Lawrence Cohn

Eugene Braunwald, MD, founding chair of the TIMI Study Group in BWH’s Division of Cardiovascular Medicine, shared that when he first met Lawrence H. Cohn, MD, in the mid-1960s, he knew that Dr. Cohn was “headed for greatness.” BWHC President Betsy Nabel, MD, said that Dr. Cohn taught her that “holding a patient’s heart in one’s hand was a privilege.” Former trainee and friend Tomislav Mihaljevic, MD, chief executive officer of Cleveland Clinic Abu Dhabi, described him as “Larry the Lion.”

During a memorial event held April 11 at Boston Symphony Hall, friends, family members, trainees and colleagues came together to honor the life and legacy of the late Dr. Cohn, who was part of the Brigham family for more than 45 years. Dr. Cohn, who was the Virginia and James Hubbard Chair in Cardiac Surgery at Harvard Medical School and former chief of BWH’s Division of Cardiac Surgery, passed away in January. The event began with Tony Bennett’s song “I Left My Heart in San Francisco,” one of Dr. Cohn’s favorites.

“Larry was the consummate physician, educator and academician,” said Nabel. “But what he cared about more than anything were his patients, and he expected the same from his trainees.”

A world-renowned expert in the field of valve repair and replacement surgery, Dr. Cohn performed more than 11,500 cardiac surgical operations during his esteemed career. He also trained more than 150 residents and fellows.

Dr. Cohn and his wife, Roberta, high-school sweethearts, were married for 55 years. In 2008, they established the Cohn Library at BWH—a collection of some of the earliest editions of books and papers about cardiac surgery and cardiology.

“He was the protector of the history of his field and of the Brigham’s history,” said Dale Adler, MD, executive vice chair of the Department of Medicine.

Dr. Cohn was also a lover of the arts, as well as a competitive tennis player. Close friend and tennis doubles partner Peter Banks, MD, director of the Center for Pancreatic Disease at BWH, shared stories of their friendship and tennis matches, as well as Dr. Cohn’s devotion to his family.

Daughters Jennifer Cohn and Leslie Bernstein closed the event with a moving tribute, recounting their father’s love for numbers—especially 11—his support and guidance throughout their lives, and his adoration of grandchildren Carly, Rachel and Cameron.

“Our father truly cared about the person behind each surgery,” said Jennifer. “His life is a testament to how much of an impact a person can make.”

Read Dr. Cohn’s obituary in Bulletin to learn more about his career, and view a recording of the event.

Suzanne Koven

On April 1, BWH clinicians and researchers from across the hospital gathered in the Zinner Conference Center for a special program that explored the role of narrative—any kind of writing that tells a story—in medicine and how physicians can better know their patients by listening to their stories.

Sponsored by the Center for Faculty Development & Diversity and the Brigham Education Institute (BEI) and organized by Christy Di Frances, PhD, MA, the morning featured an engaging presentation by Suzanne Koven, MD, an assistant professor of Medicine at Harvard Medical School (HMS) and writer-in-residence and primary care physician at Massachusetts General Hospital.

“We lose something if we don’t acknowledge that the fundamental tool we have as clinicians is finding out and understanding our patients’ stories,” said Koven. “Getting to the story makes all the difference between diagnosing and not diagnosing, between healing and not healing.”

Koven’s presentation was followed by breakout workshops on fiction and poetry writing, scientific storytelling and close reading, which is the careful interpretation of a brief passage of text.   

Poetry in Medicine Workshop

Medicine is not only about writing but reading as well, poet Gregory Abel, MD, MPH, MFA, an oncologist at Dana-Farber Cancer Institute and assistant professor of Medicine at HMS, shared with a group of participants in a workshop on reading and writing poetry.

During the one-hour session, poems with themes in medicine written by famous poets, such as Anne Sexton and Jane Kenyon, were read aloud and examined for content, technique and style.

The workshop concluded with a writing exercise in which participants wrote about a time leading up to an event that affected them. Participants shared their drafts with a partner, and partners then wrote what they thought happened next, illustrating the narrative significance of differing points of view.

Close-Reading Workshop

“Oh I suppose I should” are the opening words of William Carlos Williams’s poem “Le Médecin Malgré Lui” and also served as a writing prompt for those who attended a close-reading workshop led by Koven and Andrea Wershof Schwartz, MD, MPH, of BWH’s Department of Medicine. Schwartz began the workshop by reading Williams’s poem aloud and then inviting participants to closely examine the phrases and words Williams used and share their reactions.

Koven then led the group in a five-minute writing exercise, instructing participants to begin with the same opening line as the poem and write continuously for five minutes before sharing the results with the group.

“This kind of writing is highly desired,” said Koven, noting that publications such as The New England Journal of Medicine and The New York Times are interested in personal essays by clinicians.

creative writing workshop

Author and Simmons College professor Lowry Pei, PhD, MA, led participants through a discussion of Richard Selzer’s short story “Four Appointments with the Discus Thrower,” noting areas where Selzer exercised restraint and lets readers make their own judgments. Pei emphasized how, with such storytelling, the key is to dramatize rather than explain everything.

Scientific-Storytelling Seminar

Rafael Luna, PhD, author of the book “The Art of Scientific Storytelling” and program director for Senior Faculty Promotions in the Office for Faculty Affairs at HMS, described how to incorporate the elements of narrative craft into scientific manuscripts. He challenged the audience to think about how to capture seven years of work in the seven words of a paper’s title and noted that even the most complex scientific studies can have conflict and resolution, a beginning, middle and end, and a protagonist, which can be in the form of a protein, pathway or process.

To learn more about the CFDD’s work and offerings, visit cfdd.brighamandwomens.org.

Stephanie Caterson

BWH plastic surgeon Stephanie Caterson, MD, originally went to medical school with the goal of becoming an astronaut. She studied aerospace engineering in college and graduate school, but it wasn’t until medical school that she discovered that she loved medicine and surgery as well—so much so that she went on to a residency in general surgery.

