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25
2019

Why, yes, it is rocket surgery

The Class of 1979's Richard Williams (third from left), former chief health and medical officer for NASA, returned to the MCV Campus.

The Class of 1979’s Richard Williams (third from left), former chief health and medical officer for NASA, returned to the MCV Campus at the invitation of the newly formed Aerospace Medicine Student Interest Group.

Space travel grabbed the public’s attention in the 1960s, and it seemed every little boy wanted to be a NASA astronaut. But Richard S. Williams had a different dream. He aimed to be a pilot.

But though being diagnosed with below-standard eyesight for military pilots kept him from training when he was young, Williams eventually held an even rarer title: “There’s only one NASA chief health and medical officer in the world.” He was just the second person to hold the position, beginning in 2002 and bridging the end of the space shuttle program and the start of the International Space Station era.

A 1979 VCU School of Medicine alumnus, Williams recently returned to Richmond to speak to medical students in the newly formed Aerospace Medicine Student Interest Group about what it’s like to work in the aerospace field, including some of the unusual physical effects of space flight on the body. Astronauts have higher exposure to radiation than any other occupation, he said, and risks include cancer, cataracts, and acute radiation sickness.

During his time as chief health and medical officer, NASA optometry experts noticed increased farsightedness with optic nerve swelling that occurs only after returning from space. Known as Spaceflight Associated Neuro-Ocular Syndrome, or SANS, “It can possibly progress to blindness if not treated,” Williams says, and it affects male astronauts more often than female. “We think this is associated with high intracranial pressure, but the true cause has not yet been determined.”

Williams also was there when the Columbia Shuttle broke up during re-entry in February 2003, a “devastating tragedy,” he says.

“As a group, they understood the risk,” Williams says of the seven lost astronauts. And the other qualified astronauts on the ground — then, about 130 people — “They grieved, they understood.”

Williams, who grew up around the world as part of an Air Force family, graduated from the College of William & Mary. As an Explorer Scout in the early 1970s in Hampton, Virginia, he visited the MCV Campus’ Sanger Hall and recalls being fascinated by the anatomy lab and facilities. Then he saw the movie “M*A*S*H” about wartime surgeons and their hijinks, and he decided he wanted to be a physician.

Entering medical school in 1975 was a “very humbling experience for me,” Williams says. “I went from fairly accomplished to fairly mediocre.” But as he got his footing as a medical student, his experience improved. That drew him back to VCU, when he returned to get a master’s degree in public health in 1996. “The faculty here was just outstanding.”

Medical student Nilan Vaghjiani, who started the aerospace medicine interest group, grew up in California’s Antelope Valley, where Boeing, Lockheed Martin’s Skunk Works, NASA’s Dryden Flight Research Center and the Edwards Air Force Base have manufacturing plants and test facilities. He was thrilled when Williams was available to talk to him and his classmates about his experiences, and hopes that they’ll be able to schedule an astronaut to speak to the group sometime in the future.

“The feedback was great,” Vaghjiani says. “Some students really didn’t know that aerospace medicine was a field.” Now, though, he and a few other students are looking into a rotation in Houston that specializes in spaceflight medicine.

After finishing medical school 40 years ago, Williams completed a general surgery residency, working 120 hours per week. He served as a general surgeon and a flight surgeon in the U.S. Air Force, commanding a field hospital during the first Gulf War in 1990.

“That toughened me up,” says Williams of his war experience. “It prepared me to succeed everywhere I went.”

It also led to some unexpected opportunities. He spent time on network morning shows discussing the medical care of soldiers, and received fan mail and even a marriage proposal.

He joined NASA on detail from the U.S. Air Force as the director of the Office of Health Affairs, and was selected as NASA’s chief health and medical officer when he retired four years later.

After 15 years of studying and treating astronauts’ medical issues and advocating for health care for retired astronauts, Williams retired in 2017. He remains active as a senior aviation medical examiner for the Federal Aviation Administration and as director of the Three Rivers Health District for the Virginia Department of Health, a return to his interest in public health.

