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F R O M

T H E

D E A N

Buffalo Physician
VICE PRESIDENT FOR
UNIVERSITY ADVANCEMENT

Jennifer McDonough
ASSISTANT VICE PRESIDENT FOR
NEWS SERVICES AND PERIODICALS

Arthur Page

Dear Alumni and Friends,

EDITOR

Stephanie A. Unger
ART DIRECTOR & DESIGN

Alan J. Kegler and David J. Riley

n August I had the pleasure of speaking to the Class of 2007 at their White Coat Ceremony.
This ceremony is held as a symbolic "rite of passage" to mark their first steps towards en­
tering the medical profession and emphasizes the importance of professionalism and
empathy in the practice of medicine. I warned these students that part of our profession
involves telling people things they don't want to hear. This is not restricted to telling a
patient he or she is facing a fatal illness. We deliver far more mundane "bad news" on a
daily basis. I recalled a colleague once telling me, "If you never want to see a patient again,
tell them they're fat or tell them they're crazy. If you really never want to see them again,
tell them they're fat and crazy!" While said in jest, this remark high­
lights how uncomfortable most physicians are about talking to patients
about these issues. We don't want to embarrass an obese patient by
bringing up the topic of weight loss, and as a result obesity has become
a national epidemic. We don't want to upset a patient by suggesting that
a referral to a psychiatrist would be helpful, so conditions such as anx­
iety and depression go untreated. Our discomfort with discussing these
issues is hurting our patients and we need to address it.
Money is one of those topics that can be difficult to talk about. For
years, our Medical Alumni Association has prided itself in being a
"friend-raiser," not a fund-raiser. We were willing to solicit donations for class gifts at
reunions, but otherwise wanted to stay at arm's length from the perceived distastefulness
of fund-raising. We no longer have that luxury, because our discomfort with fund-raising
is compromising the growth and evolution of our school.
Years ago, when my father, James A. Werick,MD '49,was chief of medicine at St. Francis
Hospital, he was concerned about how little money the hospital had available for con­
tinuing education for the nursing staff. So he started a fund called "Gimme Your Dough"
(I kid you not, that was really the name; subtlety was never my father's strong suit!). I once
asked him if he found it embarrassing to strong-arm the medical staff (which by then
included me) into making donations. Not at all, he assured me. Not only was he not
embarrassed, he was proud to raise money for this worthy cause.
So today it is with pride, not embarrassment, that I am asking you to invest in the
future of your medical school. Calvin Coolidge counseled us, "No person was ever honor­
ed for what he received. Honor has been the reward for what he gave." A recent cartoon
in The Chronicle of Philanthropy showed one gentleman earnestly telling another. "I'm
always embarrassed that I'm not giving more, so I don't give anything." Many of us
assume that because we don't have the funds to endow a chair or a named scholarship,
that our gift is meaningless. I assure you that every dollar donated makes a measurable
difference in the quality of our school.
If you haven't already, you will be receiving a call from a student about making a gift
to the annual fund for the School of Medicine and Biomedical Sciences. Your generosity
will make a real difference and your investment will generate important and tangible
returns for our students, faculty and programs.

M A R G A R E T PAROskf) M D " s o , M M M
Interim Dean, School of Medicine and Biomedical Sciences
Interim Vice President for Health Affairs

DESIGN

Karen Lichner
CONTRIBUTING WRITER

Lois Baker
PRODUCTION COORDINATOR

Cynthia Todd-Flick
UNIVERSITY AT BUFFALO
SCHOOL OF MEDICINE AND
BIOMEDICAL SCIENCES

Dr. Margaret Paroski,
Interim Dean
EDITORIAL BOARD

Dr. John Bodkin
Dr. Harold Brody
Dr. Linda J. Corder
Dr. James Kanski
Brian Neubauer,Class of 2006
Dr. Elizabeth Olmsted Ross
Dr. James R. Olson
Dr. Stephen Spaulding
Dr. Bradley T. Truax
Dr. Franklin Zeplowitz
TEACHING HOSPITALS
Erie County Medical Center
Roswell Park Cancer Institute
Veterans Affairs Western
New York Healthcare System
KALEIDA HEALTH:

The Buffalo General Hospital
The Women and Children's Hospital
of Buffalo
Millard Fillmore Gates Hospital
Millard Fillmore Suburban Hospital
CATHOLIC HEALTH SYSTEM:

Mercy Health System
Sisters of Charity Hospital
Niagara Falls Memorial
Medical Center

© UNIVERSITY AT BUFFALO.
THE STATE UNIVERSITY OF NEW YORK

Letters to the Editor
Buffalo Physician is published
quarterly by the University at Buffalo
School of Medicine and Biomedical
Sciences in cooperation with
University Communications.
Letters to the Editor are welcome
and can be sent c/o Buffalo Physician,
330 Crofts Hall, University at Buffalo,
Buffalo, NY 14260; or via e-mail to
bp-notes@buffalo.edu. Telephone:
(716) 645-5000, ext. 1387.
The staff reserves the right to edit
all submissions for clarity and length.

I

University a t Bu f f alo ,
9 The State University of New yotk

V O L U M E

38,

N U M B E R

©

P

H

Features
Remembering Samuel Sanes
Professor—and cancer patient—
whose teachings about physician
communication skills still
resonate 25 years after his death
BY JACOB STEINHART, MD '45

Where Are We Today?
A look at how UB medical students
and residents today are being trained
to be skillful communicators
BY MARIA SCRIVANI

Roseanne Berger. MD, senior associate dean for graduate medical education, left, and
surgeons Robert Milch, MD '68, center, and James Hassett, MD, right, are leading efforts
to teach communications skills to UR residents.
COVER: PHOTO OF SAMUEL SANES PROVIDED BY UNIVERSITY ARCHIVES

Medical:
18 UB selected
by the AMA
to develop
professionalism
curricula

19 Humanism
in Medicine
Award

22 "Lights,
Camera,
Suction," a look
at the work of
emergency
medicine
physician and
photographer
Elsburgh
Clarke, MD '77

i isaipu Dealing,
MD '43, endows
dermatology
chair at UB

32 2003 Stockton
Kimball Award,
Dean's Award

34 In Memoriam:
Ellen Dickinson,
Leon E. Farhi

36 UB molecular
biologists
discover novel
way to inhibit
the replication
of poxvirus

Development

Classnotes

40 More on

45 News from

Samuel Sanes
and his legacy
"Beyond the
Classroom"

41 Annual list of
endowments

your UB
classmates and
other alumni

4R In memoriam:
Harold Planker,
MD '40

E d i t o r ' s n o t e :
Samuel Sanes, MD '30, was a much-loved professor of pathology and legal medicine who taught at the University at
Buffalo for forty years, retiring in 1971. In the 1950s, he was coordinator of Modern Medicine, one of the first medical
shows on television. He was also a moderator of the university's Summer Medical Roundtable, a talk show
first on radio, then television.

Sanes was dedicated to educating the public, and when he contracted cancer

in 1973, he wrote a series of ten articles for Buffalo Physician on what he learned being a patient.

Remembering
The articles evoked strong and widespread responses from readers; by the time the fourth article was published,
Sanes had received more than 100 letters from 17 states and two foreign countries. The majority of writers were
physicians, colleagues and former students representing 24 areas of medicine; others included residents, spouses of
physicians, nurses, members of the religious community and the public, including cancer patients and their families.

Samuel Sanes
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This year marks the 25th anniversary of Sanes's death. In the following article, Jacob Steinhart, MD '45, a
former student and friend of Sanes, honors this anniversary by reviewing and commenting on the articles Sanes
wrote for Buffalo Physician about his illness.

In doing so, Steinhart acknowledges that, among other things,

these articles played a role "in awakening our profession to the fact that medical students need to be taught
communication skills while in school, rather than expecting them to learn these skills in a haphazard way through
'on-the-job-training.'

He also commemorates the fact that "much progress has been made in end-of-life

care over the past 25 years."
— S.A.Unger
I L L U S T R A T I O N S

Buffalo Physician

B Y

M I C H A E L

C E L E N

A u t u m n

2 0 0 3

n 1943,1 was a medical student in Dr. Samuel Sanes's pa­
thology class at the University of Buffalo* School of Med­
icine. I remember him so well. He was extremely popular.
No one fell asleep during a session with him, as his
booming voice kept us alert and eager to be prepared when
called upon. Some brave souls even volunteered to give
answers. If a student did not give a correct answer, however,
he was never berated or left to feel bad.
In the early 1970s I was invited to join the medical
school's admissions committee and I sought Dr. Sanes's
advice since he had been a member of the committee for
many years.
He generously gave me advice, which made me enthusi­
astic, and three years of interesting experiences followed.
When he retired in 1971 after teaching at UB for 40 years,
Dr. Sanes was looking forward to relaxation and travel.
Because he was embarking on a new phase of life, he thought
it advisable to have a thorough physical checkup. This he
underwent, and his doctor gave him a clean bill of health
except for previously detected cervical arthritis. He was ad­

vised to go ahead with the plans he had made for retirement
and was not told to restrict his activities in any way.
Sadly, 17 months later, in February 1973, he found a lump
on his shoulder that on biopsy showed disseminated reticu­
lum cell sarcoma. He then had a complete diagnostic work­
up, from urinalysis and blood count to lymphangiograms
and total body gallium scan, which confirmed the diagnosis.
When I learned of Dr. Sanes's illness, I phoned him sev­
eral times to see if he would like a visit. I felt close to him not
only because of these calls and the earlier advice he had
given me, but also because he had sent me postcards when
he traveled abroad.
As his health continued to decline, he never had me over
to visit. At first this left me disappointed and confused;
later, I was able to understand his not wanting to be seen as
his condition deteriorated.

He was a very courageous man.
He was a fabulous teacher.

*In 1962, the University of Buffalo, a private institution founded as a medical
school in 1846, merged with the State University of New York system to become
University at Buffalo, The State University of New York.

He was always well organized.
He was a good friend and counselor.
-J.S.

A u t u m n

2 0 0 3

Buffalo Physician

3

This year marks the 25th anniversary of Dr. Sanes's death.
Those of us fortunate enough to be his students and his
colleagues know that he not only was a talented teacher but
also a gifted philosopher. This was demonstrated in a series
of ten articles he published in Buffalo Physician between
1974 and 1978, titled "A Physician Faces Reticulum Cell Sar­
coma in Himself," in which he chronicles his illness.
On the following pages are passages excerpted from
these articles, along with brief commentaries I have added
in an attempt to provide a context for Dr. Sanes's remarks
where needed.
It is clear to anyone reading these passages—whether 25
years ago, or today—that Dr. Sanes hoped his experiences
and insights would prompt physicians and other caregivers
to closely reflect on how they care for and communicate with
patients who have a terminal illness.
Certainly his writings had their desired effect on me, as
having read them, I was—and am—more able to comfort­
ably and competently visit and talk with cancer patients.

I can't help but think that Dr. Sanes's effort to publish
these articles also played a role in awakening our profession
to the fact that medical students need to be taught commu­
nication skills while in school, rather than expecting them
to learn these skills in a haphazard way through 'on-the-job
training.'
As Dr. Sanes's experience demonstrated, this former way
of learning left a wide and lonely gap in the care provided to
some patients and, at times, put the patient in the position
of having to better educate the physician.
By publishing excerpts from these articles, it is my hope
that we may be reminded of the fact that first and foremost
Dr. Sanes was an exemplary teacher and that, through his
writings, his legacy endures and is honored.
Perhaps by reprinting his words here we will also be
reminded of how much progress has been made in end-oflife care over the past 25 years. This, in turn, may inspire
physicians practicing today to rededicate themselves to
ensuring that this momentum continues.

Excerpts from Buffalo Physician
Part I

A Physician Faces Reticulum Cell Sarcoma in Himself

OMEONE ONCE SAID cancer is a
lonely disease. It is especially true if its
victim is a physician.
No one who hasn't faced cancer in
himself can truly imagine what a cancer
patient is experiencing. Even those closest
to the patient, who love him, can only
sympathize.
They can't empathize.
Individual reactions toward disease
and death spring from individual minds
and hearts. They depend on various fac­
tors in one's personal life situation,
character and personality, social and
cultural background, what one knows
about his disease.
The cancer patient has not only a
medical problem but a semantic one.
The word "cancer" carries terrifying
connotations accumulated over the
centuries when it was practically 10Q.
percent untreatable, incurable, fatal.

u ffa Io

Physician

Autumn 2 oo3

Dr. Sanes found that the first three
months following his diagnosis were
the most difficult, as they were devoted
largely to treatment, follow-up exami­
nations and resting at home. During
this time, all of his physical problems
seemed traceable to the radiation treat­
ment; for example, loss of hair, loss and
perversion of sense of taste, diminu­
tion of appetite, fairly constant nausea,
dry mouth, painful swallowing, weight
loss, fatigue, and an episode of herpes
zoster with fever.
Before treatment he had no com­
plaints apparently referable to his dis­
ease, except the lumps. He was active,
met social obligations and traveled.

The disease and its treatment will
be a monkey on a patient's back for the
rest of his life. To the healthy person,
even if he is no longer young, the future
seems infinite. With his cancer diagnosis
a curtain drops across it. Life becomes a
matter of day-to-day planning. Goals
are short-term ones.
There is gratitude for a remission
and despair over a relapse or resistance
to further treatment. Many patients
have to curtail social, recreational, orga­
nizational and community activities...
Before taking a trip he may have to make
arrangements for seeing a physician or
physicians at intervals during his absence
from home.
To fight emotional and mental battles,
Dr. Sanes formulated what he called
"The Three A's": Acceptance of his
disease, Adjustment to it, and

Assurance ... with the latter dependent

His battle was won with time.

As the cancer patient adjusts to life

on the attention, notice, understanding

Time, he found, was not only a

with its limitations, through reason

and sympathy of others.

medium in which reason could neu­

and determination or as many do,

tralize the potency of fears, but in itself

through faith and prayer, he also adjusts

When his cancer appeared, reason fail­

acted as a dilutent. His thinking and

to death. No matter how self-sufficient

ed to allay and dispel his fearful

feeling became more positive. He de­

the patient may have been before his dis­

thoughts and he became increasingly

termined to continue living and en­

ease wasdiagnosed, hecannotdo it alone.

self-occupied. His fears were not so

during, to make the best of life within

Like most cancer sufferers, I needed

much for his life as for the loss of all

the limits imposed by his disease, to

the assurance of others, wanted desper­
ately to be remembered by family,

that made life worthwhile and enjoy­

fulfill as best he could his personal and

able: useful work, multiple interests,

social roles; in other words, not let the

friends, professional colleagues and

professional and personal relations.

cancer take over all aspects of his life.

co-workers.

P a r t II R e s p o n s e s o f Lay P e r s o n s a n d P h y s i c i a n s
to Patients with Disseminated Cancer

R. SANES ATTENDED a clinic at Ros-

education and practice.

well Park Memorial Institute (now Ros-

... during the past one-and-a-half

well Park Cancer Institute), where he

years, with the exception of my immedi­
ate family, I have felt closer to no one

met patients with disease similar to his.

more than my fellow lymphoma patients.
Forgetting the chronically ill—especially
those with disseminated cancer—is easy
for those who are chronically healthy.

don't want to be reminded of death!"
Thus the patient with disseminated

Dr. Sanes further felt that physi­

cancer, who must contend with his own

cians who are trained in oncology ap­

When we do respond to disease in an­

fears, is deprived by the fears of the healthy

proach the patient and his family in a

other person, we do so best when his illness

of the assurance he needs. Unfortunately

more understanding way, yet hold out

is one that leads to recovery or cure after

physicians in general have the same hang

no false hope.

five to ten days in the hospital and a brief

ups about cancer that lay persons do.

convalescence at home... But what of the

For medical students, Dr. Sanes

You might assume that as students in

quoted the following words from
Dr. Frances Peabody, professor of

patientwhose recoveryis complicated;e.g.,

medical school and teaching hospitals

by a stroke? ... The visitors stop coming.

they should have acquired a holistic and

medicine at Harvard University, who

The occasional person who does drop in

human approach to their patients, one

died from malignant disease at age 46:

enters the room reluctantly and departs as

that would enable them to look at any­

quickly as possible. Few Americans re­

one with cancer as a sick person with a

spond with understanding to chronic, lin­

variety of problems and needs, thoughts

not just a photograph of a man sick in

gering disease in other persons.

and feelings.

bed. It is an impressionistic painting of

"What is spoken of as a 'clinical picture' is

Patients with disseminated cancer

[The physician] looks at patients in

carry the heaviest burden. Psychologi­

terms of overcoming disease in as rapid a

work, his relations, his friends, his joys,

cally, I did need reassurance that I was

fashion as possible, or holding it in check

his sorrows, hopes and fears ... thus the

still part of life. I didn't want to feel

over the long run. Fie is liable to think less

physician who attempts to take care of a

forgotten, discarded, cut off from the

about relief and almost not at all about

patient while he neglects this emotional

real world.

comfort and consolation.

factor is as unscientific as the investigator

the patient surrounded by his home, his

An empathetic physician can be the

who neglects to control all the conditions

crucial factor in preventing a family from

that may affect his experiments ... Treat­

throwing away their time and money on

ment of disease immediately takes its pro­

quackery ...I realize that in what I have

per place in the larger problem of the care

"People are cowards; they're terrified

written about care and empathy for

merely by the word 'cancer.' They don't

chronic "incurable" patients I may have

of the patient... the treatment of disease
may be entirely impersonal; the care of

want to see sickness or suffering. They

done an injustice to today's medical

the patient must be completely personal."

