November 2008

White Coat Ceremony marks rite of passage for new medical students

The School of Medicine welcomed its newest class of future physicians with a White Coat Ceremony held on the Health Sciences Center Campus Aug. 10.

The ceremony is an annual rite of passage for first-year medical students, who are presented with white jackets that symbolize their dedication to patients, colleagues and the medical profession. Students also pledge to uphold the highest standards of professional conduct and respect for human dignity.

This year’s class is the second-most accomplished in school history, officials said, with average exam scores and undergraduate GPAs that are surpassed only by last year’s incoming class of medical students.

Edward Halperin, M.D., M.A., dean of the School of Medicine, welcomed the 155 matriculating students to “the company of educated women and men who chose to devote their lives to the relief of pain, the amelioration of suffering and the avoidance, when possible, of premature death.”

“Remember,” Halperin said during his address, “that life is short. The art is long. Opportunity is fleeting. Experience is delusive. Judgment is difficult. Godspeed on this part of your journey, young doctors of the University of Louisville."

Brown Cancer Center gets $10.1 million for cancer research

UofL’s James Graham Brown Cancer Center will receive $10.1 million from the National Institutes of Health (NIH) to explore new ways to treat and prevent cancer, officials announced earlier this summer.

The grant is a renewal of an $11 million NIH grant awarded to the Brown Cancer Center in 2003 to fund a Center of Biomedical Research Excellence (COBRE). Like the previous funding, the renewal will provide five years of support, giving talented young scientists an opportunity to produce initial data in new fields of study so that they may quickly seek individual federal research grants.

“The renewal of our COBRE grant at this level, particularly in this highly-competitive funding environment, is well-deserved national recognition of the outstanding scientific discoveries made at the Brown Cancer Center over the past five years – discoveries that will ultimately change lives and create jobs for our community and state,” said UofL President James Ramsey, Ph.D.

“We truly have the minds behind the cures right here in Louisville,” said Brown Cancer Center director Donald Miller, M.D., Ph.D.

“Of the first five young scientists funded by the previous grant for biomedical research, four have successfully competed for individual NIH grants and two of those have discovered new cancer drugs that are being licensed for future commercialization,” Miller said. “The second group includes outstanding researchers who have already contributed to discoveries in molecular targets, cancer vaccines, stem cell biology, gene therapy and computer modeling of how carcinogens interact with genes.”

Miller added that the community’s support and Bucks for Brains have helped boost the cancer center’s national reputation.

“They have helped us bring top physicians and scientists to Louisville, renovate our clinical facilities, invest in state-of-the-art technology for both research and treatment and make exciting new discoveries that will lead to tomorrow’s cures, including at least 27 new treatments in various stages of preclinical testing,” he noted.

Between 1999 and 2008, the Brown Cancer Center’s research funding has increased from $338, 571 to more than $50 million annually.

Friedland named as new chair of neurology department

Robert Friedland, M.D., has been appointed Chair of the Department of Neurology in the School of Medicine, effective Dec. 1 The final appointment is contingent upon approval by the Board of Trustees.

Since 1990, Dr. Friedland has served in several roles at University Hospitals of Cleveland and Case Western Reserve University School of Medicine, including chief of the Laboratory of Neurogeriatrics and as a professor of neurology, psychiatry and radiology.

Prior to moving to Cleveland, he was director of the Alzheimer’s Disease and Memory Disorders Clinic at Georgetown University School of Medicine and Director of the Alzheimer’s Disease and Memory Disorders Clinic. From 1986-1990 he also served as the deputy clinical director and chief of the Brain Aging and Dementia Section of the National Institute on Aging.

Dr. Friedland’s research focuses on the epidemiology and causes of Alzheimer’s Disease with an emphasis on the biological and molecular consequences of gene-environment interaction. His research has been continuously funded through competitive awards from the National Institutes of Health since 1990.

Dr. Friedland earned his B.S. in biology at the City College of New York and his M.D. at the University of Kentucky College of Medicine and Mount Sinai School of Medicine He completed his internship at Beth Israel Hospital in New York and his neurology residency at Mount Sinai School of Medicine, where he also served as chief resident He has pursued additional graduate education in management, health finance and economics and health systems management He is board certified in neurology

A fellow of the American Academy of Neurology, Dr. Friedland serves on the organization’s geriatric neurology, behavioral neurology and neuroepidemiology sections. He is a member of multiple professional organizations including the American Neurological Association, the International Society for Vascular, Behavioral and Cognitive Disorders, the Society for Neuroscience, the Behavioral Neurology Society and the World Federation of Neurology, where he is a member of the dementia and neuroepidemiology research groups.

