This Is a Scientist?
Talmesha Richards has been leading a double life
for months now, but lately her secret has been exposed.
By day, Richards is a mild-mannered budding researcher
clad in a simple white lab coat that comes down to
her knees. But off-duty, she is a rockin' Baltimore
Ravens cheerleader, sporting a purple miniskirt and
a bare midriff while gyrating before 70,000 screaming
fans at the M&T Bank Stadium.
The only clue to her secret life might have been found
in the name tag on her lab coat: The lettering is purple,
Ravens purple. “Otherwise,” she confesses, “I didn't
really tell anyone about it.”
As a second-year student in the Graduate Program in
Cellular and Molecular Medicine, Richards spends long
hours learning the complexities of a basic science
discipline that links trainees early on with clinical
medicine. And so, the recent revelations of her moonlighting
habit on the football field have prompted some comical
reactions among unsuspecting colleagues. A lot of what
she's been hearing is something like: “You do what?!”
Of course, similar reactions come from the people
she meets during special public appearances she makes
in her full Ravens regalia, as happened in November
when she visited with injured U.S. troops convalescing
at the Walter Reed Army Medical Center in Washington.
Something about the cheerleader outfit is hard to reconcile
with the image of a serious research scientist.
But to Richards, her purportedly opposing personas
have lived comfortably together since early childhood.
As a precocious elementary school student growing up
in the shadow of Hopkins' Homewood campus, she was
always drawn to neighborhood dance contests in which
she routinely outperformed the older boys and girls.
That led to her taking dance classes in high school
at The Bryn Mawr School, where she excelled academically.
Her mastery of the academic world gave Richards entrée
to all seven of the colleges to which she applied—including
full scholarships at Princeton and Hopkins—but she
felt most comfortable heading to the University of
Maryland Baltimore County, which offered her a post
in its ballyhooed Meyerhoff Scholars program. The chance
to pursue her doctorate in the lab of breast cancer
researcher Nancy Davidson at the School of Medicine
was the perfect next step.
Recently, we sent Richards an e-mail to ask about
her academic focus. She picked up our query on her
computer in a cubicle in the Bunting Blaustein Cancer
Research Building, where she's lately been seen toiling
away, and responded quickly. Her current hands-on project,
she said, involves “the potential effect that interference
with the polyamine metabolic pathway has on the human
epidermal growth factor receptor-2 (HER2) signaling
That should take care of anyone who thought the science
might be getting shortchanged.
Academic Tribal Councils
Fourth-year med student David Grelotti with his new mentor anesthesiologist Theresa Hartsell.
When a promising medical student gets in over his
head with a tough course, who does he turn to? When
another student needs to chart a path in research,
who will advise her on which scientist might best match
her interests? Such dilemmas might typically be handled
by an advisor, but the 450-plus students in the School
of Medicine have traditionally relied on a hope and
a prayer to find the right faculty member for that
role. Up until now, the School has asked faculty to
volunteer to act as advisors, but the pairings with
students were random and there was no incentive to
sign up for duty.
Now that will no longer be left to chance. Administrators
have created a new structure that will match students
with faculty mentors who can guide them through medical
school. To create the new system, the SOM has divided
the school into four separate colleges—each with its
own tribal council of sorts. The four colleges are
not yet named, but groups are already forming. Each
college will have 120 students, 30 from each class.
Twenty-four select physicians will oversee the schools,
each assigned to five students in each medical school
class. And backed by a $1.1 million budget, the new
system will compensate the faculty members who agree
to spend 20 percent of their time in this mentoring
“This represents a substantial and tangible investment
in the development of our students as physicians,” says
David Nichols, vice dean for education.
For fourth-year medical student David Grelotti, a
better-organized mentoring system is long overdue. “There's
this obvious wealth of resources here,” he says, alluding
to the school's 2,333 full-time faculty members. “But
we had no structured way to find these people. We figured
it out by word of mouth.”