He quoted a nurse who had years
of practice with cancer patients:

Buffalo Physician

P a r t III R e s p o n s e s o f P r o f e s s i o n a l C o l l e a g u e s a n d C o w o r k e r s
to a Physician with Disseminated Cancer

I

AM NOW—18 months after diagnosis

Dana Launer, MD '73, who had been

of disseminated reticulum cell sarcoma

diagnosed with Hodgkin's disease while

and the onset of therapy—psychologi­

a second-year student. (Dana was in

cally adjusted to my disease and its treat­

the last laboratory section Dr. Sanes

ment. I am physically fairly comfortable

taught before his retirement and, for­

and leading a satisfying active life intel­

4. I would not overlook or minimize his

tunately, his disease came under con­

lectually and socially. Yet it is good to

symptoms or physical state and as­

trol and he graduated. Currently, he is

hear from old friends and former stu­

sume—or pretend—that everything

chair of surgery at Scripps Memorial

dents, to know they are thinking of me,

is the same as it was before his diag­

Hospital in La Jolla, CA. See related

nosis and treatment.

article on page 40; also, comments from

that I am not forgotten.

5. I would guard against revealing any
Based on his own experience, Dr.
Sanes listed ways in which a physician
should respond to a patient with dis­
seminated cancer:

John Wright, MD, on page 11.)

undue pessimism or offering extrava­
gant optimism on prognosis.
6. As to ways of expressing assurance,

"Dr. Sanes, I heard through the med­
ical grapevine of your illness and can't

I would consider the needs of the

tell you what shocking news that was to

patient.

me. To be faced with malignancy is never

1. I would keep in touch with him,

7. As to discussions and conversations, I

an easy experience, but to have this

particularly during critical periods of

would keep in mind some patients

burden so soon after starting a 'new' life

his illness.

with disseminated cancer want to talk

makes matters so much more difficult.

2. I would not necessarily express my

openly about their disease.

assurance and good wishes in the

"I have felt the fear and frustration
you feel now. I know very well what it is

conventional way ... such as those

Dr. Sanes found discussion of his

for a patient with a recoverable, con­

experiences to be a catharsis. It helped

Carpe Diem.' We must learn to ap­

trollable, curable disease.

him accept reality and make adjust­

preciate each day and prize every oppor­

ments easier.

tunity to enjoy our lives and loved ones."

3. I would determine whether he wel­
comes the opportunity to discuss his

He appreciated receiving the follow­

disease and its treatment and, if so,

ing note from a former student of his,

like to wonder what the future will bring.

discuss it with him.

P a r t IV H i s R e l a t i o n s h i p w i t h O t h e r C a n c e r P a t i e n t s a n d
S o m e o f t h e T h i n g s He L e a r n e d f r o m T h e m

s a surgical pathologist turned lympho­

nisms of facing and coping with cancer,

ma patient I came to see cancer as more

about the meaning of anger, of faith and

than a structural abnormality in a gross

prayer, of humor and wit, of mutuality.

specimen and histologic specimen. I also

I must go on. I'll beat this son-of-

saw it as involvement of the total hu­
man being in all the relatedness to him­

6

a-bitch.
cancer institute I have found myself a

This is the anger bent on life and

self, to other persons, and to the world

source of information, a partner for sci­

survival. This is the anger I felt and

around him ... I became keenly aware of

entific discussion, a depository for con­

expressed.

the changes that cancer, particularly dis­

fidences and a provider of assurance and

We derive our philosophic ways of

seminated cancer, brings about in inter­

personal example to other cancer pa­

coping from our upbringing, education

personal relationships ... As a physician

tients ... I have learned from my fellow

and personal thinking and experiences.

in the lymphoma-leukemia clinic of the

patients'.. 7 of the fundamental mecha­

Buffalo Physician

Autumn 2003

Men and women who have prided

Dr. Sanes did not turn to the super­
natural, but stated the following:

patient's faith and prayer as part of the

The cancer patient who believes in God as

call in a qualified clergyman to assist in

ity, cachexia and dehydration, urinary

a loving Father, is never alone ... faith

the care of the patient, particularly if the

and fecal incontinence.

and prayer are important coping mecha­

patient indicates an interest in religion
but has no clergyman of his own.

themselves on their self-sufficiency are
no longer able to go it alone in the face of
fear and depression, insomnia, pain,
nausea and emesis, loss of weight, debil­

The wise physician will utilize a
therapeutic armamentarium ... He can

nisms for many cancer patients.

Conclusion

ANCER IS NOT a matter for levity and

The empathy of

flippancy.

cancer patients for

Cancer patients resent—even more

each other can be of

than healthy patients do—any indica­

real value as a coping

tion that others take cancer lightly.

mechanism ...

A college girl composed ... an epic

is an excellent coping mechanism for some

New patients are
"surprised" and "re­

poem, covering the whole struggle for

cancer patients. It saves them from deny­

adjustment by the patient discovered to

ing their predicament, from indulging in

lieved" that others felt

have lymphoma-leukemia:

self-pity. It relieves inner tensions. It per­

helplessness, uncer­

'Mope

mits them to make other patients as well

tainty and frustration

Hope

as themselves feel brighter and better.

just as they do.

Cope'

Cancer patients identify with each

Humor, genuinely felt and expressed,

other...

Part V Response of Readers by Letter
t o Dr. S a m u e l S a n e s ' s S e r i e s

here were many wonderful letters. The
response to the series indicated that
Dr. Sanes's experiences, observations

and reactions struck a common note
beyond anything he had anticipated.
A typical letter stated, "I am glad

you chose to communicate your expe­
rience to us in order to help us treat our
patients with more understanding."

P a r t VI, A, A C a n c e r : I t s E f f e c t s o n t h e F a m i l y o f t h e P a t i e n t

r. Sanes introduced his next article,
published in the winter 1976 issue of
Buffalo Physician, with the following
explanation:

winter in Guadalajara, Mexico, I re­

families—pay more than superficial at­

my former students, who is now retired

tention to the family of a cancer patient

in Florida.
"What did that for the present'

In the autumn 1975 issue of Buffalo
Physician, the Editors mentioned that

experience of cancer in their immediate

ceived a letter from a pathologist, one of

mean?" she asked? "When are you going
to resume the series?"

for whom they have accepted primary
responsibility?
The physician who accepts a cancer pa­
tient professionally... has a dual respon­

my series of articles . . . had ended

Here is my answer.

sibility. Primarily he is responsible for

for the present.'

How often I thought do physicians—

the well-being of the affected person, but

A few months later, spending the

healthy themselves and without the

also, in a measure for that of his family.

Autumn 2003

Buffalo Physician

7

In any type and stage of cancer both

Cancer in a family may be so divisive

On the other hand, it may be so

may need help in coping with the initial

and destructive a force that it produces

strengthening and unifying that it leads

psychologic shock and panic induced by

sufficient tension and friction to lead to

to a closer, deeper and more sustaining

the diagnosis.

estrangement, separation and divorce.

relationship than ever existed before.

P a r t VI, B, Cancer: I t s E f f e c t s on t h e Family of t h e Patient

OR SOME PHYSICIANS, communi­
cation with the family of the cancer
patient is ... more difficult than com­

V

«f5Tr'"
i

£

sometimes more so. Lack of proper com­

it difficult to talk

frankly and sufficiently, emphatically

patients and their families as total, inti­

and helpfully with the family ...

mately related, interdependent human

The following are a number of
factors Dr. Sanes identified in an at­
tempt to explain this:

as lay persons to the mental, emotional,
economic and other effects of the disease,

munication with the patient ... Some
physicians ... find

A physician who has cancer, and mem­
bers of his family, can be just as vulnerable

munication intensifies that vulnerability.
Some physicians may think or find

beings, especially in a chronic, serious

themselves too busy professionally and

illness like cancer.

personally to spend time communicating

Conventional medical education has

with patients and their families ...

done little to equip the young doctor with

I must be fair.

knowledge how to convey the diagnosis

Sometimes communication with the

Even before applying for admission to

of a potentially fatal disease or how to

family of a cancer patient is notaproblem

medical school, some individuals

offer continuing emotional support

which lies in the physician's personality

through inborn and acquired influ­

along with physical care.

... Rather, it's a dilemma imposed upon

ences develop a type of personality that

Some primary care physicians relin­

the physician by the cancer patient him­

will inhibit or prevent them from re­

quish their relationship with a patient

self who requests that the family not be

sponding openly and confidently, un-

and his family after they refer the patient

informed of his disease.

derstandingly and compassionately to

to a center, clinic, group or specialist.

Part VI, C, Communication, continued

assistance and reassurance.

The physician, too, benefits from free

g^\

OMMUNICATION WITH a fellow pro-

\- j

fessional or his family in regard to cancer

The patient who knows his diagnosis

and open communication with the

involves the same consideration as com­

and understands his disease with its

family and with the patient. They will

munication with a layman and his family.

treatment and prognosis is better able to

have more confidence in him, accept his

(It) should include not only the giv­

cope and adapt to it than the patient

recommendations and carry out his or­

whose physician keeps him in the dark.

ders more faithfully.

ing of the facts of the diagnosis and
management of the disease, but help in

... and the knowledgeable, under­

(The physician) who so often feels

understanding the treatment, course

standing family is better equipped to

defeated by medicine's failure when a

and prognosis. It embraces continuing

give him the day-to-day care and sup­

patient dies may find positive satisfac­

professional attention, information and

port he needs. In so doing the family is,

tion in continuing his relationship with

referral for certain practical problems

at the same time, helping to preserve its

and supporting the remaining members

that may arise (transportation, finan­

own well-being, stability, unity, perhaps

of the family.

cial assistance, etc.) and psychologic

its very existence.

Buffalo Physician

Autumn 2003

Part VI, D, Communication, continued

E MUST CONSIDER both the giver and

Patients and family welcome ancil­

receiver of information and support.

lary personnel if they need and want

The first is the physician—or those

information and support that their

members of today's medical team whom

physicians cannot or will not give them.

he calls in for communicating in their
special fields of expertise.

Ancillary personnel can smooth the
ture, the primary care physician should

path almost every step of the way but...

The second is the family member or

retain his relationship with the family,

will not satisfy patients and their fam­

members who deserve, seek and need

visiting the patient daily when he is in

ilies when it comes to information about

the hospital and continuing his visits as

the medical aspect and problems of

needed after the patient returns home.

their disease.

information and support.
Even when specialists enter the pic­

Part VI, E, Communication, continued

T ALL TIMES the physician should tell

(The physician) at no time should ...

Tell the truth as far as it is known

the responsible family member or

destroy hope by projecting personal feel­

from a scientific clinical basis. Beware of

members the truth as far as it is known.

ings, fears and liang-ups. He should not

personal, emotional influences which

That means during the initial workup,

make unjustified predictions based on

project pessimism and defeatism or false

at diagnosis and throughout the entire

his own lack of up-to-date knowledge

optimism. Preserve hope if possible.

course of the illness.

and experience in oncology.

Take all measurable and unidentified

In his relationship with a family

Hopelessness and helplessness may

variables into consideration. Avoid spe­

member, or members, a physician ought

disorganize family life. They can send

cific chronologic predictions. Keep in

not be just a scientific diagnostician and

patients and families to other physi­

mind the possibility of future diagnosis

therapist. He should also be an all-

cians or even lead them to consult

and treatment. Set up control as a more

around compassionate communicator.

quacks or to use scientifically unproven

realistic goal than cure at a certain limit

He should supply factual information,

methods at a time when cancers may

of oncologic knowledge and practice.

educate, advise, counsel, make arrange­

still be in controllable form.

ments and referrals, support the family
psychologically.
The family should be impressed with
the fact that the threat of cancer never
ends, even with a supposed "cure," and
that it is good insurance to have periodic
checkups.

Samuel Sanes giving his final lecture upon
retirement from the medical school in 1971.

Autumn 2003

Buffalo

Physician

P a r t VI, F, C o m m u n i c a t i o n , c o n t i n u e d

OR THIS FINAL ARTICLE, Dr. Sanes no

Here are some of the reactions he can

longer could write because of muscular

expect from families:

weakness; instead, he dictated to his wife.

1. No apparent reaction or denial
2. Pyschologic shock

The WAY we tell a patient and the
family is as important asWHAT, WHY,
WHEN and WHERE we tell them.
... if a physician can't be all things to
all people there are steps he can follow to
communicate with all of his patients.

3. Tears
12. See that the family gets information,

5. Insistence on more communication,

nonmedical problems that may arise

a second or third opinion, referral to

as a result of the patient's cancer.

another physician or to a medical or

13. Give the family your phone number.

cancer center, a written report. Don't

1. Establish rapport.

Advise them they should feel free

2. Be available and be on time.

to call.
14. Advise the family that you will stick

3. Take time.
4. Go through the formalities of intro­
duction. Be calm and poised, open
but not casual, objective but not cold,

with the patientand with them for the

and to expand upon it.

5. Avoid interruptions.
6. Be truthful and honest within the
limits of available knowledge.
7. Use simple, understandable English,
not medical terminology or jargon.
8. Avoid expressing your thoughts and
emotions in nonverbal form which

developments, including changes in

Physician is still publishing my articles,
I shall write about the HOW of commu­

17. Keep your promises to the patient and

nication during the apparent terminal

the family.
18. Don't get angry if asked about a new
proven or unproven treatment or

9. If the patient has cancer, say the

elsewhere and whether it could be
applied to the patient's case.
19. Don't get angry if a friend of the
family intervenes.

10. Use a printed sheet or diagram to help

20. Preserve hope, encouragement and
support as far as possible.

get the message across.

If I live long enough, if my physical

treatment and reasons for them.

procedure reported in the press or

explain it.

A final n o t e by Dr. S a n e s
reads:
condition permits and if Buffalo

facial expression, tone of voice, etc.).

When you do give a verdict of cancer,

thing that is going to happen, and
exactly how and when.

16. Keep the family informed as to new

may upset the patient or family (e.g.,

word. And specify the type of cancer.

respond angrily.
6. An obsessive desire to know every­

duration of the illness and beyond.
15. Don't try to give all the information
at one time. Be prepared to repeat...

warm and concerned.

4. Anger or rage

education, advice and counsel about

11. Listen to the questions the family
member asks and then answer them
to the best of your ability.

episode, of course based on my wife's
observations and experience.
There were no more articles due to
Dr. Sanes's death.
One can see that just as he taught us
about tissues, organs, and the human
body, he was even more determined to
teach us about humanity, empathy
and understanding of patients and
their families facing the strong possi­
bility of death from cancer.
We should be forever grateful.

About the Author
J a c o b M. S t e i n h a r t , MD ' 4 5 . i s a clinical p r o f e s s o r e m e r i t u s of p e d i a t r i c s a t t h e University a t
B u f f a l o S c h o o l o f M e d i c i n e a n d B i o m e d i c a l S c i e n c e s . F r o m 1 9 5 1 t o 1 9 9 5 , h e w a s i n p r i v a t e a nndd
g r o u p p r a c t i c e in A m h e r s t . NY. d u r i n g which t i m e h e a l s o s e r v e d on t h e f a c u l t y of t h e UB m e d i c a l
school. He continues to teach one morning a week in the ambulatory clinic a t Kaleida Health'
Women and Children's Hospital of Buffalo, where he supervises students, residents and
nurse practitioners.

Buffalo

Physician

Autumn

2003

r

Comments from Former Students and Colleagues

t~l

ONE OF THE MOST MOVING presentations I ever witnessed was one in which Sam teamed up with a
UB medical student who, unknown to his classmates, was being treated for Hodgkin's disease.*
Since it was Friday afternoon, the class was, to put it mildly, 'restless.' He introduced the student and
observed they had become close friends; then he asked what a young medical student and an older man
like himself had in common. When the medical student replied, 'We both have cancer,' silence was
immediate—you could hear a pin drop. Sam, as usual, had the students' rapt attention for the duration
of the session and not only taught them the pathology of lymphoma but dealing with malignacy
in general.
He was truly a marvelous human being and a teacher extraordinaire.
His former students—most of us getting a little on in years—fondly remember this outstanding
mentor, educator and friend.
John R.Wright. MO
Professor of Pathology

*Seepage 40for more about this student, Dana Launer, MD '73.
.
DR. SANES SPENT much of his time at Millard Fillmore with the pathology residents and the OB/GYN
residents ... He was always available to those of us who wished to learn and listen to his mini-lectures
at our microscope. At these moments he was no longer the lecturer but an understanding teacher.
A few years later, something momentous occurred when this gentle, quiet, modest man startled us
with articles about his own illness, and more importantly, how he had been received within the medical
community.
In his later years he grew in stature. He became a voice for reform and compassion, and for some of
us, a hero.
Ray G. Schiferle. MD
Clinical Assistant Professor Emeritus of Medicine

IT IS AN HONOR to be asked to comment on Dr. Samuel Sanes. I remember being so impressed with the
series of articles he wrote in this very same [magazine]. Thankfully, I had a chance to express to him that
I thought they should be required reading for everyone in family practice residency.
This is hereby recommended to every doctor who takes care of patients.
George Ellis, MD '45
Cornersville, Indiana

THE WEEK BEFORE SAM DIED unable even to turn from one side to the other without assistance, he
lay in his hospital bed in Roswell Park Memorial Institute. I sat at his side.
"Anyway," he murmured, knowing what lay ahead, "I still have my children."
For a moment I thought he was dreaming! "Children?" I asked.
"Yes," he replied, "my students."
That says it all. He loved you all. Thank you for loving him too.
Mrs. Mildred Spencer Sanes
Former Buffalo EveningNews medical writer

l!