“Many astronauts who are physicians don’t actually complete a residency program,” said Caterson. “They graduate from medical school and then go straight to the astronaut program. But I felt like I wouldn’t be an effective astronaut or physician if I didn’t do a residency because that’s where you learn how to really be a doctor. Medical school is like learning a new language, but residency is when you submerge yourself in a new country and become fluent.”

During her residency, Caterson met an inspiring plastic surgeon who divided his time between reconstruction and cosmetic surgery and encouraged her to specialize in plastics.

“I thought it was amazing that a woman with breast cancer could fall asleep for a mastectomy [the surgical removal of one or both breasts] and wake up with a full breast reconstruction,” said Caterson. “It was such a silver lining.”

Plastic surgery and the path of an astronaut did not align, so Caterson decided to apply for a plastics fellowship and the astronaut program after her general surgery residency and see what transpired. A few months before Caterson started her astronaut program application, NASA closed the program due to a shuttle disaster. So she continued her path to plastic surgery, which would include a microsurgical breast reconstruction fellowship.

Pushing the Envelope to Provide Better Options

Since joining BWH in 2007, Caterson has been a champion of new options for breast cancer patients seeking breast reconstruction. She began the hospital’s deep inferior epigastric perforator (DIEP) flap program, which marked its 1,000th procedure late last year. In 2009, plastic surgeon Matthew Carty, MD, joined the team, and he and Caterson have since done the majority of DIEP flaps together.

“It’s a complex operation, and it’s very different than most plastic surgery procedures,” said Caterson. “There are always two attending surgeons in the room working on different areas of the body; it’s almost two separate operations that meld together.”

The DIEP flap procedure uses a patient’s abdominal tissue—skin, fat and blood vessels, which together are called a “flap”—to create a new breast after a mastectomy. It is the most common type of flap procedure performed at BWH. The flap is transferred to the chest, where the surgeon, aided by a microscope, attaches the tissue’s blood vessels to the chest blood vessels and reconstructs the breast.

The biggest difference between DIEP flaps and other types of flaps, such as transverse rectus abdominis (TRAM) flaps, is that the DIEP flap preserves the patient’s abdominal muscle, and in turn, abdominal strength. The procedure also lessens the likelihood of a hernia, shortens recovery time and produces a more natural-looking breast and slimmer appearance of the stomach.

A Deeper Look at the DIEP Flap Team

For the first few years after Carty joined the DIEP flap team, he and Caterson performed about 100 DIEP flaps per year. In 2012, former BWH resident Jessica Erdmann-Sager, MD, came back to the Brigham after completing a fellowship in breast microsurgery, and in 2013, Eric Halvorson, MD, another expert in breast microsurgery, joined the team, doubling its capacity to perform these intensive surgeries.

“Between the four of us, we have been able to ramp up the program, and now we’re doing more than 200 flaps a year,” said Caterson. “The Brigham has been very supportive of us and of this procedure for patients.”

Caterson is quick to emphasize that the success of her program is a team effort and the superior results could not be delivered by one person alone. From preoperative evaluation to postoperative care, the DIEP flap team includes staff from the Weiner Center for Preoperative Evaluation, Department of Surgery, Department of Anesthesiology, Perioperative and Pain Medicine, Operating Room and floor nurses, scrub techs, coordinators, residents, nurse practitioners, physician assistants, physical therapists and more recently, Radiology staff. Caterson has been working with Radiology resident Tatiana Kelil, MD, who is using CT volumetric imaging and 3-D printing to improve breast reconstruction. Using CT images, a model of the patient’s healthy breast can be 3-D printed and used in the OR as a cutting guide to help reshape and contour the tissue flap.

“Residents are an essential part of these complex microsurgical cases, so there is a huge opportunity for teaching in a controlled environment, which I love,” said Caterson, who started a microsurgery skills lab for residents several years ago. “Residents in most other plastic surgery programs who are interested in offering DIEP flaps usually go on to a microsurgery fellowship. However, due to BWH’s high DIEP flap volume, our residents are able to take that skill and perform DIEP flaps right after graduating from residency.”

Keeping Patients at the Forefront

Caterson says that her patients continue to motivate and inspire her as she performs the delicate and complex DIEP flap procedure, which has an average recovery time of six weeks.

“They are women who have been through the devastation of breast cancer, and we have the privilege of helping them feel whole again,” said Caterson, who sees each of her DIEP flap patients at least once per year for follow-up. “I’m grateful that they put their lives in our hands. We make every decision based on the questions, ‘What care would I want a loved one to receive?’ and ‘What is the safest approach for each individual patient?’ Our entire DIEP flap team has this same approach, which gives our patients the highest quality of care.”

From left: Alex Hannenberg and James Rathmell

Earlier this month, BWH’s Department of Anesthesiology, Perioperative and Pain Medicine hosted a series of events to celebrate Physician Anesthesiologist Week, including a discussion with BWH’s Beverly Philip, MD, director of Ambulatory Anesthesia and the Day Surgery Unit, and Massachusetts Society of Anesthesiologists President Sheila Barnett, MD, as well as an ice cream social. Department Chair James Rathmell, MD, and past American Society of Anesthesiologists President Alex Hannenberg, MD, also came together for a conversation about advocacy, the perioperative surgical home, research challenges and the evolving scope of anesthesiologists’ daily practice.

From left: LCU nurses Dina Sousa, Joan Morgan, Irene Cooper, Gail Slotnick, Karen Reilly, Kathleen Ryan-Avery, Teana Gilinson and Laura Rossi

Last month, the BWH Heart & Vascular Center and Division of Cardiovascular Medicine celebrated a major milestone: the 50th anniversary of the Levine Cardiac Intensive Care Unit (LCU). Members of the center and division, as well as the broader BWH community, gathered in Bornstein Amphitheater on Dec. 17 to reflect on the highlights of the LCU’s 50 years and hear from guest speaker John Rutherford, MB, ChB, FRACP, former co-director of the LCU who is now at the University of Texas Southwestern.