Anesthesiologist Theresa Hartsell, who will be a faculty
leader for one of the unnamed colleges, hopes to develop
a network of other faculty members “so students can
have at their fingertips the richness of Hopkins.” Each
college held its inaugural reception in November. Hartsell
is now looking forward to inviting her students to
her home as well.
“When we asked second-year students what they were
hoping to get from the advisors,” Hartsell says, “they
wanted to know what we were like outside the hospital,
why we went into medicine, things like that. This is
an opportunity to get to know people on a different
Hospitals are no one’s idea of fun. But the
thought of coming in at night through the emergency
department and then having to wait for hours on a gurney
for a bed can make anyone cringe. A year ago, Hopkins
Hospital was not immune to such problems. Even Hospital
president Ron Peterson found himself personally receiving
complaints from clinical directors about “a lack
of smoothness and efficiency” in the transfer
of patients from the ED to beds during evening hours.
But Peterson, who’s been around this place for
years, knew what to do—reactivate an old position.
As a young administrative resident at Hopkins in 1972,
Peterson had shadowed the then full-time evening administrator.
Cost cuts did away with that evening slot, but he never
forgot his nocturnal travels through the wards with
the after-hours administrator. A similar position,
the Hospital head decided, provided the perfect answer
to the mounting traffic.
Enter Stacy Sanders, the evening administrator, who
came on board last winter. Since then, she’s
become intimately familiar with all of the challenges
that might bedevil the facility after dark. Chief among
them, she says, are the maddening logjams that slow
down a patient’s transfer from the emergency
department to the intended hospital floor. But she’s
learned how to quickly remove bureaucratic obstacles.
“That’s been the bulk of my work,” says
Sanders, who spent months of her 3:30 p.m. to 11 p.m.
shift roaming the floors, making hourly visits to the
ED and dropping in on clinical units. As she roamed,
she asked nurses, physicians, shift coordinators, admissions
facilitators and housekeepers such questions as, How
many patients are in the waiting room? How many have
come up to your unit? How many are waiting to be discharged?
She also asked if she could help resolve any problems
or disputes. “I recognized that this position
couldn’t operate in isolation,” she says.
After commanding the post for over 12 months, Sanders
knows that moving patients through the ED and into
a bed on a Hospital floor takes about 100 different
steps. “A hold-up at any one step can delay a
patient’s flow through the system for hours.” She
says she’s gotten a pretty good sense of where
the typical bottlenecks occur and how they can be avoided— or
at last how to lessen their consequences.
Neil A. Grauer
Search of Tranquility
Everyone who's spent time in a hospital gives some
version of the story—the blaring loudspeakers, beeping
monitors, and raucous hallway conversations. In a couple
of units in Hopkins Hospital, all that din (which can
affect patient safety and contribute to stress) finally
got to Stephanie Reel.
Reel, the University's chief information officer,
contacted a team of Hopkins acoustical engineers and
asked them to attack the noise in the intensive care
units in pediatrics and oncology. Now, that single
step has brought greater tranquility to patients and
potentially also to clinical spaces under construction.
The acoustics engineers, Ilene Busch-Vishniac and
James West, both from the Whiting School for Engineering,
agreed that a daytime average of 35 decibels—like a
loud whisper—would be ideal for their noise-level goal.
They then identified the major disturbers of the peace
on both units and attacked.
On the pediatrics unit, the klaxon sound of the unit's
loudspeaker paging system won the noise contest. And
so, the engineers equipped each staffer with a silent
handheld device similar to a cell phone. The number
of loudspeaker pages quickly plummeted from 12 times
per hour to just one.
In oncology's ICU, the engineers discovered that traditional
sound-muffling acoustic tiles had long been banished
as hotbeds of bacterial growth. The team's solution
was to invent a new form of sound-absorbing material
by wrapping anti-bacterial fabric around panels of
fiberglass insulation and suspending them from walls
and ceilings with the aid of Velcro. “That treatment
reduced the reverberation time by almost a factor of
three,” West reports.