Working in eastern Virginia not far from the Langley Research Center in Hampton, Williams oversees health care for at-risk populations in the Three Rivers district. His staff of health care workers, he says, “reminds me a lot of NASA — very selfless.”

By Kate Andrews

28
2019

‘Opening the door for students like me’

The Class of 2020's Shevani Sahai

The Class of 2020’s Shevani Sahai, assistant district representative for the American Academy of Pediatrics’ Section on Pediatric Trainees

While our understanding of what it means to be a doctor has shifted over the centuries, nearly all have placed on doctors the unique responsibility of self-regulation: of ensuring that the medical tradition lives up to the high standards that have always shaped its evolution.

Such a mission requires leaders. And within VCU’s School of Medicine, more and more students are answering that call.

Susan DiGiovanni, M’84, H’87, F’89, senior associate dean for medical education and student affairs, notes that increasing numbers of SOM students are looking beyond their local classrooms toward leadership roles in the broader community.

“Today we see more and more students who are interested in health care policy, interested in the national level, interested in what’s going on internationally,” she says. “Physicians should definitely have access to leadership skills, and we do encourage our students to take on these roles as students so they can develop them in an environment where they can be mentored.”

DiGiovanni says leadership positions can be a valuable part of medical training. “I get to work on making lasting impressions on the way we practice medicine,” says Shevani Sahai, an M3 student at VCU’s Inova Fairfax campus who serves as an assistant district representative for the American Academy of Pediatrics’ Section on Pediatric Trainees.

For Emily Lee, an M2 who was recently elected to the American College of Physicians Council of Student Members, the leadership opportunity offers a chance to help shape other students’ perspectives and experience of medicine.

“ACP has a lot of resources for students,” she says. “The challenge is how to reach those students.”

Given the rigors of the medical curriculum, taking on a leadership role as a student requires a deep-seated passion for medicine. That’s certainly the case for both Sahai and Lee.

Sahai made the decision to attend medical school in high school, when she was accepted by VCU’s Guaranteed Admission Program in medicine.

“At 17, I basically knew I was going to be a doctor,” she says. And when it came to choosing pediatrics as her specialty, “It’s basically been written on my forehead.”

The American Academy of Pediatrics quickly proved influential in her training. “I felt like I had found my people,” says Sahai of her introduction to the academy. Sahai jumped at the opportunity to become involved in the AAP’s Section on Pediatric Trainees and was appointed to the role of medical student delegate last year, a position in which she acted as a liaison between the AAP and VCU’s School of Medicine.

From there, she moved up to her current role of assistant district representative, connecting students at all medical schools in Kentucky, North and South Carolina, Tennessee, and Virginia with the Academy; next year, she will be promoted to district representative.

The Class of 2021's Emily Lee

The Class of 2021’s Emily Lee, who sits on the American College of Physicians Council of Student members

Lee was attracted to ACP’s role in the advocacy and reform of various policies, and the resources it offered. As a new medical student, she reflects, “I wanted to gain a broader perspective of medicine through better understanding the current policies at stake and how they can impact our careers and our patients in the future.”

The San Francisco native came to VCU via Wellesley College in the greater Boston area, where she developed an interest in medicine through laboratory research in pediatric hematology and oncology.

“I enjoyed not only learning about the science in a laboratory setting but actually understanding how the treatments can be applied to people and hopefully improve their lives,” she recalls.

On the MCV Campus, her interest in the ACP was encouraged through her membership in the Internal Medicine Student Interest group and faculty sponsor Steven Bishop, M.D., H’13.

VCU M.D.-Ph.D. student Chelsea Cockburn, who is serving as chair of ACP’s 13-member Council of Student Members, also helped spark Lee’s involvement in the group. While Lee is just getting started in her new leadership role, Sahai is already forging ahead with brainstorming what she describes as “innovative ways to change the way that we practice pediatrics.

“It’s so easy to think that as a medical student, I can’t cause people to change the way they practice medicine,” she said. But that, she points out, isn’t true. As an example, she cites one project by the AAP Section on Pediatric Trainees that works with police departments to provide free gun locks to families who have indicated to a doctor that they own guns.