Dr. Friedland is author or co-author of more than 150 peer-reviewed papers, more than 35 books or book chapters, almost 100 invited presentations and hundreds of abstracts and other presentations. He has mentored more than a dozen postdoctoral fellows and has a distinguished track record of educational activity.

“I am delighted to have Dr. Friedland’s leadership at the helm of the Department of Neurology, and look forward to his contributions as chair,” said Edward C. Halperin, M.D., M.A., dean of the School of Medicine.

Prough to serve as vice dean for research

Russell Prough, Ph.D., has accepted the post of Vice Dean for Research at the School of Medicine, beginning Sept. 1 His final appointment is contingent upon approval by the Board of Trustees.

Dr. Prough will be responsible for supporting an appropriate research infrastructure and liaison with the executive vice president for research, providing leadership within the School of Medicine and HSC in areas such as grants and contracts, IRB processes and oversight of animal care and use. In addition, the vice dean is charged with assuring that the School of Medicine meets or exceeds all requirements for research compliance, while balancing the needs of faculty work assignments with those efforts.

With the staff in the SOM Research Office and in the Office of the Executive Vice President for Research, other areas of responsibility will be to assist the administration in assuring adequate support for the clinical research enterprise including the development of protocols and budgets, completion of required documents, adherence to guidelines, dissemination of information about available clinical trails, streamlining the accounting process and providing training to investigators and clinical coordinators. This position is also charged with serving as the School of Medicine’s primary liaison with the effort to achieve funding of the CTSA at the University of Louisville.

Dr. Prough joined the University of Louisville in 1986 as Chair of the Department of Biochemistry and Molecular Biology, holding the post until October 2000. He has served as professor of biochemistry and oral biology for 22 years He previously served as vice dean for research and vice president for health affairs/research from 1998-2003. He is currently the Preston Pope Joyes Endowed Chair of Biochemical Research and the acting chair of the Department of Biochemistry and Molecular Biology.

Dr. Prough has distinguished record of research, funding and publication in the area of drug and carcinogen metabolism and aldehyde toxicity in cardiovascular tissues. He participates on collaborative projects in these areas with other UofL research faculty. He is the author or co-author of more than 100 peer-reviewed papers, a monograph on the metabolism of anti-cancer drugs and has presented more than 100 invited lectures.

As an educator, Dr. Prough has mentored dozens of pre- and post-doctoral fellows and taught a number of graduate and medical school courses. He has a consistent and exemplary record of institutional service on various university committees and task forces over the last two decades.

“I am delighted that Dr. Prough has once again agreed to serve the School of Medicine as ice dean for research and look forward to his leadership,” said Edward C. Halperin, M.D., M.A., dean of the School of Medicine.

Remmel appointed as associate dean for clinical development and regionalization

Kerri Remmel, M.D., Ph.D., an associate professor of neurology at UofL, has been named associate dean for clinical development and regionalization at the School of Medicine, dean Edward Dalperin, M.D., M.A., announced.

Dr. Remmel’s appointment on an interim basis was effective July 1, 2008, and she will be appointed to the post on a permanent basis pending approval by the UofL Board of Trustees.

As associate dean, Dr. Remmel will help the School of Medicine advance its clinical enterprise by serving as the regional clinical ambassador for UofL Health Care, with the goal of developing, executing and expanding regional clinical care programs.

“She will implement strategies to enhance UofL’s clinical activities and promote the capabilities and offerings of our medical, dental, nursing and allied health providers to key regional stakeholders, including hospitals, private practices, community groups and local and state government,” Dr. Halperin said.

Dr. Remmel, who has served as acting chair and residency program director of the Department of Neurology since April 2006, has been instrumental in the growth, development and accreditation of University Hospital’s Stroke Center, which she has directed since 2002. As a result, the Stroke Center was the first joint-commission certified stroke center in Kentucky. Her extensive educational and outreach efforts in support of early identification and appropriate diagnosis of stroke were recognized when she was named a McCann Scholar for Outstanding Mentors in Science and Medicine in 2005.

Dr. Remmel earned her bachelor’s and master’s degrees in speech-language pathology and went on to complete her Ph.D. in communication disorders and linguistics at Louisiana State University. She earned her M.D. at the University of Louisville and also completed her internship in internal medicine and her residency in neurology at UofL, where she served as chief resident. Dr. Remmel is board-certified in neurology and board-certified as a diplomate in vascular neurology.

