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21
2018

Curtis Sessler, F’85: Career-long work with nursing colleagues leads to national honors

Whenever a co-worker asks Curtis N. Sessler, M.D., F’85, how he’s doing, Sessler’s response is simple and telling: “I’m living the dream.”

Curtis N. Sessler, M.D., F’85

According to nursing leaders, Curtis N. Sessler, M.D., F’85, was ahead of his time in fostering an environment where physicians, nurses and other members of the care team work together.

Sessler, the Orhan Muren Distinguished Professor of Medicine in the Division of Pulmonary Disease and Critical Care Medicine in the VCU Department of Internal Medicine, has earned a national reputation for helping patients in the ICU, conducting groundbreaking research and working with several organizations to improve care delivery.

Sessler credits much of his success to mentors – including his professorship namesake, Orhan Muren, M.D. – and colleagues, particularly in nursing. His longstanding commitment to teamwork, and the achievements it helped produce, recently led him to receive the Pioneering Spirit Award from the American Association of Critical-Care Nurses.

“It is pretty unusual for a physician to receive an award from a nursing association,” says Sessler, who also serves as the medical director of critical care and the medical respiratory intensive care unit with VCU Health. “Over three decades of ICU patient care, I’ve had the pleasure of working hand in hand with ICU nurses. That has been a big part of my career. The accomplishment is the positive impact we’ve had on patient outcomes and healthcare professional well-being.”

According to AACN leaders, Sessler was ahead of his time in health care delivery, fostering an environment in which physicians, nurses and other members of the care team work together more readily than they had in the past.

“Curt Sessler personifies AACN’s healthy work environment standard of true collaboration,” says AACN Chief Clinical Officer Connie Barden, M.S.N., R.N. “Long before teamwork and collaboration were the norm, Curt worked with colleagues from many disciplines to conduct research on the best approaches to care for critically ill patients.”

Each member of the care team fills an indispensible role. Early in his career, Sessler learned to respect each role and, in turn, build a more complete picture of each patient and his or her needs.

“Nurses spend hours and hours with patients and their families—that’s unique on the team,” Sessler says. “It’s important to bring different skill sets, and that voices are heard from all members of the team.”

Although the ICU is his primary workplace, Sessler’s influence is widely felt, and in many cases nurses served as key partners.

In research, Sessler undertook a number of investigations with counterparts in the VCU School of Nursing, specifically AACN leaders Cindy Munro, Ph.D., R.N., now dean of the University of Miami School of Nursing and Health Studies, and Mary Jo Grap, Ph.D., R.N., who retired in 2015 after a stellar research career. Perhaps their most important breakthrough was the Richmond Agitation-Sedation Scale or RASS, a tool that measures agitation and level of responsiveness in hospitalized patients.

“We had a tremendous research partnership, tackling important causes of infections as well as how best to provide comfort and sedation in the ICU,” Sessler says. “The RASS is probably the most used scale of its kind in the world now.”

Sessler also has served in leadership roles for influential health care organizations. This includes serving as president of the American College of Chest Physicians (CHEST) and working with the Critical Care Societies Collaborative (CCSC), which links AACN, CHEST, the American Thoracic Society and the Society of Critical Care Medicine.

“The work with CCSC has been especially satisfying as it emphasizes the importance of collaboration at a national level,” Sessler said.

Sessler’s imprint on critical care is clear, and his commitment to collaboration is a big driver of that success—and his latest accolade.

“The thing that I hold close is a strong belief in the power of a team,” Sessler says. “If everyone is pulling together in the same direction, we can get a lot done.”

By Scott Harris

21
2018

From flakka to opioids: PharmTox alumna’s front-row seat to nation’s drug epidemic

When Teri Stockham, PhD’87 (PHTX), left the MCV Campus, she worked as a forensic toxicologist for Richmond and New York City before becoming one of the nation’s youngest chief toxicologists in Broward County, Florida, in 1991.

Teri Stockham, PhD'87 (PHTX)

Teri Stockham, PhD’87 (PHTX), returned to VCU to speak with students about the ever-changing landscape of novel psychoactive substances and the challenges they present to law enforcement, the medical community and forensic toxicologists.

The move put her at the heart of the nation’s drug epidemic. “Broward County was the epicenter of the Flakka epidemic and was the pill mill capital of the country when the opioid epidemic first started,” says Stockham, who for the last 20 years has owned a forensic toxicology consulting business now based in Parkland, Florida.