Unabridged versions of the articles Dr. Sanes wrote for Buffalo Physician—and additional comments from former
students and colleagues—can be read at www.smbs.buffalo.edu/bp. The articles are also published in a book,
titled A Physician Faces Cancer in Himself. which is available at the University at Suffalo's Health Sciences Library.

Autumn

2003

"J

Buffalo Physician

1

Where
ARE WE
Today ?
Assessing communication skills 25 years later
BY MARIA SCRIVANI

The practice of medicine, lately
dominated by high technology
and rampant pharmacology, is
getting a heart transplant.

a return to the kinder, gentler medical art practiced before
the mid- to late-20th century avalanche of information—
and the more recent focus on costs—had a decidedly
negative impact on the doctor-patient relationship.
Such was the insight of the revered UB professor of
pathology Samuel Sanes, MD '30, who, prior to his death
from cancer 25 years ago, wrote a series of articles in

Credit a dedicated team of professors at the University

Buffalo Physician about his experience as a patient (see re­

at Buffalo School of Medicine and Biomedical Sciences for

lated article on page 2). "The physician looks at patients in

aiding in the development of this treatment, which focuses

terms of overcoming disease in as rapid a fashion as pos­

on training medical students and residents to be better

sible, or holding it in check over the long run," he wrote.

communicators. Among other things, this includes edu­

"He is liable to think less about relief and almost not at all

cation in ways to present bad news to patients, as well as

about comfort and consolation."

how to skillfully address complex issues that arise in the
care of patients with terminal or life-altering illnesses.

In the years since Sanes's death, an appreciation for the
need to teach medical students and residents effective and

"It's not just about making patients feel better; it's

sensitive communication skills has only increased, accord­

about practicing better medicine," says Jack Freer, MD '75,

ing to David Milling, MD '93, assistant professor of clini­

an ethicist and UB associate professor of clinical medicine

cal medicine and director for the introduction to clinical

who helped develop the "How to Deliver Bad News" mod­

medicine course for second-year medical students.

ule in the clinical practice of medicine course at UB.

"What we've come to realize is how important it is for

What is being taught today in the medical school

the physician to understand the impact information has

classroom and on residents' rotations is "an alternative

on the patient. The patient must be made to feel comfort­

approach to being cool, collected and scientific," says

able asking questions and must get the answers needed,"

Roseanne Berger, MD, a family physician and senior

explains Milling, who is also assistant dean for multi­

associate dean for graduate medieafedacation at UB. It is

cultural affairs in the UB Office of Medical Education.

Giving students a global perspective is the goal, he
continues. "They tend to have tunnel vision when they
come in, thinking communication skills are important
in delivering bad news to, say, a cancer patient. But it's

teaching and training programs in the field include a psy­
chologist or a behavioral scientist on its faculty to focus on
teaching students and residents about communication
and doctor-patient relations," she explains. "The expan­

much more than that. In a recent rehabilitation-medicine
session, for example, we had a patient speak to a portion of
the class about his experience with medical care. What he
remembered most was how the news that he wouldn't
walk again was delivered to him."
Starting about 25 years ago, three factors in health care
began to push patient-physician communication skills to
the foreground, according to lames Hassett, MD, UB pro­
fessor of clinical surgery and director of the medical
school's surgical residency training program.
"The first was the realization that we had a responsi­
bility to interact more effectively with patients who were
dying," he says.
"The second factor was informed consent. How can a
patient give this without being well informed?
"The third was malpractice—and, over the years, what
we have learned is that physicians are vulnerable to this
not because of what they do so much as what they say or
don't say; that is, how they discuss issues with a patient
and his or her family."
In the past five years, two additional factors have plac­
ed further emphasis on the need to train physicians to be
good communicators, says Hassett.

sion of this emphasis into other specialties has been
very exciting."

"The first is that patients are much more knowl­
edgeable about their health condition than they
used to be," he explains. "They come to their
physician's office with pages from the Internet and
online queries and all sorts of other information.
And they're right to do so, but they have much
higher expectations and have learned to ask better
questions."
The second new factor is that the Accreditation
Council for Graduate Medical Education (ACGME)
now requires that communication skills be taught
to residents.
"And not only are we required to teach these
skills to residents," Hassett notes, "but we must also
prove that we have taught them before we can
graduate the residents."
Berger points out that family medicine was the
first area of medicine to formally recognize the
importance of teaching communication skills.
"Ever since the inception of family medicine as
a medical specialty, it has been mandated that all

STANDARDIZED PATIENT PROGRAM
EXPANDED

A

decade ago, UB instituted the Standardized
Patient Clinical Competency Program to ad­
dress concerns that third- and fourth-year
students were not learning the skills necessary
to forge good doctor-patient relations. Standardized pa­
tients are persons trained to portray patients in specific
scenarios in order to help evaluate medical students' com­
munication skills. "It's a way of carefully looking at perfor­
mance and trying to improve it,"says Karen H. Zinnerstrom,
PhD, program coordinator for training and evaluation.
Since its inception, the Standardized Patient Program
has expanded to include first- and second-year students,
as well as residents.
During their first semester, first-year students are taught
how to conduct a medical interview, including how to
introduce themselves, how to elicit a chief complaint, how

to do a history of personal illness, and how to take a

doctors, nurses, social workers and chaplains, so they get

pharmacy record, according to Zinnerstrom.

to see the patient through other professional eyes. Too,

The students then combine what they have been taught
and practice their skills with a variety of patients; for

they take part in team meetings and family conferences
to get used to the idea of communicating frequently."

example they are required to complete a medical interview

This is not the traditional multidisciplinary model,

with a teenager and a geriatric patient. During the second

where the doctor is on top and "everyone else tags along

semester, they also learn how to complete a medical inter­

after," emphasizes Milch. Communication in the old mod­

view with a patient involved in domestic violence.
In their second year, students take the "How to Deliver

el is inconsistent, infrequent and too often "through the
chart," rather than face-to-face or mouth-to-ear, he says.

Bad News Module" and continue developing the clinical

In addition to gaining exposure to a rich hospice

exam skills they were introduced to during the second

experience, participants in the elective also receive train­

semester of their first year.

ing in other kinds of palliative care, such as that available

"Currently, we also work with residents in surgery,
family medicine and psychiatry," explains Zinnerstrom.
"In psychiatry, for example, how do you tell someone

through Roswell Park Pain Clinic, where participants can
learn firsthand

about symptom management.

Within the elective, there is also a strong communica­

that his or her son has schizophrenia? There are many

tion skills component, and the standardized patient pro­

different forms of bad news.

gram is implemented.

"Because we are teaching students and residents the

"The focus is on dealing with the family and psychoso­

skills required for such difficult interactions, I think they

cial and spiritual issues," explains Freer, course coordina­

are a lot more comfortable than they used to be."

tor for the palliative-care elective. This focus, he adds,

Getting doctors-in-training to hone their communi­

must take into account the fact that "ours is a death-

cations skills is sort of like "imprinting in ducks" in the

denying culture, and death has meant failure to us as phy­

sense that a skill learned early on is a skill retained and

sicians, as well as to the system within which we work."

passed on, according to Robert Milch, MD '68, medical

Given this context, communication skills taught in the

director for the Center for Hospice and Palliative Care and

elective include how to begin talking to a patient about

UB clinical professor of surgery and family medicine. "We

the possibility that there is no cure, that his or her hopes

have lost the opportunity to mentor, particularly at the

cannot be met, and that it is time to start thinking

bedside," he observes. "More and more medical work is

about hospice.

being done in the office and at outpatient clinics. You
don't get to see the great doctors at work anymore."
Milch sees a tremendous need for physicians to return

Establishing a comprehensive and patient-centered
care plan is the goal under these circumstances, explains
Milch. "The one thing we hammer home with residents

to the old model of hands-on medical care, especially

and students is that they must ask: 'What are the patient's

when treating highly symptomatic or terminally ill pa­

goals of care?' Then a plan of care is much easier to

tients. "Our medical capabilities have rapidly outstripped

articulate. The goals might be to maximize comfort, pro­

our wisdom," he says.

vide psychosocial support to stressed family members, and

PALLIATIVE CARE ELECTIVE

It all adds up to better medicine for the patient and,

to look at the body and mind needs in an advanced illness.

A

t Hospice, Milch and his colleagues oversee
UB's palliative-care elective, designed to give

professionally, it's a lot more gratifying for the doctor."

participants "a full experience" with Hospice

COMMUNICATIONS SKILLS—A CORE
COMPETENCY

and palliative care—interdisciplinary care

that addresses the multiple needs of patients with ad­
vanced illness. "They learn about our services, what we can
offer, and when it is appropriate to make a Hospice refer­
ral," he explains. "They are taught about the hospice Med­
icare benefit on which all hospice care is based, regardless
of whether someone is a Medicare patient or not. They
spend time in the unit, and make home care visits with

irst-year surgical residents at UB are required
to spend a week in the palliative-care elective,
learning the kind of communication skills
not generally attributed to those in this
technology-driven specialty. (UB is one of the first schools
in the nation to require this for surgical residents.)
"Communicating with a patient about routine health

concerns is one thing, but communicating about end-oflife issues is very different and hard for surgeons to do,"
says Hassett. "It's hard because they're accepting defeat.
"Many surgeons in training also have a sort of person­
al battle with cancer or trauma," he continues. "Although
they realize they aren't going to be able to help everyone
all the time, it's extremely difficult because they see them­
selves in that terminally ill patient and it forces them to
admit, 'Hey, I'm just as vulnerable; that could be me.' So,
it's a very complex process. That's why we place such an
emphasis on learning these skills, not only in the one-week
elective, but also at every conference we can, every activity."
Berger, who focuses on resident medical education,em­
phasizes the fact that the ACGME recently revamped its
standards for residency program curricula across the coun­
try. "Communication skills have been identified as one of
the core competencies physicians must acquire," she notes.
"Residents, as opposed to medical students, are playing
a central role in patient care. My hope is that, through our
initiatives, UB medical faculty and residents will become
more comfortable with not just delivering bad news, but
dealing with dying patients," she continues. "Ifyour patients
aren't comfortable sharing informa­
tion with you, then you do not have
all the data you need to treat them
effectively, nor can you assist them
in making informed decisions."
Hassett adds: "The most inti­
mate thing you can do to someone
else is operate on them, and if a
patient is going to allow you the
privilege of doing that, you have to
be able to talk to them about their
options and about the relative risk
of doing a procedure. And if, as a
surgeon, you don't have the com­
munication skills to do that, it
doesn't matter how much you
know or how well you can perform
a procedure. Sooner or later, you
will have a real problem because
the patient won't trust you."
The most common reason resi­
dents do not complete training to­
day is their failure to communicate
well, according to Hassett. "If they
can't explain an issue to a patient or
can't communicate well with other

physicians or colleagues, then we begin to exclude them
because they can't compete," he says.
In an ongoing effort to teach residents how to commu­
nicate in a skillful, compassionate way, a new training tool
called the National Wit Project was recently incorporat­
ed into UB's graduate medical education program at the
suggestion of Milch.
Wit, a film in which Emma Thompson plays a literature
professor afflicted with ovarian cancer, is a wrenching por­
trayal of a dying patient who does not receive the human
contact she needs from her physicians. A copy of the film
is distributed to all UB medical residents, who then attend
discussions facilitated by Milch and Freer.

A ROAD MAP FOR DIFFICULT TERRAIN

I

n emergency medicine, physicians refer to

the first hour of care following trauma as the
"golden hour" because what happens—or
doesn't happen—then determines treatment
options from that point forward. For physicians working
in the palliative-care setting, it could be said that the gold­
en hour for their patients is the time they are told of the

serious nature of their illness, because how this informa­
tion is presented will significantly affect the patient from
that point forward.
Recognizing that the communication skills needed to
deliver bad news in a caring, effective way are best learned
in a supervised setting rather than haphazardly on the
job, medical educators at UB have integrated the teach­
ing of these crucial skills into the school's curriculum in
recent years.
"When you give a patient unhappy news, it's difficult.
And because it's something that's hard to do well, we've
tended to avoid it. As a result, it's a skill that was not
taught—until now," says Freer, who five years ago as­
sisted Alan Baer, MD, associate professor of medicine, to
develop the "How to Deliver Bad News" module at UB.
Though the structure of the module is continually
being revised and updated, the key components remain
the same. In a lecture format, Freer outlines a simple,
clear protocol for breaking bad news, as developed by
Robert Buckman, MD, an oncologist and professor of
medicine at the University of Toronto. To help students
quickly grasp the fundamentals of the protocol, the mne­
monic "SPIKES" is used. "S" is for setting: arrange for
privacy, close the door; both patient and doctor should
be sitting down. "P" is for perceptions: find out what the
patient knows. "I" is for invitation by the patient for the
information: Do they want lots of detail? Is there some­
one else they'd like to be involved in the decision making?
If a patient says, "Do you have my test results?"—that's
an invitation to a dialogue.
"K" is for knowledge, as in sharing the knowledge. "E" is
for emotions, and dealing with those emotions in a direct
way. The final "S" is for summarize. Following the lecture,
Freer shows a video of Buckman delivering bad news to a
standardized patient. The class is invited to critique the
doctor's performance, according to the objective outline.
"I've been doing this for about five years, and everyyear
the students come up with new observations," says Freer.
The didactic portion of the program is followed by a
more hands-on exercise that provides students with an
opportunity to meet with patients one-on-one and in
larger groups. Actual cancer survivors participate in a
panel discussion with the UB class. Notes Freer: "This is a
wonderful opportunity for students to learn from pa­
tients. How were they told about their disease? How
might it have been handled better?
"In teaching clinical medicine, which is basically
teaching someone how to practice medicine, there are
cognitive elements—the book learning and'the memoriz­

ing—in which all the medical students do well," he con­
tinues. "They're good at that; that's how they got into
medical school in the first place.
"But then there are the skills like learning how to deal
with actual patients. The truth is, [in this module] we're
practicing on people; there's no other way to do it.
"People such as cancer survivors, who have been in
dire situations, sometimes have been hurt by a caregiver's
inexperience. That's why we take any opportunity to give
students a chance to work with these patients, as well as
standardized patients, before they talk to someone who is
really vulnerable. It's as if we're providing a road map for
how to do these things."
COMPREHENSIVE, INTEGRATED TRAINING
ilch envisions a coordinated curriculum
J\ /I in palliative care for all the health sciences
I \/ I
schools at UB, a goal that is only partially
attained right now, as each of the schools
has at least some involvement with the program. "We
need to start at the beginning of the education process
to get that interdisciplinary communication going," he
stresses. "Doctors should be learning early on to work
with nurses and social workers."
In his articles in Buffalo Physician, the prescient Sanes
warned 25 years ago of our current predicament when he
commented that "... the treatment of disease may be
entirely impersonal; the care of the patient must be com­
pletely personal."
At UB, the problem of physicians' poor interpersonal
skills has been recognized and addressed, but how is pro­
gress measured? Anecdotally, there are many reports of
residents and students feeling more comfortable and test­
ing better in simulated patient settings. "In the real world,
we have the instant feedback of compliments or com­
plaints from patients," notes Berger. "Hospitals are asking
patients to fill out satisfaction surveys after a stay, and
physician communication skills are part of that."
In addition, the ACGME measures competency with
tools like the "360-degree evaluation" in which residents
are evaluated not only through the eyes of their attending
physicians or their teachers but also through the eyes of
nurses, other hospital staff, and patients, thereby provid­
ing multiple assessments of residents' skills. There also is a
self-evaluation form, as well as peer-evaluation process in
which residents observe and assess each other.
"Residents need to become good self-assessors," says
Berger. "Some of our programs have begun to use
portfolios in evaluations that contain written examples

of consultations, lists of procedures performed, letters
from patients, and so on."
With all these efforts under way, Milch is full of hope.
"It's a relief that we're finally doing something," he says.
"We can identify deficits and figure out the tools we need
to address them."
A challenge now, Freer concludes, is to "get this new

information out there, so more general internists,
surgeons and neurologists who are teaching can incorpo­
rate it into their lessons and it becomes part of the med­
ical culture.
"My hope," he says, "is that someday we won't need to
teach these types of skills because everybody will be prac­
ticing them and learning from one another."