While at UofL, she has held the appointments of instructor (2000-2002), assistant professor (2002-2006) and associate professor (2006-Present) of neurology. She directed neurology’s clerkship from 2000-2002 and co-directed the Neuroscience Course in 2002 She served as vice chair of the department from 2002-2006.

Dr. Remmel is active in numerous professional organizations including the American Academy of Neurology and the AAN Section on Stroke and Behavioral Neurology, the American Medical Association, the American Heart Association and the National Stroke Association.

She partners with the Kentucky Department of Public Health in efforts to improve systems of care for stroke patients in the commonwealth, serves on the Kentucky Stroke Systems of Care Planning task force and represents Kentucky at the Stroke Belt Consortium meeting annually.

Dr. Remmel is author or co-author of numerous abstracts and a text on symptom-oriented neurology. She has served as principal investigator or co-PI on numerous clinical trials related to stroke and has presented dozens of invited lectures.

“I am delighted to have Dr. Remmel’s leadership in building our regionalization efforts and look forward to her contribution as part of the School of Medicine’s leadership team,” Dr. Halperin said.

‘Before the Colors Fade’ presents the recollections of a national leader in obstetrics

By Dale Greer

Louisville’s first ultrasound machine was an eye-popping revelation, oral contraceptives were so controversial that the city’s primary teaching hospital wouldn’t even stock them, and laparoscopic surgery was once regarded as the province of charlatans.

These were some of the memories recalled by UofL’s Ronald Levine, M.D., as he looked back on a lengthy career as a professor in the School of Medicine’s Department of Obstetrics, Gynecology and Women’s Health during a special program held Aug. 25 on the Health Sciences Center campus.

The program, called “Before the Colors Fade,” is an ongoing effort to document the history of the medical school and its affiliated programs, as told by individuals who experienced the events first-hand. It began last fall with a presentation by former UofL surgery department chair Hiram Polk, M.D., and is modeled on a regular feature of American Heritage magazine, said Edward Halperin, M.D., M.A., dean of the School of Medicine.

Levine, the son of a Russian émigré father and an American mother, grew up poor in Queens, N.Y., and was the first member of his family to attend college. He went on to a distinguished career in obstetrics and gynecology, serving on national health policy committees and becoming one of the nation’s leading experts in advanced laparoscopic surgical techniques.

His path to medicine was a curious one, he told the audience during a question-and-answer session with Halperin. As a young man, he decided to study chemistry because of the influence of a popular book of the time, “Microbe Hunters” by Paul De Kruif.

In 1946, at the age of 17, Levine applied to the University of Denver, in part because a friend was planning to go there, but also because he had never been west of the Hudson River. While in Denver, Levine joined the Colorado Air National Guard to help pay for school. With the Korean War looming, however, he eventually resigned his post — a calculated bid to avoid combat duty that ended up backfiring. Now free of his voluntary military obligation, Levine was immediately drafted into the Army and sent to combat infantry training at Fort Dix, N.J., in 1951.

The young private was offered a commission as an officer but turned it down because “they only gave you a couple of choices — infantry, artillery and armor,” Levine recalled. “All three sounded like someone was going to shoot at me, so I decided to take my chances as an enlisted man.”

As it had done before, however, fate intervened — this time to Levine’s benefit. Because of his just-completed bachelor’s degree in chemistry, the Army decided not to deploy its newly minted infantryman overseas. Levine was sent instead to the Army Medical Research Laboratory at Fort Knox, Ky., where he conducted research on cold injuries like frostbite for the next 18 months.

When his enlistment was up, Levine stayed at Fort Knox for another year as a civilian employee, doing the same research as before. During this time, he co-developed a novel method for conducting electrical resistance studies of fluids and tissues. The techniques gained the attention of a UofL physiology professor who recruited Levine to become a graduate student in Louisville.

It was during his tenure as a graduate student that Levine decided to pursue a medical degree — partly, he joked, because a mentor advised him that “the M.D.s get all the good grant money.” He graduated from medical school in 1959.

Levine also stepped into the arena of professional boxing, serving as a fight physician for the Golden Gloves during his residency in family medicine at UofL. Through this affiliation, Levine attended to a young Cassius Clay, who would go on to become the heavyweight boxing champion of the world as Muhammad Ali.