Needless to say, patients and staff are elated with
their new-found solace. Only the expertise of these
specially trained engineers could have conquered our
noise, says Sharon Krumm, the director of nursing for
the Kimmel Cancer Center.
in the OR
For the first time in as long as anyone can
remember, surgeons at Hopkins Hospital are performing
non-emergency operations on Saturdays. Weekends, of
course, have always been business as usual for trauma
surgery, transplants and other such emergencies, but
most planned-for procedures took place Monday through
As the number of patients scheduled for necessary
surgical procedures has continued to grow, however,
administrators decided that implementing a Saturday
operating schedule simply was logical (at least until
new clinical buildings open and make more operating
rooms available). Saturday hours made good sense in
other ways, too. They maximize available resources,
for example. With each operating room containing over
$1 million worth of equipment, extending the use of
that technology beyond 44 hours a week just seemed
more fiscally responsible.
In fact, “the Saturday schedule is a win-win for everybody,” says
Judy Reitz, the Hospital's executive vice president.
Clinicians can smooth out their cramped and hassled
Monday-to-Fridays, and patients coming in through the
door find it easier to get a time slot for their surgery.
And so, after a modest beginning in early December
when just one service—thoracic surgery—was using one
operating room for three consecutive cases (an esophageal
dilation, a bronchoscopy and a mediastinoscopy), the
Saturday schedule is growing robust. Soon it's scheduled
to involve four ORs and specialties like neurosurgery,
urology, and orthopedics. Two more ORs will be reserved
for emergencies, which continue rolling in through
To staff the Saturday schedule, OR nursing coordinator
Brenda Nack at first called for volunteers. “The response
was pretty good,” she says. But with nurses and techs
looking to their weekends for family life, no one dreamed
that system would work forever. New recruits are now
being hired with an understanding that they'll work
on Saturdays. Anne Bennett Swingle
The Bow Tie Club
|> Eighty and thriving: Sol Permutt and Ken Zierler
A recent eyeballing
of neckwear on physicians around the medical campus
has turned up a curious trend: Bow ties appear to adorn
the necks of a disproportionate number of senior physicians.
And many of them aren't just passing through; they're
still on the job.
“I can tell you where I got the habit,” says Ken Zierler,
an endocrinologist still active in research at 87. “When
I came home from overseas duty in the Army, I was working
in a lab. I was afraid my long ties would fall into
a beaker. So my wife bought me a bow tie, and one of
my neighbors taught me how to tie it.”
Zierler says he's noticed bow ties on about a half
dozen other senior physicians around the institution,
and he's not sure if their sartorial tendencies share
the same origins. He also suspects future generations
of senior physicians will be less inclined to maintain
the tradition. “I think there's more acceptance among
young people for not wearing ties at all,” he says.
Zierler, who's lately been focused on glucose uptake
and experiments on the mechanism of insulin action,
celebrates his 60th consecutive year on the faculty
in February. He shares this tendency for longevity
with close colleague Sol Permutt, a pulmonologist who,
at 80, looks up to Zierler as a mentor.
Like Zierler, Permutt has remained active. He still
works in the pulmonary function laboratory, trains
fellows and conducts clinical research on asthma and
immunology. And he, too, is a committed devotee of
the bow tie.
“I've been wearing them since I was a teenager,” Permutt
says, adding that his favorite specimen is a hand-crafted
number from a dear medical colleague, who's married
to another pulmonologist. “Her husband and I,” Permutt
explains, “just happen to share a passion for very
big bow ties.”
