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School of Medicine discoveries

07
2018

The Class of 88’s Greg Hundley joins Pauley Heart Center as inaugural director

Greg Hundley, M'88 (left), Pauley Heart Center inaugural director, with former cardiology chair George Vetrovec, M.D., H'74, F'76 (center), and current cardiology chair Kenneth Ellenbogen, M.D.

Greg Hundley, M’88 (left), Pauley Heart Center inaugural director, with former cardiology chair George Vetrovec, M.D., H’74, F’76 (center), and current cardiology chair Kenneth Ellenbogen, M.D.

In the early 1980s, a bright-eyed William & Mary undergraduate took the bus from Williamsburg, Va., to Richmond on a whim. He was thinking of becoming a doctor and wanted to get a feel for the MCV Campus. He wandered the floors of Sanger Hall and happened upon the office of then-cardiology professor Hermes A. Kontos, M.D., H’62, PhD’67 (PHIS).

“Hi, I’m Greg Hundley.”

He explained his interest in medicine and asked if he could work for Kontos that summer. Kontos, as he had done for many students before, said he had a perfect project for the aspiring physician.

It marked the start of a years-long mentorship that continued during Hundley’s undergraduate and medical school years as he worked in the lab with Kontos, who would go on to become dean of the medical school and later vice president for health sciences and CEO of VCU Health System.

“It was a blessing because when I started medical school, other students were trying to get into a lab and I was thrilled to already be working with one of the most famous people here,” laughs Hundley, M’88. “It was just happenstance.”

What wasn’t happenstance was his return to his alma mater in July 2018 as the inaugural director of the VCU Pauley Heart Center. Now a longtime leader in the field of cardiovascular imaging, Hundley was the first in the world to use magnetic resonance imaging to demonstrate that MRI stress testing can identify those at risk of heart attack. He’s also recognized for studying the impact of chemotherapy and radiation therapy on heart health, advancing treatment options for patients in need of cardiovascular and oncology care.

“He is going to do wonderful things for the Pauley Heart Center,” says former cardiology chair George Vetrovec, M.D., H’74, F’76. “Having his specialized and internationally recognized expertise related to cardiology imaging will significantly improve our research opportunities and recruitment of trainees. It really moves the Pauley Heart Center forward and is going to have an impact for Massey Cancer Center as well. It’s a win-win.”

The two men have known each other for years – “In fact, I tried to recruit him here a couple of times,” Vetrovec says — and share a common mentor in Kontos. Hundley’s appointment became even sweeter when he was named the first holder of the George Vetrovec Chair in September.

“It’s very special to have the chair and then for the first scholar to be a leader like Dr. Hundley, who I know and respect,” Vetrovec says. “There couldn’t be a better match.”

The significance isn’t lost on Hundley, who cites the work of professor emeritus David Richardson, M.D., H’55, as well as Kontos and Vetrovec, as a legacy he will work hard to further in his new role. “Those men are giants in their own right in the field of cardiovascular medicine.”

Hundley’s arrival marks the opening of a new Cardiovascular Imaging Suite made possible by an investment from the Pauley Family Foundation. The cornerstone of the suite is a Magnetom Vida 3 Tesla (3T) MRI system that increases accuracy of diagnosis, reduces image distortion and enhances opportunities to develop personalized treatment plans.

Hundley compares it to high-definition television. “You can appreciate anatomy, where everything is, what the structure is, what the function is. When those processes are broken we can understand the exact cause of the heart not working properly, producing two great outcomes. First, doctors get to clearly see what the problem is, and second, patients also have that clear understanding so both can work together to come up with a solution to prevent cardiovascular complication.”

The 3T MRI takes nine seconds to produce 15, high-def images. It’s a long way from the days when Hundley would wait nine minutes for one image and then stay up all night to code its results.

Exploring the ways patients can benefit from high-def imaging is what inspires Hundley’s research. In the past 20 years, he’s participated in research funded by more than $71 million in National Institutes of Health grants.

As he brings his next-level technology expertise and research to the MCV Campus, Hundley also hopes to hold on to the values instilled in him by mentors like Kontos.

“He really encouraged me to shoot and aim high,” Hundley says. “I want to do for everybody else what he and others who came before have done for me.”

