Alpha Omega Alpha, 2008

Dr. David Guzick, M.D., Ph.D.

April 25, 2008

This is a special edition of this newsletter. It’s special for two reasons, which makes it a doubly-long newsletter, but for good reason. One thing that’s very special is our class of 2008 AOA inductees, whose accomplishments we all celebrate. They are listed below, as introduced by their Advisory Deans at the AOA banquet. Another special feature of this newsletter is that our AOA lecturer, Dr. Chin-to Fong (selected by the AOA inductees) took the time to write out his lecture. It is my privilege to preserve it in our newsletter archives, and to present it to those who may not have been present.

The Beginning, the End and a New Beginning—
Education and the Academic Life Cycle

AOA Lecture, February 7, 2008
Chin-to Fong, MD
Professor of Pediatrics

Chin-to Fong, MD Several years ago I had the privilege of being nominated for an AAMC Humanism Award. The students who organized the award event wanted me to say a few words, and I remember telling them that I really do not know what the word “humanism” means, although I do know what the word “award” means. I am approaching this talk with the same spirit. I do not know what qualifies me to give this talk. However, one thing I do know is that I know everyone in the Class of 2008, and I suppose that if “connection means everything” in this world, then I do have something to say to every one of you.

The Class of 2008 will always be special to me because in 2004 I began my tenure as the sole course director of the Molecules to Cells course. I remember walking into the Case Method Room on that first cold and dark morning, like one of those early-season American Idol competitors, thinking that I truly have something good to show off. Humility came quickly! Soon, I would find a student falling fast asleep in the front row, another muttering what sounds like curses in the back row, and someone else seemingly practicing chorus – where I couldn’t tell. I remember Brooke Miller wearing her ski cap and wrapped in her scarf in class everyday probably wishing that she was really still skiing in Jackson Wyoming, and James Bradley coming up to the podium telling me that somehow his shoes have gone missing. What a wickedly colorful class! At the end of the Course, right before the final exam, I found that most of the class had donned a T-shirt with the logo “Fongtastic”, and they even gave me a sweatshirt with the same logo. I have to say I could not come up with the ego to wear it even once to work, but it does come in handy for family reunions!

A couple of weeks ago I was agonizing over this lecture, and I turned to my good friends Dr. Stephanie Brown-Clark and Dr. Anne Nofziger for advice. Great advisors that they are, they helped me come up with something interesting. Then I ran into Dr. Jules Cohen last week, and when I told him that I do not really have any signature career discovery to talk about, he simply said, “You’ll be fine, just say something inspirational.” I took that to heart, and found my MTC role model William Hung’s new CD Inspiration….and this calls for a costume change!

Now that I have killed 10 minutes off the clock, I will get serious and tell you a little about the rest of what I am going to say. I can promise you that this lecture will violate every cardinal rule about how to give a good lecture. There will be no learning objective. There will be plenty of digressions. I will talk incessantly about myself and people you may not know. The talk will only target part of the audience (the Class of 2008). I will jump back and forth, and go around in circles. All these are part of the formula of how to give a bad lecture, but nevertheless, here we go.

While the letters Alpha Omega Alpha came from the organization motto “Worthy to Serve the Suffering”, their positions in the Greek alphabet have instead always connoted to me something cyclical. Thus, I have entitled today’s talk “The Beginning, the End and a New Beginning: Education and the Academic Life Cycle”.

I will first tell you a few things about my own beginning.

I came from a very humble family in the ghettos of Hong Kong. My father was born in a village in southern China, and having had little formal education, went to Hong Kong in 1937 to look for work at the tender age of 13, barely a year before China was to be plundered by the brutalities of World War II. My mother received most of her schooling during wartime when political propaganda by the military conqueror substituted for formal education, and daily air raid sirens and curfews did not enhance learning either. My siblings and I were therefore welcome products of the post-war baby-boom years. Uneducated as they might have been, my parents have the pragmatic intelligence characteristic of generations of peasants before them. They taught me family values and personal morals, but above all, they taught me common-sense. I actually do not remember which one of my parents taught me this, but one of them told me, “Son, in this world there are stupid people and there are smart people; there are mean people and there are nice people. If you are smart and nice, you will do well in your work and have a lot of friends. If you are smart and mean, you will be successful but not happy. If you are stupid and nice, you will not be successful but at least you will be happy. But if you are stupid and mean, you will not get anywhere in life.” Knowing my limitations, I have always aspired to be the nicest person I can ever be. I tell you this story because there is a simplistic beauty to the way my parents conceptualized the world, a method that I call simple 2 X 2 thinking.

Many years later, as a third year medical student sitting across the desk from the late fabled Surgeon-in-Chief of Boston Children’s Hospital, Dr. Judah Folkman (1993-2008), I heard something very similar. I had the occasion of being on a Pediatric Surgery Clerkship with Dr. Folkman. It was 8 pm, and we were waiting for the OR to be ready for the next patient. Because of an anticipated long wait, he took me back to his office and proceeded to describe to me in detail his work on what he then called the tumor angiogenesis factor, and concluded his narrative by saying that no one actually seemed to believe him. The conversation moved on to other topics. He showed me the books on his shelf, including the classic “On Growth and Forms” by D’Arcy Thompson. And then, all of a sudden, he got excited and said, “I have a little trick to help you practice coming up with differential diagnoses.” He said “You have to start simple. Think of two entities, say blood pressure and heart rate, and do a 2 X 2 cross. For example, think of diagnoses that give you high BP and high HR, high BP and low HR, low BP and high HR and finally low BP and low HR. When you are done, pick another two entities, say body temperature and white cell count. Then come up with diagnosis that gives you body high temperature and high WBC, high body temperature and low WBC etc. When you are done, start mixing up the entities, and start considering diagnoses that give high BP and high body temperature etc. While impressed by Dr. Folkman’s patience in teaching an ordinary third year student late into the evening, it dawned on me at that moment that my parents actually had the same reasoning skills, and they did not need to be a world-class academic giant to know that. I realized then that ability in simple logical processing is shared by all, and that education is contextual learning that takes advantage of these logical processing skills. In other words, you can teach anyone anything if you put it in a context that they are familiar with. A great teacher like Dr. Folkman uses the simplest logical device common to all people to educate. Of course, I did not have the heart to tell Dr. Folkman then that some modest son and daughter of peasants from half way around the world had beaten him to it when it came to teaching me that little logical trick.