Longtime faculty members in this bastion of scholarly
medicine probably never thought they'd see the day
when acupuncture would become an accepted treatment
here. But with peer institutions like the Mayo Clinic,
Duke, Stanford and UCLA already offering the popular
needle therapy, it was only a matter of time. And now
the ancient Chinese treatment has made its modest debut
Practiced by a clinical nurse specialist who's a licensed
acupuncturist, the therapy is currently available only
to cancer patients and eventually is projected to be
used on about 15 of them a week. Most will be outpatients,
and all will need a written referral from a medical
What finally managed to sway medical conservatives
here to allow the ancient treatment to enter Johns
Hopkins were the results of several clinical trials.
Smartly placed needles, the studies found, really can
reduce pain and nausea following surgery or chemotherapy.
Sponsored by a Sidney Kimmel Foundation grant, the acupuncture
service here is just one of several “alternative” offerings
the foundation makes possible for cancer patients. Others
include a six-week mind-body course and a consultation
service on complementary therapies.
about the Animals?
The School of Medicine may have come a long way since
the dark days in 2001, when regulators criticized its
care and housing of lab animals (read mice and rats),
but its animal overseers are still wrestling with dilemmas.
The current challenge comes from the growing demand
for more animals, which means that even the new state-of-the-art
vivarium and other facilities will soon be bursting
at the seams if the issue is left unattended. It seems
that 80,000 rodents and 25,000 cages are not enough
in an era in which the bulk of research involves genetic
studies with lab animals.
Authorities have not yet devised the optimal solution
for the looming space crunch—lab directors are discouraged
from sheltering rodents within their own quarters—but
they report progress in other key sectors. Animal health,
for instance, always a key concern at universities
housing large groups of mice for research, has improved
“We developed a concerted effort to eliminate all
the infected animals on campus,” says Chris Newcomer,
who came from a senior lab animal post at NIH in 2003
to become Hopkins' associate provost for animal research
and resources. “Now we've pretty much eradicated all
the infectious disease.”
With two new clinical towers—a children's hospital
and a cardiovascular and critical care center—now in
the final stages of planning, Dean/CEO Ed Miller has
lately been spending inordinate hours on planes, trains
and automobiles trying to keep generous donors attuned
to the need for these buildings. “That's what I've
been focusing on for the past two years,” he says. “I
haven't had much time to focus on anything else.”
And as if persuading people to support buildings (not
just research for new treatments) weren't hard enough,
Miller's mission has been accelerated by cost estimates
that refuse to sit still. Just in November, trustees
approved $725 million for the construction, $190 million
more than the previous estimate. Part of what Miller
is striving for, he says, are “no surprises” down the
road in the amount of money it takes to construct the
desperately needed two buildings, along with no compromises
on building quality.
Originally, the project's budgeteers had tracked the
rate of construction inflation at 2.7 percent over
10 years, and thought they'd hedged their bets by planning
for three percent. But inflation has spiked to eight
percent annually since 2003, with Hurricane Katrina's
construction demands causing the final jump.
By planning for the destabilized construction costs,
Hopkins hopes to avoid the scenario that recently afflicted
UCLA. After going over budget with its hospital building
costs, the West Coast school is straining to afford
to equip it.
Says Miller: “I don't want to leave the next generation
with high debt, bad bond ratings or limited clinical
programs to pay for those towers.”
The Emergency Virtuoso
“Controlling chaos,” says Gabor
Kelen, is the essence
of emergency medicine. He should know. The soft-spoken
Toronto native who is chief of the Department of Emergency
Medicine—and was recently elected to the National Academy
of Sciences' Institute of Medicine—has spent his professional
life gaining a firmer grasp on managing the unwieldy.
As director of the Office of Critical Event Preparedness
and Response (CEPAR), created here shortly after 9/11,
Kelen oversees institutional planning and reaction
to all catastrophes, whether man-made (terrorist attacks)
or natural (blizzards, floods, hurricanes).
