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December 2015 Archives

11
2015

Class of 1966’s Llewellyn Stringer heads innovative mobile disaster hospital

When a disaster strikes, the medical community leaps into action. Hospitals brace for an influx of patients, emergency medical teams seek out those that may be injured and doctors provide care to their community in a time of great need. But what happens when a tornado, earthquake or hurricane destroys a community’s hospital and prevents people from getting the care they need?

In steps Llewellyn Stringer, M’66.

Stringer is the project manager for the National Mobile Disaster Hospital, which is designed to deploy anywhere in the country when disaster strikes. The mobile hospital contains all the familiar elements of a normal hospital, such as an x-ray unit, blood banks and pharmacy. This one, however, can be loaded on tractor-trailers, sent to a disaster area and begin receiving patients within days.

Llewellyn Stringer, M’66, outside the National Mobile Disaster Hospital

The mobile hospital project was conceived in 2005 after hurricane Katrina hit New Orleans and left many without access to medical services. FEMA decided it needed to find a way to respond to such disasters, when local hospitals are either damaged or overwhelmed by the number of patients.

Stringer, who served for 10 years as commander of the National Medical Response Team and was the senior medical advisor to FEMA under the Department of Homeland Security, was an obvious choice to lead the project. He retired from FEMA in 2006, but went back to work for the North Carolina Office of Emergency Medical Services. In 2008 FEMA moved the hospital from Fort Detrick to North Carolina, and Stringer took charge again.

The hospital is made up of large tents and mobile hard structures. It features a 21-bed emergency department, 10-bed critical care unit, two operating rooms, full digital X-rays, a small lab, blood bank, a pharmacy and a central medical supply with enough stores for 72 hours of operation, a morgue and an administrative and command control unit.

“We can perform just about anything other than open heart surgery,” says Stringer.

Flexibility is key for Stringer and his team. Their home base in central N.C. allows them to quickly respond to tornadoes in the Midwest and hurricanes on the East Coast or in the Gulf. “The goal is to deploy within 24 hours of receiving an assignment, bring all units, except the ICU, online within 48 hours after arrival on site and have the ICU operational within 72 hours.”

Collaboration is another central part of the project. It is funded by FEMA when deployed, but maintained by NCEMS with funding from the US Department of Health and Human Service’s Assistant Secretary for Preparedness and Response grants. Much of the grunt work of unloading and setting up the hospital is done by volunteers from the N.C. Baptist Men’s Disaster Relief organization, who travel with the hospital when it’s deployed.

The volunteers include plumbers, electricians, carpenters and other tradesmen ready to solve any problems that might slow down the hospital’s deployment. Stringer has even partnered with a local N.C. hospital to make sure he can maintain a stockpile of medical materials that are ready at a moment’s notice.

Stringer and his team got their first taste of action last year when the hospital deployed to Louisville, Miss. The town and its local hospital were badly damaged by tornados and in need of help. Within days of being deployed the hospital was able to offer basic services and soon after was able to accept a wide range of patients.

Officials plan to have a temporary hospital open in some capacity until 2018 when construction of a new hospital in Louisville is complete. “Quick response time is obviously an important part of our mission, but maintaining a presence in the affected communities can be equally important. One of the major obstacles to New Orleans’ recovery after Katrina was that many of the health care workers had left town. There weren’t hospitals for them to work in.

“In Louisville we’ve managed to keep 100 of the 140 hospital employees. These people have relationships with their patients and it’s important that they stay in this community to continue providing care.”

The deployment in Louisville also provided an important opportunity to see what worked and what needed to be improved. Nurses told him that showers need to be wheelchair accessible and that they prefer simpler, single-channel IV pumps. Patients requested more private rooms. Doctors asked for improved access to electronic medical records.

Perhaps the biggest problem is one you wouldn’t expect. “Truckers. We have all the equipment loaded and ready to go, but it’s hard to find drivers and rigs to haul 23 trailers across the country at the drop of a hat. That hurt our response time.”

Despite the problems he encountered, says Stringer, the first deployment was a success. “I was the senior medical officer for many natural disasters in the country for 10 years, and I can honestly say that the collaboration and sense of community I witnessed on this project was the best I’ve ever seen.”