In the tiny British colony of Hong Kong, whatever misgivings one might have about the lack of political freedom, one thing is clear: if you are motivated in your academic pursuits, there is a way for you to work yourself out of poverty. British colonialism had learned a hard lesson from its earlier American experience, and realized that the most effective way of pre-empting a massive rebellion in her colonies was to make sure that the more intelligent sector of their colonial populations got rewarded with upward mobility. Successful revolutions require sustained efforts by intelligent leaders. By luring intelligent people into the “ruling class,” successful colonial rule was maintained. So with our education as their first priority in life, my parents managed to keep us focused on schoolwork, such that upon graduation from high school, I was admitted to the medical school of the University of Hong Kong. However, I was not interested in becoming a physician, and the reason was very simple.

In 1957, two Chinese physicists, CN Yang and TD Li, working in the US, were awarded the Nobel Prize in Physics, “for their penetrating investigation of the so-called parity laws which has led to important discoveries regarding the elementary particles…” In other words, all is not symmetric in nature. Parenthetically, like the Watson, Crick and Rosalind Franklin situation, the experimental evidence for Yang and Li’s discovery were furnished by a woman scientist, CS Wu, whose seminal contribution went unrecognized by the Nobel committee. Yang and Li remained the only ethnic Chinese Nobel Laureate for the next 20 years. So it was that as a young Chinese boy growing up in the 60s, ethnic pride dictated that any self-respecting aspiring student of science would want to grow up to be like Yang and Li. It is therefore no surprise that I passed up the opportunity of medical school in Hong Kong and in the fall of 1973, after my family managed to scrape together $700, with the help of relatives, for a one-way plane ticket to the US, I found myself as a freshman in the campus of one of the world’s premiere institutions for scientific and technology, eager to become a physicist.

However, life held many surprises. At MIT, Physics classes were interesting, challenging, and very humbling. The buzz on campus, however, was a newly emerging young Biology Department, with new young faculty members by the names of David Baltimore, MaryLou Pardue, Harvey Lodish, Robert Weinberg, David Housman and Nancy Hopkins, to name a few, all young and brand new Assistant Professors. However, teaching Introductory Biology was a professor called Salvador Luria (1912-1991), who was a Nobel Laureate himself for his work showing that spontaneous mutations provide the substrate whereupon natural selection occurs. In other words, genetic diversity is the underpinning of biological diversity. I remember very clearly that on the first day of class, Dr. Luria started the lecture with the following metaphor (which he later captured in the book Life; The Unfinished Experiment):

“Among certain orthodox Jewish groups, there used to be a custom that sons should not follow their father’s bier. Some early rabbi apparently taught that the funeral procession of each man is watched by the souls of those children of his that might have been born and never were – seeds spilled or unused – and these should not be given the chance to curse their living brothers with their envy: “ Why they and not me?”

There is biological wisdom in this odd superstition….

Like human history, life also is a historical process. The living organisms of today are an incomplete record of the possibilities of the past. The smallest bacteria, the humblest worms and snails, algae and mosses, as well as the proudest trees, the most gorgeous birds, and the billions of human beings are a sparse sample of the total range of possibilities of livings that might have existed. Individual men and women often experience a strange nostalgia – a thought of what might have been, a longing for past opportunities either missed or never available, and even more often a longing for horizons that might have opened up, if only…..

And yet, how many ever stop to think that they should exist at all? Each human being is the actualization of an extreme improbable chance – in fact, a series of extreme improbably chances, extending all the way back to the unique event that more than 3 billions years ago started life on earth on its chancy course….”

When I heard Dr. Luria that day, I knew that he was not only teaching us the science of life, but about life itself. It was my first encounter with someone I considered a humanist. I was an instant convert to Biology. Upon reflection now, perhaps it was more his prose, and less his science, that had inspired me (something that all the writers among you should be so proud of!). I am sure that if he had just said “Life is an improbable event and you should consider yourself fortunate that you are here”, I would have gone back to being a physics major! I also learned that day that intellectual exchange knows no ethnic boundaries, and that your role models do not have to be someone just like you. I wish I could tell you that Dr. Luria became my life-long mentor and that we developed a long teacher-student relationship. However, that never happened even though I would see him in the hallways often. I remained respectful of, but invisible to him. I have never spoken to him. My point in telling you this is that to those of you who will be teachers one day, realize that you never know who you will inspire by what you do, and it behooves you to do your best all the time. There may be students in the shadows of the back row who will take what you say to heart, and you will change many lives without even knowing.