During her tenure in Broward County, Stockham has seen the rise of synthetic drugs like flakka, a potent street drug whose high starts as fleeting euphoria but rapidly evolves into paranoia, rage and delirium. This recent round of synthetic drugs — chemical compounds illegally made to mimic the effect of known drugs but with a different chemical profile that evades detection and regulation — got their start in the early 2000s with synthetic cannabinoids, commonly known as spice.

“Everything I learned about cannabinoids, I learned from Dr. Billy Martin on the MCV Campus,” says Stockham, referring to the former chair of the Department of Pharmacology and Toxicology who had an international reputation in the field.

Synthetic production and its resulting variations changed the game. “It becomes quite the nightmare in the laboratory,” Stockham says. “Standard tests don’t pick up the chemicals. Once we do figure it out, regulate it and create tests to identify it, drug dealers just switch up the chemicals.”

Then it’s back to the lab to create another battery of tests and the cycle begins again. In a spring lecture to forensic toxicology students in VCU’s College of Humanities and Sciences, Stockham spoke of “the shell game of addictive drugs.”

The popularity of synthetic drugs also took off in part because of the Internet, where online dealers could sell drugs from foreign countries where chemicals weren’t as tightly regulated as the U.S.

Yet the good news is that legislation does work. Stockham credits physician-monitoring programs in part with cracking down on illegal pill mills. In addition, the Chinese government banned 140 chemicals after meeting with Broward County officials in 2015.

But it’s a race between the drugs on the streets and what’s known to law enforcement, the medical community and forensic toxicologists. “We’re always a couple of years behind,” Stockham says.

The reasons vary, she continues. The new drugs aren’t yet in institutional databases; no analytical standards are available; and development and validation of the drug tests are time-consuming. “There’s no standard way of testing for synthetics at this point and no field tests.”

That’s why Stockham encouraged the students to enter the forensic toxicology field, spark new ideas and make a difference. She is doing her part to ensure the best and brightest students stay on the forensic toxicology path. In 2017, she endowed a scholarship to support graduate students in the Department of Forensic Science.

“I made it through 10 years of education through scholarships and working – no loans or family assistance,” Stockham says. “I feel blessed to be in this position at this time in my life and wanted to give back.”

Stockham carries fond memories of her time on the MCV Campus, where she says she immediately felt at home. In the 1980s, forensic science programs were still housed in the School of Medicine’s Department of Pharmacology and Toxicology.

Downtown Richmond’s charm, from the historic buildings to the museums, along with friendly faculty, made Stockham’s decision an easy one. She accepted her admissions offer the same day as her first campus visit — and canceled a scheduled interview with another university.

“I knew when I walked on campus that this was it.”

By Polly Roberts

21
2018

The Class of 2019’s Joanne Chiao: Art class with dementia patients shines new light on patient experience

After completing a third-year wellness workshop with Art for the Journey, the Class of 2019’s Joanne Chiao was inspired to volunteer with the nonprofit dedicated to bringing art to non-traditional groups. The dual degree M.D./M.H.A. candidate wrote about her experience for the Association of American Medical Colleges. In her own words:

Silver or gold?

“Silver or gold?” I ask, showing two paint palettes.

A water color painting by an adult artist from a local retirement community

Over the past year, the Class of 2019’s Joanne Chiao spent her Friday mornings volunteering at a local retirement community where she served as a painting partner for adults with early-onset Alzheimer’s dementia. Pictured is one of her adult artist’s creations.

“Silver,” she replies. I place the palette on the table. The artist takes a crumpled ball of foil and dips it into the silver paint. She then presses the foil ball against her canvas creating texture, contrast and depth. At times, the foil ball goes off the page, as if she loses sight of the edge of the canvas. I guide her back to center. When she completes her painting, I ask her, “What would you like to call it?”

“I don’t know,” she says, “What do you think I should call it?” I tell her that it is her artwork. It could be any name. It is abstract art after all.

“How about ‘A Starry Night’?”

“That’s perfect! It reflects the silver texture with the foil paint, the contrast against the darker water-colored background, and the glitter dashed across the page.”

“Well, I meant to do that … that … was what I was thinking.” She takes the pencil in her hand but as she presses pencil to paper, she pauses.

“What was I supposed to do?”