“When he was very young and I used to work the Friday night fights, he was very impressive, very brash, very fast,” Levine said of Clay.

After medical school, Levine joined a private family practice in Pleasure Ridge Park, where he soon began covering all the obstetrical cases. (“I loved delivering babies,” Levine said.) He also maintained ties to the boxing world, giving Clay the inoculations that were necessary for him to make his historic trip to Rome for the 1960 Summer Olympic Games, where Clay claimed a gold medal in the light heavyweight category.

When Levine’s family practice group dissolved in 1963, he decided it was time to pursue obstetrics full-time by seeking a residency at UofL.

“I decided this was my chance,” he said. “I always loved OB/GYN.”

As it turned out, Levine had no difficulty getting a residency. The Vietnam War had placed a tremendous demand on the medical system nationwide, making it exceedingly difficult for civilian hospitals to keep enough residents on staff.

“They were so short of residents,’ Levine joked, “ I think they would have taken an educated ape.”

Levine did well in the obstetrics program, where he found a lifelong mentor in Douglas M. Haynes, M.D., who at 35 became the youngest chair of OB in the nation. Haynes went on to serve as dean of the medical school before retiring to teach Hebrew and Greek at the Presbyterian Seminary.

“Dr. Haynes was one of the most brilliant people I’ve ever met in my life,” Levine said. “He spoke five languages absolutely fluently and loved history. I just adored the guy as a model for knowledge.

“God forbid a resident should say ‘C-section,’ ” Levine recalled. “He would say, ‘Oh? Is there an A-section or a B-section?’ ”

Levine’s residency, which he completed in 1966, came at a tumultuous time in American medicine. Birth control pills were political kryptonite, and illegal abortions kept emergency rooms stocked with a steady flow of septic cases.

“The main (forms of contraception) were diaphragms and condoms,” Levine said. “Louisville General Hospital Pharmacy was not even allowed to have oral contraceptives,” even though they were available through agencies like Planned Parenthood, with which Levine would later develop a close association.

“As residents, we would see people with septic shock almost weekly. We became real experts at treating septic shock because we would have people who would have all these illegal abortions. We saw some horrible things — women coming in bleeding, very sick, high fevers with anaerobic infections, all types of infections. It was, indeed, a big problem.”

Those sights made Levin conclude that contraception was “absolutely imperative.”

“It was something we had to do,” he said. “Contraception was the answer to prevent abortion.”

Thus began his long affiliation with Planned Parenthood, an organization in which he eventually would hold several leadership positions, including a seat on its national medical committee. In that capacity, Levin helped chart a groundbreaking course for the establishment of modern contraception techniques that was adopted worldwide.

“We set up the standard of care in contraception,” Levine said. “It was really exciting.”

Levine also was a pioneer in the use of advanced laparoscopic medical techniques, which he learned during a surgical fellowship in Germany in 1983.

At the time, laparoscopy — a technique that uses precision instruments to conduct surgical procedures through a small incision rather than a large opening — was used only for sterilizations and diagnostic procedures in the United States.

“When I brought back the things I learned in Germany to Louisville, Ky., people called me anything from an idiot to a charlatan,” Levine said.

But laparoscopy went on to become standard surgical practice, and today hundreds of surgeons from around the world have trained in advanced laparoscopic techniques at a course Levine developed in UofL’s Fresh Tissue Lab.

Levine noted that the practice of medicine is far less hands-on today than it used to be, with students, residents and physicians relying heavily on MRIs, CAT scans and ultrasounds even though a physical exam could be just as effective.

Nonetheless, he admitted a fondness for modern equipment — “I was always a sucker for technology” — and recalled the first time he ever saw an ultrasound machine.

“You could hardly see the screen, and (then) I saw a baby, and I said, ‘Oh, my God! Isn’t that something!’ ”

All the developments of the past 40 years haven’t been as positive, however.

Levine recalled the onset of the AIDS epidemic in the early 1980s and the climate of palpable fear that temporarily enveloped medicine.

“At first, we didn’t realize what we were dealing with,” he said. “One day it was nothing; a few months later, it became a horror I remember fear — doing an ectopic pregnancy on a woman who has a belly full of blood and is HIV positive. It made me take a deep breath.”

Levine retired from a private practice in OB/GYN in 1997, but he continues to teach at UofL and currently serves on the medical advisory committee of the Louisville Planned Parenthood Association.

For information on upcoming installments of “Before the Colors Fade,” please call the School of Medicine Alumni Affairs Office at (502) 852-6906