“The LCU is a crown jewel of our clinical services and academic training programs,” said David Morrow, MD, MPH, LCU director. “If there is one unifying theme for this celebration, it is that the rich history of the LCU rests in its people and partnerships.”

When the LCU first opened in February 1965 at Peter Bent Brigham Hospital, it was one of a handful of novel, specialized coronary care centers that would revolutionize both the care and survival of heart attack patients. The unit was specifically designed, equipped and staffed to monitor heart rhythm and resuscitate patients experiencing fatal arrhythmias. It was outfitted with electrocardiographic monitors for continuous heart rhythm surveillance, alarms to alert staff of rhythm disturbances and highly trained coronary care nurses prepared to intervene during cardiac arrest. Much of Rutherford’s presentation highlighted the critical importance of nurses’ insight and knowledge from the unit’s earliest days through the present.

“The unit continues to lead the way in caring for the most complex, critical cardiac patients and training the next generation of world leaders in the field,” said Rutherford.

From left: LCU Directors, past and present, Gregory Curfman, John Rutherford, David Morrow, Joseph Alpert and Elliott Antman

Rutherford also detailed the far-reaching impact of the unit’s physicians and former directors, including Samuel Levine, MD, the  unit’s namesake, Bernard Lown, MD, Elliott Antman, MD, and Peter Libby, MD, and highlighted the staff’s commitment to keeping patients and families at the forefront.

“We stand on the shoulders of giants, and I hope the past 50 years forecast our future,” Morrow said.

BWH and the Division of Rheumatology, Immunology and Allergy mourn the loss of Albert L. Sheffer, MD, who died Dec. 22.

During his 50-year career at BWH, Dr. Sheffer, of Weston, provided compassionate care to thousands of patients with allergic and immunologic diseases, as well as training and mentorship to more than 100 fellows. He conducted innovative clinical research to create or expand treatment options for conditions such as allergic rhinitis, bronchial asthma and hereditary angioedema. For the latter condition, he developed a prophylactic therapy that reduced spontaneous flares. Dr. Sheffer also discovered what proved to be the most common form of physical allergy elicited by exercise. Thanks to his concern for his patients and a thorough exploration into this phenomenon, exercise-related anaphylaxis remains a well-recognized form of physical allergy to this day.

Born in Lewistown, Penn., Dr. Sheffer graduated from Franklin & Marshall College and George Washington University Medical School. He completed his internal medicine and pulmonary training at the University of Pennsylvania Graduate Hospital, an allergy/immunology fellowship at Temple University Hospital and a post-doctoral research year at the Rockefeller Institute.

He joined Harvard Medical School in 1964 and Peter Bent Brigham Hospital in 1966. Soon after, he and K. Frank Austen, MD, established the Allergy Clinic and the Allergy Training Program. His trainees went on to hold leadership positions in the specialty. Dr. Sheffer engaged in private practice from 1969 until 1993, when he became a full-time staff member at BWH, serving as the director of Allergy until 1998.

“Shef’s passion to understand mechanism so as to more effectively alleviate symptoms for his patients was accompanied by unwavering attention to both basic and translational possibilities,” said Austen.

A pioneer in emphasizing the science underlying asthma and allergic disease, Dr. Sheffer was past-president of the American Academy of Allergy, Asthma and Immunology (AAAAI), the first chair of the expert panel that generated the National Heart, Lung, and Blood Institute’s (NHLBI) Guidelines for the Diagnosis and Treatment of Asthma, and co-chairman of the first Global Initiative for Asthma Committee. He also served on the United Nations Technical Options Committee. He received the Distinguished Service Award from NHLBI, as well as the Distinguished Clinician’s Award from the AAAAI. He and Austen were co-recipients of the first annual Mentoring Award from the AAAAI for their contributions. He was also elected to the American Association of Physicians based on the importance of his discoveries.

“Dr. Sheffer cared passionately about the education of his fellows,” said Joshua Boyce, MD, the current Albert L. Sheffer Professor of Medicine and associate chief of Rheumatology, Immunology and Allergy at BWH. “He was a selfless and dedicated physician and mentor who modeled exemplary clinical care for all of us.”

Dr. Sheffer was also a longtime donor to BWH and a member of both The Hippocrates Society and The President’s Pillar Society.

He is survived by his wife, Barbara Sheffer; children Andrew Sheffer, Susan Sheffer, Peter Sheffer and wife, Mary, and Linda Larabee and husband, John; grandchildren Emma, Bea, Will and Jack Sheffer, Matthew Larabee, and Katherine Larabee Tuttle and husband, Samuel Tuttle. 

A memorial service will be held on Saturday, Jan. 30, at 11 a.m. at the First Parish Church, 349 Boston Post Road in Weston. In lieu of flowers, contributions may be made to the Albert L. Sheffer, MD, Fellowship Fund for Allergic Diseases (giving.brighamandwomens.org/sheffer), Development Office, BWH, 116 Huntington Ave., Third Floor, Boston, MA 02116.

From left: Ameera Cluntun and Samantha Majcher treat a mock trauma patient in STRATUS.

From practicing IV placement and CPR to managing a difficult airway or a complicated multi-system failure, the Neil and Elise Wallace Simulation, Training, Research and Technology Utilization System (STRATUS) Center for Medical Simulation at BWH offers a variety of training to meet the needs of staff and trainees throughout the hospital, as well as beyond BWH.

In January, the STRATUS Center was re-accredited by the American College of Surgeons (ACS) as a comprehensive training institute. The ACS, which sets standards for how surgical education and training should be offered, lauded the center’s scope of educational programs, curriculum development and resources for delivery of effective education as among the best in the nation.