Vetrovec has no doubt Hundley will rise to the challenge.

“I’m sure he’ll do it and then some.”

By Polly Roberts

07
2018

VCU schools of the Arts and Medicine launch physician-scientist-in-residence program

John E. Nestler, M.D., the first physician-scientist-in-residence at the VCU School of the Arts.

John E. Nestler, M.D., the first physician-scientist-in-residence at the VCU School of the Arts.

John E. Nestler, M.D., has been named the inaugural physician-scientist-in-residence at the Virginia Commonwealth University School of the Arts. Former chair of VCU’s Department of Internal Medicine in the School of Medicine and a member of the Division of Endocrinology, Diabetes and Metabolism, Nestler will bring his in-depth knowledge of medical science, the local medical environment and clinical research to the School of the Arts.

The physician-scientist-in-residence program, one of the first residencies of its kind in an arts school, is part of an ongoing collaboration between the School of the Arts and the School of Medicine to help improve medical education and advance the clinical health and well-being in the community by addressing and solving problems through art and design.

“The creation of our physician-scientist-in-residence program is fueling the frontier of artistic discovery within Virginia Commonwealth University, in Richmond and beyond,” says Shawn Brixey, dean of the School of the Arts. “Dr. Nestler will accelerate the more than 20 existing collaborations between Arts and Medicine, helping to shape future discoveries. From using design to improve the daily lives of cancer patients, to using virtual reality to treat patients with anxiety disorders, we can use our specialized creative skills to solve real-world problems. We are thrilled to have Dr. Nestler on board to help share our future discoveries.”

While serving in his residency, one of Nestler’s primary responsibilities will be creating a School of Medicine elective, “Medicine, Art and the Humanities,” which will launch in spring 2019. The course will have a transdisciplinary approach, bringing together various arts principles and techniques, with the support of arts faculty members, to help bring new perspective to the medical student curriculum.

“We’ve seen lots of wonderful programs and projects grow out of partnerships between faculty from the School of Medicine and the School of the Arts,” said Peter F. Buckley, M.D., dean of the School of Medicine. “We are particularly enthusiastic about Dr. Nestler’s new role because he will be looking so broadly for new opportunities. From solutions to clinical problems to teaching medical students empathy, humanism and observation skills, or even building resiliency and fighting physician burnout, the intersection between arts and medicine has the potential to be life-changing.”

As physician-scientist-in-residence, Nestler, who holds joint appointments as professor in the departments of Obstetrics and Gynecology and Pharmacology and Toxicology, will assist with projects in the Arts Research Institute, which serves faculty in their creative research and interdisciplinary practices across the university.

By Suzanne Silitch

07
2018

Urology professor’s volunteer trips to Vietnam help patients at home and abroad

This story first appeared in Impact, VCU’s award-winning publication that shows how philanthropy changes the lives of students and faculty on campus.

This story first appeared in Impact, VCU’s award-winning publication that shows how philanthropy changes the lives of students and faculty on campus.

VCU School of Medicine Urology Chair Lance Hampton, M.D., has traveled to Vietnam almost every year since 2009 as a volunteer mentor for IVUmed’s Traveling Resident Scholarship Program. The program pairs a mentor with a urology resident from the U.S. and sends them to a host country, where they provide training in the advanced techniques they use at home and experience surgery in a developing country with minimal resources.

At VCU, Hampton is the holder of the Barbara and William B. Thalhimer, Jr. Professorship in Urology, which was established in 1989 to attract and retain eminent urology scholars. The professorship supports all of Hampton’s efforts to advance VCU’s urology program, including his work with the Vietnam volunteer program. “These trips have enhanced my surgical practice in many ways,” Hampton says, “and have helped me to educate future urologists and help the patients of central Virginia as well.”

This is Hampton’s personal account of his trips over the years.

Like most Americans, the only things I knew about Vietnam were the stories that I had heard about the Vietnam War. As a child of the ’70s, I grew up in a time where everyone, from my parents to the media, was trying to put the war behind them. Little did I know then that many years later, I would be traveling regularly to the heart of the Tet Offensive in Hue, Vietnam.

