for an Aging Body
No more basketball or running for
this sports doctor. Biking is a kinder, gentler pastime.
If there’s one guy around who knows the price
a super jock may pay for his habit, it’s Ed McFarland.
The 50-year-old ex-all-American football player—a
professor of orthopedics and shoulder surgery here—has
built his career patching the battered bodies of overzealous
But McFarland’s a sports nut himself—so
he’s got his own tales to tell. He’s herniated
a disc mountain biking; he blew his ankle out playing
football in college; he suffers from chronic tennis
elbow; tendinitis nags his shoulder.
And just like the men and women whose knees and shoulders
he so craftily reconstructs, McFarland has lately been
receiving direct messages from his own aging body. “It’s
gotten to the point where if I go running, my knees
hurt for days,” he grieves.
Your best bet as you get older, McFarland tells action-addicted
patients, is to cut way back on sports that put a lot
of pressure on your joints. “There’s a
reason you don’t see many people in their 80s
Following his own advice, Mc-Farland has returned
to a passion from his boyhood when he rode a paper
route around his hometown of Paducah, Kentucky. “Biking,” he
says, “is an activity that’s easy on the
joints and ligaments—the perfect sport for an
Of course, McFarland would love to get back on a basketball
court. But given that his feet go numb when he runs—a
leftover from his old back injury—he’ll
stick to biking. “It’s easier on the body,” he
says. “You remember how your mother used to tell
you your injuries would come back to haunt you? Well
she was right. If you’re active, you’re
going to rack up injuries. And those injuries can cause
problems as you get older.”
Studies show, in fact, that the first signs of tendinitis
appear around age 30 and become more common and severe
the older we get. “And if you have arthritis
or damage to your ligaments or cartilage, it’s
that much worse,” McFarland laments.
The sports doctor now bikes to work. He bikes his
neighborhood. He bikes county roads. He bikes rails
to trails. And when it’s raining or snowing,
he bikes on his front porch—on a stationary number
(which doesn’t quite do it for him). Biking,
he exudes, gives him the same high he used to experience
running long distance. “It generates those same
endorphins. It’s like a drug.”
Still, cycling the six miles of city streets between
his home and his East Baltimore office can prove hairy.
To avoid rush-hour pitfalls, McFarland leaves home
at the crack of dawn. At the end of the day, he navigates
the side streets for his return trip. Even so, “there’s
one street where I have to ride alongside a stretch
of parked cars,” he sighs, “and if someone
opens a car door, I’m toast.”
Nevertheless, McFarland has vowed to keep cycling
until he can’t move. His 80-year-old father,
he says, still bicycles around his Florida neighborhood. “You
see a lot of old people down there cruising around
on three-wheelers. It helps keep them healthy.”
Once More, With Feeling
ABC returns for "24/7."
The producers at ABC News have decided it’s
time for the Hospital’s residents and interns
to take center stage.
Six years after airing the award-winning ABC docudrama
Hopkins 24/7, a team of 16 producers and videographers
has again descended on the medical campus. This time,
says series producer Terry Wrong, he’s angling
to show how some of the world’s best physicians
The Hospital has arranged wide access for the crew,
which typically gathers up to 30 hours of video material
daily. Their work is expected to arrive as a six-part
series in the summer of 2008.
And since they’ll be dovetailing patient cases
into their story-telling, “we don’t know
what will happen,” Wrong says. “Some of
these cases will have poor outcomes, and you can’t
have something that is unremittingly bleak. It’s
terribly risky and nerve-racking.”
In the end, Wrong says, the series will show both
the Hospital’s glories and pitfalls, adding to
the documentary’s verité qualities.
Anne Bennett Swingle
We Try Harder
SOM keeps lofty rank.
If we’ve got to be stuck somewhere, it’s
nice to be up high. So it is with the School of Medicine’s
ranking in U.S. News & World Report. Once again
this year, we’re No. 2 among American medical
schools—right behind Harvard. Since Hopkins has
held this perch for most of the last two decades, the
news lies in how our specialties are faring.