Physicians, nurses, physician assistants, residents, fellows, students and other clinicians from all specialties use the center for simulation-based educational programs, either as part of individual skills training programs or as part of a Graduate Medical Education training program. Recently, outside groups have traveled to the STRATUS Center from across the U.S., as well as from Saudi Arabia, Brazil, Colombia, China, the United Arab Emirates, India and parts of Europe.

The center, which prides itself on being service-oriented, offers curriculum experts and simulation specialists, as well as state-of-the-art equipment and an operating room (OR) that is a replica of a BWH OR. Through a one-way mirror, faculty and technicians can watch the activity inside and regulate a mannequin’s vitals, breath sounds, pulse and blood flow for simulation exercises.

“In addition to being a local and international leader in clinical education, STRATUS has been on the cutting-edge of simulation-based assessment, research and process improvement,” said Charles Pozner, MD, medical director of STRATUS. “It also has a robust research program, publishing more than 130 manuscripts over the last decade, including the first scientific investigation employing simulation in the New England Journal of Medicine. Hospital departments also use STRATUS to introduce or assess clinical processes to improve patient safety.”

Programs can be one of several formats:

Scenario-based simulations. Participants are presented with a clinical scenario and asked to manage the situation. Vital signs and other physiology can be altered to meet the needs of learners or the team’s actions. Post-scenario debriefing enables the faculty to interactively deconstruct the case with participants, providing an engaging learning environment.

Skills trainings. Expert faculty hosts these sessions, intended to teach a specific surgical or medical skill such as knot tying, tissue dissection, IV line placement, lumbar puncture and airway management.

System and quality assessment. These sessions mimic scenarios that involve emergency preparedness, such as Ebola preparedness training and mock codes, so staff can develop and reinforce best practices.

Assessments. Participants are evaluated on a particular skill set by completing competency exercises. BWH mandates that all clinicians who insert central lines pass a standardized assessment using mannequins at STRATUS before performing the procedure on patients. 

Non-technical skill development, such as collaboration and communication among teams, are also of the utmost importance to STRATUS. “Learning how to communicate and understand each other’s thought processes is essential,” said Pozner. “In times of high stress, even experts have gaps in knowledge. Collaboration helps clinicians to find the answers they need.”

Added Sheldon Singh, operations manager: “We help clinicians develop and hone their clinical skills, striving to provide a great experience so that patients can have the best experience possible at BWH and beyond.”

From left: Xiaojie Liu, of Biomedical Engineering, and Brenda Griffin, of Nursing, at BWH’s Joint Commission Readiness Fair last September.

One surveyor from The Joint Commission (TJC) stated that “the heart of health care beats at the Brigham.”

Others lauded Watkins Clinic staff for “outstanding work and documentation” and their strong knowledge around process.

When a surveyor asked Liljana Zheku, a unit coordinator on Shapiro 9 East, about the purple sticker on her ID badge and if she was required to get the flu shot this season, Zheku responded by saying that she received flu vaccine because it protects patients and employees. The surveyor was impressed by this and later praised Zheku at a debriefing session.

Through these interactions and observations and many others, BWH showcased its commitment to patient safety and excellent care during TJC’s 2016 review, which was conducted earlier this month.

“We want to extend our sincere gratitude to the many people across our institution who helped us prepare for this visit,” said BWHC President Betsy Nabel, MD, on behalf of leadership. “Your commitment to our patients and families are evident across our distributed campus every day, always guided by our mission of delivering the highest standard of care to everyone we serve.”

During their five-day visit, surveyors used the tracer methodology, a means of evaluation in which surveyors select a patient and use that individual’s record as a roadmap to assess an organization’s compliance with certain standards and its systems of care and services. Surveyors visited many locations across BWH, from the Emergency Department, NICU, Tower and Shapiro Center to Pharmacy, Food Services and ambulatory practices, including Foxborough and Brookside Community Health Center.

Surveyors were eager to learn more about BWH’s Centering Pregnancy Program—a partnership between the Center for Community Health and Health Equity and the Midwifery Service that combines health assessment, education and support in a group setting for women receiving prenatal care at three BWH obstetric sites. Surveyors were also interested in BWH’s primary care population health management efforts and were impressed with Pharmacy’s management of a complication of heparin therapy—a blood thinning treatment—and the cost savings associated with this initiative.

One of TJC’s responsibilities is to make sure hospitals abide by Centers for Medicare & Medicaid Services (CMS) conditions, including physical environment, which TJC refers to as “life safety and environment of care.” In the environment-of-care evaluation, the surveyor team found BWH’s standards overall were “excellent.” However, with nearly 3 million square feet of buildings on campus, some of which are older facilities not designed for today’s medical equipment demands, 13 minor issues were observed in the inpatient Tower in particular. These issues—which included oxygen cylinders not in their holders, and carts, equipment or beds temporarily positioned in front of electrical panels and medical emergency shut-off valves—resulted in a finding that will require correction and a return visit by a TJC surveyor to confirm compliance. This finding does not impact BWH’s CMS certification or TJC accreditation.

“With the help of Engineering and Support Services, BWH has a mitigation plan in place; in fact, many of the issues were corrected as they were identified,” said Kelly Doorley, director of Clinical Compliance. “We will correct all of these issues within the 45-day timeframe. We appreciate all of your support in ensuring we stay compliant.”

James Rathmell stands by two of many photographs he has taken.

BWH Bulletin recently sat down with James Rathmell, MD, chair of the Department of Anesthesiology, Perioperative and Pain Medicine, to discuss his first seven months at BWH, his goals for the department and how his diverse interests in medicine and photography have shaped his career path. An established leader in pain medicine, Rathmell joined BWHC in June 2015.

What initially attracted you to BWH?

I spent the last 10 years at MGH, and when this opportunity arose, the chance to stay in the Harvard system and to join one of the best hospitals in the country was an opportunity I couldn’t pass up. This department has a great long history of being one of the best training grounds for anesthesiologists in the country. It was an opportunity to join all of these great innovators here at the Brigham.