Hospice Care in Buffalo
Almost 30 years ago, an ecumenical group of physicians, nurses, clergy members and University at

yospicE

Buffalo faculty members began discussing a concept that started in England. They wanted to bring to

BUFFALO

Buffalo a hospice, a unique organization that helps to comfort, counsel and care for the terminally ill

tn
>
pa

and their families. Hospice Buffalo was born from these visionaries and celebrates its 25th anniversary
of service this year. In fact, 2003 marks the silver anniversary of New York State's approval for

c,n
1 9 7 8 - 2 0 0 3

hospice to become part of the state's health-care system.
Hospice Buffalo began in 1978 with 20 patients. Today, it is the core program of The Center for Hospice & Palliative
Care, serving more than 2,400 patients a year in homes, hospitals, nursing facilities, adult homes, and at the Hospice
Mitchell Campus in Cheektowaga.
—ROSEMARY COLLINS

For young and old.
For patients and families
Hospice care touches everyone,
including children with a sick mom
or dad, grandparent or sibling. Wit
chaplains and social workers helping
out, the whole family feels better. The
sooner you call, the more we can help
Hospice. A plan for living.
686-8077 hospicebuffalo.com
T H E

C K V I t R

F O R

HOSPICE &
PALLIATIVE CARE

M

Medical Professionalism

UB s e l e c t e d t o d e v e l o p c u r r i c u l a
B Y

The University at Buffalo School of Medicine
and Biomedical Sciences is one of 10 medical
schools nationwide selected by the American
Medical Association (AMA) to participate in a
new initiative aimed at integrating medical
professionalism issues into the medical-school
curriculum.

L O I S

B A K E R

and sounding boards for uncomfortable
emotions and difficult situations.
"The integration we are planning com­
bines a reflective look at the art and liter­
ature of medicine with their own daily
encounters on the wards and a variety of
experiences that we think are key to devel­
oping professionalism," she adds.
The readings, case studies and Webbased learning assignments will be based
on specific study topics geared to each
medical school year. The "Professional­

ical errors, the AMA noted in announcing

ism" course begins with the White Coat

Teaching and Evaluating Professionalism,

the selections. The 10 institutions taking part

Ceremony that initiates students into the

or STEP. Nancy H. Nielsen, PhD, MD '76,

in the initiative will develop educational

medical world. First-year issues to be ad­

clinical professor of medicine and interim

programs to incorporate these issues and

dressed include medical codes and oaths,

senior associate dean for medical educa­

others into a medical school curriculum.

The initiative is called Strategies for

tion, developed the UB medical school's
proposal and will direct the project.

health-insurance regulations, paternalism

model, four-year, self-directed course in

in medicine, ethical disparities in medical

"We're delighted and honored to par­

professionalism.

ticipate in this important undertaking,"

The plan involves

says Nielsen. "There's nothing more criti­

Web-based and

cal in the education of a physician than

printed readings,

developing an understanding of profes­

case studies, stan­
dardized patient

sionalism."
Issues of professionalism unrelated to

encounters, on-

specific clinical proficiencies currently are

site experiences,

addressed by each institution individually.

and student jour­

Through the STEP project, the AMA aims

nal keeping.
"There

to develop a set of educational tools that

is

a

can be used by all medical educators and

body of material

would establish consistency across U.S.

that needs to be

medical education.

imparted," says

care and impairment in

"Students need to reflect,

health professionals.

to experience and to inter­

studied during the sec­

act with faculty mentors

years of medical school

who can serve as guides
and sounding boards for
uncomfortable emotions
and difficult situations."

Nielsen, "but the

Today's physicians confront increasing­

privacy and confidentiality, federal

UB's contribution will be to develop a

Issues that will

be

ond, third and fourth
include cultural compe­
tence, health literacy,
domestic violence, endof-life care, homelessness, human sexuality,
organ donation, com­
plementary medicine,
spirituality in health
care, ethics of managed

ly difficult ethical and professional chal­

students also need to combine earlier

care and malevolent and benevolent uses

lenges, given the scientific advances of

knowledge with later experiences and to

of medical science.

modern medicine and the need to address

make the concept of 'professional' mean­

Students will spend time at a refugee

issues such as end-of-life care, rationing of

ingful in their daily lives. Students need to

shelter, clinic for the homeless, hospice,

expensive medical technologies, potential

reflect, to experience and to interact with

conflicts of interest and disclosure of med­

JacuJty mentors who can serve as guides

I 11 f I a I 1 P h y s i c i a n

A u t u m n

2 0 0 3

I CONTINUED ON PAGE 21

f 2003 Humanism Award
Chester Fox, MD, clinical associate professor of family medicine, was presented with the University

at Buffalo School of Medicine and Biomedical Sciences' Humanism in Medicine Award at this year's
White Coat Ceremony. In addition to his teaching and practice responsibilities, Fox serves as sole
physician advisor to UB medical student volunteers at the Lighthouse Free Medical Clinic.
Nominations for the award are made by students in the clerkship years.
In presenting the award, CharlesSeverin, PhD, MD '97, interim associate dean of medical education
and admissions, read a composite of the comments made by students who nominated Fox for the award.
"I can think of no more deserving individual than Dr. Fox. He not only meets but far exceeds all
of the attributes this award recognizes. Before the Lighthouse Free Clinic ever opened its doors,
Dr. Fox worked tirelessly to establish its foundational building blocks. He selflessly set aside countless hours when we need­
ed his guidance or that extra assurance that our dreams and our vision for this clinic were indeed obtainable.
"Dr. Fox consistently demonstrates compassion and empathy and delivers the same quality of care for the less fortunate
among us as he does for his regular patients at Deaconess Medical Center. With our clinic's diverse clientele we are lucky to
have Dr. Fox to demonstrate the sensitivity needed to develop a trusting, caring and productive relationship with all patients.
"It has been said that the most effective way to learn is by having a living example. Dr. Fox is ours."
Support for the Humanism Award is provided by the Healthcare Foundation of New Jersey.

< l->
—S. A. UNGER

White Coat Ceremony, a "Class Profile"
The sixth annual White Coat Ceremony at the University at Buffalo School of Medicine
and Biomedical Sciences was held on August 15, 2003, in Slee Auditorium. During the
ceremony, Charles Severin, PhD, MD '97, interim associate dean of medical education,
shared the following "profile" of the Class of2007:
Class Size: 135

The 2004 Spring Clinical
Day and Reunion Weekend
will be held April 30 to
May 1 at Roswell Park
Cancer Institute.

Male-Female Ratio: 63 MEN, 72 WOMEN
Where They Call Home: 54 FROM WESTERN NEW YORK.; IS FROM

Events include the first-

EXTENDED WESTERN NEW YORK; 14 FROM UPSTATE; 30 FROM
DOWNSTATE; 19 FROM OUT OF STATE

ever All Reunion Class
Dinner at the Pierce Arrow

Age: AVERAGE AGE IS 23; THE OLDEST IS 34; THE YOUNGEST, 20-,

Car Museum.

12 ARE OVER 26

Academic Background: AVERAGE GPA IS 3.57; MEAN MCAT IS 9.48.
ONE STUDENT HAS A PHD AND EIGHT HAVE A MASTER'S DEGREE; 109
ARE SCIENCE MAJORS AND 26 ARE NON-SCIENCE MAJORS

For more information, call
the medical school's Office

Number of Applicants: 2,063; INTERVIEWED 464

of Alumni Affairs and Devel­
opment at (716) 829-2773;

The White Coat ceremony is sponsored by the Arnold I! Gold Foundation, the University at Buffalo Medical Alumni
Association, and the UB Medical School Parents Council.

Autumn 2003

or email: kventi@buffalo.edu.

I ii f f a I o

Physician

1

M

E

D

I

C

A

L

S

C

H

O

O

L

N

E

W

S

Residents Honored
Student Clinicians' Ceremony

S

ix University at Buffalo residents
were presented the Arnold P. Gold

Foundation Humanism and Ex­
cellence in Teaching Award at the
Student Clinicians' Ceremony held
on August 3, 2003, in Slee Audito­
rium on UB's North Campus. The
ceremony was initiated last year by the
School of Medicine and Biomedical Sci­
ence's Professional Conduct Committee.
This year's awards were presented by
Troy Pittman, Class of 2006, on behalf of
Recipients were chosen by
Class of 2004 based on
Rating a commitment to
[compassionate treatment
lilies, students and col[lts selected to receive the
aelow, followed by a comj by a nominating student:

VID, earned a medical deveis University in BudaI in 1998, after which he
served a preliminary year in surgery at
UB. Currently, he holds a position in psy­
chiatry at the Medical College of Virginia.
"Dr. De Luca was always approachable and
eager to help and teach me. Each day he
tried to show me something new, and

SCHOOL OF MEDICINE
AND BIOMEDICAL SCIENCES

University at Buffalo The State University of New York

ireil;
YY?' -

Left to right: Jeanette Figueroa. MD 01; George Deeb. MD: Jan Penvose-Yi, MD: John Improta. MD;
Toni Ferrario, MD. assistant professor of surgery, who delivered the keynote address; and Mark De Luca. MD.

anatomic pathology (1997) and anatomic/
clinical pathology (2003), the latter of which
was at UB. Currently he is an oncologic
surgical pathology fellow at Roswell Park
Cancer Institute. In 2004, he will begin
a hematopathology fellowship at the
University of Wisconsin, Madison, WI.

whether it was a new procedure or a new
concept for me, he was the ultimate teacher.

//

University School of Medicine. Upon
graduation, he entered residency training
in psychiatry at UB. Currently, he is resi­
dent representative for the American Psy­
chiatric Association, Western New York
chapter. In 2003, he received the Resident
Service Award for outstanding service to
the Department of Psychiatry.

"Dr. Deeb is an outstanding teacher. He

It was a pleasure to watch him and to learn

makes an effort to gradually increase stu­

"The special thing about Dr. Improta's

from his interactions. I have come to think

dents' responsibilities. He creates a relaxed

teaching style is that he does not just talk at

of Dr. De Luca as a mentor and a friend.

environment that encourages discussion and

you. Rather, he draws the answers out of

He has all of the qualities of knowledge, un­

questioning. He is always professional and

you, which builds your confidence and keeps

derstanding of disease, compassion and bed­

respectful when interacting with colleagues.

you engaged. In addition to being a solid

side manner that I hope to have one day."

And, finally, he sets a superb example that I

teacher, he demonstrates a professional

hope to emulate as I enter my residency."

attitude and solid ethical behavior. Dr.

John Improta, MD, a native of Buffalo,
NYYeafried Amedical degree at St. George's

edge that medical students need to witness

George Deeb, MD, graduated from Dam­
ascus University School of Medicine in
Syria, in 1995. He completed residencies in

Buffalo Physician

Autumn 2003

Improta personifies the energy and knowl­
during their third year of medical school."

Jan Penvose-Yi, MD, a native of the City
of Tonawanda, NY, graduated cum laude
from Rensselaer Polytechnic Institute in
1992 with a bachelor of science degree in
chemistry. She worked for several years as
a medicinal chemist before returning to
school to earn a medical degree at Michi­
gan State University College of Human
Medicine. Currently she is a second-year
resident in obstetrics/gynecology at UB.
"Dr. Penvose-Yi is the type of physician that I

which is home to a predominantly underserved Hispanic population.
"Dr. Figueroa's most noteworthy character­
istic is her sensitivity to others. She demon­

Match Day

Correction

strates compassion and empathy on a daily
basis, not only to her patients, but to her

In the summer 2003 issue of Buffalo Phy­

colleagues and students. She is a role model

sician it was incorrectly reported that

of ethical behavior and cultural sensitivity.

Elizabeth Bourke, Melissa Franckowiak

She knows what resources are available in

and Maria Podebryi-Tsur-Tsar, Class of

the community so that she can provide ad­

2003, matched for residency training in

vice that is specific and helpful. She treats all

anesthesiology at New York Presbyterian

want to be and the kind that I want as my

her patients with respect—so much so that

Hospital (Cornell Campus), New York. All

doctor. She treats every patient with respect,

you can't imagine her giving better, more

three are training in anesthesiology in the

regardless of their situation. She always has

sensitive care to her own family or friends. I

SUNY at Buffalo Graduate Medical-Dental

an encouraging word for her students and

hope to someday display a similar level of

Education Consortium.

colleagues. When I think of an ideal phys­

patience, empathy, sensitivity and compe­

ician, Dr. Penvose-Yi comes to mind."

tence in my teaching and clinical practice."

Jeanette Figueroa, MD '01, a native of
Buffalo, NY, graduated cum laude from
UB in 1994 with a bachelor of science
degree in biochemical pharmacology. She
earned a medical degree from UB in 2001.

Emily Tenney, MD '02, graduated from
St. Lawrence University 1997, after which
she earned a medical degree at UB.
"From her dedicated teaching to her compas­

the answers to other questions and situations.

Currently, she is a third-year resident in
family medicine. Her outpatient clinic is
located in Buffalo's Lower-West Side,

sion and professionalism, Dr. Tenney is an

Her commitment to teaching is evident in
every interaction she has with her students."

encouraged our desire to be active members of
the team and therefore gave us the opportu­
nity to do that. She not only answered our
questions, but provided the context to apply

intern that any medical student or physician
would love to work beside. She respected and

—S.A. UNGER

Medical Professionalism
continued from page 18

organ procurement agency and other sites
as necessary. They will meet quarterly with
faculty mentors to review their progress
and to evaluate their understanding of
the principles of professionalism studied.
Standardized patient cases, exams and
essays will be used to assess students'
competency.
"We've already begun planning activi­
ties," Nielsen says, "and we'll join with
the other schools chosen in a fall meeting.
Elements of the project will be implemen­
ted with the incoming first-year class."
Core faculty for the STEP program, in
addition to Nielsen, are Margaret Paroski,

MD '80, professor of neurology, interim
vice president for health affairs and in­
terim dean of the medical school; Jack
Freer, MD '75, clinical associate professor
of medicine;Charles Severin, MD '97, PhD,
associate professor of pathology and ana­
tomical sciences and interim associate
dean for medical education; David Mill­
ing, MD '93, clinical assistant professor of
medicine and assistant dean for multi­
cultural affairs; Robert Milch, MD '68,
clinical assistant professor of surgery and
medical director for the Center for Hos­
pice and Palliative Care, and Jack Coyne,
MD '85, clinical assistant professor of

pediatrics. David Block, incoming fourthyear medical student, who spent a year at
the AMA Institute of Ethics before com­
ing to medical school, will serve as the
core's student advisor.
Also selected as STEP program par­
ticipants were medical schools at Indiana
University, Loyola University Chicago,
McGill University, Michigan State Uni­
versity, New York University, University
of Minnesota, University of North
Dakota, University of Pennsylvania and
University of Texas-Houston. < ' -*

Autumn 200 3

Buffalo

Physician

21

After 25 years as an emergency medicine physician, ilsburgh Clarke,
MD 77, is harmoniously in synch with an erratic and highly spontaneous
line of work, the nature of which is aptly symbolized by the wide-angle
lens and high-speed Kodachrome he reaches for to capture lives on
film when he's not busy saving them.
In addition to his demanding work as a physician, Clarke is
a professional photographer who, not surprisingly, is drawn to
creating tableaux that are steeped in emotion and energy,
whether they be of emergency departments, NASCAR race
tracks, NFL end zones or U.S. Naval Academy midshipmen.
Clarke is currently medical director of emergency services at
the Methodist Medical Center of Illinois in Peoria, Illinois, a
40,000-visit-per year, Level 2 trauma center. In this position, as
throughout his career, he has successfully melded his dedication
to medicine with his passion for photography, earning a reputa­
tion as a talented practitioner in both fields.
In 1997, photographs that Clarke entered in Emergency
Medicine News's annual photography contest were selected
"Best Overall" by a panel of judges, one of whom stated, "The
emergencyphysician [who took these] may have missed hiscalling
as a photographer."

Autumn 2003

Buffalo Physician

Navy vs.
Georgia
Tech

graphy," but notes that it became more than a curiosity
when he left home to attend Howard University in

In 1997. this photograph

Washington D.C.

by Clarke was named

"My father used to take pictures, and he kept a scrapbook of his college days that he would show me,"

"Best Overall" by the

Clarke recalls.

editorial board of

When it was time for Clarke to depart for college, his

emergency Medicine

father gave him a Kodak Instamatic camera, thinking his

News in its annual

son might like to chronicle his own college experiences.

photography contest.lt

After graduating from Howard with a bachelor of science

was taken at Milford

degree in zoology, Clarke bought himself a 35mm Pentax

Memorial Hospital in

K1000 with his first American Express card. But it wasn't
until he arrived at the University at Buffalo's School of

Milford. Delaware, where

Medicine and Biomedical Sciences in 1973 that his pas­

Clarke served as medical

sion for photography started to become a force in his life.

director of the Emergency

Soon after arriving in Buffalo, Clarke began to take

Department prior to

advantage of Western New York's world-famous scenery
to improve his photography skills. "I lived in Tonawanda

moving to Peoria.

and I used to drive up to Niagara Falls in the dead of
Rather than feeling that he's missed out, Clarke prefers

winter just to take pictures of the natural beauty," he

to think he's been extraordinarily fortunate to have the

says. "This allowed me to be outdoors, which I enjoyed."

opportunity, and artistry, to fulfill his dual calling in life.