Both Sahai and Lee hope to use their leadership roles to get more students involved in the profession, whether by taking advantage of opportunities to publish and engage in broader dialogues within the medical community or by harnessing the talents and time of students on particular issues at the national level.
At the end of the day, Sahai says, it’s all about “opening the door for more students like me.”

By Sarah Vogelsong

28
2019

M2 Shivam Gulhar went blind for two weeks. Then he found his calling.

In February, the Class of 2021's Shivam Gulhar will present findings from his stroke patient research at Johns Hopkins Hospital.

In February, the Class of 2021’s Shivam Gulhar will present findings from his stroke patient research at Johns Hopkins Hospital at the Association of Academic Physiatrists annual conference in Puerto Rico.

In high school, the Class of 2021’s Shivam Gulhar dreamed of becoming a computer engineer and changing the world through technology. But plans shifted his junior year when a misdiagnosed cornea ulcer left him blind for two weeks.

Suddenly, Gulhar found another calling, inspired by the care of an ophthalmologist he met at Johns Hopkins Hospital.

“He was my first exposure to how a doctor could really help a patient,” Gulhar says. “I was extremely upset — if my scar had been a centimeter down, I would have needed a transplant — but he quickly put me at ease. The care he provided saved me from permanent blindness and made me realize the importance of medicine.”

The Maryland native went on to shadow his ophthalmologist several times before coming to Virginia Commonwealth University as an undergraduate biology major with aspirations for a medical career. In 2017, he was accepted to the VCU School of Medicine.

His decision to study on the MCV Campus was reinforced when he learned he’d been awarded the Sarah Snyder Laughon Medical Scholarship.

The scholarship had been established upon Laughon’s passing, when she bequeathed a generous gift to the School of Medicine for scholarship support to deserving medical students. Her daughter, S. Katherine Laughon Grantz, is a 2000 graduate of the School of Medicine.

“While I worked hard to realize my dreams, I did not entirely understand the price that it would cost me,” Gulhar says. “Now that I have begun medical school, the financial burden is astonishing. But just as I was shown how medicine is the path for me earlier on in my life, I felt that earning a scholarship was nothing short of a sign that I truly deserved to be here and that medicine was my calling.”

Last summer, Gulhar returned to Johns Hopkins for a research rotation in the hospital’s Motion Analysis Lab at the Kennedy Krieger Institute. Through the Rehabilitation Research Experience for Medical Students, provided by the Association of Academic Physiatrists, he researched gait patterns of stroke patients and healthy adults with the ultimate goal of finding the best way to teach stroke patients how to improve their walking.

While on a treadmill, patients walked wearing oxygen masks and electrodes attached to nine different leg muscles, sending data to a computer to create a patient model. “Then we can develop a model that mimics stroke patients, giving physical therapists tools to target the most affected muscles during therapy and providing patients with the best treatment possible,” Gulhar says.

In February, he will present the lab’s findings at the Association of Academic Physiatrists annual conference in Puerto Rico.

“With the increasingly competitive nature of the residency match, being able to present his research at a national conference will distinguish Shivam from other applicants regardless of his eventual specialty choice,” says Christopher Woleben, M’97, H’01, associate dean for student affairs.

1838 Scholarship Campaign
The School of Medicine’s 1838 Campaign aims to increase the number and size of scholarships to students. Full- and half-tuition scholarships are most urgently needed and serve as one of the medical school’s best resources for recruiting and rewarding top students. Learn more about how you can help a medical student escape debt.

Originally drawn to ophthalmology, Gulhar says the summer research experience — suggested to him by his sister, a medical student at Howard University who had worked with stroke patients — opened his eyes to other specialties where patient interaction plays a prominent role.

Luckily, thanks to the Sarah Snyder Laughon Scholarship that pays a portion of his tuition and fees, he has the freedom to let his interests (and not his student loans) decide his ultimate path in medicine.

“Debt can cause students to choose fields for monetary reasons,” Gulhar says. “I’m glad I don’t have that constraint. This scholarship allows me to choose what I want to do.”