What early goals did you have for the department?

Interim chair Bhavani Kodali, MD, did an excellent job of keeping the department stable and moving forward, which is always a challenge during an interim period. The first three months, I was meeting everyone and learning. At the 90-day mark, I made the first changes, which largely involved getting everyone working in the same direction.

My vision is broadly about creating the next generation of innovative anesthesiologists—the people who go on to practice anesthesiology and pain management and define how it is practiced across the U.S. and around the world. We want to continue to train those people, something the Brigham has done for many decades. We also have several extraordinary labs that are doing groundbreaking research; now we need to develop the next tier of young and mid-career researchers who go on to build their own labs.

Increasingly in health care, there’s an administrative and leadership piece as well, and we want to develop the next generation of anesthesiologists who are going to be leading Operating Rooms (ORs) and ICUs and pre-operative assessment centers.

How have you seen the field change over your career?

Anesthesiology has changed dramatically. One example is that we’ve gone from a specialty where the vast majority of anesthesiologists spend the majority of their time in the OR, either directly administering anesthesia or supervising other providers giving anesthesia, to a good proportion of faculty spending the majority of their time outside of the OR. About 50 percent of the work we do now is outside of the OR.

How has anesthesiologists’ role across the continuum of care changed?

Anesthesiologists’ role has become more prominent. We’re involved in the continuum of care from the decision to perform surgery all the way through recovery. We’ve become critical members of the team who enable surgeons to do what they do in the safest possible fashion.

Dr. Rathmell talks more about anesthesiologists’ role on the care team.

How and when did you first become interested in the field?

I went to medical school to be an oncologist. One of my passions is photography, and so as I got into my second and third years of medical school, I became very interested in ophthalmology and actually started an ophthalmology residency. During intern year, I realized that I liked taking care of people who are sick, but you largely don’t take care of systemic illness in ophthalmology. I switched to anesthesiology because I loved pharmacology, and I never looked back. That was 28 years ago.

Dr. Rathmell offers advice for medical students and residents struggling with their choice of specialty.

Can you describe your research?

I’m a clinical researcher, so I’m involved with clinical trials all the way from phase 1 (first-in-human) through post-marketing studies on drugs and sometimes devices. In the past five years, my research has focused on using image guidance to safely place needles for pain treatment.

Does your love of photography influence your work as a clinician and hospital leader?

I do all of the cover design and images for the journal Anesthesiology, so I am constantly thinking about how to present complex information in a way that gets the message across clearly and visually. I often bring photos or illustrations into the education realm, too. When I learn new techniques and teach others, I use those same visual skills.

How do you decide which photos will be featured on the cover of the journal?

I read the issue and try to take something out of it that we can illustrate visually. The November issue (see image at right) featured a new survey comparing the demographics of anesthesiologists 10 years ago vs. today. The survey was nationwide and takes into account gender, age, ethnicity, type of practice, etc. I wanted to illustrate that diversity, and what came to mind was our beautiful lobby at the Brigham. I wondered, could I get a large group from the department together and photograph them in the lobby? Collaborating with professional photographer and artist Diemut Strebe, we gathered everyone in the lobby late one Friday afternoon. Diemut had the brilliant idea of scattering everyone across the lobby, which gave the image a wonderful effect. Our department is extremely diverse, and I thought the cover would speak to the diversity across anesthesiology. It worked, and the department loved it.

Can you talk about the importance of mentorship?

In each phase of my career, mentorship has been critically important. I think that each phase or task that you have to accomplish requires a unique mentor, and I’ve had many mentors over the years. A good mentor helps guide you through and then celebrates when you are successful.

What do you want the rest of the BWH community to know about the department?

You have this incredible group of physician innovators who are great team members and facilitators. We can be very innovative no matter what you’re doing across medicine—from clinical care to education to research to leadership. Come find us; we’re good teammates.

We asked Dr. Rathmell if he enjoys teaching medical students and residents.

What is Dr. Rathmell’s favorite book?

BWH and the Division of Cardiac Surgery mourn the loss of Lawrence H. Cohn, MD, a pioneering cardiac surgeon and devoted educator, former chief of the Division of Cardiac Surgery and the Virginia and James Hubbard Chair in Cardiac Surgery at Harvard Medical School. He passed away Jan. 9 at the age of 78.

“Dr. Cohn believed that holding a patient’s heart in one’s hand was a privilege, and he was determined that those he taught would be worthy of that privilege,” said BWHC President Betsy Nabel, MD.

Added Michael Zinner, MD, chair of the Department of Surgery: “In his nearly 45 years at BWH, Dr. Cohn has left an indelible mark on the hospital, helping to position it as a leader in minimally invasive cardiac surgery and training scores of surgeons, many of whom have become national leaders in the field. He was a giant in the field of cardiac surgery and will be missed.”

Having performed more than 11,000 cardiac surgical operations, Dr. Cohn was a world-renowned expert in the field of valve repair and replacement surgery and minimally invasive heart valve surgery. His leadership was instrumental to many “firsts” at the hospital. In 1984, he was part of a team that completed the first heart transplant in New England at a time when very few medical centers in the country were performing such operations. In 1996, he led a team that replaced an aortic valve through a three-inch incision instead of opening the entire chest.

Eugene Braunwald, MD, founding chairman of the TIMI Study Group and former BWH physician-in-chief, was a mentor and close friend of Dr. Cohn. They worked together in the 1960s when Dr. Cohn was training at the NIH and again later at the Brigham.

“He was brilliant, one of the world’s top cardiac surgeons and had a great sense of humor,” said Braunwald. “He was very devoted to his patients and interacted closely with their families. He trained many of the most outstanding cardiac surgeons around the world; they came to the Brigham to train with him. He was a good personal friend, and we will miss him terribly.”