Hopkins stayed tops in internal medicine and biomedical
engineering and climbed to the top slot in geriatrics.
We rose two notches—to third place—in neuroscience/neurobiology.
Watch for that last category to move up: An infusion
of funding just got behind the new Brain Science Institute,
which dean/CEO Ed Miller says will bring “rapid
progress” to that field here.
Med students learn to champion health care causes.
About halfway into the two-hour presentation, the
room takes on the feeling of a pre-game pep rally:
As Glenn Schneider saunters back to the podium, he
chides the 20 gathered medical students. “I don’t
feel enough energy in here!”
The admonishment may be in jest, but there’s
no denying the bigger picture: Schneider, executive
director of the Maryland Citizens’ Health Initiative,
is an advocate for government-supported health care.
It’s a topic he believes in—passionately.
That made him one of two public officials to be invited
to address first-year students in a course called “The
Patient, Physician and Society.” Sharing the
platform with him was Peter Beilenson, Baltimore’s
former health commissioner,
“We’re clearly tilting this class in one
direction,” acknowledges Eric Bass, the internal
medicine and public health specialist who leads the
course. “Like many physicians, I think this is
an issue we have some responsibility to take a stance
Schneider and Beilenson tell these budding M.D.’s
how they can become leaders in pushing for legislation
to expand health care coverage to everyone. Whether
students follow their suggestion, of course, will be
up to them. But, as Schneider notes, “hopefully,
today you’re going to have a tool you can use
should you want to change the world.”
In Maryland, Beilenson states, 810,000 citizens have
no health insurance at all; another 800,000 have “lousy” health
coverage, the sort that covers only catastrophic cases. “This
cause could use the support of bright physicians.”
“We’re one of the few countries in the
world without universal health coverage,” Beilenson
points out. “And yet, we’re the wealthiest
nation in the world.” The fight has suffered
defeats, he declares, because “opponents call
it socialized medicine,” invoking a term loaded
with the baggage of inefficiency and failure.
So, what if a med student disagrees with the idea
of health care for everyone? Not a problem, says Bass.
He hopes any student with a dissenting position “would
plunge right in” with an argument.
The 120 members of the Class of 2011, he makes clear,
were free to choose from among seven topics for this
advocacy portion of the course. “But there’s
a better chance of improving health care coverage if
physicians understand crucial issues like this one.”
The Bumpy Road Up
A helping hand arrives for young faculty who hope to make it at the School of Medicine.
Ask Diana Scorpio how she felt about being appointed
to the faculty here a few years ago and she’ll
tell you. Scared. The School of Medicine has high expectations
of its scientists, and Scorpio knew it. They need to
publish; they need to earn grants, present papers at
national meetings and work with medical students. To
make it all the way up to full professor, they’re
even expected to hold international reputations.
But Scorpio—who learns about human diseases
by studying laboratory animals in the Department of
Molecular and Comparative Microbiology—had no
idea how to get the ball rolling. What’s more,
she was in the dark about where to look for guidance.
Today, thanks to Janice Clements, vice dean for the
faculty, young doctors and scientists find the path
upward less murky. Deciding it was high time they had
some help mapping out their careers, Clements opened
the Office of Faculty Development last year and drafted
Lisa Heiser, a skilled career advisor, to head it.
“Lisa hit the ground running,” Clements
says of Heiser, who’s since peppered her office
with resources. Programs now teach faculty how to build
dossiers. Seminars for department directors show them
how to coach faculty at each stage. And formal mentoring
arrangements link assistant professors with experienced
“These designated mentors,” Heiser says, “felt
equally lost when they were beginning, so they resonate
to their new role. It’s like we’re teaching
the orphans to be parents.”