As a freshman, I started doing research work with Dr. John Stanbury. Stanbury was an endocrinologist and my project was to develop a radioimmunoassay for thyrotropin-releasing factor. I have no doubt that none of the students in this audience have ever heard of Dr. Stanbury. In my student days, Stanbury was known as the lead editor of a major textbook called Metabolic Basis of Inherited Diseases, which in recent years under different editorship has grown into a 4 volume tome called Molecular and Metabolic Basis of Inherited Diseases. Through his work in third world countries on endemic goiter, Stanbury had helped eradicate cretinism in many countries in South America. One would think that such great academic and humanistic achievement would have guaranteed a celebrated career for a lifetime. So it was with considerable surprise that one day in the beginning of my sophomore year, Dr. Stanbury told me that because of a grant problem, he would be closing his lab in the next few months, and that I should be looking for other research mentors for the next semester. He gave me recommendations for other potential mentors and following his suggestions, I found a different academic home in the laboratory of Dr. Herman Eisen, an immunologist, who became my research advisor for the next 6 years. I have great admiration for Dr. Stanbury for caring about an ordinary college student even at a difficult time of his career. This experience also taught me in those early days that academic fame and fortune can be ephemeral, and that academic institutions often have short memory. Another interesting sidelight is that Dr. Stanbury’s influence on my ultimate career choice of Medical Genetics had not been apparent to me until recently: when I told an acquaintance about my work in Dr. Stanbury’s lab, her response was “Oh, that makes sense…” Only then did it occur to me that it is from Dr. Stanbury’s book that I first learned that there is genetic/biochemical cause and effect in human diseases, and that studying families from these perspectives represents an important approach to therapy. I have not seen Dr. Stanbury again since I left school, and I have recently felt that maybe I should write him a note of thanks, but then after this many years, I could not figure out how to find him, and if I do, he may not even remember who I am. For the students in the audience, you should know that it may take you years to realize who has most influenced you, and when that happens, you may feel as surprised as I was in not recognizing the obvious a long time ago.

Dr. Stanbury’s and Dr. Eisen’s influence in my early academic development had channeled me back to medicine. As a foreign student, there were not many schools who were interested in my application (including the University of Rochester). One of the few medical schools I got into was the Harvard-MIT Program in Health Science and Technology. As someone who had always enjoyed hands-on bench research, first year medical school was a very difficult transition. Add to that a very poor personal study discipline, and things became a bit untenable. I remember that during January of the first year, I had to take a short course in Human Emrbyology. As circumstances had it, a friend of mine had introduced me to Tolkien’s Ring Trilogy shortly after Christmas, I found myself spending more time reading about Frodo than studying Langman’s. After failing the course, I was given a second chance by my course director, Dr. Elizabeth Hay (1927-2007), a renowned developmental biologist at Harvard Medical School. With a marginal grade in the remediation exam, I remember Dr. Hay telling me that she would do me a favor to let me pass, and that she understood that not every physician had to use embryology in everyday practice. Thinking back, I am always humored that as intelligent and accomplished as Dr. Hay was, she could not have predicted that a student who came close to failing her course would someday draw upon what he learned from her on a daily basis. However, I am grateful to Dr. Hay not so much for what she taught me, but for her tolerance of a student such as myself and for giving me a real second chance. My point in telling you this anecdote is not to set myself as a good example to follow, but to implore you not to spurn your students who are not doing well at some point in their life, and recognize that like children, they may just have a little more growing-up to do.

As I was motivated to go into medicine because of my love for science, I became one of those rare medical students for whom medical school got more unbearable as it moved into the clinical years. The clinical clerkship seemed to me endless exercises in learning how to behave as a medical student. My discontent and disillusionment deepened throughout the third year, only to be relieved by a long stint in the lab during my fourth year. I am telling you this not to disparage my alma mater. After all, I had many beloved professors there, and there are many distinguished physicians who went there. My lack of success or satisfaction as a medical student bespoke more of my attitudinal problems at the time than the inadequacy of the education I received. It was not until internship at St. Louis Children’s Hospital, where I had the good fortune of being under the tutelage of Dr. James P. Keating, when my love of clinical medicine blossomed. Medicine was no longer a “game” of showing who was smarter than whom. It was about real people in need of help and whatever little each one of us could do to help them. Internship was a defining year of my career and Dr. Keating had a lot to do with it. He is a teacher’s teacher. To this day, he still sends us interesting cases through e-mails on a regular basis. Once a teacher, always a teacher!

As you may have noticed, of the many professors who have significantly influenced me, many have passed on and many are no longer accessible to me. Over the past few years, I had many moments when I regretted that I had never taken the time or mustered the courage to re-contact them to tell them how much they had meant to me. I had simply procrastinated until it was too late. I certainly hope that you will not make the same mistake that I did.

Now that I have exhausted your patience hearing about part of my life, I would like to turn to another perspective of the academic life cycle. In the MTC course, we spent a lot of time discussing biochemical pathways, and study how one metabolite can be converted into another metabolite through a series of enzymatic reactions. Like a biochemical cascade, the life history of Homo sapiens is that of a temporally linear existence from an early embryo to senescence and death – each stage of development likened to that of a biochemical intermediate. In an individual’s career, stages of development are often attained with the help of mentors – metaphorical human enzymes – who fit the student substrate like a key to unlock his or her potential. This notion of compatibility between the mentor and mentee, and curriculum and student, is reflected in the medical school admission process where we select candidates that best “fit” the strengths of our curriculum. We speak of the candidates’ “track records” and constantly ask: “Does this student know where he or she is going?” Furthermore, we create curriculum pathways for students to follow in case they may go astray, and we advise them about their “career trajectories”. It seems to me that we spend our whole life going from one station to another, and the measurement of success is whether we can control the path of our life history. Thus, there are few occasions of greater stress in a medical student’s life than Match Day for residency, when the notion of a small element of chance seems so unsettling to many. The future is not good if it is not predictable. What happen to the joy and excitement of “Surprise!” I have often felt that like enzyme reaction cascades, there can be enormous gain or expenditure of energy along the career path, and I often wonder at the end of a long pathway whether a student would feel totally energized, or completely spent?