Called a “master of masters in cardiac surgery” by the Journal of Thoracic Disease, Dr. Cohn trained more than 150 residents and fellows at the BWH/Boston Children’s Hospital Program in Cardiothoracic Surgery. He helped to launch the careers of many surgeons who practice at major medical centers worldwide, including about 30 who went on to serve as division chiefs or department chairs.

“Dr. Cohn was a fantastic surgeon to watch and to learn from,” said Prem Shekar, MD, chief of Cardiac Surgery. “Training under Dr. Cohn was a life-changing experience for a surgeon.”

Born in San Francisco, Calif., Dr. Cohn earned his bachelor’s degree from the University of California, Berkeley, and his medical degree from Stanford School of Medicine. He completed his training at Boston City Hospital and the University of California, San Francisco Medical Center, and a fellowship at the National Heart Institute. Dr. Cohn joined the staff of BWH in 1971 and served as chief of Cardiac Surgery from 1987 until 2005. In 2000, he was awarded the first endowed chair in Cardiac Surgery at Harvard Medical School. Past leadership roles also include chair of the Brigham and Women’s Physicians Organization and director of the Cardiac Surgery Research Laboratory.

He published more than 500 peer-reviewed publications, 105 book chapters and 12 books, including the second, third and fourth editions of “Cardiac Surgery in the Adult,” the most referenced textbook in adult cardiac surgery today. Dr. Cohn’s clinical and research interests included reconstructive valve surgery, minimally invasive technology, adult congenital heart surgery and thoracic aortic pathology.

Dr. Cohn received numerous awards and accolades for his work as a physician, researcher and educator, including an honorary Masters of Medicine from Harvard and a Doctor Honoris Causa from the University of Paris. He also received the American Heart Association’s highest award, the Paul Dudley White Award.

In 2008, he and his wife, Roberta, established the Cohn Library—a collection of some of the earliest editions of books and papers about cardiac surgery and cardiology, donated by the Cohns to BWH.

“The library is an extremely valuable collection that is especially inspiring to young people in seeing how these fields have developed over the centuries,” said Braunwald.

Dr. Cohn’s generosity to BWH extended beyond the library. In addition to his own philanthropy and leadership as a founding member of the Hippocrates Society Committee, he was a tireless advocate for securing philanthropic support for research, education and innovative programs in cardiac surgery. With his leadership and passion, he helped raise funds for BWH’s minimally invasive valve repair and replacement program and outcomes research in cardiac surgery, as well as the establishment of a dedicated outcomes research fellowship program in the division.

Dr. Cohn was a board member of the Boston Symphony Orchestra and the Boys and Girls Club of Boston. He was also an active member of the Museum of Fine Arts and the Boston Historical Society and a former trustee of Massachusetts Financial Services. In his free time, Dr. Cohn was a competitive tennis player and avid golfer. He also enjoyed studying history, skiing, fishing and sailing. His family was extremely important to him, and he especially enjoyed spending time with his grandchildren.

He is survived by his wife, Roberta; daughters, Leslie Bernstein and Jennifer Cohn; son in-law, Stephen Bernstein; granddaughters, Carly and Rachel; and grandson, Cameron Ellis Cohn.

Information about a BWH memorial service will be forthcoming. Learn more about Dr. Cohn’s career by viewing a video.

From left: Susan, Robert and Hillary Davidson and Terri Halperin, outside the newly dedicated Michael J. Davidson, MD, Hybrid Operating Room

On Dec. 16, hugs and smiles were exchanged as members of the BWH community and guests filled Bornstein Amphitheater for a special Department of Surgery Grand Rounds honoring the late Michael J. Davidson, MD.

“This is one of the more significant grand rounds this department can have, as it honors the life of our dear colleague and to me, a dear friend,” said Surgery Chair Michael Zinner, MD. “He has left an indelible mark on this institution.”

Davidson’s father, cardiologist Robert Davidson, MD, shared a few words at the beginning of the event, detailing his son’s interest in science and medicine from an early age, his visionary proposal of universal access to medical care as his 1992 senior thesis at Duke University, and his devotion to his family. Davidson’s wife, Terri Halperin, MD; mother, Susan Davidson; and sister, Hillary Davidson, were also present.

The keynote address, entitled “Caring Goes All the Way: A Talk to Honor Michael J. Davidson, MD,” was presented by Mark Rosenberg, MD, president and CEO of the Task Force for Global Health—an international organization that focuses on health system strengthening, immunization and vaccines, and neglected tropical diseases. Rosenberg, an expert on violence prevention who worked at the Centers for Disease Control and Prevention (CDC) for 20 years, talked about the role of research in preventing gun violence.

“Violence is a problem; it is not a part of life to be accepted,” said Rosenberg. He advocates for the use of the CDC’s public health model to address gun violence. The model consists of four parts: defining the problem, identifying causes, developing and testing prevention strategies, and assuring widespread adoption. Though the problem has been defined and the causes identified, a halt in gun violence research for the past 20 years, largely due to politics, has left the country with little information in terms of what prevention strategies work and how to apply them. Rosenberg is optimistic that gun violence research is starting to begin again and encouraged the BWH community to be leaders in the response.

Hybrid OR Dedication

Later the same morning, BWHers gathered in Shapiro—many wearing MJD pins and blue surgical caps with gold stars and the initials MJD on them in honor of Davidson—for the dedication of the Hybrid Operating Room (OR) as the Michael J. Davidson, MD, Hybrid Operating Room. With his bold vision for less invasive approaches for treating heart valve disease and his ability to bring together cardiology and cardiac surgery for the purpose of delivering better care to patients, Davidson was a driving force in establishing the Hybrid OR.

“Michael was steadfast in becoming a cardiac surgeon,” said Halperin. “He pursued an additional year in interventional cardiology because he was convinced that cross-training was the future. He was a visionary, and he was right.”