I

Since Clarke had no formal training in photography,

Born in Westchester County and raised on Long Island,

he learned by trial and error, by reading about photo­

Clarke remembers "always having'an interest in photo­

graphic processes and by talking to other photographers.

Indy Racing
League,Dover
Downs

NASCAR.
Dover Downs

San Francisco
49ers vs.the
Los Angeles Rams

Soon after coming
to UB Clarke purchas­

working with black-and-white film.

Using the darkroom

facilities at the LA Arts Center, Sipsey taught Clarke how

ed a Nikon and started

to shoot, develop and print black-and-white photo­

snapping candid pho­

graphs, which further sparked his interest in the photo-

tos of his fellow classmates—between classes, at class func­

journalistic style. It didn't take long for Clarke to get per­

tions, and any time an opportunity arose—gradually

mission to photograph action in the hospital's ER and to

becoming a kind of unofficial documentarian of student

launch an avocation that continues to the present day.

life. Many of Clarke's photos from this time were publish­

Following his residency, Clarke spent 13 years as a cli­

ed in the 1977 edition of Iris, the medical school yearbook.

nician and administrator in the emergency departments

In particular, Clarke remembers how gratifying it was to

at a number of Los Angeles-area hospitals, including 10

have taken photos of classmate Leonard Spicer, who died

years at Pomona Valley Medical Center, five of which

several months before graduation.

were as assistant director of the emergency department.

The spontaneity of photographing unposed subjects is

In 1993, he moved back East to become medical

what appealed to Clarke early on, he says, as did the

director of the emergency department at Bayhealth-

challenge of documenting the essence of a scene. "I enjoy

Milford Memorial Hospital in Milford, Delaware, as well

capturing moments," he observes. "Every photographer's

as medical director of the Sussex County Paramedics. At

dream is to capture people's moments on film

because

that time, the governor of Delaware also appointed him

After completing his internship at the University of

Committee and the EMS Oversight Council. In addition,

California at Irvine, in 1978, Clarke began his residency

Clarke served as chair of both the State Trauma Commit­

in emergency medicine at the LA County/University of

tee and the Sussex County EMS Advisory Committee.

those moments will never happen again."

to the Emergency Medical Services (EMS) Improvement

Southern California Medical Center. There he befriend­

While living in Delaware, Clarke continued to photo­

ed Jeff Sipsey, MD, one of the attendings on staff, who was

graph hospital ERs, often collaborating with his wife,

an experienced photographer with a strong interest in

Patricia, also a photographer. Together they shot thou-

Autumn

2003

Buffalo Physician

Firefighters, Los
Angeles County
Fire Department

Rams' quarterback
in a 1993 game
against the Giants

sands of emergency department photos in hospitals where
Clarke worked, as well as at Bellevue Hospital and Bronx
Jacobi Medical Center in New York City, and while ac­
companying paramedics at trauma scenes.
In 1997, Clarke was named photo editor for the maga­
zine Emergency Physicians Monthly, a national trade mag­
azine, and in 2001, a chapter he wrote, titled "Medical
Photojournalism," was published in the Handbook of
Medical Photography. An accomplished essayist, Clarke
also published a series of photojournalism features for
the regional magazine Delaware Today between October
1999 and June of 2000. These included an article titled
"On the Edge," which gave an insider's view of two hos­
pital emergency departments, including BayhealthMilford Memorial Hospital; an article, titled "Crash
Course," on the NASCAR medical clinic at Dover Downs,
where he'd worked as both a photographer and a physi­
cian; an article profiling three female midshipmen from
Delaware who were attending the U.S. Naval Academy;
and an essay about a historic black barbershop.
Sports photography, another one of Clarke's special­
ties, has led to freelance assignments with several Na­
tional Football League teams, including the Philadelphia

26

Buffalo Physician

Autumn 2 003

Eagles, the Miami Dol­
phins and the former
Los Angeles Rams. He
has also completed as­
signments for the U.S.
Naval Academy foot­
ball team, NASCAR,
and the 1995 United
States Olympic Festi­
val Committee.
Though action in
the ER can at times be
as fast-paced as a sport­
ing event, Clarke's approach to photographing ER scenes
is somewhat different. He almost always uses black-andwhite film instead of color, which results in more dramat­
ic pictures, he says, and avoids the greenish tint so often
inherent in photos taken under an ER's fluorescent light­
ing. He rarely uses a flash, preferring instead to use a faster
film speed of at least 400 or higher in whichever one of
his eight Nikons he's using that day. He takes lots of
pictures, sometimes as many as 30 to 35 rolls of 36exposure film. (When using a motor-drive camera, as

Clarke does, and shooting 1 to 2 frames per second—
compared to the 3 to 5 frames per second in sports
photography—it's easy to go through a lot of film.)
Looking back on some of the photos he took 20-odd
years ago, Clarke notes that he has not only chronicled
patients and their caregivers, but also a bit of medical
history. He says it's interesting to see that some equip­
ment used at the time, such as an EKG machine, looks
dated now because of rapidly changing technology.
When taking photographs, Clarke says he tries to cap­
ture the intensity, emotions and feelings of his subjects.
"I like to photograph the eyes," he explains. "1 like clarity;
I like close-ups of a person's hands."
Clarke feels that one of his most enduring medical
photographs in terms of emotion and intensity is a black-

says he hasn't had as much time for taking pictures as he
would like due to his increased responsibilities and the
emergency department's high patient volume. Still, he
and his wife plan to continue working on a book that will
be a series of photo essays about the daily activities of
emergency medical physicians, nurses and staff. When
envisioning this ambitious project, Clarke says he'd like
to take advantage of his close proximity to Chicago, two
hours away, to shoot some of that city's ERs.
Another project he's considering is a 24-hour photo
essay on Peoria.
Would Clarke ever give up emergency medicine for
photography?
"Maybe—if I won the lottery," he says with a laugh.
"But I love the ER, too," he quickly adds. "With photogra­

and-white shot he took of a surgeon holding a heart,
"cradling and massaging it over the patient's open chest,
literally holding life in his hands."
Since moving to Peoria in November 2000, Clarke

phy I get to meet people and it's an extension of what 1
do every day, which is take care of people. Ultimately, it's
about capturing moments: I love people, and I love to
capture their expressions. To me, that's priceless."

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#
NEWS ABOUT UB'S SCHOOL OF MEDICINE
AND BIOMEDICAL SCIENCES AND ITS
ALUMNI, FACULTY, STUDENTS AND STAFF

Patnways
Fischer Joins
Bioinformatics
Center
Daniel Fischer, PhD, who
coordinates the bioinfor­
matics track at Ben-Gurion
University of the
Negev in BeerSheva, Israel, has
been named di­
rector of educa­
tional programs
for the University
at Buffalo Center
of Excellence in
FISCHER
Bioinformatics.

FISCHER WILL
DEVELOP UB'S
EDUCATIONAL
PROGRAMS IN
BIOINFORMATICS
AT THE UNDER­
GRADUATE AND
GRADUATE LEVEL,
AS WELL AS
CERTIFICATE
PROGRAMS.

BuM9I a Physiciin

In addition, he will serve as a
professor in the Department
of Computer Science and
Engineering in the UB
School of Engineering and
Applied Sciences.
As director of educational
programs for the UB Center
of Excellence in Bioinfor­
matics, Fischer will develop
UB's educational programs in
bioinformatics at the under­
graduate and graduate level,
as well as certificate pro­
grams. He will also teach and
conduct research in the UB
Graduate School of Education.

A u t u m n

2 0 0 3

For the past five years,
Fischer has been with BenGurion University, where he
is a tenured senior lecturer in
its Department of Computer
Science. He holds a bachelor's
degree in computer science
from Universidad Autonoma
Metropolitana in Mexico, a
master's degree in computer
science with honors from
Technion, Israel Institute of
Technology and a doctoral
degree in computer science
with honors from Tel Aviv
University in Israel.
Before joining the faculty
at Ben-Gurion, Fischer was an
assistant researcher in the
Molecular Biology Institute at
UCLA from 1995-1998. He
also has worked as a CAD
developing engineer with
Intel in Haifa, Israel, and as
a postdoctoral fellow in the
Department of Mathematical
Biology at the National
Cancer Institute of the
National Institutes of Health.
—ARTHUR PAGE

Kuramitsu Elected a
Fellow in the AAM
Howard Kuramitsu, PhD,
University at
Buffalo
Distinguished
Professor in
the Depart­
ment of Oral
Biology in the
University at
Buffalo School
KURAMITSU
of Dental
Medicine, has been elected
a fellow in the American
Academy of Microbiology, an
honorific leadership group
within the American Society
of Microbiology. One of only
1,800 scientists elected to
fellowship status in the
academy's almost 50-year
history, Kuramitsu was
recognized for his work
defining virulence factors
of potentially pathogenic
oral biology.
Kuramitsu holds a joint
appointment in the Depart­
ment of Microbiology in the
UB School of Medicine and
Biomedical Sciences and is a
member of the Center for

*

Refiling Endows Dermatology Chair
At his 60th Class Reunion in April, Ralph T. Behling, MD '43, announced plans to endow a $1.5 million chair in dermatology
at the University at Buffalo School of Medicine and Biomedical Sciences.
"Dr. Behling's generous gift will help the University at Buffalo attract nationally known faculty to the Department of
Dermatology," says Margaret W. Paroski, MD '80, UB interim vice president for health affairs and interim dean of the School
of Medicine and Biomedical Sciences. "Although he moved across the country years ago, he has never forgotten his roots here
at UB, and for that we are grateful."
A native of Buffalo, NY, Behling graduated from UB with degrees in pharmacy and medicine. His remarkable career as
a dermatologist and his pioneering work with penicillin and the Pap test were highlighted in the summer 2003 issue of
Buffalo Physician.

The chair, which will be known as the Rita M. and Ralph T. Behling, M.D., Chair in Dermatology, in part memorializes his
first wife, who died in 1998 and who also was a UB graduate. Behling says his motive for endowing the chair is to ensure that
"future students enjoy the same kind of quality education I had at UB."
Behling lives in San Mateo, CA, with his second wife, Eileen. Between them, they have ten children, all over age 40.
—Lyn Corder, PhD, associate dean

Advanced Molecular Biology
and Immunology (CAMBI)
at UB. He and his colleagues
have found that oral bacteria
can exchange genes, raising
the possibility that organisms
in the oral cavity can be
transformed from harmless
to destructive, and from
antibiotic-susceptible to
antibiotic-resistant.
—S U E W U E T C H E R

Fudyma Named
Medical Director
The Erie County Medical
Center (ECMC) Healthcare
Network Board of Managers
has appoint­
ed John R.
Fudyma,
MD '85, to
the position
of medical
director of
the Health­
care Network.
FU D Y M A
Fudyma
previously served as associate
medical director of ECMC
(2001-2002) and as a member
of the ECMC board of

managers (1998-2001). He
is currently associate profes­
sor of clinical medicine in
internal medicine (1998present) and associate
program director of the
Internal Medicine Residency
Program A (1996-present) at
the UB School of Medicine
and Biomedical Sciences.
Originally from Utica, NY,
Fudyma obtained his under­
graduate degree in biology
from Hamilton College,
Clinton, NY, and his medical
degree from UB in 1985.
He completed his resi­
dency in internal medicine in
Buffalo (1990) and a year as
chief medical resident at
ECMC (1991).
— JO E CI R I L L O

Urologic Oncology
Chair Named
James L. Mohler, MD, has
been named chair of the
Department of Urologic
Oncology at Roswell Park
Cancer Institute (RPCI). He
comes to RPCI from the
University of North Carolina

(UNC),
Lineberger
Compre­
hensive
Cancer
Center,
Chapel
Hill, NC,
where he
served as associate professor
of surgery, associate professor
of pathology and laboratory
medicine, and director of the
UNC Prostate Cancer
Research Program.
At RPCI, Mohler will work
with Robert Huben, MD,
chief of clinical urology, on
training programs for
urologic oncology residents
and fellows, as well to
enhance as RPCI's translational research activities.
Mohler received a medical
degree from the Medical
College of Georgia, Augusta,
GA, and completed an
internship in internal
medicine at Duke University
Medical Center, Durham,
NC. He completed residency
training in surgery and

A u t u m n

urology at the University of
Kentucky Medical Center,
Lexington, KY, and a research
fellowship in urologic
oncology at The Johns
Hopkins University School of
Medicine, Baltimore, MD.
—D E B O R A H P E T T I B O N E

Vision Research
Funded by NIH
Two researchers in the
University at Buffalo School
of Medicine and Biomedical
Sciences have received grants
from the National Institutes
of Health to conduct research
into the function and
development of the human
vision system.
Malcolm M. Slaughter,
PhD, professor of physiology
and biophysics, has received a
grant of $369,700 to study the
different ways in which
glycine can increase vision
clarity and benefit the
nervous system.
A pioneer in the study
of vision, Slaughter has

r

CONTINUED ON PAGE 31

20 03

Buffalo Physician

V A
^

PA

T

H

W

A

Y

S

BREAST CARE CENTER OPENED

I

n July 2003, Kaleida Health opened its Breast Care Center on the fifth floor of the Women and
Children's Hospital of Buffalo. Staffed by eight, the center includes state-of-the art mammography
equipment, ultrasound, a patient resource center, and a stereotactic core biopsy suite. In addition,

KENNETH
ECKHERT JR

LISA A. HANSEN

genetic counseling and evaluation are provided for patients and families.
The Breast Care Center's concept—which is to provide patients optimal diagnoses and treatment in
days, instead of weeks—was developed by breast surgeon and center director Kenneth Eckhert Jr, MD '68,
assistant clinical professor in the University at Buffalo School of Medicine and Biomedical Sciences.
Eckhert is a founding partner of Breast Health Associates, a private practice focused on the evaluation
of management of breast conditions. Prior to joining Kaleida Health in October 2002, he served as chief of
surgery at the Sisters of Charity Hospital in the Catholic Health System.
Lisa A. Hansen, MD '91, was recruited back to Buffalo to serve as a dedicated mammographer at the
Breast Cancer Center. Following graduation from UB medical school, Hansen completed a pediatrics
internship at Children's Hospital of Buffalo. She finished her residency training in radiology at the
University of Toronto, followed by a breast imaging fellowship at Thomas Jefferson University in Phila­
delphia, PA. Prior to joining Kaleida, Hansen was director of the Breast Imaging Clinic at the University
of Mississippi in Jackson, MS.
The Genetics Division located at The Women and Children's Hospital, led by Richard W. Erbe, MD,
will provide genetic counseling and evaluation for Breast Care Center patients. fr>

RICHARD W. ERBE

Hospital Name Change
THE WOMEN AND CHILDREN'S HOSPITAL OF BUFFALO

In April, Kaleida Health's Children's Hospital of Buffalo was renamed The Women
and Children S Hospital of Buffalo. One impetus for the change, as reported in the KaleidaScope newsletter,
was a decision by the hospital's OB/GYN group to remain at the facility, where it will play a key role in the development
of new services for women in the entire Kaleida Health organization.
Another reason for the change was the hospital's history of offering specialized services and facilities for women,
including care for low- and high-risk pregnancies, a perinatal center, and The Breast Care Center.
""We've been caring for women for more than 85 years. The staff is very excited that the hospital is being recognized
for the work we do for women," says Craig L. Anderson, MD, the hospital's chief medical officer and Kaleida Health
vice president.
In a parallel move, Kaleida Health is looking at the gap in women's services nationwide, asking health-care
professionals, community leaders and women what services they'd like to see offered, according to Cynthia Ambres, MD,
executive vice president and chief medical officer for Kaleida Health.
"It's critically important for us to listen to what the community has to say as we work to develop a strategic plan
for women's services throughout our system," she says. C3>

30

Buffalo P hy sic ia i

A u t u m n

2 0 0 3

such injury. His research
group is studying the
molecular basis of inherited
retinal diseases and is
focusing on developing
gene-directed therapeutic
approaches for these blind­
ing disorders.

|CONTINUED FROM PAGE 29

published past research
findings in Nature and
Science, as well as in leading
journals in the vision field.
His research focuses on
information processing in
the retina; in particular, the
events that occur at synapses.
Shahrokh C. Khani, MD,
assistant professor of ophthal­
mology and biochemistry,
received a $271,703 grant to
study the enzyme rhodospin
(which can cause retinal
disease) and the susceptibility
of the retina to light-induced

—SUE WUETCHER

Bodkin Wins Top
Research Honors
A project submitted by John
J. Bodkin, III, a master's
candidate in physiology in
the University at Buffalo
School of Medicine and Bio­
medical Sciences, received

injury and how to prevent

second
place at the
annual in­
ternational
meeting of
the Under­
water Hy­
perbaric
Medical
Society held in Quebec City,
Quebec. His project was titled
"Prevention and Treatment
of Decompression Sickness:
Potentially Field-Usable
Methods to Enhance Inert
Gas Elimination."
Bodkin, who earned a
bachelor of science degree in

physiology and neurobiology
in 2000 at the University of
Connecticut, was mentored
on the project by Claes
Lundgren, MD, PhD,
professor of physiology and
biophysics at UB and director
of the university's Center for
Research and Education in
Special Environments.
Timothy B. Curry, MD,
PhD, at the Mayo Clinic in
Rochester, MN, collaborated
on the project.
Bodkin plans to continue
research in hyperbaric
medicine and to pursue a
doctorate in physiology.
—S. A. UNGER

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Autumn 2003

Buffalo Physician

F)earis Award
THE DEAN'S AWARD IS GIVEN IN SPECIAL RECOGNITION OF EXTRAORDINARY
SERVICE TO THE SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES.
This year, Interim Dean Margaret Paroski, MD '80, presented the award to Alexander C. Brownie, PhD, DSc, SUNY Distinguished
Professor Emeritus, "for his phenomenal dedication to developing and rolling out the new curriculum for the preclinical years."
"In addition to teaching extensively in the new curriculum, Dr. Brownie has helped collect feedback, integrate modules
and revise the content of the modules," says Paroski. "He is ever present for the students and has helped soothe the anxieties—
of students and faculty—regarding the new curriculum. This kind of commitment and enthusiasm is what impressed the LCME about
our new curriculum."
A member of the University at Buffalo faculty since 1963 and former chair of the Department of Biochemistry (1977-1989),
Brownie has received many awards from the UB School of Medicine and Biomedical Sciences. These include the Louis A. and Ruth
Siegel Excellence in Teaching Award (1983) and the Stockton Kimball Award (1986) for his research on control of the adrenal
cortex, as well as for his outstanding teaching and service to the university. In 1993, Brownie was named SUNY Distinguished
Professor, the highest rank in the State University of New York System, by the SUNY Board of Trustees.
A native of Scotland, Brownie was educated at Edinburgh University. In 1996, he was elected a Fellow of the Royal Society
of Edinburgh.