In the 1930’s, Hans Krebs, working in Sheffield, England, discovered the Citric Acid Cycle. If the career path of a student is like that of a biochemical pathway, a medical school is like a biochemical cycle. We take the appropriate student substrates and turn them through a machinery we call the “curriculum” and in the end, students emerged transformed. Every year at graduation, I cannot help but think that the great cycle has turned one more time as I bid farewell to the graduating class, only to realize that another new class of students is already being buckled-in and is ready for the launch through our curriculum. Of course I would like to think of our medical schools as more like the Citric Acid Cycle which turns out high-energy products, instead of another biochemical cycle discovered even earlier by Hans Krebs – the Urea Cycle – which turns out only waste products!

In recent years, there is increasing realization that pathways and cycles are gross simplifications of the actual biochemical environment in biological systems. The work of Albert-Laszlo Barabasi and others have convincingly shown that a network configuration, described in terms of nodes and links, is a much more accurate and realistic description of biological and biochemical relationships. The idea that scale-free networks, which display hub-like features, are natural consequences of evolving genetic and biochemical relationships in a biological system have taken hold, just as evolving information and air-traffic networks have been similarly studied with great success. Nodes on a network are described as high connectivity or low connectivity. Likened to your career, I do not know if becoming a node with a high connectivity reflects that your career is more successful and vice versa. As you graduate from this school, I hope that your own pathways will take you to your desired node in the network. I will miss seeing you all but it gives me great comfort to at least know that you will be somewhere on the network, the fraternity-sorority (or humanity) who vows to take care of the sick, connected!

For an academic physician, balancing a career between research, clinical practice and teaching has always been a difficult juggle, not to mention the great attention one has to pay to family and friends as pointed out by Dr. Arthur Moss in his AOA lecture last year. There are some who hold a cynical view of the career path of an academic physician towards career senescence: do research when you are young and innovative; see patients when that fails; teach when you become too burned out in the clinics (left hand panel of the following diagram).

Life Cycle

I do not subscribe to this dim view of the academic life cycle, and would like to offer up three alternatives. First, one can liken the academic career as depicted in middle panel of the figure above. The three rings representing research, patient care and teaching processed simultaneously. In some situations, they augment each other. However, it is quite clear that the three cycles cannot turn in the same direction all the time. Where the turning of two pairs of cycles augment each other (e.g. research augments teaching, and research augment clinic), the third pair suffers (e.g. clinic is opposed by teaching). For many, this is perhaps the reality of academic medicine but there are other models worthy of consideration.

In the diagram on the right hand panel of the figure above, one can cycle continuously and harmoniously through research, clinic and teaching phases. The transition from one to the other is seamless, even though at any given time, one is performing only a single task. Productivity in each is reduced, even though life may be simpler at any given time.

Finally, perhaps the best model for describing the responsibilities of the academic physician is that of a tricycle. One can readily appreciate that in a tricycle, wherever the wheel with the greatest strength leads (the peddled wheel), the two others will follow in synchrony. I hope that you will think of this model of the academic “life tricycle” in the years to come.

Tricycle

To honor the title of the talk, I will now return to the beginning of my academic life and tell you another anecdote.

Those of you who have been to Hong Kong would know that summer there is notorious for its sweltering heat and high humidity. Our family of six resided within a few hundred square feet of living space in low-income government housing with “natural ventilation”. Because this was not a good environment for studying, I had to look for alternative venues, but public libraries were often too crowded. During my high school years, I had developed the following survival strategy: each day, I would take my school work to the lobby of a grand hotel for foreign tourists and sit there to do my work as if I totally belonged there. Since there was usually a lot of human traffic in those settings, it would often be a few hours before the hotel management noticed my presence, upon which they would gently ask me to leave. On a good day, I would have left before I was noticed and re-located to another hotel lobby. This was a poor boy’s method of getting free air-conditioning to help with his studies.

So it was that one day in the summer of 1973, a few weeks before I was to depart for the States, I was sitting in the lobby of one of the grandest hotels in Hong Kong. Sitting next to me was an American tourist who looked to be in his 60s. Seeing that I could read English, he began some small talk. He told me that he was a recently retired steel worker from Ohio who had decided to use part of his life-long savings to travel the world before it was too late for him. Upon learning that I was going to go to MIT for college on a full scholarship, he broke into a broad smile and said, “Son, your future is under your feet!” Soon the tour guide came and he left with his tour group. I never knew his name.

Almost 35 years have passed since that encounter but my memory is still vivid. I remember the genuine expression of pride on his face that his country was taking on the responsibility of educating the underprivileged of the world. The America I saw in his eyes was generous, friendly and had a strong sense of responsibility. In a very real way, I felt as though he had welcomed me to his country and his home long before I even set foot in North America. Much has changed in this country in our attitude towards foreigners since then, and I cringe to think of the shame that he must feel should he still be alive today. Nevertheless, the United States has given me the greatest gift a poor boy can ever get: not citizenship, freedom or the right to vote, but the education of a lifetime. Now, as a naturalized citizen, I have felt that the only way I know how to repay the gift is to educate in return. As we head toward an election season, there will be many who will remind us of our patriotic duties, or try to define for us what patriotism means. I do not define patriotism with guns and missiles, borders or barriers, or event the Constitution or the Flag. To me education is the essence of humanity, and to be patriotic is to teach – our students, our children, our patients, our citizens and our world.

Medical Student AOA Inductees

Advisory Dean: David Lambert

Tara Arndt Wenger
Blink, blink, blink….you would have to close your eyes for a long time to not see all that this student has accomplished. From an early age, Tara Wenger showed academic distinction. Her abilities were fostered and supported by her parents as she began college at the University of Washington at age 14, obtaining two degrees in 2001, a BS in Neurobiology and a BA in Psychology. She was a technician with the Infant Primate Research Lab and volunteered as an educational assistant for children with autism and developmental disorders along with doing some acting in stage plays.

Tara came to Rochester to be in the Medical Scientist Training Program to obtain the joint degrees of MD and PhD. Working at understanding pervasive developmental disorders or autism, her thesis was titled “Eyeblink Conditioning in Autism and Fetal Valproate Syndrome”. Tara looked at the frequency of eyeblinking in children with autism compared with those with normal development. She completed and defended her PhD in 27 months and her PhD was awarded last year.