By Jack Carmichael

02
2015

From medieval literature to medical school: Cambridge grad sets his sights on helping others

Gabrovsky,Alexander  Hiking in the Scottish Highlands

The Class of 2019’s Alexander Gabrovsky unusual path to medical school included publishing a 312-page book about the English poet Geoffrey Chaucer.

As an elementary school student living in the picturesque village of Murs, France, Alexander Gabrovsky’s fascination with the medieval world took hold.

“The family we rented our house from lived in a hilltop chateau from the 12th century,” he said. “I used to spend time there and was mesmerized by the architecture and the family’s stories of their medieval ancestors.”

So much so that he has spent much of his life studying that time period. The Class of 2019’s Gabrovsky not only holds a master’s degree and Ph.D. in medieval literature from the University of Cambridge in England, but he has written a book about Geoffrey Chaucer, who is widely considered the greatest English poet of the Middle Ages.

Published in September, “Chaucer the Alchemist: Physics, Mutability and the Medieval Imagination” investigates Chaucer’s fascination with the philosophical and scientific thinking surrounding change in the natural world. Gabrovsky argues an integrated knowledge of alchemy and physics is crucial to our understanding of the physical and psychological transformations that are central to Chaucer’s poetry. The 312-page tome expands on Gabrovsky’s Ph.D. dissertation.

“It was a lot of work, but I also had a lot of fun,” said Gabrovsky, who traveled to Italy to trace Chaucer’s footsteps and spent time in Scotland and Cambridge studying medieval manuscripts and deciphering cryptic verses on alchemy. “It’s surreal. It’s a strange feeling walking into the library here and seeing my book on the shelves.”

Some of Gabrovsky’s classmates who were on hand for his recent book signing on campus have the same reaction. But making the transition from medieval literature to medicine makes perfect sense, he said.

“I have a long list of reasons for going into medicine,” Gabrovsky said. “I enjoy the multi-disciplinary aspect of it and the problem solving. But it also comes down to helping the sick and vulnerable.”

Gabrovsky, 31, grew up Portland, Maine, then lived in southern France for a year while in elementary school. He graduated from high school in Los Angeles and earned a bachelor’s degree in English from UCLA in 2006. He took two semesters in Beijing, then completed a post- baccalaureate program at Johns Hopkins before completing his master’s and doctorate at Cambridge.

Now he’s pursing a degree that’s been a dream of his all along.

Gabrovsky,Alexander  Restoring a medieval skeleton in Pisa Italy

Alexander Gabrovsky restoring a medieval skeleton in Pisa, Italy.

“I must really like wearing a backpack,” joked Gabrovsky, who taught medieval literature at Cambridge for a semester. “I love learning. With medicine, you take classes in all different aspects of science – there’s a broad spectrum of learning, but you have to integrate that knowledge to understand the rich complexity of the entire human body.”

This past summer, Gabrovsky spent time in Italy, where he worked in a lab reconstructing the skeleton of a 14th century Tuscan peasant, who he thinks sustained a war injury to his femur. He analyzed bones from gravesites and studied ancient diseases.

Next summer, he will work alongside a pathologist from the MCV Campus as they analyze and study South American mummies from pre-Columbian civilizations, such as the Incan empire. He recently arranged a postdoctoral position in the UK, hoping to take a research year between his second and third year of medical school to examine the influence ancient and medieval parasites may have had on human evolution.

“Alexander may not be your typical medical student, but that’s what makes VCU so great,” said Susan DiGiovanni, M’84, H’89, interim senior associate dean for medical education and student affairs. “Students like him add interest and depth to any conversation. They add such diversity to the class.”

Gabrovsky, who is not only fluent in both French and Mandarin Chinese but also reads several medieval languages, is not yet sure of his specialty, but is confident it will take shape over the next few years.

“I am sure that VCU is the perfect place for that to happen,” he said. “We have a well-known paleopathology lab here, as well as a Paleopathology Club, which is really unique for a medical school. And VCU has such a great culture. Everyone is so warm and welcoming. I really get the feeling we are all here to learn and help each other become the best in our field.”

By Janet Showalter

Virginia Commonwealth University
VCU Medical Center
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Updated: 04/29/2016