Dr. Darrell Triulzi, M.D., gets excited when thinking about the direct impact his work has on patients.
The former URMC Pathology resident (1986-1990) now serves as the director of Transfusion Medicine at the University of Pittsburgh Medical Center Department of Pathology and medical director of the Institute for Transfusion Medicine.
He originally intended to work in internal medicine but switched to pathology during his second year of residency. After a rotation in the Blood Bank, Triulzi says he found his calling.
“I immediately fell in love with the Blood Bank because it combined clinical medicine and pathology," he said. "It was one of those niches where you could do both clinical and laboratory medicine, and there aren’t many places where you can do both.”
After residency, he completed a fellowship at Johns Hopkins University and later joined the faculty at University of Pittsburgh, where he's worked for the last 25 years. His driving inspiration is finding ways to improve patient care and safety in transfusions, and a practical way to do that is by participating in clinical research.
He has taken part in a number of multi-institutional NIH-funded clinical trials since the 1990s. These studies have addressed such questions as: Will HIV patients who receive transfusions progress to AIDS more quickly? The findings said no. Or, a study published in The New England Journal of Medicine asked, what’s the proper platelet dosing strategy for cancer patients? What about the storage duration of blood in cardiac surgery patients?
A follow up study published in Blood questioned whether it made a difference if platelets are apheresis or pooled, fresh or stored or ABO matched. When results showed that it did not, a number of providers responded positively, saying this information helped them strategically manage platelet inventory. Triulzi most recently began working on an NIH study examining the use of an antifibrinolytic agent to reduce bleeding in cancer patients.
He is co-chair of a multidisciplinary health system-wide patient blood management (PBM) committee at UPMC alongside fellow co-chairs, an anesthesiologist and a trauma surgeon. Like many PBM groups across the U.S. the committee has worked to promote restrictive transfusion practices in clinical settings.
While blood transfusions can be life-saving, there are safety risks linked to using them. Physicians are therefore encouraged to only administer transfusions when absolutely necessary for the patient. Triulzi says this effort is having a real impact in recent years as UPMC has reduced total transfusions by more than 30 percent.
“I’ve always enjoyed taking care of patients and the clinical side of medicine,” said Triulzi. “I think one of the reasons I chose blood banking is because it’s a consultative service to the clinicians that’s not so much looking at slides like most pathologists do. There is a more outward focus.” He added, “Most physicians at the hospital think that I’m a hematologist as opposed to a pathologist, and I take that as a compliment.”
Triulzi has fond memories of his time in Rochester, where he met his wife Mary, a dietician. He continues to keep in contact with longtime mentor, Dr. Neil Blumberg, director of Clinical Pathology, and credits Blumberg with triggering his interest in academic pursuit within his career.
An Albany area native, he and his wife have three children, Leah, 23, Ben, 20, and Sam, 15. In his free time Triulzi enjoys studying American and European history, attending University of Pittsburgh football and basketball games, and playing fantasy football.
Former Pathology resident, Dr. Lorraine Lopez-Morell, is achieving her dream of being a forensic pathologist right in Rochester.
Dr. Lopez is the Associate Medical Examiner in the Office of the Monroe County Medical Examiner.
She was raised in Puerto Rico and came to the U.S. at the age of 18 to go to Michigan State University for undergrad. While she was very young, her father passed away while waiting for a heart transplant.
This tragedy inspired her to pursue a career that would allow her to help other people. The field of pathology drew her interest.
"I love taking things apart and figuring out how everything works in the body like a machine, and that's what pathology essentially is," she said. "You have to know every single aspect of the human body."
After earning her MD from Columbia University in NY City, Dr. Lopez came to UR for residency from 2010-14. During that time, she was impressed by the work ethic that played a big part in shaping the culture there.
"Most of the attendings taught me what it means to be a real professional; how to do the hard work and appreciate what you've done at the end of the day, and go home satisfied with that,” she said. “I think that was really important to everyone as an overarching theme – to leave no stone unturned and be really at peace with what you've worked on that day."
As a medical examiner, she is doing just that. From testifying in court to dealing with police, attorneys, jury members and those who are laypeople in terms of medicine, she is able to take something as complex as an autopsy and make it easy to understand.
The Office of the Medical Examiner follows statues on what cases require autopsies or what examination is required for a given case. While the chief medical examiner (whom, in Monroe County, is fellow alumna, Dr. Nadia Granger) has discretionary power over what kinds of cases require autopsy, there are several types of cases in which it’s always required: If a person is killed or suspected to have been killed at the hands of someone else, killed by their own hand, or dies accidentally. Dr. Lopez says these requirements are not likely to change anytime soon.
Every autopsy is very hands-on. And while some see digital imaging as a feasible alternative (in some cases), the necessary equipment is costly and the image resolution not up to par with an actual autopsy.
Part of her role includes explaining the cause of death to family members of the deceased.
"Here, if families have a lot of questions, we're happy to speak with them about interpreting what's in our reports," she said. "I find it rewarding, to listen to someone come to the realization that they understand what really happened to their loved one."
In addition to her daily workload, Dr. Lopez is interested in doing research. This month, she will present research on a heart condition called left-dominant arrhythmogenic cardiomyopathy to the National Association of Medical Examiners.
She hopes to explore public health issues in the future, such as the rising number of opioid-related deaths in the county.
After finishing residency, Dr. Lopez completed two forensic pathology fellowships; first at Wake Forest Baptist Medical Center, and at East Carolina University. A self-proclaimed Northeasterner, she now enjoys living in Rochester.
Her work requires the sort of strength and composure that doesn't waver in the midst of tragedy and the need to find answers. For her, though, it’s nothing to be afraid of.
"I'm not affected as much by thinking of death because it's an inevitable part of life," she said. "We can come to accept it, and talking about it is the first step."