By Polly Roberts

08
2019

AMSA fellow sees beyond the individual: “I view the community as my patient”

The Class of 2020's Avanthi Jayaweera, second from right, and other AMSA members meet California congressman and physician Raul Ruis.

The Class of 2020’s Avanthi Jayaweera, second from right, and other AMSA members meet California congressman and physician Raul Ruis (center) in Washington, D.C. Jayaweera is AMSA’s 2018-19 Education and Advocacy Fellow.

Academic medicine can sometimes seem like an ivory tower: a sterilized, well-lit operating room, high above the dirt and chaos of the world below, to which students climb, step by step, until they arrive at the final height and are called “Doctor.”

But to the Class of 2020’s Avanthi Jayaweera, not only is the path to the coveted M.D. less linear, but the ivory tower itself is an illusion. Where medicine belongs, the enterprising student advocate believes, is down in the streets, not hovering above them.

“My medical training can only take me so far,” Jayaweera says. “If we want to strive for sustainable solutions for the community, we need to challenge ourselves to look at our system as a whole and analyze the intersection of policy and health.”

For one year, Jayaweera will explore those intersections thanks to her American Medical Student Association Education and Advocacy Fellowship.

Awarded annually to a single U.S. medical student, the AMSA Education and Advocacy Fellowship offers recipients a chance to help shape educational and advocacy programming while delving into issues ranging from health care access to global health equity, diversity and social justice.

Accepting the fellowship meant deferring graduation for one year, a choice that can feel risky for students already committed to at least seven years of medical school and training.

“I was nervous about possibly being away from clinical medicine for a year,” Jayaweera says. “But I just knew this was a once-in-a-lifetime opportunity to have this much time to study these policies.”

Support she received from the Harry and Zackia Shaia Scholarship, awarded to students who demonstrate a commitment to community service, helped ease her decision. The scholarship has covered a portion of her tuition and fees for the past three years.

“To know I had that type of support and financial aid was a tremendous help,” she says.

As part of her fellowship, Jayaweera spends time in AMSA’s Northern Virginia headquarters and travels around the nation to work with local AMSA chapters. She also completed a six-week clinical rotation with Kaiser Permanente Northern California Residency Programs focused on community-based issues — in Jayaweera’s case, working with Spanish-speaking patients as well as transgender and non-binary communities.

As the Education and Advocacy Fellow, Jayaweera oversees AMSA campaigns including but not limited to Med Out the Vote, a program that encourages health care providers to vote, and Just Medicine, an initiative that seeks to diminish the influence of corporations in medicine and increase transparency in order to make access to health care more equitable and fact-based.

The latter issue in particular has been close to Jayaweera’s heart since volunteering at a free clinic near Virginia Tech, her undergraduate alma mater, and encountering a host of patients who couldn’t afford medication.

“It’s frustrating when the problem isn’t that we don’t have a cure. The problem is that we have a cure, but it’s too expensive,” she said. “It’s almost the same problem: patients still don’t have access to it. We can’t have affordable health care without affordable meds.”

Many of Jayaweera’s efforts as a fellow have focused on coming up with more effective strategies to get medical students involved with health care policy and training them to be good advocates within the profession.

That task has involved everything from offering local AMSA chapters seminars on prescription drug costs and other issues to teaching them how to set up advocacy days and meet with elected officials. Jayaweera also organized the Advocacy Leadership Summit at VCU this past November and will plan AMSA Advocacy Day in March 2019.

“I’m trying to find different ways to empower students to talk about these issues with confidence and expertise,” Jayaweera says.

Involved in AMSA since premed, Jayaweera has from the start been acutely sensitive to the intersections between medicine and the political and social factors that impact individuals’ health.

“Even as a physician, there are lots of factors outside of our clinical scope that affect health,” she says. Access to grocery stores with healthy food, living in a safe neighborhood where people can go outside to exercise, and affordable drug prices are only a few of the most obvious, she says, “and those are things that I can’t personally control in the clinic.”

It is for that reason that in looking at her own mission, Jayaweera sees more than each individual patient.

“I view the community as my patient,” says Jayaweera, who is active with the medical school’s International/Inner City/Rural Preceptorship program.