When I arrived at VCU Medical Center from Southern California in 2008, I found out about a longtime urology volunteer program based out of the University of Utah, International Volunteers in Urology (soon to become IVUmed). IVUmed is a nonprofit organization dedicated to teaching urology in developing countries, and the program offered the chance for a “resident mentor” trip to Hue, Vietnam. I was interested in international volunteering, so I immediately applied and was accepted. One of my residents, Cameron Wilson, M’07, H’12, also applied and accompanied me to Hue in October 2009.

Hue is known as the imperial capital of Vietnam. It was home to the Nguyen emperors for hundreds of years. In the middle of the current modern city is the Citadel, an ancient, walled city. The Perfume River splits the city and runs just south of the Citadel. Nationwide, the Vietnamese recognize the Perfume River as the “most beautiful river in all of Vietnam.”

The city is also home to Hue University School of Medicine and Pharmacy, which is the third-largest medical school in Vietnam and graduates more than 1,000 physicians every year, who practice throughout the country. The medical school is our base during our time there. Our days are filled with a continuous rotating schedule of operating, teaching, lecturing and, of course, eating and drinking with our extraordinarily friendly Vietnamese hosts.

The VCU trips to Hue have been extremely beneficial to both institutions. “A good mechanic never blames his tools” is a common expression in surgery, and these trips have taught me that a master surgeon provides excellent care, regardless of the available tools. Surgically, the Vietnamese urologists are masters of their craft, but they are working with severely limited resources. Laparoscopy, which has been a standard feature of American operating rooms for 30 years, has only recently been possible in Vietnam. At VCU, we have been performing robot-assisted surgery for the past decade. Virtually all major hospitals in the U.S. have at least one surgical robot (and most have multiple robots). Vietnam has two robots in the entire country, servicing a population of 92 million people.

We have expanded the services provided at Hue University to include urologic cancer care, advanced laparoscopy, pediatric urology, reconstructive surgery, percutaneous stone surgery and even advanced plastic surgery techniques with our colleagues in the VCU Division of Plastic Surgery.

Returning to the U.S. after these trips, I have incorporated many Vietnamese surgical techniques into my practice, and they have been used to help patients in central Virginia. Just a few weeks after returning from our inaugural trip, I met a patient with an extremely large renal stone that I removed in a single operation using an “old-fashioned” open technique I had learned in Hue. In the U.S., this type of operation is typically performed using minimally invasive techniques that can involve multiple procedures, last several hours and leave the patient with multiple stone fragments.

For the seven VCU urology residents who have participated over the years, this has been an opportunity of a lifetime. A global perspective of education and surgical care enables these future urologists to appreciate what they have and to practice an altruistic approach to global health care. After graduating from VCU urology, many residents have continued to be involved in international surgical volunteering.

Personally, I have also found it rewarding to have the opportunity to work with urology residents from other institutions including Duke; the University of Miami; the University of California, San Francisco; and Ohio State, as well as urologists from Boston, San Francisco and Texas.

Thanks to the Thalhimer Professorship held at the MCV Foundation, along with the VCU Department of Surgery and the Division of Urology, these trips have been met with tremendous support, including financial. Through the medical school’s dean’s office and the VCU Global Education Office, we now have a formal collaboration agreement between the VCU School of Medicine and Hue University School of Medicine and Pharmacy to provide teaching and continued interaction.

As surgeons and educators in the most prosperous country in the world, we have a debt to the rest of the world. It’s not enough to sit back and enjoy the many benefits and luxuries that we are lucky to have. We are obliged to give back and leave this world better than we found it. For me, this means improving surgical care and the education of residents, medical students and patients in central Vietnam as well as in central Virginia.

By Lance Hampton, M.D.

10
2018

Diastole: Residents at rest

The Department of Internal Medicine’s Diastole blog encourages residents like Sarah Lee, M.D., to use writing as a chance to reflect and build resiliency.

The Department of Internal Medicine’s Diastole blog encourages residents like Sarah Lee, M.D., to use writing as a chance to reflect and build resiliency.

The patient lay in her hospital bed and stared into space, unable to make eye contact with the doctors who had come to help her.

Battling end-stage HIV/AIDS, the woman seemed unable to come to terms with her condition.