—S. A. UNGER

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32

u f f a Io Physician

A u t u m n

2 0 0 3

•

FREDONIA

•

JAMESTOWN

•

NEW YORK

•

ROCHESTER

H U B E R

L L P

Sforlcfori
Kimball Award
Stanley Schwartz, MD, PhD

T

he Stockton Kimball Award honors a faculty member for

senior associate dean for research and

academic accomplishments and worldwide recognition as an

biomedical education at UB, who presented

investigator and researcher. Stockton Kimball, MD '29, was

him with the award.

the dean of the University at Buffalo School of Medicine from

"He has been recognized by his peers not

1946 to 1958, and his contributionsto the training of physicians in Buffalo

only as demonstrated by his competitive fund­

spanned more than a quarter of a century.

ing record, but also his selection to serve on

The 2003 recipient of the Stockton Kimball Award is Stanley Schwartz,

the editorial boards of several top immunol­

MD, PhD, professor of medicine, pediatrics and microbiology, and direc­

ogy journals," she added. "In hiscareer, Stan

tor of the Division of Allergy, Immunology, and Rheumatology in the UB

has been rewarded and honored with an NIH

Department of Medicine.

Research Career Development Award, the

Schwartz received a doctorate in cellular biology from the University

Metier Award for Outstanding Research (Memorial Sloan-Kettering

of California at San Diego in 1968, and a medical degree from Albert

Cancer Center), and as an American Association for the United Nations

Einstein College of Medicine in 1972. He was a postdoctoral fellow at

World Travel Fellow, among others."

the University of California, San Diego, and later at the Albert Einstein

According to Laychock, Schwartz has published well over 100 scien­

College of Medicine, where he was an American Cancer Society Postdoc­

tific articles, most recently on the subject of AIDS and immunoregulatory

toral Scholar. He completed residency training at the Albert Einstein

activities of HIV-1 proteins and their effects on cytokine expression.

College of Medicine and continued his research training as a clinical

Besides outstanding scholarship, the Stockton Kimball awardee also

fellow in immunology at Memorial Sloan-Kettering Cancer Center and

must demonstrate significant service to the University at Buffalo. Since

Sloan-Kettering Institute for Cancer Research.

joining the University at Buffalo, Schwartz has served as director of the

Schwartz began his clinical academic career in 1978 at the University

Division of Allergy, Immunology and Rheumatology. He has also served as

of Michigan, Ann Arbor, where he rose through the ranks to become

chair and facilitator for the Ad Hoc Committee on Specialist Training, on

professor of pediatrics and communicable diseases and professor of

the Program Directors Committee for the Graduate Medical/Dental

microbiology and immunology (1983-92). He also became a charter

Education Consortium of Buffalo, as a member of the Buswell Fellowship

member of the University of Michigan Cancer Center.

Committee, and on the professional staff of the Witebsky Center for

In 1992, Schwartz joined the faculty at the University at Buffalo as
professor of medicine and, subsequently was appointed professor of
pediatrics and microbiology.

Immunology at UB, in addition to other service activities.
"Dr. Stanley Schwartz exemplifies the balance of research and clinical
dedication that makes for an outstanding academic clinician and transla-

Throughout his career, Schwartz has primarily focused his research

tional scientist," concluded Laychock. "The Stockton Kimball Award is a

on the mechanisms of immunoregulation in humans and the immuno-

testament not only to the success of Dr. Schwartz as one of UB's most

pathogenesis of HIV infections.

talented professors of medicine but also his participation as a generous

"Stan has been consistently funded by NIH grants and other grants
and awards to support his research," said Suzanne Laychock, PhD,

and concerned faculty member who has contributed to the betterment of
our university and the School of Medicine and Biomedical Sciences."

A u t u m n

2 0 0 3

Buffalo

Physician

Leon E. Farhi, MD

exchange and the human circulatory

Born in Cairo and raised in

department chair from 1982 to

—Former chair of physiology

system. He was instrumental in

Lebanon and Italy, Farhi moved to

1991. He was promoted to the

and biophysics

developing new approaches for mea­

Israel in 1947 to fight for the Israeli

rank of Distinguished Professor—

suring cardiac output and distri­

underground. He received his medi­

the highest rank in the SUNY

Leon E. Farhi,

bution of respiratory gases within

cal degree in 1947 from the

system—in 1989.

MD, SUNY

the lung and tissues of the body.

Universite St. Joseph in Beirut and

Distinguished

Farhi ran the Themis Project, a

Farhi received numerous honors

completed his medical training in

and awards over the course of his

Hadassah Hospital in Jerusalem.

career, including the Stockton

Professor in the

Defense Department-funded study

Department of

that assessed the effect of different

Physiology and

environments on breathing. Inter­

the United States in 1952 to treat

of Medicine and Biomedical

Biophysics, died

ested in how deep-sea diving and

tuberculosis patients at Saranac

Sciences, a Humboldt Fellowship

on July 9, 2003,

high- and low-gravity environments

Lake. After serving postdoctoral fel­

and a fellowship in the American

in the Cleveland Clinic while under­

affected respiration, he conducted

lowships at Johns Hopkins University

Institute of Medical and Biological

going surgery for a heart infection.

experiments for NASA with astro­

and the University of Rochester, he

Engineering.

He was 79.

nauts on Spacelab missions, as well

joined the UB faculty as an assistant

as in the human centrifuge in UB's

professor. Farhi rose through the

54 years, Haya; daughter, Nitza F.

1958, Farhi studied physiological

Center for Research and Education

ranks at UB, being promoted to full

Ellis, MD '77, clinical assistant

problems of human lung-gas

in Special Environments.

professor in 1966 and serving as

professor of pediatrics in the UB

A UB faculty member since

A pulmonologist, he came to

Kimball Award from the UB School

Survivors include his wife of

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Buffalo Physician

A u t u m n

2 0 0 3

Daniel Schneider, AuD

Jennifer Schneider, MA

Jerri Kaplan Joyce, MA

School of Medicine and Biomedical

Ellen Dickinson, MD

and had served the university in

a neurologist there and at Millard

Sciences; and son, Eli R. Farhi, MD,

—Interim chair of psychiatry

many capacities, including a term

Fillmore, the Veteran Affairs West­

associate professor of clinical
medicine, also at UB.
Contributions can be made to

Ellen S. Dickinson, a neurologist
and psychiatrist who served as

as co-chair of the medical school's

ern New York Healthcare System

admissions committee.

and BryLin hospitals. She was chair

Dickinson also was clinical

of the psychiatry department at

the Leon E. Farhi Memorial Fund

interim chair of

director of psychiatric services

c/o UB Foundation and addressed

the Department

at Erie County Medical Center

to P. Davison, Department of

of Psychiatry in

(ECMCI for eight years. In May

having a double specialty when she

Millard Fillmore from 1992 to 1995.
Dickinson fulfilled her dream of

Physiology and Biophysics, 124

the University at

2002, she was the first woman

attended Cornell University for resi­

Sherman Hall, University at Buffalo,

Buffalo School

honored as Physician of the Year

dency training in psychiatry in 1983.

School of Medicine and Biomedical

of Medicine and

at ECMC's annual Springfest.

Sciences, 3435 Main Street,

Biomedical Sci­

Buffalo, NY 14214.
—SUE WUETCHER

ences, died on

A native of Barker in Niagara
County, Dickinson received a

In May 2003, Dickinson was
named a distinguished fellow of the
American Psychiatric Association.

July 31, 2003, in Roswell Park Can­

bachelor's degree from Ohio

cer Institute after a brief illness.

Wesleyan University and a medical

Dorothy Wilson Dickinson, of Buf­

She was 61.
A clinical assistant professor,
Dickinson taught at UB since 1971

Survivors include her mother,

degree from Indiana University.

falo, and two brothers, James L. of

She completed residency training

Barker, and Robert J. of Buffalo.

in neurology at ECMC and worked as

—SUE WUETCHER

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Autumn

2003

1 II f I a I o

Physician

\ 1

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E

S

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Poxvirus
REPLICATION INHIBITED
Work could result in a new treatment for smallpox
BY LOIS

BAKER

M

olecular biologists at the Univer­
sity at Buffalo have discovered a
novel way to inhibit the replica­

tion of poxviruses (the group that
includes smallpox virus) by interfering
with messenger RNA synthesis necessary
for the viruses to reproduce in a host or­
ganism. The discovery, which has a patent
pending, could lead to the development
of drugs to treat the potentially deadly
disease in the event of a bioterrorismrelated outbreak.
Such drugs also would be effective
against related poxviruses such as
monkeypox, which recently has infected
dozens of people in the U.S who came in
contact with animals imported from

Africa, where monkeypox is indigenous.
"Any success that results in a treatment
is a success for everyone," says Edward
Niles, PhD, professor of microbiology
and biochemistry in the University at
Buffalo School of Medicine and Biomed­
ical Sciences and primary discoverer of
the new anti-replication mechanism. "We
need something."
Work that could lead to new drugs is in
the early stages, Niles notes.
To date, there is no effective treatment
for smallpox or other poxviruses. Small­
pox was declared eradicated in 1980 after
a worldwide vaccination campaign. The
U.S. and Russia maintain the only autho­
rized repositories of the virus, but virolo­
gists acknowledge that the virus may exist
outside these sites.
Existing vaccines that could be used to

Buffalo Physician

Autumn 2003

Edward Niles. PhD. professor of microbiology and biochemistry, left,and Mohamed Ragaa Mohamed. PhD.
right, a postdoctoral fellow who collaborated with Niles on the poxvirus research.

protect against smallpox bioterrorism
have a high incidence of side effects and
may not be administered to certain seg­
ments of the population, notably preg­
nant women, persons with compromised
immune systems due to disease or medi­
cations, persons with a history of eczema
and children under one year of age.
Drugs developed using this novel ap­
proach could be stockpiled for use if an
outbreak occurs, says Niles. If a new small­
pox vaccination campaign were under­
taken, such drugs also could be available to
treat persons who have serious reactions
to the vaccine.

Niles's discovery, achieved working
with vaccinia virus, exploits a peculiar as­
pect of poxvirus biochemistry: Instead of
creating copies of itself in the nucleus of
the infected cell like other DNA viruses do
(such as the herpes virus), poxviruses rep­
licate in the cell's cytoplasm, the gel-like
material surrounding the nucleus.
"Since poxviruses replicate in the cyto­
plasm, they can't use the host's enzymes
present in the nucleus to make viral
mRNA, which is translated to synthesize
viral proteins," explains Niles. "These vi­
ruses have evolved in a manner that allows
them to produce their own enzymes,

which are used to express their genes and
permit their replication.
"This quirk in the poxvirus replication
process should make it possible for scien­
tists to design drugs targeted to those unique
viral enzymes without interrupting nor­
mal cellular functions," he says.
Vaccinia virus is the virus strain used
for immunization against smallpox. The
initial interest of Niles and colleagues was
to understand the basic process in the
early stage of poxvirus gene expression
(virus gene expression takes place in three
stages: early, intermediate and late).
"The early phase is unique in that for
transcription (mRNA synthesis) to pro­
ceed, it requires an initiating event at a
site on the DNA called a promoter," he
explains. "Another signal, called a termi­
nator, is required to stop the early gene
transcription. We wanted to know what
that terminator signal does."

To study this mechanism, the UB re­
searchers synthesized a short RNA frag­
ment, or oligonucleotide, that contained
the known termination signal. They then
added the fragment to a test tube transcrip­
tion reaction and measured RNA synthesis.
"We expected the oligonucleotide to
inhibit the termination reaction," says
Niles, "but instead of stopping it, the pres­
ence of the oligonucleotide stimulated
premature termination. This resulted in
the synthesis of truncated RNA mole­
cules, which would be unable to direct the
synthesis of normal proteins.
"This termination mechanism is
unique to poxviruses, and this method of
inhibition of gene expression should work
on all poxviruses," he continues. "If this
oligonucleotide could be delivered as a
drug, it would inhibit synthesis of all pox­
virus proteins early in infection and stop
the virus from replicating in the host."

The work is in its very early stages,
Niles cautions, with many steps that must
be completed before a viable drug can be
developed.
"We have to identify the most active
compounds in vitro, test their activities
on virus replication in tissue culture, and
then figure out how best to deliver it in an
animal model before we can even begin to
test it in humans."
Mohamed Ragaa Mohamed, PhD, a
postdoctoral fellow working in Niles's lab­
oratory, collaborated on the research,
which was funded by the National Insti­
tute of Allergies and Infectious Diseases
of the National Institutes of Health. CT>
An article about this work was originally
published in the Journal of Biological
Chemistry. An abstract can be found at
JBC Online at www.jbc.org/cgi/content/
abstract/278/14/11794.

A law firm that
stands out...,
Suburban location, extended
hours and personal service.
We practice law for your
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Autumn 2003

Buffalo Physician

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The Electronic
1 Patient Record
i^&9g

Will it finally happen?
his past summer, I participated in a conference that could presage a sea change in the way patient medical
records are kept. The conference, "Developing a National Action Agenda forNHII (National Health Informa­
tion Infrastructure) 2003," was sponsored by the U.S. Department of Health and Human Services. It set forth
what its organizers called "an initiative to improve the effectiveness and efficiency of overall quality of health
and health care in the United States."
Keynote speaker Secretary Tommy Thompson challenged the invited stakeholders to "develop a comprehen­
sive, knowledge-based network of interoperable systems of clinical, public health and personal health informa­
tion that would improve decision making by makinghealth information available when and where it is needed."
Over the course ofthe three-day meeting, certain standards were recommended, but the program is voluntary
and does not envision a centralized database of medical records or government regulation.

P

atient medical records are traditionally paperbased and kept by the patient's doctor or hospital.
As a patient moves from one doctor or hospital
to another, medical knowledge becomes fragment­
ed and no one has a clear, long-term view of the pa­
tient's progress.

In an electronic era, medical data on a patient
could be shared; however, all systems now in use
were originated to address particular local conditions
and utilize disparate hardware and software. As a
result, data cannot be readily moved from one such
system to another.
Government concern over this problem is not
new. In 1991, the Institute of Medicine recommend­
ed that "health-care professionals and organizations
adopt the computer-based patient record (CPR) as the
standard for medical and all other records related to
patient care." Since then, much effort has been ex­
pended to realize a common model, but consensus has

Autumn 2003

been elusive. The NHII initiative challenges stake­
holders in health care to come up with a "national
health information infrastructure" and offers leader­
ship, as well as possible financial incentives. A point
made at the conference is that health care currently
spends much less on information technology than do
many grocery chains. One expert warned, however,
that throwing more money into conventional dataprocessing approaches would be pointless.