Last year, two senior colleagues in Scorpio’s
department, Christine Zink and Christian Newcomer,
signed on as her mentors. Among other things, Zink—who
says she didn’t even know who her department
head was when she began—helped Scorpio understand
the benefits of collaborating with scientists from
other institutions. She even coached her in how to
introduce her studies of tickborne diseases to colleagues
she met at conferences. Clear at last about what she
needed to do, Scorpio arrived back from a professional
meeting a few months ago with three leads for research
Now 36 and well on her way, Scorpio says her career concerns
these days focus on her next potential obstacle in ascending
the faculty: She and her husband are contemplating parenthood. “I’m
kind of petrified about how I’m going to make it
work with a baby,” she confesses. Next on her list
of Heiser’s course offerings: “Balancing
Work and Life.”
Meanwhile on the Coast of Ecuador...
Plastic surgeon Jaime Flores took a break amid a marathon
series of procedures with indigent patients at a naval
station outside Guayaquil in February. After he drifted
off, colleagues strategically placed stuffed toys (intended
for the pediatric patients) under his arm. In Ecuador
as part of a 10-day humanitarian mission, the Hopkins
team performed under intense tropical heat with sparse
equipment and translators bedeviled by complex local
dialects. Still, Flores says, the group logged 85 operations,
including cleft palates and lips, burns and general
surgeries. Among Flores’s most satisfying results?
After he released the contracted knee joint on a 9-year-old
boy, the patient gazed up and smiled: “Now I
can walk to school.”
Pushing Every Day: Ron Peterson
The head of The Johns Hopkins
Hospital and Health System talks about the struggles,
how he remains content 10 years into the job, and
watching his daughter become a doctor.
The head of The Johns Hopkins
Hospital and Health System talks
about the struggles, how he remains
content 10 years into the job,
and watching his daughter become
tumultuous decade in health care, is there one thing
you’re most proud of as head of the
Well, the fact that we’re finally moving forward with the redevelopment
of our clinical buildings will probably constitute the capstone of my career.
In some parts of the Hospital, we’ve been doing world-class medicine in
You and the dean/CEO, Ed Miller, seem to have been
focusing on this rebuilding project for a while.
To the skeptics who say we’re giving too much
attention to physical structures, I would only repeat
that we’ve had to remain focused because we’d
gotten so far behind. Everything we do depends on our
buildings. They provide the environment where we care
for our patients; they’re the workshops for our
faculty, staff and nurses; and they determine which
physicians and scientists Hopkins is able to attract
and retain. But now that the buildings are under way,
we’re turning our attention to issues of diversity
among employees and support for young faculty who are
trying to move forward in their academic careers here.
What do you think of the current trend to give report
cards to hospitals and doctors?
I think it’s inevitable that people are becoming
more savvy about health care and want to make more
informed choices about where they are treated. Like
it or not, we are heading toward more transparency,
so we need to embrace that idea. It’s probably
Are these the kinds of issues
you talk about with other national hospital leaders?
I was down in Washington yesterday. The American Hospital
Association invites me to a little think-tank group
once a year to do some brainstorming with senior leaders
from around the country. We talk about things like
the president’s budget, which proposes a reduction
of $101 billion from Medicare and Medicaid over the
next five years, much of which will be coming out of
the hides of hospitals. We talk about an anticipated
10 percent reduction in Medicare’s reimbursement
rates for physicians, and the move toward pay for performance
for doctors. Patient safety is always on the agenda.
And of course we worry about hospitals being able to
amass enough funds to replace their aging physical
It sounds like nothing but problems. Does anything
make you smile on the job?
Every once in a while, I’ll stop in to visit
a patient. Spending time with someone who’s had
successful treatment here and feels grateful for the
care is one of the best things I do. Another thing
is watching entry-level workers—often people
who grew up right here in East Baltimore—gaining
new abilities through the Hospital’s programs
and then moving into jobs a couple of pay grades higher.
I see them feeling so good about what they’ve
accomplished—and also about the organization
that employs them. Those things make me smile.
You thought of becoming a physician once. Now your
daughter is a medical student here. Do you ever live
her life vicariously?