Mark Ryan, M’00, H’03, now an associate professor with the School of Medicine, serves as one of Jayaweera’s mentors, both in his capacity as the director of the I2CRP program and as adviser to the school’s AMSA chapter. He sees her fellowship as a logical extension of a path she has walked since arriving at VCU.

“The thing that strikes me most powerfully is her genuine desire to use her training and her skills as a health professional to help communities and individuals strive for the best possible health that’s available to them,” he says. “It’s been this common theme of seeing the role of a physician, the role of a medical professional, as being more than a prescription.”

For Jayaweera, perhaps the best gift to patients beyond prescriptions is policy.

“If I don’t speak up on these issues, who will?” she asks. “As physicians and future physicians, we are in a position where we’re natural leaders. This is not being political. This is standing up for our communities and our neighbors and the people we live with on a day-to-day basis.”

By Sarah Vogelsong

26
2018

Lessons learned from Dr. Oz internship: M4 Michelle Baer aims to use communication to help patients lead healthier lives

Fourth-year medical student Michelle Baer spent a one-month internship on The Dr. Oz Show in October 2018. "I was really interested in finding out how he shares his information so that I can one day incorporate that into my own practice."

Fourth-year medical student Michelle Baer spent a one-month internship on The Dr. Oz Show in October 2018. “I was really interested in finding out how he shares his information so that I can one day incorporate that into my own practice.”

Fourth-year medical student Michelle Baer understands the hunger people have for trustworthy information on fitness and health.

She craves it herself.

A part-time fitness instructor and nutrition coach, Baer is always looking for ways to help people lead healthier lives. So it was a no-brainer, she said, when she had the opportunity to intern with the Dr. Oz TV show for four weeks this fall.

“It was a great experience,” she says. “I was really interested in finding out how he shares his information so that I can one day incorporate that into my own practice. We have all this knowledge as health care providers, but how do we best relay it all in a 10- to 15-minute appointment?”

Baer helped research and shape content for the show, fact-checking information and researching data. She worked closely with producers to help write the scripts.

“Michelle impressed me with her enthusiasm,” says Michael Crupain, M.D., medical unit chief of staff for the Dr. Oz Show. “She jumped right in there and was a valuable member of the team.”

The show employs two to three interns a month. These medical students are in their third or fourth years of school. Some stay one month, like Baer, while others are on set for a full year.

The show delves into a variety of topics, including food safety, nutrition, health trends, skin care, fitness and new products on the market. Baer helped research the benefits of apple cider vinegar and coconut oil, among other things.

“What was great was I also got to work on things for Dr. Oz’s other platforms, like his website and Instagram page,” she says.

During her one-month internship on The Dr. Oz Show, fourth-year Michelle Baer helped research and shape content for the show and worked closely with producers to help write the scripts.

During her one-month internship on The Dr. Oz Show, fourth-year Michelle Baer helped research and shape content for the show and worked closely with producers to help write the scripts.

Mostly, she worked behind the scenes, but had the opportunity to interact with Dr. Oz several times.

“He is very personable,” she says. “My first day he walked up to me and gave me a bottle of honey he had made. You can tell he is passionate about what he does. He really cares.”

Growing up in and around New York City, Baer knew early on she wanted to pursue a career in health. She holds a bachelor’s degree in human biology, health and society from Cornell University and a master’s from Columbia University in human nutrition and metabolic biology.

During her first semester of medical school, Baer worked at the World Health Organization helping to develop a costing tool that details the long-term advantages of preventive care. She has been a certified yoga instructor since 2014, and in 2016 joined Boho Studios in Richmond as a health coach and fitness instructor.

“It seems there are health bloggers popping up out there every two minutes,” Baer says. “But you don’t know what their qualifications are. It’s difficult to find reliable information. I want to be a source people can trust.”

Baer is enrolled in fmSTAT, the medical school’s Family Medicine Scholar Training and Admission Track that’s designed to develop and nurture students interested in family medicine careers. After medical school, she hopes integrate preventive medicine, holistic care and patient advocacy into her own practice.