Tara’s contributions to community service have been tremendous. Tutoring at risk inner city children on Saturday mornings for five years, along with other volunteer work, she contributed over 400 hours and recently received the Class of 1996 Community Service Award.

Tara has an ability to connect with anyone at any level. Whether discussing events of the day with a preschooler or reviewing the science behind a neuropathway with a senior faculty member, Tara connects and is engaged. Her warm and accepting personality endears her to all. In discussions, Tara is always a few steps ahead and can help all members of a group make the trip with her to the next level. Having Tara in a lunch group really took the burden off me of trying to stimulate meaningful conversation on my own—thanks Tara, I owe you.

Tara not only found great medical knowledge, scientific discovery and the rewards of helping others, she also found her husband and soulmate, Jesse. Tara has done outstanding work in medical school in all spheres—clinical care, research, education, community service. Her immediate future is in pediatrics and likely pediatric genetics where her accomplishments will continue.

Caitlin Dwyer-McNally
Somersault in a pike position, Phelps vault, tumbling pass, nailing the landing. No, these are not medical terms, they are daily conversations in this student’s life before medical school. Caitlin Dwyer McNally trained over 25 hours a week as a gymnast. The idea of hard work and dedication were part of her life early on. To pursue academic and gymnastic challenges, she chose to go to MIT where she studied biology, competed in gymnastics and her skills at leading her team were evident as she was named captain her junior and senior years. A fractured tibia and torn ligaments pulled her out of competition for a time but helped her gain insight into the perspectives of a patient, solidifying her desire to pursue medicine. Choosing to gain medical experience, she worked for a year at MGH doing transcranial Doppler examinations acquiring knowledge about neuroanatomy.

Here in Rochester, Caitlin attacked her courses as she would an apparatus. One on one but contributing to her new team, her classmates. A research project looking at gender differences in ACL injuries at Pittsburgh occupied the summer after her first year. She managed to coach gymnastics locally, and do competitive sailing as well. Tireless in all her efforts, she as an ability to identify what needs to be done and gets it done at an outstanding level. A reliable member of a team and a clear team leader, Caitlin has chosen a career in Emergency Medicine. Her gymnasium will be an emergency department, her apparatuses will be the trauma bay, urgent clinic, ortho room and others. Once again the member of a team, she will treat, heal, comfort and cure and do all with precision and compassion.

Matthew Davis
52698. This number was given to a woman in 1944 when she entered Auschwitz. Faced with great uncertainty, she probably never imagined that her grandson would graduate from medical school in Rochester, New York in 2008. Matthew (Matt) Davis grew up in the Granite State, played football and left New Hampshire to attend college at Duke University and pursued double degrees in Chemistry and Public Policy Studies. He also threw in a concentration in Biochemistry. Matt volunteered as a patient advocate on a surgery floor and an oncology floor at Duke Medical Center. Advocacy skills he may have inherited from his father the attorney, perhaps. Working with oncology patients he was struck by the human condition, the strength of others and the ability to provide comfort. These all led him to medicine and to our school where he excelled. Matt was also a less verbal student in our lunch sessions. He was later described by a classmate as someone who “…clearly is listening all the time and on the instances where he says something, he always says something important…” Matt is always very thoughtful, analytical and insightful. Matt is your leader in the background. In small group settings he would help the group to move forward in a facilitative way.

In medical school, Matt served as a tutor (his mother the high school principal’s influence), conducted research in Urology, was a member of the Surgery Interest Group, participated in the Humanities Pathway working on a video documentary on suicide prevention in Iraqi veterans along with other activities and contributions. It has been fun for me to have Matt periodically e-mail or drop by with a few questions. Sitting and talking I often felt like I was discussing things with a colleague.

Many of us would have predicted that given his athletic achievements, membership in the Surgery Interest Group, research work in Urology that he would be destined for a career in surgery or a surgical subspecialty. But for Matt, these fields are not invasive enough. Instead, Matt will pursue a career in psychiatry. His contributions will be tremendous and he will help others develop the skills, foster the resilience needed to face adversity in their lives. These are characteristics his grandmother clearly possessed and would be proud to see him facilitate in others.

Anne Fender
The daughter of two attorneys who moved her from Southern California to London and back again, Anne Fender entered Stanford set on medical career caring for animals. Yes, her goal was to be a veterinarian. Although she enjoyed learning to play polo at Stanford, experiences teaching disadvantaged grammar school students, emergency room volunteer work and a trek to India led her to focus on medicine for humans, instead. I believe we have her husband to thank for helping her see the many merits of medical school in Rochester—a decision I know she feels is the right one.

Anne’s quiet, analytical way made me often wonder the first two years in Dean’s Lunch meetings, what is she thinking? I came to realize that she was thinking about everything, constantly and with a critical eye. That was evidenced in not only her outstanding academic performance but also by the organized meticulous way she approached everything she did in medical school. Anne founded the Dermatology Interest group and participated in a bioethics journal club. Volunteer work she did included tutoring pregnant teenagers and teens with small children. Evaluations in medical school often cited her intelligence, ability to put patients at ease and her mature demeanor.

Taking a year out in pathology, Anne further broadened her knowledge and skills and became enamored with dermatopathology. Educational and research projects in the field of dermatology followed. Her interest in the science and clinical aspects of the field of dermatology are evident to all who work with her. Anne is not all serious work, she is an athletic woman who has run marathons, loves to travel and has a great laugh and a wonderful sense of humor.