Oh sure, I think about that. My daughter, Susie, is
in between years two and three, and it’s a great
thrill. I don’t bother her every day, but I pay
attention to what she’s doing and I enjoy seeing
her progress. She’s doing a year of research
in HIV immunology right now and thoroughly loves it.
She would love to continue here at Hopkins for training
after med school, if she can. My son’s also in
town. He’s a lawyer, and he and his wife are
expecting their first child. It’s nice for us
to have our young adult children in the vicinity.
A lot of people would have
trouble spending 10 years in an organization’s number two spot. What’s
I don’t think of it as the number two position.
I think of it as a partnership. That’s the way
Ed has always dealt with me. Even though he understands
health care operations, he hasn’t dabbled in
micro-management. And you know, I’ve come to
appreciate that at a research-focused medical institution
like this, the dean should be at the top of the pecking
order. He’s the head of the medical faculty.
Leaders like you are always getting job offers from
competitors and head hunters. Are you ever tempted?
Occasionally I get a call or an e-mail. In fact, I
have one sitting on my desk right now. I generally
just give a courteous no. I think Hopkins is the best.
I enjoy being associated with this institution. I also
have significant ties to this region. My family is
here. I have a mother who, unfortunately, has Alzheimer’s
and is in a long-term-care facility in the area. I’m
not interested in looking anywhere else.
So how much longer?
Well, Dr. Miller and I are both believers in succession
planning. He’d like to stay on until the completion
of the medical buildings. At 58, I’m a little
younger, and I think it would be in the institution’s
best interest to have a bit of overlap when he leaves.
But his successor will be the one who decides if
someone new should be in my position.
Everything is in order, then?
Oh, I’m not complacent
or too comfortable. I’m respectful of the challenges
ahead. I’m not resting on my laurels. I’m
pushing every day, believe me.
African American Pantheon
Five surgeons become museum icons.
|>Carson, Thomas, Cornwell, Brock and Watkins (seated)
The School of Medicine has always suffered an embarrassment of riches when
it comes to its surgeons. But now, five of them are being honored in a whole
new light. Baltimore’s Reginald F. Lewis Museum of Maryland African American
History and Culture has included Malcolm Brock, Ben Carson, Edward
Cornwell, Claudia Thomas and Levi Watkins in a series of 7-foot-high panels celebrating
17 African American academic surgeons. These five make up the largest group
from a single medical school.
The display touts Brock as a thoracic oncology surgeon who uses cancer’s
molecular code to reveal signatures of the disease. The world-famous Carson,
director of pediatric neurosurgery, is acclaimed for separating conjoined twins.
Cornwell, chief of adult trauma surgery, is known for his expertise in treating
critically injured patients. Thomas became the nation’s first African
American female orthopedic surgeon. And Watkins, a professor of cardiac surgery,
performed the world’s first human implantation of an automatic defibrillator.
Exhibition curator Jill Newmark says the selections were easy for the museum
because the Hopkins surgeons had strong track records for mentoring younger
minority physicians. “They pass on the torch,” she says.
That’s especially true of Watkins, who joined the School of Medicine
admissions committee and within four years increased minority representation
by 400 percent. This exhibit, he says, “documents the power and beauty
of diversity. America is better off when we include the excluded.”
Thomas, meanwhile, welcomes the exhibit’s greater mission. “It
was my childhood exposure to an African American female pediatrician,” she
says, “that encouraged me to believe that I could achieve the same.”
Carson, true to form, says he hails any event that honors African American
success “in areas other than sports and entertainment.” America’s
future, he says, “will only be maintained by intellectual accomplishments.”
Opening the Book of Life
The genetic institute’s new head puts out the welcome mat.
On first pass, David Valle’s vision for the Institute of Genetic Medicine
sounds as startling as JFK’s 1962 proposal to land a man on the moon:
Valle wants to “enable genetic research by all members of the faculty.”
Does this mean the IGM’s new director wants every one of these people
to participate in genetic research? Not quite, but he’d certainly like
colleagues to feel welcome to everything his institute has to offer. “This
reflects our realization that genes play a role in virtually all aspects of
health and disease,” he says, proposing to extend the IGM’s genetic
tools throughout the School of Medicine.