It was Kelen, for instance, who oversaw a Labor Day
weekend CEPAR telephone marathon that rounded up more
than 600 members of the medical community here prepared
to go to the storm-battered Gulf Coast after Hurricane
Katrina struck. “It was like the Jerry Lewis telethon,” Kelen
says. Ultimately, CEPAR dispatched 32 volunteers to
set up and operate an emergency clinic near New Orleans
that treated more than 300 patients over a 16-day period.
Later it arranged for a Hopkins team to help assess
medical needs in Pakistan following the earthquake
Kelen's leadership was a key reason for the Department
of Homeland Security's decision in December to award
Hopkins a $15 million grant. The funding makes CEPAR
the headquarters for a nationwide, 20-institution consortium
to study all aspects of preparing for and responding
to national emergencies. A key goal will be developing
ways to train tomorrow's scientists and health care
professionals to handle disasters.
Kelen's attraction to emergency medicine dates back
to his med student days, but he came to Hopkins in
1986 for his residency, he says, because “the whole
concept of promoting emergency medicine didn't have
the same impetus” in Canada as it did here.
“I just liked the excitement of the ED,” he says, “and
I've never really lost it.”
Neil A. Grauer
Swimming For a Lost Hero
|Photo by Allen J. Schaben, L.A. Times
With his arms rhythmically
slicing the dark water of Catalina Bay, shortly after
midnight last Oct. 11, surgical resident Peter
Attia completed a feat achieved by only 119 others—swimming
the 20.2 miles between Santa Catalina Island and the
Southern California coast. But rather than focusing
on his own accomplishment, Attia spoke about the person
who had inspired him: Terry Fox.
As a Toronto grade schooler in 1980, Attia was transfixed
by photos of the boyish, curly-haired Fox, a 22-year-old
British Columbian who had lost his right leg to bone
cancer, but then ran a 3,339-mile “Marathon of Hope” across
Canada on his artificial limb to raise money for research
on the disease that would kill him a year later.
In the quarter-century since, Canadians have voted
Fox their nation's greatest hero; issued two stamps
and a commemorative coin in his honor; and bestowed
his name on a mountain, a highway, a coast guard cutter,
annual charitable marathons and a foundation that has
raised $360 million for cancer research.
At 32, Attia made the swim to raise $10,000 in pledges
for the Terry Fox Foundation. With the help of his
wife, Jill, a nurse practitioner, he swam 20 to 30
miles a week in a health club pool and a Northern Virginia
lake. He studied how fish move and diagrammed the physics
of his stroke and how best to balance his body in the
water. The young resident also discovered parallels
between surgery and open water distance-swimming. “Swimming
is really a technically driven sport,” he says. “And
surgery is very technical. You're always practicing
Averaging a planned 48 strokes per minute, Attia completed
the swim in 10 hours, 34 minutes, 51 seconds. “I'm
irrelevant,” he insists. “The Terry Fox runs are important.”
Neil A. Grauer
One Step Forward for Faculty Women
For now, Lisa
Heiser’s focus is on women. Appointed
to the new position of assistant dean for faculty development,
Heiser is setting out to make sure that Hopkins’ professional
opportunities for its faculty are available equally
to both genders throughout their careers. In addition,
she will undertake an annual analysis of faculty salaries
and help department directors work toward the equal
treatment, promotion and retention of women in the
School of Medicine.
The reasoning behind Heiser’s new job stems
directly from the data. In 2002, the school’s
Women’s Leadership Council reported that despite
a decade’s worth of significant increases in
the number of faculty women in lower ranks, few had
eventually attained full professorships. And even though
the number of women moving up the ranks has increased
significantly since then, last June a committee reported
on other inequities: Promotion of women takes longer
than it does for men; the total salary for female faculty
is, on average, 6.3 percent lower than that of men;
a large majority of women—80 percent—believe
men and women are not treated equally in their departments.
The dean’s office has created Heiser’s
position to remedy such impediments. An Ohio native,
she spent 13 years as director of the career management
program for the university. About her new focus, she
says, “It will take a community to create a more
Neil A. Grauer