Anne arrived at Stanford believing her future would involve fur, shells and scales, but life’s experiences and her passions led her to Rochester where she will leave focusing not only on skin but on the science and clinical care of people with dermatologic diseases

Advisory Dean: Frank Richeson

Marjorie Gloff
At the luncheon after this class’ White Coat Ceremony, I happened to sit at the table with Marjorie Gloff and her family. I was blown away, not only by Marjorie’s vim, vigor, and enthusiasm, but also by her wonderfully supportive family. Her father is an arborist from the Buffalo area, and he gave me sage advice about my ailing trees.
Marjorie was a UR Phi Beta Kappa undergrad who was an old hand at the Medical Center when she matriculated as a medical student: she had not only published research, but she had worked for four years on the NICU. Hard work, enthusiasm, and a smile-that-won’t-quit are the qualities I would say best characterize Marjorie’s last four years. We’re lucky that Marjorie hopes to stay in Rochester, as an Anesthesiology resident.

Natt Songdej
In my Dean’s Letter for Natt Songdej, I wrote “Occasionally, a student comes along who fulfills and far exceeds all of the aspirations the School has of its students. Natt is one such student.” Originally from Thailand, he grew up in California, attended UCLA, and distinguished himself both academically and working with at-risk and developmentally-disabled youth. Community service, both locally and globally, has been one of Natt’s strengths. After first year, he won the Hoffman Award for the best international research project, based upon work done in Thailand, and he took an extra year last year to earn his MPH degree.

Natt is a wonderfully humble, warm, and soft-spoken man whom any of us would be delighted to have as our doctor. Having said all of this, however, his greatest accomplishment in the past five years has been to link up with another of our inductees: Pooja Rao.

Advisory Dean: Larry Guttmacher

Tracy Fuller
Born prematurely at Strong Memorial Hospital, she will now graduate from the U of R very maturely. She may well be one of the only students who will graduate from the U of R having made money as a student. She managed to win every conceivable award, some of them with money attached. She was the recipient of the Hrolfe and Dorothy Ziegler Prize for Excellence in Anatomy; The Book Award for DPT I; the Book Award for DPT II, and is probably up for the Presidential Medal of Freedom for all that I know.

After leaving the NICU, she was raised in West Seneca, NY, then attended Case Western Reserve University where she double majored in Biology and Psychology. It will undoubtedly come as a great shock to you to learn that she won every award there. She was co captain of the varsity volley ball team, led various student government groups, their Honor Board, etc. I also believe that she cured those with Hansen’s Disease in her spare time.

When she arrived in Rochester she pursued a similar list of activities singing with On Call, served as VP of Class Council and of Interclass Senate, worked at St Joe’s Neighborhood Center, etc, etc.

Tracy set the pattern and utterly ignored the first advice that I gave her and all entering medical students: “Whatever you do, do not fall in love with someone in the early match”. Her fiancée, JP, who attended Ohio State, has now matched at Walter Reed in the military match, so barring remarkably inept admission committees; she will end up in the Baltimore/Washington metropolitan area.

As a final note, I would like to thank whoever the neonatologist was and I hope that he or she knows what she or he had a hand in. I expect similar miracles out of Tracy in her career as a pediatrician.

Koto Ishida
Koto grew up in Cleveland in an academic family. A self-described weak and shy kid, she took up Tae Kwon Do, achieving black belt status while still in high school. Not satisfied with this achievement alone, she also became a gifted pianist and clarinetist.

She went from Cleveland to Berkley where she continued to shine academically, musically, and athletically. She was a member of their collegiate national champion Tae Kwon Do team, was principal clarinetist in the Berkeley Wind Ensemble, and volunteered in an Alzheimer’s day program. This latter activity was one of those things which made her opt for medicine. She spent a year after medical school working as a medical assistant and fortunately for the U of R decided to attend school here.

Her musical gifts remain a wonder. She has performed with the U of R Symphony as a clarinetist, and recently entered a concerto competition with them and emerged as the winner as a pianist. She will be performing with them on March 1.
While at U of R, she has worked at UR Well, has volunteered as an Art Therapist with the Children’s Hospital, joined the local U of R Tae Kwon Do Club, volunteered at local nursing homes bringing live music to the residents, and worked with Physicians for Human Rights. She spent the summer after her first year working in Thailand with street children. This resulted in a wonderful publication in AMSA’s International Health Journal.

Koto is, in short, precisely the child that my parents hoped for and never had. She is going to be one marvelous neurologist.

Her personal statement for residency application quoted Nina Simone, “It’s a new dawn, it’s a new day, it’s a new life for me. And I’m feelin’ good.” She’s got every right to be feelin’ really good. She’s earned it.

Advisory Dean: Betsy Naumburg

Matteo LoPiccolo
Mr. LoPiccolo has a quiet, congenial style, and a track record of hard work. He is loyal to his Michigan roots, returning there for research and other experiences. His presented “The Effectiveness of the Cavus Foot Orthosis,” in Michigan in the spring of 2006, based on work conducted in Michigan the prior summer. He also did a clinical rotation at the Henry Ford Health System this past summer. Matteo has also been a dedicated athlete. He was captain of his college foot ball team, active in intramural sports at medical school, again serving as captain of the intramural football team and trained for a “mini-triathlon”. The focus of his early research, as well as his love of sports and athletics seemed to predict a career in orthopedics. However, he has surprised us and is headed towards a career in Dermatology. I wish him well, as I know that he will continue to challenge himself to excellence in every arena.

Brooke Miller
Ms. Miller came to medical school with more life experience than the average medical student, which contributed to her stellar performance, but is not the whole story. She is delightful to work with both because of her “can-do” attitude and her self –awareness. She is highly intelligent and analytical but just as importantly has a huge amount of down to earth common sense.