“You are naming your piece and signing your name,” I reply. “Oh, that’s right,” but she pauses again and hesitates. “Can you write it for me?” She asks, “I am not very good at writing this.”

“Sure,” I reply, “I can write the name of your painting, but it’s important to sign your work yourself.” She nods in agreement, and with an unsteady hand, signs her name.

‘Outside of my comfort zone’

Last fall, I did this every Friday morning. My painting partner was an adult artist at a local retirement community. Every Friday morning, since our first session together, I would ask her to sign and name her piece. Every time, she would hesitate, and sometimes, forget what she was doing.

The Class of 2019's Joanne Chiao, who is pursuing a dual M.D./M.H.A.

The Class of 2019’s Joanne Chiao, who is pursuing a dual M.D./M.H.A.

My artist partner has early-onset Alzheimer’s dementia. For 10 Fridays every fall and spring, Art for the Journey, a nonprofit organization located in Richmond, Virginia, offers an abstract art program for adults with Alzheimer’s and dementia called Opening Minds through Art.

An evidence-based program founded by Elizabeth Lokon, Ph.D., at the Scripps Gerontology Center, Miami University, Ohio, OMA aims to restore and maintain quality of life and function for adults experiencing neurocognitive decline. OMA trains young adult volunteers to assist adult artists to help facilitate an inter-generational abstract art-making session. As a volunteer, I do not make any decisions for the artist — I simply provide them the space, time and opportunity to be creative. In taking charge of their self-expression, the artists regain their autonomy, demonstrate their inner creativity, and gain a sense of emotional well-being and achievement.

At first, I found the sessions challenging. Her artwork often deviated from the assigned project and I worried that she would be unhappy with her work. At times, she was frustrated that the watercolors had turned muddy or that the masking tape failed to create the negative space that she intended. By far, what was most challenging was discussing her abstract artwork. As a person who struggles to see and analyze intangible patterns or grasp abstract concepts, commenting and giving feedback about abstract art placed me outside of my comfort zone.

But she did not give up on me. Every week she challenged me in interpreting her abstract paintings. She challenged me to see critically the pigments, shapes and shadows that I would easily overlook. And out from those colors, shapes and shadows, I began to see her feelings of achievement, well-being and peace. I came to embrace that it wasn’t about how close or realistic the final product was, but rather, how the unstructured and intangible interpretation of each art-making task healed and preserved her identity.

Hearing a patient’s symptoms vs. listening to their pain

A few months later, while I was shadowing clinic, a middle-aged woman sought help for excruciating chronic pain, numbness and tingling in her right leg. Each time she described her pain she would become overwhelmed and cry. At the conclusion of her interview, her doctor discussed his assessment, presented the advantages and disadvantages of her options, and gave her time to make a decision. What struck me the most about this encounter was how her pain affected her. Where previously, I would have honed in on the science, the clinical dilemma and its associated decision-making — I saw instead, a person’s frustration, their struggle with a chronic condition. I heard how distressing and debilitating the pain was. I heard, but, even more, saw, how that pain stole her autonomy, function, and above all, quality of life.

I never expected an artist to show me how the world of shapes, lines and colors could transfer to an improved ability to understand and appreciate how people interpret and see themselves — how each individual person perceives their health and disease. As a clinician-in-training, it is all too easy to only hear what relevant symptoms indicate what disease, rather than listening to how the symptoms are interpreted by patients. Painting with another person reminded me how important this is for future clinicians. It reminded me to take a step back, tune out the white noise of a bustling, fast-paced ambulatory clinic and dial in to the frame of the patient.

From the sessions, I made a friend who paints and illuminates her world like no other. Through the unique opportunity that I have had in working with Art for the Journey, I gained a better understanding of individuals struggling with dementia not as patients, but as people. On one hand, painting with another person showed how opportunities for artistic expression can rebuild confidence where broken, heal what was shattered and return to others their autonomy through decision making in their own art.

On the other hand, painting with another person has provided a new appreciation and awareness of the often overlooked, unseen, unheard part of a narrative. Who ever thought that a series of simple abstract art-making sessions could so profoundly influence and alter the fundamental way in which I approach interpersonal interactions and serve my future patients?

So pick up a brush and make a choice — silver or gold?

Joanne Chiao’s story was first published by the AAMC; read more first-person accounts on the Aspiring Docs Diaries blog.

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Updated: 04/29/2016