“As people are becoming more invested in their own health, they are asking more questions,” she says. “We need to be able to provide the information they want, hone it down and make it succinct and understandable. If we don’t, they will never make the changes they need to make to lead healthier lives. I feel that’s what being a doctor is all about.”

By Janet Showalter

05
2018

Clinical rotation takes M4 Kathryn Gouthro to Yellowstone: “You never know what’s going to walk through that door”

A clinical rotation took the Class of 2019’s Kathryn Gouthro to Yellowstone National Park.

A clinical rotation took the Class of 2019’s Kathryn Gouthro to Yellowstone National Park – where they remind visitors that all of the park is bear habitat!

Growing up inside Yellowstone National Park, fourth-year medical student Kathryn Gouthro never had far to travel to see her family doctor.

Three clinics were strategically located throughout the park, but only one was staffed with a full-time doctor. That’s where Gouthro went to be treated for colds, strep throat and other childhood aliments.

“That sparked my interest in family medicine,” says Gouthro, whose father managed Yellowstone’s hotels and restaurants. “The doctor there was not only someone who took care of the people, but he was part of the community. I respected that.”

More than 20 years later, Gouthro was back at Yellowstone completing a month-long clinical rotation. She lived and worked at two of the clinics alongside registered nurses and a physician’s assistant.

“It was a really awesome experience figuring out what to do with the resources available,” she says.

The clinics have X-ray and EKG machines, but no ultrasounds or CT scans. Gouthro could not take a basic metabolic panel, instead sending blood work to an outside lab. With limited resources, she relied on thorough physical exams. She took extra time to get to know her patients, their health habits, lifestyles and family history.

The Class of 2019's Kathryn Gouthro, catching a cutthroat trout on Yellowstone Lake as a child.

The Class of 2019’s Kathryn Gouthro, catching a cutthroat trout on Yellowstone Lake as a child.

She also consulted with her supervising physician and medical director at Yellowstone, Luanne Freer, M’88. But since Freer was off site, Gouthro uploaded patients’ files to a secure server and the two discussed treatment options by phone.

“This is such a great experience for students because they can hone their skills,” Freer says. “It opens their eyes to the fact that you don’t always have to order expensive and extraneous tests. We sometimes can get a little complacent relying on tests instead of really listening.”

Freer, who is based outside Seattle, is the associate medical director at Medcor, a large company that holds the contract for medical services in Yellowstone. Since 2005, when Medcor began overseeing the medical rotation elective at Yellowstone, more than 100 physician assistants, nurse practitioners and medical students have completed the program. Gouthro’s rotation marked the last time the elective will be open to medial students.

“Rural medicine challenges you,” says Gouthro, president of the Class of 2019. “You never know what is going to walk through that door.”

Patients are primarily park visitors or employees who live in the park. Gouthro treated everything from ear infections and high-altitude illness to bug bites, cuts, bruises and broken bones. On one occasion she called in a helicopter to transport a stroke patient to the hospital.

“Most of the patients were bummed because they are on vacation and find themselves at the clinic,” Gouthro says. “They are just looking for help and are so grateful that you are there. It felt wonderful to make a difference.”

The Class of 2019's Kathryn Gouthro at Yellowstone's Old Faithful Clinic.

The Class of 2019’s Kathryn Gouthro at Yellowstone’s Old Faithful Clinic.

Gouthro, who holds a bachelor’s degree in political science from Columbia University, learned about the Yellowstone rotation while volunteering at the clinic one summer. She met Freer about that same time when the two raced on the same relay team. When Gouthro applied to medical school, Freer was happy to write her a reference letter.

“She has this way of connecting with people,” says Freer, who founded the Everest Base Camp Medical Clinic, the highest-altitude emergency room in the world, in 2003. “She is special.”

A member of the Army Reserves, Gouthro is enrolled in fmSTAT – the medical school’s Family Medicine Scholar Training and Admission Track that’s designed to nurture and develop students interested in family medicine careers.

After she completes a seven-year commitment with the Army after school, she says, “I would love to be a rural family doctor. When you are it – when you are the only person available – you have the opportunity to really become a resource for the people there. You become part of the community, which is really a special thing.”

By Janet Showalter

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