She is a planner- certainly getting her money’s worth out of the Advisory Dean System. She came to discuss plans for summer breaks, her commitment to community service, a wedding, pregnancy, combining children and residency and many of life’s challenges. Her style of looking ahead serves her well.
She used her skills of being positive, organized, and adaptable to turn the demise of a desired summer fellowship in reproductive medicine into award winning community service. That was only one of many community service projects that she was involved in. She will undoubtedly find the balanced life that she seeks, but as part of that, she will offer the lucky community she serves, the very best that health care has to give.

Brian Morray
Mr. Morray is a hard working and focused individual but combines that with an easy and affable style. He traveled extensively and lived abroad as a child and attributes his introspective nature and open mindedness to those formative experiences. As an undergrad he had a major commitment to the Duke University Chronicle as Design Editor. Similarly, in medical school he has taken on several projects and dedicated many hours to each including:

successful research with Dr. Moss from Cardiology,
UR Well, the student run free clinic,
Vice President of the local student AMA chapter which led to
coordinating American Red Cross Blood Drives, and
Serving as best friend and best man for a class mate.

From even before his entry to medical school he was passionate about Pediatric Cardiology. He has remained committed to that goal. Unfortunately, I fear that we will lose him to the northwest, as that is also where his heart lies.

Sydney Montesi
Ms. Montesi has a smile that can light up the world and the qualities of warmth, humility and integrity to go with it. In addition to her academic accomplishments, she provided leadership to organizations that completed significant projects under her guidance. She was the Co-Chair for the Internal Medicine Interest Group when it was chosen as the student group of the month by the Council of Student Members of the American College of Physicians and Co- Chair of the Operation Smile project which published the successful, fundraising cookbook, “Rxcipes for Smiles.”

The arts have remained an important part of Sydney’s life. She has been an active part of “Art of Observation”, completed the Humanities pathway and published an essay in the Yale Journal for Humanities in Medicine.

Her medical school career was delayed at the onset for a year while she took time out to be with her father, who was undergoing treatment for serious medical problems. While he is not here with us tonight, I am happy to say that he is still able to celebrate Sydney’s success and hopefully will be there at graduation.

Sydney has demonstrated all of the talents to achieve, not only as a superlative physician but as a humanistic healer.

Maryann Overland
Ms. Overland is simply a delightful person. She came to medical school leaving behind a career as an opera singer. But she brought the energy with her. Her presence is upbeat with a contagious sense of joy for the work of medicine. Her maturity is manifested in her excellent balance of competence and confidence. She has held leadership positions in school organizations and made major contributions to community service and student activities, especially in the area of reproductive health. These include AMSA president, Medical Students for Choice coordinator and teaching at the Sojourner House. She is a successful author, with an essay published in the Annals of Internal Medicine.

She is headed towards a career in primary care with an outstanding medical school performance as well as the skill of empathy well in hand. As evidence, I offer Maryann’s words from her story “Joan’s Education”. In the story a medical student, Joan, immersed in the demanding world of medical school, needs to re-find her heart to really help her patient, Alicia.

“Joan put down the chart and pen, unwrapped the noose-like stethoscope from around her neck, shrugged off her white coat, and said, "Tell me." .....Crying for the distance she had strayed from her vision of what it meant to be a healer, and crying because she hadn't realized it until now. She resisted the voice in her head that told her she was being unprofessional, and allowed herself to weep with Alicia until they were both out of tears.”

Tracey Perazone
Ms. Perazone has the attitude and skills of someone who has spent a lot of time in the woods...which she has. She is cheerful, pragmatic, adaptable, and self-reliant. She also loves leading teams- teams of kids as a camp counselor at Fowler Camp in the Adirondacks, teams of medical students as a PBL tutor and teams of runners and walkers as the organizer of a 5K fundraiser event for UR Well, the student run free clinic. She has also found the time to pursue her love of hiking and running through medical school. Given her love of young people, it is no surprise that she is planning to enter the field of pediatrics. And as a born and bred upstate New Yorker, hopefully she will be part of the Rochester community for years to come.

Pooja Rao
Ms. Rao is an earnest and compassionate individual who is motivated to work hard in the service of others. It is clear that her caring attitude and passion for excellence are heartfelt. Her clerkship evaluations consistently comment on her remarkable rapport with patients and describe how Pooja often performed the simple but crucial tasks that can make a substantial difference to patients’ well being such as “calling physician’s offices, making appointments, and updating family members”. Her humility informs all of her actions.

Her background in the Peace Corps has given her a more comprehensive understanding of health which she has continued to pursue in International Medical activities and community service at home. It is logical that she has chosen to enter primary care, which will give her the skills to work anywhere in the world, which she is likely to do.

Deanne Robinson
I had the pleasure of knowing Ms. Robinson since she was a medical assistant at Highland Family Medicine, when medical school was only a dream. As you can imagine, she was an amazing medical assistant--caring and compassionate with patients and supportive for the provider, always anticipating every need. She is an unusually well organized and clear thinker. Her stellar medical school performance has been coupled with commitments of wife and mother. She spent a productive fellowship year exploring academic medicine and was a member of a highly successful community health initiative to address lead poisoning called “Get the Lead Out”. Her notable strengths were recognized by the leadership of the medical school with a position on the medical school admissions committee, which is also a major commitment.

After much soul searching, she has chosen a career as a dermatologist but will undoubtedly incorporate her love of children and genetics into the mix. Her fans back at Highland Family Medicine are delighted to see how far she has gone and expect that there will be more.

Resident and Faculty Inductees

Rona Norelius, MD
(Introduced by Tracey Perazone)
Rona Norelius is a fourth year surgical resident. I first worked with her during my third year surgery clerkship at Rochester General Hospital. I began surgery with a lot of anxiety, but Rona and the rest of the team immediately made me feel welcome. Rona always made sure I was included in discussions of patients, and encouraged me to scrub into as many cases as possible. At one point, I was scrubbed into an operation with Rona, a female attending, and a female nurse, and it occurred to me that all the people around the patient were women. That was very striking to me. Rona is an excellent role model and teacher and was an integral part of making the surgery clerkship one of my best experiences during third year.