That toolbox, he explains, includes high -throughput genotyping, the use of
their “zebrafish technology,” and a host of exotic genetic research
tools gathered in an internally managed database known as the “Genetic
Core.” And, just in case it’s not self-evident, Valle says, the
institute will offer the whole faculty its “knowledge and resources in
clinical genetics and genetic counseling.”
All told, it’s a formidable offer. The 8-year-old McKusick-Nathans Institute
stems from powerful DNA. It’s named for Victor McKusick, one of the founders
of the whole field of medical genetics (and now a University Professor here),
and the late Daniel Nathans, a 1978 Nobel Prize winner who helped kick off
today’s genetic biotechnology revolution. The institute is now endowed
with some 30 faculty members. Under Valle’s predecessor, Aravinda Chakravarti—who
is becoming head of the IGM’s new Center for Complex Disease Genomics—the
institute moved into new facilities and built bridges between the basic sciences
and clinical research.
Valle, meanwhile, possesses his own sterling credentials. A long-time Howard
Hughes investigator, he established himself as a wunderkind with his 1978 work
on an inherited form of blindness called gyrate atrophy, and he ran the pediatric
genetics clinic during his early years on the faculty, focusing on understanding
the basis for rare, inherited disorders.
Citing a host of dramatic advances in genetic medicine, Valle envisions a
glowing future for the IGM. “I see this as a crucial time,” he
Neil A. Grauer
More Alpha Docs
Charles Balch, professor of surgery and oncology,
has received the Society of Surgical Oncology Heritage
Award. He was president of the society from 1991 to
1992 and helped launch its Annals of Surgical Oncology,
of which he was editor in chief for 12 years.
Todd Dorman, associate professor of anesthesiology,
surgery and medicine and associate dean and director
of continuing medical education, has been appointed
chair of the Critical Care Work Group, which works
with Medicare on payment and regulatory issues.
Linda Fried, director of the Division of Geriatric
Medicine and Gerontology and the Center on Aging and
Health, has received the 2007 Mary Betty Stevens Award
from the American College of Physicians for her research
on conditions common to older adults.
III, professor of medicine, has
been named to the inaugural, 27-member class of ambassadors
in the Paul G. Rogers Society for Global Health Research.
James Harris, professor of
psychiatry, is the 2007 recipient of the American
Agnes Purcell McGavin Award for Distinguished Career
Achievement in Child and Adolescent Psychiatry.
Lehmann, director of clinical information
technology, has been elected to the board of directors
of the American Medical Informatics Association.
of the Department of Psychiatry at Hopkins Bayview,
received the 2006 William Proxmire Award for leadership
in the fight against Alzheimer’s
Lee McCabe, associate professor of psychiatry and
behavioral sciences and director of the Office of Behavioral
Health Care, has been elected president of the Academic
Behavioral Health Consortium.
Richard North, professor of neurosurgery, anesthesiology
and critical care medicine, has received the Founders
Award from the American Academy of Pain Medicine for
his groundbreaking studies of spinal cord stimulation
Karen Swartz, Psychiatry’s
associate director for residency education, has received
the 2007 Irma Bland Award for Excellence in Teaching
Residents from the American Psychiatric Association.
She also received the Eli Lilly 2007 Welcome Back
Award in Psychiatry for her work with depressed adolescents.
Peter van ZijiL, professor
of radiology, radiological science-nuclear magnetic
resonance, and biophysics and biophysical chemistry,
is the winner of the International Society for Magnetic
Resonance’s 2007 Gold Medal,
the group’s highest honor.
Distinguished Service Professor of Urology, has been
awarded the King Faisal International Prize for Medicine
for developing nerve-sparing radical surgery for prostate
cancer, as well as his research into genetic aspects
of prostate cancer. He also received the Physician
of the Year Award for Clinical Excellence from Castle
Connolly Medical Ltd., a company known for publishing
America’s Top Doctors.