Added BWHC President Betsy Nabel, MD: “It is fitting that Dr. Davidson’s calling in medicine was the heart. He cared deeply for every patient who sought his help. No matter how busy he was, he had a way of making each one feel as though they were his only patient.”

Nabel read the words of a plaque that now appears inside the Hybrid OR with Davidson’s smiling photo: With heartfelt gratitude to Dr. Davidson for his incredible commitment to his patients and his profession, and in celebration of his legacy as an outstanding, compassionate, and innovative cardiac surgeon.

“Michael felt honored to work with an incredible team,” said Halperin. “The Brigham was his other family. He would be honored to have his name on the OR. He dedicated his life to the OR; it is only fitting that this room be dedicated to him.”

View a photo gallery of the events, along with recordings of Surgery Grand Rounds and the Hybrid OR dedication.

Save the Date

“Remembering Michael J. Davidson, MD: Reflections on His Life and Legacy” will be held on Jan. 20, at 10:30 a.m., in Bornstein Amphitheater. All are welcome to attend. Learn more at BWHPikeNotes.org.

Michael VanRooyen

Interim Emergency Medicine Chair Michael VanRooyen, MD, MPH, has been appointed chair of the Department of Emergency Medicine at Brigham and Women’s Health Care (BWHC), effective Jan. 1.

VanRooyen has been serving as interim chair since Jan. 1, 2015, when Ron M. Walls, MD, assumed the role of BWHC executive vice president and chief operating officer. As interim chair, VanRooyen and the Emergency Department (ED) team have launched several new initiatives, including the integration of Partners eCare, the expansion of global partnerships and the design of an expanded ED with a new Oncology Emergency Care Unit, a plan set for completion in 2017. 

VanRooyen, who joined the Brigham in 2004 as an emergency medicine physician, is a professor of Emergency Medicine at Harvard Medical School and professor of Global Health at Harvard T.H. Chan School of Public Health. He co-founded and directs the Harvard Humanitarian Initiative (HHI), the largest academic and research center of its kind, focused on improving humanitarian strategies for relief in regions affected by war and disaster. He also founded and directs the Humanitarian Academy at Harvard (HAH), a Harvard-wide educational effort designed to advance humanitarian professionalism and develop the next generation of humanitarian leadership.

VanRooyen’s commitment to humanitarian work began long before he joined the Brigham family. Upon completing his residency in 1991, he began working with NGOs in conflict settings, such as Somalia, to advance emergency medical care. For the next two decades, he worked in some of the world’s most active conflict zones and disaster settings, including Sudan, Bosnia, Rwanda, North Korea, Iraq and Haiti. Through his work abroad, VanRooyen became further convinced that the field of humanitarian aid must create an evidence base and a professional pathway to advance quality and efficiency in the field.

Domestically, he worked with the American Red Cross to provide relief assistance at the site of the World Trade Center in New York on Sept. 11, 2001. He also helped to coordinate the American Red Cross public health response to Hurricane Katrina and worked with the Navajo and Apache tribes in Arizona and New Mexico.

“Dr. VanRooyen’s leadership and experience in the fields of global health and emergency medicine are unparalleled,” said Betsy Nabel, MD, BWHC president. “He is recognized by his colleagues as an outstanding leader with an unwavering commitment to emergency medicine, training the next generation of emergency medicine clinicians and providing superb compassionate care to patients and families. I look forward to a continued tradition of service to our mission in the department under his guidance.”

VanRooyen earned his MD from Wayne State University School of Medicine in Detroit and his MPH from the University of Illinois in Chicago.

On Oct. 26, BWHers gathered in Bornstein Amphitheater to celebrate the launch of the new Patient & Family Advisory Council (PFAC) for Gender and Sexuality, one of the first of its kind in the nation.

Consisting of patients, family members and employees who are patients, the council will focus on health care issues faced by LGBT patients, serve as a resource to staff and ultimately help improve the experience of all patients at BWH.

“The Brigham is a wonderful place,” said council member Barry Nelson. “Patients are looking to you as their care providers to have their best interests at heart and support their needs.”

Maureen Fagan, DNP, MHA, WHNP-BC, FNP-BC, associate chief nurse for the Connors Center for Women and Newborns-OB/GYN and executive director of the BWH Center for Patients and Families, spoke about the important role the council will play in collaborating with staff.

“Working together on issues of inclusivity is important for the BWH community and will help us learn and improve the care we provide to all patients,” she said.

From left: PFAC members Carrie Braverman, Maureen Fagan, Martie Carnie, Juan Jaime de Zengotita, keynote speaker Gary Bailey, Kevin Benisvy and Barry Nelson

The event included insightful remarks by Gary Bailey, DHL, MSW, ACSW, professor at the School of Social Work at Simmons College. He spoke about intersectionality, the study of intersections among forms of discrimination. Whether based on race, gender, sexual orientation, ethnicity, abilities or socioeconomic class, forms of discrimination can be interrelated and result in injustice and inequality.

“What is good for those whom society has placed at the margins is ultimately in the best interest of all of us,” said Bailey. “I commend Brigham and Women’s Hospital for responding to the needs of all patients and families by seeking to better understand LGBT health care concerns.”

Simmons College nursing students from Tower 15C, with their instructor Lisa Gillis, BWH staff nurse (far right)

Martie Carnie, BWH senior patient advisor, spoke about the importance of creating a positive and welcoming environment. “We can’t always control the outcome of a patient’s care or diagnosis, no matter how hard we try. But we can control the experience people have here by treating everyone who comes through our doors with the utmost dignity and respect,” she said.

Since 2008, PFACs have been working to create an environment that fosters patient- and family-centered care across BWH and BWFH. There are currently 16 councils comprised of 95 patient and family advisors who serve inpatient and ambulatory populations, using their experiences to help inform the relationship between patients, families and staff. Most of the councils are geared toward a specific line of service, such as cardiology or neurology. However, the Gender and Sexuality PFAC will support all departments.