“I’m not sure if she could hear us, or if she was in denial and chose not to respond,” says Sarah Lee, M.D., a second-year resident in the Department of Internal Medicine. “It was frustrating and sad. That was my first year, and it was tough to deal with something like that so early on.”

Lucky for Lee, she had help. For the past two years, first-year residents have written reflective blog posts with the hopes of normalizing reflection and increasing resilience.

“That first year can be pretty jarring,” says Megan S. Lemay, M’11, assistant professor of medicine in the Division of Internal Medicine. “It is overwhelming for the best of us. As they face extremely difficult tasks, we are teaching the residents skills in resilience so that they can keep themselves well.”

Diastole, the relaxation phase of the heartbeat, is the perfect name for the blogs, Lemay says.

“If the heart does not take time to relax and then fill up, blood won’t be pumped out,” she says. “In the same way, if you don’t take time to relax and reflect, you have nothing to give.”

Interns have reflected on a variety of assigned topics, including the role model whose traits they want to emulate and the challenges they face in treating patients with mental illness. When Lee and her classmates were asked to reflect on their lowest and highest day in haiku form, she shared her experience with the non-verbal patient by writing,
She won’t look at me.
Only nods and sighs out loud.
Wonder what she feels.

Her haiku along with others from her fellow residents are featured in the latest issue of the Medical Literary Messenger, a web-based journal that strives to promote humanism and the healing arts through prose, poetry and photography.

“Sometimes it’s easier to try to forget a difficult experience,” Lee says. “But to share them, as well as your good ones, is healthy.”

Interns have also written about the embarrassment they feel when they make a mistake, the stresses of long hours and the sadness of losing a patient.

“They are identifying with each other and building empathy,” says Lemay, who is also an associate editor of the Messenger. “When they share their emotions the feedback they are getting is, ‘I didn’t realize anyone else felt that way.’”

The blogs are part of a larger resiliency program that includes monthly meetings and workshops that help interns cope with the demands of residency. Lemay oversees the blogs and meetings that are part of the overall resiliency curriculum created and run by Stephanie Call, M.D. M.S.P.H., program director, and Rebecca Miller, M.D., assistant professor.

“I don’t think people realize that taking the time to reflect on the challenges they face is normal,” Lemay says.

Lemay has been writing and publishing prose since she was a resident. When a patient she had been visiting throughout her first year passed away, she doubted her career choice.

“I wrote about it four months later as part of a workshop, and it lifted this burden from me,” she says. “It was extremely powerful.”

She hopes interns today experience similar benefits.

“I think 20 years ago the attitude was to suck it up,” Lee says. “But today, it’s OK to talk about what you are feeling. It’s great we can focus on our wellness too.”

By Janet Showalter

10
2018

Surgeon and inventor: Class of 2012’s Max Sirkin brings military medicine closer to home

Max Sirkin, M’12, and Col. Jason Hiles have invented the SHRAIL, a new system that helps improve care for soldiers injured in the field.

Max Sirkin, M’12, and Col. Jason Hiles have invented the SHRAIL, a new system that helps improve care for soldiers injured in the field.

There are many qualities that make a good surgeon. According to surgeons themselves, one of those qualities is an innate desire to understand how something works and find ways to make it work better.

Surgeons, of course, apply that talent to the human body. But there are a few who seek additional outlets for that inner drive. That was the case for Max Sirkin, M’12, who has found a second calling as an inventor.

“Doing surgery is a dream job, but I had always wanted to do more,” Sirkin says. “I wanted to be an inventor, but all my ideas had been taken and research wasn’t for me.”

As he worked his way up to the rank of major in the U.S. Army, Sirkin began to speak with physicians and surgeons who had served overseas, sometimes in far-flung parts of the world. In those areas, taking care of soldiers can present challenges, they said. Sometimes, those challenges can be life-threatening.

Sirkin, who is also now an attending general surgeon at Fort Bragg in North Carolina, learned that the mobile medical equipment doctors rely on in more austere areas of operation can be very difficult to assemble and move. Sometimes, certain pieces of equipment are not compatible with other equipment or materials. When minutes and seconds count, equipment that is easy to use can make all the difference.

