Suddenly, Haldeman, M.B.A. in hand, was working directly with clinical departments, smoothing patient flow by cutting roadblocks impeding care delivery.

Health care marketing—with its emphasis on putting patients in touch with clinical services—was the logical next step. In 1996, Cleveland’s Children’s Hospital for Rehabilitation brought her on to direct marketing, business development and PR. When the hospital became part of the Cleveland Clinic, the Clinic chose Haldeman to head strategic marketing. She found herself in a key position at one of the nation’s booming clinical operations.

At Hopkins, managing the “brand,” she says, will be a vital part of her job. “It’s the most recognized name in health care, and we have to be careful how it’s used. I’m in awe of this institution. Since its beginning, it has dreamed of what it wanted to be and then become that.”

Still, Haldeman admits, it was Johns Hopkins’ reputation in biomedical research—the science—that drew her here. “When I was leaving the Clinic,” she says, “a colleague told me, ‘you won’t like Hopkins; it’s a research institution.’ I smiled. ‘That’s the big reason why I’m going there’ I said.”

Edith Nichols