The council hopes to establish resources for clinicians and other staff to help them learn how to be more inclusive of every patient they care for. The council also plans to design and implement a series of community-wide conversations to foster ongoing dialogue about inclusivity.

As part of the event, BWH launched a social media campaign, inviting staff and the public to come out as allies in support of the LGBT community.

The council is currently recruiting members. To join or recommend a patient, family member or colleague, or to ask the council a question, email Maureen Fagan at mfagan@partners.org.

From left: Juan Jaime de Zengotita, Martie Carnie, Carrie Braverman and Barry Nelson

John Saltzman

Recognized for its quality of service, the expertise of its faculty and the contributions it has made to international teaching in digestive endoscopy, BWH’s Endoscopy Center was recently designated for the second time as a Center of Excellence by the World Endoscopy Organization (WEO).

“Our goal is to train physicians and fellows to become leaders in the field,” said John Saltzman, MD, director of the BWH Endoscopy Center and chair of educational affairs for the American College of Gastroenterology. “We choose physicians who have the drive to make lasting contributions to the work we do every day to care for our patients.”

Endoscopy is a nonsurgical procedure that is used to examine and treat issues inside a person’s digestive tract. The Endoscopy Center at BWH offers inpatient evaluations, outpatient evaluations and treatments for disorders of the esophagus, stomach, small bowel, colon and the biliary/pancreatic system.

The WEO Centers of Excellence are a select group of endoscopy units that are chosen from around the world. BWH was one of 16 Centers of Excellence to be designated this year. The designation, which lasts through 2020, also comes with the expectation that the centers will consider ways that they can collaborate with one another to advance research and teaching.

Saltzman, who was named director of the center in 2006, said he has been building educational programs, including the advanced Endoscopy Fellowship, a specialized program designed for physicians looking for a comprehensive therapeutic endoscopy training program and for those interested in pursuing an academic medical career.

The BWH Endoscopy Center sponsors several major endoscopy courses, including those in Boston, Utah and Bermuda. The center’s leadership for the last 10 years in an international live endoscopy course, the New England Boston International Live Endoscopy Course, also contributed to it being designated as a Center of Excellence.

The course, designed for gastroenterologists, surgical endoscopists, gastroenterology fellows and nurses, includes simultaneous live viewings of endoscopic procedures being performed at hospitals including BWH, Beth Israel Deaconess Medical Center, Massachusetts General Hospital and Boston Medical Center. The course employs a wide range of internationally renowned endoscopists, including Saltzman and other members of his team.

Describing his team as a “powerhouse of innovative ideas,” Saltzman said team members also teach various courses each year to clinicians around the country on different endoscopy techniques, such as reducing weight endoscopically. The team is also devoted to research in areas including management of gastrointestinal bleeding and new endoscopic devices.

One technique that Saltzman is especially excited about is being brought to BWH from Japan by physician Hiroyuki Aihara, MD, PhD. Endoscopic submucosal dissection has been applied in Japan primarily to treat gastric (stomach) cancers. The technique, which can be performed in the colon, esophagus or stomach, is used to remove gastrointestinal tumors that have not entered the muscle layer.

Aihara is a recognized expert in the performance of endoscopic submucosal dissection of the colon and previously spent two years at BWH in a research position before joining the center in a clinical role earlier this month.

“Hiroyuki is bringing with him a skill that is new to the U.S.,” Saltzman said. “He knows this technique at an advanced level, and we are excited to begin to employ it here to improve patient care.”

The BBF has reached its full size at 11 floors and 620,000 square feet.

The Brigham Building for the Future (BBF) might look like a ghostly figure right now as tarps covering the soon-to-be walls of the steel structure flap in the wind, but behind the cloth, the 11-story translational research and clinical space is transforming into something spectacular every day.

With the final piece of steel placed on the building in December and the addition of an extra floor, the BBF has now reached its full height, which is a significant milestone, says lead architect Tom Sieniewicz, a partner at NBBJ architecture firm in Boston. Work is also being done to complete the underground parking garage.

The BBF, a 620,000-square-foot building scheduled to open in fall 2016, will include research laboratories, outpatient clinical space, a state-of-the-art imaging facility and a conference and teaching center. It will also house a co-generation power plant built in Germany—a natural gas-fired engine that will supply the building with electricity and steam.

Another major underground component will be the imaging facility. Inside the space, crews are currently building vibration isolation pads, which are massive blocks of concrete that will be used to ensure that the six highly-sophisticated MRI and CT machines maintain separation from the building structure and produce precise images.

An underground tunnel that connects the imaging facility and BBF to the Shapiro Cardiovascular Center is also being constructed. A bridge that will offer a public connection over Fenwood Road is being built and will also link the BBF to Shapiro and the rest of BWH via the second-floor Pike.

Steve Dempsey, director of Planning and Construction at BWH, said BWH was able to fund an additional floor with unused project funds that were left over as a result of effective design and cost projection efforts. Also, because the building was shorter—by a half floor—than the proposal approved by the city, adding an extra floor was an option.

Dempsey said the additional floor, which will house faculty offices, helped the project team go a long way toward aligning faculty, staff and researchers inside the BBF. He and his team have had discussions with all of the clinical and research groups that will practice and study inside the BBF and know who will be on which floors and in what locations.

Designed to achieve the environmentally friendly Leadership in Energy and Environmental Design (LEED) Gold certification, the building will feature a roof garden to reduce storm water runoff, a system that cleans and reuses storm water for mechanical equipment, the co-generation plant and other “green” aspects.

Vinnie McDermott, vice president of Finance and Real Estate for BWHC, said the project has proceeded remarkably well, which is a testament to the efforts of many people.

“The BBF will provide a platform for collaboration of clinical and research talent, investigating leading-edge discovery and providing innovative clinical care to our patients across the region, nation and world,” he said.

By springtime of this year, the building will be fully enclosed and transformed visually. This is when additional crews will be called in to work on the inside of the structure.