Therein lay Sirkin’s big idea.

Max Sirkin, M’12 (left) and Col. Jason Hiles demonstrate the SHRAIL.

Max Sirkin, M’12 (left) and Col. Jason Hiles demonstrate the SHRAIL.

“I had never deployed, but doctors who had saw a real problem,” Sirkin says. “There was a problem when surgeons were setting up in remote geographies, and it was a problem I thought I could fix.”

Sirkin and his inventing partner, Col. Jason Hiles, developed the SHRAIL (short for the Sirkin-Hiles Rail System), a system that affixes to a standard stretcher – or litter in Army parlance. A variety of devices, monitors and products can be easily attached to and removed from the rails, so that they are accessible even while the patient is on the move.

“We thought why don’t we start with the rails on the side of every OR table, which are all created with set dimensions?” Sirkin recalls. “We found a way to make a rail that attached to the litter and can snap into place. We designed it so an 18-year-old in a stressful situation could put it together.”

The design, which Sirkin and Hiles first conceived in 2014, allows for far more freedom and mobility than previous options.

“Other options are big and expensive and you have to use specific devices that match a specific system,” Sirkin says. “It can take people who really know what they are doing to set it up, and even then the patient often still needs to get from the point of injury to the mobile medical station.”

One of Sirkin’s mentors, who saw the SHRAIL when it was still its “back of the napkin” stage, says Sirkin has long had a drive to invent.

A soldier tests the SHRAIL in near Fort Bliss, Texas.

A soldier tests the SHRAIL in near Fort Bliss, Texas.

“He has always struck me as someone dedicated to surgery,” says Col. David Cox, M.D., a cardiothoracic surgeon and deputy corps chief for the Army Medical Corps. “This was the result of his curiosity. One thing surgeons like to do is fix problems. With the SHRAIL, Max saw a problem that needed solving, and he solved it.”

The SHRAIL was featured in May at the Smithsonian Institution’s Military Invention Day. More importantly, it has been deployed to an undisclosed location, where it was successfully used.

Sirkin said the SHRAIL could serve other purposes that are not necessarily military in nature, such as search-and-rescue or disaster relief operations.

“Everyone who has been in an austere environment and had to do a medical intervention understands,” Sirkin says. “You can set up an operating room with what you can carry in your backpack. That puts the doctor and the soldier one step closer to being back at home, where doctors have everything they need to help a patient, and that means more lives saved. The goal is to get people closer to home.”

By Scott Harris

09
2018

The incredible Class of 2022

The Class of 2022’s John Nestler paddled solo for 27 days through the Grand Canyon.

The Class of 2022’s John Nestler paddled solo for 27 days through the Grand Canyon. Scroll below for more pictures from the incoming class.

A tropical disease researcher who can diagnose Chagas disease and remove parasites from cows. And her classmate who has first-hand experience with typhoid fever and malaria – but as a patient.

EMTs and emergency department scribes. A ballerina who bakes wedding cakes, and an R&D engineer who has patents pending on the next generation of razors.

Volunteers who have staffed an HIV food bank in Barbados, free clinics in Ghana, a traveling Peruvian medical mission and the Domestic Policy Council in the White House.

A student who’s the first in his family to graduate college, and a classmate who’s the third generation to come to our medical school.

Thrill seekers and wilderness explorers who’ve skydived from a plane and scuba dived to a shipwreck. A kayaker who paddled solo for 27 days through the Grand Canyon, and a marathoner who ran his race without training first.

A first-generation American who was born in Sweden. A wanderer who spent their childhood living in 25 different towns all over the U.S., and another who calls Virginia’s smallest town home.

A traveler who crossed the Saharan Dessert on camelback. Another who walked 465 miles with pilgrims from around the world to visit a shrine in Spain.

One rescues cats, another names his house plants.

Wakeboarding, horseback riding and the sport of fencing – they’ve competed in all three. A pair of avid sock collectors might turn it into a competition.

One student can say the alphabet backwards – really fast.

Another applied, not only to medical school, but also to the Food Network’s Chopped TV show. Instead of waiting for her casting call – she is here on the MCV Campus now!

Story by Erin Lucero

Click the images below for expanded views.

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Updated: 04/29/2016