Patient Privacy versus Public Good

I

fundamental tenet of medical record keeping is
that patients are unlikely to disclose to their phy­
sician intimate details that are necessary for their
proper medical care unless they trust the physician
to keep that information confidential.

Clearly, no one should have access to private
health-care information without a patient's authori­
zation, and patients should be able to see their records

and correct erroneous information in them. The
Health Insurance Portability and Accountability Act
(HIPAA) of 1996 tried to apply these basic privacy
rules in an era of electronic communication, and at a
time when the U.S. health-care market was driven by
large health plans and fiercecompetition, as it is today.
The original HIPAA rules were complex and have
since been changed several times, reflecting the fun­
damental conflict between the need for privacy for
the patient and desires of public health workers,
researchers, insurers, employers and others to gain
access to the patient data. Even the use of medical rec­
ords in research currently has no national standard,
and local institutional review boards often retain dis­
cretionary authority to grant waivers of consent.

My Interest in Medical Informatics

T

hroughout my professional life I have been fasci­
nated by how medical information is categorized
and utilized. A particular area of interest was how
diagnoses were made. When individual computers
became affordable I began to develop programs for
that purpose. Gradually I became aware that the diag­
nostic problem was part of a larger task. If I could
organize all medical knowledge, then diagnosis would
be a subtask of a universal organization. This approach
became "Framemed," a computer-based framework
for medical knowledge that is based on hierarchies in
various domains of medicine. "Diseases" became a
hierarchy, as did "Agents," "Findings," "Tests," "Pro­
cedures" and more than 20 other traditional areas in
medicine. When the concept of a computer-based
patient record (CPR) became popular, that task began
to dominate my activities with Framemed. Fortu­
nately, I was able to interest my son, Geoffrey, who
brought to the problem the newer computer skills
involving Web technology with browsers and servers.

The Framemed CPR

I

he Framemed CPR is built on the premise that the
patient controls his or her own record and how its
content may be used. The key is that the patient
appoints a surrogate (e.g., a hospital, health mainte­
nance organization, or physician group) to maintain
the CPR on its server. At each medical encounter, the
patient asks the surrogate, over a secure Internet con­
nection, to download the CPR. Results of the medical
encounter are appended to the CPR, and it is uploaded
to the surrogate's server. The patient may empower a
doctor (or other health-care professional) to read or

write on the CPR. The results of all laboratory testing,
procedures and consultations are returned to the
CPR, where the patient can immediately see them. The
patient may record his or her own findings, such as
weight, blood pressure, blood glucose, accidents, etc.
All encounters in the CPR are dated and signed by the
initiator and may not be altered thereafter except that
encounter amendments may be added. To further
protect patient confidentiality, the CPR is divided into
two parts: an administrative file and a medical file. The
latter contains no direct identification of the patient
and hence its data may be used for statistical purposes
without infringing on patient confidentiality.
A surrogate managing many CPRs possesses a
valuable cross section of medical data. With the pa­
tients' permission, the surrogate can make aggregate
medical data available to outside agencies for various
uses; for example, how many in the group have asth­
ma and how many take a particular drug. The mortal­
ity and morbidity following certain procedures can be
assessed. Unusual activity of a particular nature might
signal an impending or even in-progress epidemic or
terrorist attack. Such data could flow from the CPRs
without revealing any patients' identities, hence rec­
onciling patient privacy with public good.
Also, in the Framemed system, concepts in the
various hierarchies (e.g., diseases, drugs, tests) are
hyperlinked to corresponding knowledge records, a
feature that can be utilized independently (as a medi­
cal encyclopedia) or as part of the CPR (to find out
more about a concept before selecting it from a pick
list in our CPR).

Moving On

About
the
Author
Charles W.
Bishop, PhD,
is associate
professor of
medicine and
biochemistry at
the University at
Buffalo School
of Medicine and
Biomedical
Sciences and a
facilitator in
the problem-based
learning program
for first- and
second-year

D

octors have traditionally scribbled their patients'
records and retained them. The government now
asks if these can be incorporated into standardized,
lifetime patient records for effective and efficient
patient health care. Framemed has developed the soft­
ware by which a patient can keep his or her own,
professional-quality medical record. We have recently
set up a secure Web site to test and improve this
software. The next step is for surrogates to license our

medical students.
He can be
e-mailed at
cbishop@buffalo.edu.

software and offer patients generally the ability to
maintain their own medical records. Doctors and
medical groups can use the same records, leading to
true patient-centered medical records, as promoted
by the NHII initiative.

Autumn 2003

Buffalo Physician

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Beyond the Classroom

By Linda J . Corder, PhD, CFRE

S IS EVIDENT BY THIS ISSUE OF BUFFALO PHYSICIAN,

mother died of breast cancer when he was 11. Dana met

memory of Samuel Sanes, MD '30, lives on at our school. It

Sam during his first semester in medical school; in his

is here that he spent innumerable hours teaching students

second year, he was diagnosed with Hodgkin's disease.

pathology, answering their questions and assuaging their

During Dana's initial treatments, Sam visited him every

frustration—and fatigue—by listening and providing re­

day in the hospital, taking a bus from Millard Fillmore

sponses that elicited laughter, or at least a chuckle. Sam

Hospital to Buffalo General. He tutored Dana, kept his

Sanes's dedication to students extended beyond classroom

spirits up and convinced him to stay in

doors, however, as reflected through myriad stories of

medical school. When Dana returned to

former students.

class and reported sitting through lectures

Take Maxine Hayes, MD, '73, who returned to UB in

in the middle of a ring of empty seats, Sam

2000 to deliver the Stockton Kimball Lecture. Maxine was

listened. When Dana's father died of lym­

raised in the South in the 1950s. Her family was poor and

phoma four months after Dana's diagnosis,

"lived on the other side of the tracks"; however, they instilled

Sam comforted him. He also encouraged him

in her the belief that there was nothing she couldn't do if she

through clinical rotations and helped to find

worked for it. She was awarded a scholarship to Spelman

"someone to take a chance" on him for resi­

College in Atlanta and had an opportunity to study abroad

dency training.

in 1968. That year, Martin Luther King, Jr, and Robert

Shortly before Dana began his residency, Sam was diag­

Kennedy were assassinated, protests against the Vietnam

nosed with cancer, which subsequently claimed his life in

War were at their height and demonstrators called for changes

1978. Suddenly the tables were turned and Dana became the

throughout society. As a result, leaders in higher education

teacher, encouraging Sam through rounds of chemotherapy

began to reconsider admissions policies. In 1969, UB sent

and radiation similar to what he had experienced. During

recruiters to Atlanta who met with Maxine and offered her a

his residency, Dana couldn't visit Sam often, but he wrote

place in its medical school and a scholarship.

to him regularly.

During her time in Buffalo, Maxine, who is African
American, had difficulty finding a place to live. However,

Later, Dana moved to California. Currently, he is chief
of surgery at Scripps Memorial Hospital in La Jolla.

she was mentored and encouraged by Sam Sanes and his

For both Maxine and Dana, Sam's friendship made all

wife, Mildred, who frequently invited her to their home.

the difference in their lives. Today they each remain friends

They applauded her residencies at Vanderbilt University

with Mildred while carrying the memory of Sam—an ex­

and Children's Hospital Medical Center in Boston, her

traordinary teacher and a true gentleman—in their hearts.

completion of a master's degree in public health at Harvard

A decade after Sam's death, his sister, Thelma, estab­

University and her establishment of a family health clinic in

lished a scholarship in her name and the name of their

Mississippi (which recentlycelebrated its 25th anniversary).

brother, Harold. Neither Harold nor Thelma went to col­

Today, Maxine serves as the Washington State Health

lege, and Sam had to work his way through. This was the

Officer, working closely with the medical community, local

reason Thelma gave for wanting to help others at

health departments and community groups to provide the

"Sam's medical school."CO

public the latest scientific information on how to become
and stay healthy.

Lyn Corder, PhD, is associate dean in the Office of Develop­

Or ask Dana P. Launer, MD, '73, who was raised in New
York City by his father and future mother-in-law after his

40

Buffalo Physician

Autumn

2003

ment and Alumni Affairs. She can be contacted via e-mail at
ljcorder@buffalo.edu; or by phone at 1-877-826-3246.

Endowments ofJ the School

AND BIOMEDICAL SCIENCES

Endowments, especially for scholarships, are vital to the future of this school. A list of all of the school's current endowments—as well as those
for the Health Sciences Library—follows. Those with an asterisk (* ) were initiated during the past fiscal year. Those in bold print had one
or more additional gifts during this timeframe. New endowments that were funded or partially funded have both an asterisk and appear
in bold. Read through the list. Thank your friends, colleagues, classmates who have initiated endowments or those you know who are helping
to build funds, such as the Medical Alumni Endowed Scholarship Fund, through annual gifts. Please consider the school's endowment
program in your philanthropic plans, either by adding to an existing fund or by setting up a new one. As always, your friends in the Office
of Alumni Affairs and Development will answer any questions you might have.

School of Medicine and Biomedical Sciences

PAUL K. BIRTCH, M.D., FUND

H.W. ABRAHAMER MEMORIAL SCHOLARSHIP

MARVIN A. AND LILLIAN BLOCK FUND

SIDNEY ADDLEMAN MEMORIAL

WILLARD H. BOARDMAN, M.D., AND JEAN BOARDMAN FUND

DR. GEORGE J. ALKER FUND FOR NEURORADIOLOGY

DR. SOLOMON G. BOOKE AND ROSE YASGUR BOOKE FUND

THEODORE M. & BESSIE G. ALPERT SCHOOL OF MEDICINE SCHOLARSHIP

JAMES H. BORRELL UROLOGY FUND

ALPHA OMEGA ALPHA ENDOWMENT

ANNE AND HAROLD BRODY ANATOMY LECTURE FUND

ALPHA OMEGA ALPHA LIBRARY FUND

CLAYTON MILO BROWN MEMORIAL

AMERICAN ACADEMY OF FAMILY PHYSICIANS PRESIDENT'S AWARD

BUKOWSKI FAMILY ENDOWMENT*

ANATOMICAL SCIENCES LIBRARY FUND

GEORGE N. BURWELL FUND

ANESTHESIOLOGY DEPARTMENT ENDOWMENT

DR. WINFIELD L. BUTSCH MEMORIAL LECTURE IN CLINICAL SURGERY

ANNUAL PARTICIPATING FUND FOR MEDICAL EDUCATION

VINCENT CAPRARO LECTURESHIP FUND—CLASS OF 1945

BACCELLI MEDICAL CLUB AWARD

DR. CHARLES F. CARY MEMORIAL FUND

L. B. BADGERO MEDICAL SCHOOL FUND

DR. AND MRS. JOSEPH A. CHAZAN MEDICAL SCHOLARSHIP

VIRGINIA BARNES ENDOWMENT

CLINICAL PREVENTATIVE MEDICINE FELLOWSHIP

DR. WALTER S. BARNES MEDICAL SCHOOL FUND

ALMON H. COOKE SCHOLARSHIP

DR. WALTER S. BARNES MEMORIAL SCHOLARSHIP FUND

PATRICK BRYANT COSTELLO MEMORIAL

DR. ALLEN BARNETT FELLOWSHIP IN PHARMACOLOGY

CTG ONCOLOGY FUND

DR. CHARLES A. BAUDA AWARD IN FAMILY MEDICINE

JAMES H. CUMMINGS SCHOLARSHIP

THOMAS R. BEAM, JR MEMORIAL FUND

EDWARD L. CURVISH, M.D., AWARD IN BIOCHEMISTRY

GILBERT M. BECK MEMORIAL FUND

ALFRED H. DOBRAK, M.D., RADIOLOGY LECTURE FUND

RITA M. AND RALPH T.BEHLING.M.D., CHAIR IN DERMATOLOGY*

ALFRED H. DOBRAK, M.D., RADIATION RESEARCH FUND

DR. ROBERT A. BENNINGER FUND IN ORTHOPEDICS

MAX DOUBRAVA, JR SCHOLARSHIP FUND

ROBERT S. BERKSON MEMORIAL AWARD IN THE ART OF MEDICINE

THE ELIZABETH MEDICAL AWARD

BERNHOFT FUND FOR THE NEUROANATOMY MUSEUM

DR. ROBERT M. ELLIOT SCHOLARSHIP

ERNST BEUTNER SKIN IMMUNOPATHOLOGY AWARD

GEORGE M. ELLIS, JR, M.D. ENDOWMENT FUND FOR MEDICINE

LOUIS J. BEYER SCHOLARSHIP

ELEANOR FITZGERALD FAIRBAIRN SCHOLARSHIP

Autumn 2003

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P h y s i c i a 1

41

I

I

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I

EXPERIMENTAL NEUROLOGY FUND

HILLIARD JASON AND JANE WESTBERG FUND FOR EDUCATIONAL INNOVATION

FAMILY MEDICINE ENDOWMENT

JAMES N. JOHNSTON SCHOLARSHIP

FAMILY MEDICINE RESEARCH FUND*

C. SUMNER JONES LIBRARY FUND

FEYLER FUND FOR RESEARCH IN HODGKIN'S DISEASE

HARRY E. AND LORETTA A. JORDON FUND

DR. GRANT T. FISHER FUND FOR MICROBIOLOGY

H. CALVIN KERCHEVAL MEMORIAL FUND

L. WALTER FIX, M.D., '42 '43, ENDOWED SCHOLARSHIP FUND

DEAN STOCKTON KIMBALL MEMORIAL AWARD

EDWARD FOGAN MEMORIAL LECTURE/PRIZE FUND

DEAN STOCKTON KIMBALL MEMORIAL SCHOLARSHIP

FORD FOUNDATION FUND FOR MEDICAL EDUCATION

DR. JAMES E. KING POSTGRADUATE FUND

THOMAS FRAWLEY, M.D., RESIDENCY RESEARCH FELLOWSHIP FUND

MORRIS LAMER AND DR. ROBERT BERNOT SCHOLARSHIP

FUND FOR CELEBRATING PHILANTHROPY

DR. CHARLES ALFRED LEE SCHOLARSHIP

MARCOS GALLEGO, M.D., CLINICAL EXCELLENCE AWARD FUND

DR. HEINRICH LEONHARDT PRIZE

RONALD GARVEY, M.D., STUDENT LIFE ENRICHMENT FUND

DR. GARRA K. LESTER STUDENT LOAN

JAMES A. GIBSON ANATOMICAL PRIZE

LLOYD LEVE FUND

LAWRENCE AND NANCY GOLDEN LECTURESHIP IN MIND-BODY MEDICINE

THE LIEBERMAN AWARD

WALTER S. GOODALE SCHOLARSHIP

HANS J. LOWENSTEIN AWARD

IRENE PINNEY GOODWIN SCHOLARSHIP

LUPUS SCHOLARSHIP FUND

A. CONGER GOODYEAR PROFESSORSHIP OF PEDIATRICS

WILLIAM E. MABIE, D.D.S., AND GRACE S. MABIE FUND

GEORGE GORHAM FUND

MILFORD C. MALONEY AND DIONE E. MALONEY SCHOLARSHIP FUND*

DR. BERNHARDT S. AND DR. SOPHIE B. GOTTLIEB AWARD

DR. WILLIAM H. MANSPERGER FUND

ADELE M. GOTTSCHALK SCHOLARSHIP FUND

MEDICAL ALUMNI ASSOCIATION LIFE MEMBERSHIP FUND*

CARL V. GRANGER, M.D., ENDOWMENT

MEDICAL ALUMNI ENDOWED SCHOLARSHIP

DR. PASQUALE A. GRECO LOAN FUND

MEDICAL SCHOOL CLASS OF 1957 SCHOLARSHIP

GLEN E. AND PHYLLIS K. GRESHAM FUND FOR CLINICAL RESEARCH

MEDICAL SCHOOL CLASS OF 1958 SCHOLARSHIP

GLEN E. GRESHAM, M.D., VISITING PROFESSORSHIP

MEDICAL SCHOOL CLASS OF 1963 SCHOLARSHIP

ADELAIDE AND BRENDAN GRISWOLD SCHOLARSHIP

MEDICAL SCHOOL CLASS OF 1973 SCHOLARSHIP

DR. THOMAS J. AND BARBARA L. GUTTUSO SCHOLARSHIP & AWARD

MEDICAL SCHOOL PROFESSORSHIP FUND

GYNECOLOGY-OBSTETRICS DEPARTMENT ENDOWMENT

SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES ENDOWMENT

JEAN SARAH HAHL MEMORIAL

MARIAN E. MELLEN FUND

EUGENE J. FIANAVAN SCHOLARSHIP

MICROBIOLOGY ENDOWMENT FUND

FLORENCE M. & SHERMAN R. HANSON FUND FOR MEDICAL EDUCATION

DR. DAVID KIMBALL MILLER AWARD

DEVILLO V. HARRINGTON LECTURESHIP

EUGENE R. MINDELL, M.D., CHAIR IN ORTHOPAEDIC SURGERY

THE HEKIMIAN FUND

G. NORRIS MINER, M.D., MEMORIAL AWARD

HEWLETT FAMILY ENRICHMENT FUND FOR PSYCHIATRY

COLLEEN C. AND PHILLIP D. MOREY, M.D., SCHOLARSHIP

CHARLES GORDON HEYD MEDICAL RESOURCE FUND

RICHARD J. NAGEL, M.D., ANESTHESIOLOGY RESEARCH

DR. FRANK WHITEHALL HINKEL SCHOLARSHIP FUND

DR. ANGE S. NAPLES MEMORIAL SCHOLARSHIP

RALPH HOCHSTETTER MEDICAL RESEARCH FUND

DR. S. ROBERT NARINS MEMORIAL AWARD

DR. SUK-KI HONG MEMORIAL FUND

NATIONAL MEDICAL ASSOCIATION BUFFALO CHAPTER SCHOLARSHIP FUND

ABRAHAM M. HOROWITZ FUND

JOHN P. NAUGHTON AWARD FUND

LUCIEN HOWE PRIZE FUND

NEPHROLOGY RESEARCH ENDOWMENT

DR. MYROSLAW M. HRESHCHYSHYN MEMORIAL ENDOWMENT

DR. ERWIN NETER MEMORIAL FUND

R.R. HUMPHREY & STUART L. VAUGHAN NU SIGMA NU ALUMNI SCHOLARSHIP

ANTOINETTE AND LOUIS H. NEUBECK FUND

BUFFALO

PHYSICIAN

A u t u m n

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NEUROLOGY DEPARTMENT ENDOWMENT FUND