Andrew McGarry
(Introduced by Matteo LoPiccolo)
I nominated Andy McGarry for AOA because I felt that he was one of the best residents I have had the opportunity to work with during medical school. Andy and I were on the neurology consult service together, and I was immediately impressed with his vast knowledge base. He gave very detailed answers to all of my questions, and often cited very specific points from the literature. I also appreciated the fact that Andy treated me as one of his peers and not simply as another annoying medical student tagging along at his coattails. He was always very congenial and never wasted my time with mindless tasks. Most importantly, however, I was amazed at Andy’s relentless dedication to teaching. He made it his goal to make sure I learned something new each day of my rotation.

The best example I can recall is while teaching me the neurological exam, he volunteered to be the patient, which included allowing me to perform a fundoscopic exam on him for 3-4 minutes until I was able to fully visualize the important structures of the eye. His willingness to sacrifice his time, and his vision, so that a medical student could learn clearly identifies Andy as an excellent resident who is more than worthy to be a part of AOA.

Cheryl Kodjo, MD
(Introduced by Tracy Fuller)
Dr. Cheryl Kodjo is an attending physician in the department of adolescent medicine at Strong, and is currently an assistant professor of pediatrics for the school of medicine. She is also serving her 8th year as the Medical Director of the Adolescent Primary Care/Teen-Tot Clinic.

I was privileged to have Dr. Kodjo for a teacher during our ambulatory clerkship experience, where she taught us adolescent interviewing skills. It then became my good fortune to have her for a preceptor during my third year pediatric clerkship, where she helped me put these skills into practice. While working with her in adolescent clinic, I was impressed with her ability to quickly gain the trust of her patients and to discuss sensitive issues with ease. She took time out from a busy afternoon to talk through our patients’ cases with me and answer my questions about their care. From a medical student’s point of view, willingness to teach is one of the most important qualities of a physician, and Dr. Kodjo clearly makes teaching a priority.

Another notable facet of her career is her position as Faculty Liaison for the Student National Medical Association. Students who have worked closely with her through this organization describe her as “personable, encouraging, and an exceptional mentor.”

Dr. Kodjo is not only a dedicated clinician, but also a dedicated teacher to medical students, pediatric residents and fellows in adolescent medicine. She has had a great impact on both students and young physicians during her time in Rochester, and it is my pleasure to show our gratitude by honoring her tonight.

Ralph Doerr, MD
(Introduced by Marjorie Gloff)
Back, what seems like a lifetime ago, at the end of our second year of medical school we had the opportunity to request preferences for our third year schedule. Well, all I knew at that time were 2 things. The first was that I wanted to become a pediatrician and the second was that I was scared to death of surgery– probably because of what I had seen on television and rumors about other’s experiences. Armed with this preconceived fear - I scheduled surgery dead last to put it off as long as I could. Well, all I can say is that my preconceived notion was wrong. I was so wrong in fact that I changed my career path from pediatrics to anesthesiology – largely because of the world Dr. Doerr introduced me to.

Dr. Ralph Doerr, Chief of Surgery at RGH since 2001 and Professor of Surgery at SUNY Buffalo, has been teaching since 1975. Education, in fact has been a major part of his life since medical school, winning teaching awards from Albert Einstein School of Medicine, the State University of NY, the University of Rochester and the National Board of Medical Examiners, Surgery Section. He has developed an art to they way he teaches both residents and medical students –finding insightful teaching points in the emergency room, the OR, the ICUs and on the floors. Working with Dr. Doerr is one of the greatest privileges I will take away from these four years in medical school. He was an easy choice for the Volunteer Faculty Member AOA award winner. It is with my great pleasure that I present this award to you, Dr. Doerr.

Randy Rosier, MD, PhD
(Introduced by David S. Guzick, MD, PhD)
Dr. Rosier is a 1978 graduate of our medical school and received his PhD in biophysics is 1979. He is extraordinarily well deserving of election to AOA as an alumnus due to his significant contributions to the field of orthopaedics and musculoskeletal research. After his residency in Orthopaedics at the University of Iowa, Dr. Rosier returned to Rochester to join the faculty of the Department of Orthopaedics and create an Orthopaedic Oncology service. In addition, he established a molecular biology research program in the area of cartilage development and regeneration, and an Osteoporosis Center. In 2000, Dr. Rosier was appointed Chair of the Department, and established the Center for Musculoskeletal Research. This is now the #1 NIH funded Department of Orthopaedics in the country.

In 2005, his application for a Center for Research Translation in musculoskeletal biology received the highest score in the NIH study section. He is also a Key Function Director in our Clinical and Translational Science Award. In 2007, Dr. Rosier stepped down from his position as Chair to devote more time to his research. Recently, with Dr. Regis O’Keefe (who currently chairs the Department), he began an orthopaedic oncology service at Highland Hospital. Dr. Rosier serves as a director of the American Board of Orthopaedic Surgeons and is a member of the Advisory Council of the National Institute of Arthritis, Musculoskeletal and Skin Diseases. He has authored more that 140 peer reviewed publications focused on molecular biology of skeletal tissues, osteoarthritis, osteoporosis, and orthopaedic oncology.

We are privileged to elect Dr. Rosier to AOA as an alumnus of the School of Medicine & Dentistry. He has had a distinguished career as a clinician, investigator and administrator, and has been a solid citizen of the medical center and University, always making himself available to help in any way that he can in advancing science, education and patient care. We are lucky that he has been part of the medical school community, and he will no doubt continue to contribute substantially to all of our missions in the years to come.

Meliora,

David S. Guzick, MD, PhD
Dean, School of Medicine and Dentistry
University of Rochester