IRENE SHEEHAN FUND

DEPARTMENT OF NUCLEAR MEDICINE ENDOWMENT FUND*

DEWITT HALSEY SHERMAN AND JESSICA ANTHONY SHERMAN FUND

DR. BENJAMIN E. & LILA OBLETZ PRIZE FUND IN ORTHOPAEDIC SURGERY

DR. LOUIS A. AND RUTH SIEGEL TEACHERS'AWARD FUND

DR. ELIZABETH P. OLMSTED FUND IN BIOCHEMISTRY

S. MOUCHLY SMALL, M.D., AWARD IN PSYCHIATRY

OMEGA UPSILON PHI OF PHI CHI MEDICAL FRATERNITY SCHOLARSHIP FUND

S. MOUCHLY SMALL, M.D., EDUCATION CENTER FUND

JOSEPHINE HOYER ORTON TRUST FUND

IRVINE AND ROSEMARY SMITH ENDOWED CHAIR IN NEUROLOGY

VICTOR A. PANARO MEDICAL SCHOOL FUND

DR. IRVING M. SNOW FUND

F. CARTER PANNILL, JR, M.D., AWARD ENDOWMENT

MARY ROSENBLUM SOMIT ENDOWED UNDERGRADUATE SCHOLARSHIP FUND

STEPHEN J. PAOLINI,M.D., MEMORIAL FUND

MORRIS AND SADIE STEIN NEURAL ANATOMY PRIZE FUND

ALLAN WADE PARKER DNA RESEARCH GIFT

DIANE AND MORTON STENCHEVER LECTURE FUND

PARKINSON'S DISEASE RESEARCH FUND

JOHN J. AND JANET H. SUNG SCHOLARSHIP FUND

JOHN PAROSKI MEMORIAL AWARD FUND

JOHN H. TALBOTT VISITING PROFESSORSHIP FUND

PARTICIPATING FUND FOR MEDICAL EDUCATION

KORNEL L. TERPLAN, M.D., LECTURE FUND

DR. MARK A. PATRINO MEMORIAL AWARD

TREVETT SCHOLARSHIP

ROBERT J. PATTERSON RESIDENT AWARD

UROLOGY DEPARTMENT ENDOWMENT FUND*

PRIMARY CARE ACHIEVEMENT FUND

RICHARD E. WAHLE RESEARCH FUND

PROGRESSIVE MEDICAL CLUB OF BUFFALO FUND

MILDRED SLOSBERG WEINBERG ENDOWMENT

PSYCHIATRY DEPARTMENT ENDOWMENT FUND

E. J. WEISENHEIMER OPHTHALMOLOGY AWARD

DR. HERMAN RAHN MEMORIAL LECTURE ENDOWMENT

DR. MARK W. WELCH AND BEULAH M. WELCH SCHOLARSHIP FUND

REHABILITATION MEDICINE ENDOWMENT

JOHN A. WENDEL ENDOWMENT FUND*

ALBERT AND ELIZABETH REKATE CHAIR IN CARDIOVASCULAR DISEASE

JAMES PLATT WHITE SOCIETY ENDOWMENT

ALBERT C. REKATE REHABILITATION MEDICINE LIBRARY FUND

WILLIAMS/BLOOM MEDICAL RESEARCH FUND

DONALD RENNIE PRIZE IN PHYSIOLOGY

DR. MARVIN N. WINER FUND FOR DERMATOLOGICAL RESEARCH

MARY CECINA RIFORGIATO STUDENT AWARD IN BIOTECHNICAL AND

WITEBSKY FUND FOR IMMUNOLOGY

CLINICAL LABORATORY SCIENCES

DR. ERNEST WITEBSKY MEMORIAL FUND

DOUGLAS RIGGS AWARD IN PHARMACOLOGY AND THERAPEUTICS

FARNEY R. WURLITZER PRIZE FUND

THE RING MEMORIAL FUND

FARNEY R. WURLITZER PSYCHIATRY FUND

MEYER H. RIWCHUN, M.D., PROFESSORSHIP IN OPHTHALMOLOGY

DR. MAREK B. ZALESKI AWARD FUND

EMILE DAVIS RODENBERG MEMORIAL AWARD

FRANKLIN AND PIERA ZEPLOWITZ, M.D., SCHOLARSHIP FOR MEDICAL

THOMAS A. RODENBERG AND EMILE DAVIS RODENBERG SCHOLARSHIP FUND
HARRY AND FAYE ROSENBERG PEDIATRIC ONCOLOGY RESEARCH FUND*

STUDENTS*
HERMAN AND ROSE ZINKE MEMORIAL SCHOLARSHIP

ELIZABETH ROSNER FUND
IRA G. ROSS AND ELIZABETH P. OLMSTED ROSS, M.D. CHAIR OF OPHTHALMOLOGY

Health Sciences Library

DR. SHELDON ROTHFLEISCH MEMORIAL FUND

ROBERT L. BROWN HISTORY OF MEDICINE COLLECTION

HAROLD S. SANES AND THELMA SANES MEDICAL SCHOLARSHIP

DR. BERNHARDT S. AND DR. SOPHIE B. GOTTLIEB COLLECTION IN THE

PHILIP P. SANG MEMORIAL FUND

BEHAVIORAL SCIENCES

SARKARIA FAMILY PROFESSORSHIP IN DIAGNOSTIC MEDICINE

C. K. HUANG LECTURE FUND

MARIA NAPLES SARNO, M.D., SCHOLARSHIP

STOCKTON KIMBALL SCHOLARSHIP IN MEMORY OF SYLVIA KIMBALL

SCHAEFER FUND IN CARDIOVASCULAR DISEASES

DR. EDGAR R. MCGUIRE HISTORICAL MEDICAL INSTRUMENT FUND

SCHOLARSHIP OF THE PROGRESSIVE MEDICAL CLUB OF BUFFALO
LILLIE S. SEEL SCHOLARSHIP

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BUFFALO

PHYSICIAN

MEDICAL ALUMNI ASSOCIATION

Dear Fellow Alumni,
hope you're having a great autumn! With the start of the academic year, the Medical Alumni Associa­

Officers and
Board Members
2 0 0 3-2 0 0 4

tion (MAA) Governing Board has remained busy, organizing activities within student and alumni
circles and making plans for next year's Spring Clinical Day and Reunion Weekend.
The board has been revitalized this year by the addition of three new members:
Helen Cappuccino, MD '88, Charles Niles, MD '83, and Indrani Sinha, MD '96.

PRESIDENT

Stephen B. Pollack
MD '82
VICE PRESIDENT

Colleen Mattimore
MD '91
TREASURER

Martin L. Brecher
MD '72

Helen, Chuck and Rini have already proven to be energetic, outspoken board
members who will play an active role in the functions of the organization. Addition­
ally, we have been able to retain the expertise of our outgoing past president, John
Bodkin II, MD '76, who has agreed to remain on the board as an emeritus member.
During Orientation Week, the MAA proudly sponsored the annual White Coat
Ceremony, in which first-year students were presented with their first white coats. The association also
sponsored the Student Clinician Ceremony, helping the third-year medical students "kick off' their
clinical training.

MEMBERS

Rohit Bakshi
MD '91
Helen Cappuccino
MD '88
Martin C. Mahoney
MD '95, PhD
Colleen Mattimore
MD '91
Charles Niles
MD '83

In September, the past presidents of the MAA gathered with friends, guests and alumni of the
medical school to honor our newest distinguished alumnus, Michael Cohen, MD '61. We congratulate
Dr. Cohen on receipt of this award and invite you to read more about his career and accomplishments
in the winter issue of Buffalo Physician.
Plans are taking shape for Spring Clinical Day and Reunion Weekend, scheduled for April 30May 1, 2004. After noting the fantastic response to this year's program, which showcased downtown
Buffalo, we will invade the city again next spring. The Clinical Day program is titled "Medicine 2004:
Challenges 8c Innovations." We are pleased to report that Richard O. Dolinar, MD '72, a renowned
expert on diabetes, will serve as our Stockton Kimball Lecturer. In addition to the wonderful venues

Indrani Sinha
MD '96

utilized last year, the Pierce Arrow Museum (one of Buffalo's well-kept secrets!) will be the site of the

EMERITUS MEMBERS

events planned for the weekend.

John J. Bodkin II
MD '76
Donald P. Copley
MD '70
Robert E. Reisman
MD '56
REGIONAL MEMBERS

Joseph A. Chazan
MD '60
Rhode Island
Max Doubrava
MD '59
Nevada

Saturday evening Reunion Dinner Reception. In the next issue of Buffalo Physician, I will preview

On a financial

note, I must report that review of the MAA's annual budget has driven home the

fact that the cost of providing these and other services continues to escalate. After many years of
maintaining member dues at $65 a year, it will be necessary to raise dues slightly, to $75 a year, in
order to continue to support our medical school, students and alumni. This increase will take effect
with the 2004-2005 year. Additionally, the cost of lifetime membership will increase to $1,000. That
means that a lifetime membership—at this year's price of $750—is a bargain! For your convenience,
membership materials are enclosed in this issue of the magazine.
As always, your support of our alma mater through your interest, time, membership in the MAA
and gifts remains the backbone on which our efforts and accomplishments are built. We are all part of
the family; let's show it in any way we can.

Dorothy C. Rasinski
MD '59, JD
California
STEPHEN B. POLLACK, MD '82

President, Medical Alumni Association

lassnotes

AUTUMN 2003

1940s Correct!
Maxine Hayes. MB '73,
2003 issue of

MPH, Wash­

Buffalo Physician,

the University of

also assistant professor

Washington, School

in the Department of

of Public Health.

Molecular and Cellular
Biophysics at RPCI.

ington State

Peter R. Reczek, PhD '79, has

Reczek earned his doc­

the photograph of

health of­

been appointed director

toral degree in Physiology

the Class of 1948

ficer, was
presented the
Washington

of technology transfer in
Fiscal Administration,

and Biophysics from
RPCI Graduate Division,

Office of

University at Buffalo in

Health Foundation's 2003

Health Re­

1979 and completed a

Heroes of Health Care

search, Inc.
(HRI) at

postdoctoral fellowship in

Award on June 19, 2003.
Hayes has been with the

Roswell Park

University in 1980. He

Cancer In­

through California State

Department of Health

stitute (RPCI). Reczek has

served on the faculty at
Harvard Medical School

University, Dominguez

since 1991 and is clinical

served as a consultant to

and the Dana Farber Can­

Jay B. Belsky, MB '51.

Hills. I was fortunate to

professor of pediatrics at

RPCI since 2001 and is

cer Institute until 1989.

writes: "I have been re­

have been able to attend

on page 39 was
1948 Class chair Daniel Fahey.
center, with classmatesWilliam
iloom. left.mi Francis Peisel.

1950s

incorrectly
dentified as the
ilass of 1943.

tired since 1988, after

my medical school 50th

practicing for over 33

Reunion in 2001, and I

years with Kaiser

am looking forward to

Permanente in Harbor

the 55th in 2006. My

City, CA. I was a staff in­
ternist, then chief of the

first wife, Georgette, died

Department of Internal

years of marriage. I re­

Medicine, then area asso­

married a year later to

ciate medical director. In

Carolyn. Between the two

1976 I ended my admin­

of us, we have seven

istrative work, took a

adult children, ranging in

year off to retrain and
recertify in internal

age from late 30s to early

medicine, then returned
to practice as a staff

ranging from 9 to 23,
and three great grand­

internist until my retire­

children, ranging in age

ment in 1988. After retir­

from several months to

ing, I became involved in
adult literacy tutoring,

several years."
Favorite medical

and tutoring of young

school memory: "I have

children through the lo­

loving and happy memo­
ries of Oliver P. Smith,
who gave me the won­
derful news that I had

cal library and Boys and
Girls Club. For the past
several years, I have been
a member of Omnilore, a
learning-in-retirement
program adminstered

Lifetime Achievement

biochemistry at Brandeis

Doc?

ion form

in 1983, after almost 38

50s, 20 grandchildren,

been accepted to medical
school and who was my
favorite teacher."

YOUR CLASSMATES WOULD LIKE TO HEAR FROM YOU!
Here's how to update them
in three easy steps...
Visit the UB School of Medicine and Biomedical Sciences'
Web site at

www.smbs.buffalo.edu
click on Alumni
click on What's Up, Doc?

Things your fellow alumni tell us they
would like to read about:
• family updates
• interesting 'trips and trails'
• happy occasions, humorous interludes
• moves/promotions
• retirement
• honors and awards
• publications
• public service/election to office
• research endeavors
• musings on life as a doc ....

A u t u m n

2003

B u f f a l o

P h y s i c i a n

s

1980s

N

O

T

E

s

ing Schering-Plough,

lege of Law on May 18,

Cohen, Fetter & Burstein,

provide health services to

Koestler served as a se­

2003, summa cum laude

PC, in Syracuse, NY.

women has been ex­

Thomas P. Koestler. PhD

nior vice president and

(highest academic aver­

Knoll's wife, Maritza

panded to include con­

'82, has been appointed

head of global regulatory

age). A member of the

Alvarado. MD '85, contin­

sultative second opinions

executive vice president

affairs at Pharmacia Cor­

Syracuse Law Review, his

ues her work as an at­

for breast cancer. The

for worldwide regulatory
affairs, worldwide re­
search quality assurance

poration, which has since

tending neonatalogist.

services are being pro­

merged with Pfizer. He

note, "Mea Culpa, Mea
Culpa: A Call for Privi­

The couple celebrated

vided at NFMMC by

has more than 20 years

lege for Self-Disclosure of

their 17th anniversary

Helen Cappuccino, MD

and project management

experience in the phar­
maceutical industry and
is credited with securing

Error in the Setting of

in October.

tion," won the 2002

Helen Cappuccino. MD '88.

more than 60 regulatory

American Health Law­

The collaboration be­

approvals, including ap­
proval of 24 new molecu­
lar entities.

yers Association Student
Writing Contest and was

tween

brings an expertise in

Roswell

breast cancer that previ­

published in 35 Journal of

Park Cancer

ously was unavailable to

Health Law 419 (2002).

Institute

women locally," said

Andrew M. Knoll. MD '84.

He has accepted a posi­

(RPCI) and

Joseph A. Ruffolo, the

JD, FACP, internal medi­
cine, graduated from
Syracuse University Col­

tion as an associate in the

at Schering-Plough
Research Institute
(SPRI). In this role, he
will also assume leader­
ship of the allergy and
inflammation therapy
team at SPRI, charged
with ongoing develop­
ment of strategies and
direction for this area
of research. Before join­

'88, clinical assistant pro­

Primary Medical Educa­

fessor of surgery

health law department of
Scolaro, Shulman,

at RPCI.
"Dr. Cappuccino

Niagara
Falls Memorial Medical

medical center's presi­
dent and chief executive

Center (NFMMC) to

officer at the time the ex-

"Experience the tranquility of Tropical Fish"

LARGEST SELECTION IN THE AREA

Surgeons
Onnnn tltn

Complete set-ups from
table/desk top to large central
displays
Equipment and supplies
Tropical fish, gold fish & Koi
(domestic & imported), dwarf
frogs, bottom feeders,
mollusks, crustaceans &
other unusual varieties.
Imported livestock and
frozen foods

• Wide selection of aquarium
accessories and decorative
items
• Food, antibiotics and water
conditioners
• Aquatic plants (live & artificial)
• Lighting accessories

MAT IDEAS:
«• Numerous Dry-Scape Displays in Our
Showroom
Beta Vase Plant Aquariums
#" Lucky Bamboo Plants

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in publishing an
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