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Great teacher's lecture

You don't have to be a cardiothoracic surgeon to appreciate Dr. Robert Guyton's (Surgery) motivational presidential address at the Society of Thoracic Surgeons' annual meeting in January. Dr. Guyton is the outgoing President of the Society. "Most of us attend presidential addresses out of respect for the speech giver and are often happy when they are completed," remarks his colleague, Dr. Joseph Craver (Surgery). "When Robert Guyton finished his address, there was almost a two-minute reflective silence and then 4,000 surgeons and attendees burst into standing applause, feeling that we had just witnessed a profound message from Robert's heart and mind. It was just simply terrific, beautifully presented, and obviously reflecting intense and long, thoughtful preparation."

Dr. Guyton and his specialty have faced many of the same crises that any of us have-from shrinking Medicare reimbursements to ever-changing medical practices-yet he remains optimistic for the future. One of his major points conveyed the need for physicians to participate in developing new innovations. "Innovation brings with it a heavy responsibility," Dr. Guyton points out. "We must always remain patient-centered. We should always focus on new procedures that offer the most patients benefit. Beyond just responding to innovation, we must become agents of innovation."

Dr. Guyton expressed the need for creating standards for electronic health records and a national patient safety database (including a system for reporting "near-misses and adverse events and errors of both commission and omission") that can be used to dramatically improve quality. He also included a call-to-action for physicians to become politically involved. "We must be there when society defines what should be in health care," he says.

Dr. William Wood (Chair, Surgery) supports these ideas. "Dr. Guyton's address combined felicity of style with diagnostic acumen directed at his own specialty," he says. "The proposed therapy applies more widely than to cardiac surgery alone. Taken as directed, all of medicine would be the healthier."

Dr. Guyton concluded his address with a story about a patient who came very close to death but was doing extremely well less than a day after Dr. Guyton's team of eight operated on him. "We must reinvent ourselves not only to adapt to changing technology, but also to be the initiators of progressive change," he says. "We must become the champions of quality and value in medicine. There are mountains to move. I believe that great mountains are moved by great faith. But mountains are moved stone by stone, and the faith that moves mountains is the faith that you will carry your stone and I will carry mine. And we carry these stones, not for you, not for me, but for our [patients]."

Audio of Dr. Guyton's address is available at www.sts.org. It's definitely worth listening.

Scientific coup

Dr. Eric Hunter, one of the world's leading experts on retroviruses, a class of viruses that includes HIV, will join the SOM this fall as Professor of Pathology and Laboratory Medicine and Eminent Scholar of the Georgia Research Alliance. Physician and renowned international researcher Dr. Susan Allen, Dr. Hunter's wife and colleague, will join the Rollins School of Public Health as Professor of International Health with a joint appointment in the SOM. They come to us from the University of Alabama at Birmingham, where Dr. Hunter is Director of the UAB Center for AIDS Research.

I am especially pleased we were able to recruit this couple because they are two of the world's most respected AIDS researchers and will help solidify Emory's role as a worldwide leader in the fight against AIDS and other infectious diseases. Dr. Hunter's groundbreaking retrovirus research plus Dr. Allen's study of HIV prevention and spread in Rwanda and Zambia have helped them identify factors that allow HIV to spread between heterosexual partners, the most common route of HIV transmission worldwide. "Drs. Hunter and Allen bring remarkable new energy, resources, and ideas that not only benefit Georgia, but enable us to extend our efforts to help people around the world, particularly Africa," says Dr. Tristram Parslow (Chair, Pathology and Laboratory Medicine).

Dr. Hunter is the 49th scientist recruited to a Georgia university under the Georgia Research Alliance Eminent Scholars Program.

Grady past and present

Please join us as we dedicate the Emory Clinical Training Center and Faculty Office Building at Grady Memorial Hospital on Thursday, April 8, at 11:30 am. Open since November, this state-of-the-art structure rises four stories at the historic intersection of Armstrong Street and Jesse Hill Jr. Drive. Our beginnings can be traced to this site, where the Atlanta Medical College, founded in 1854, moved into a new building in 1856. The original building was replaced in 1906 with one housing the Atlanta College of Physicians and Surgeons. In 1915, this structure became the first home of the newly named Emory University School of Medicine. The 1906 building served as a hospital for African-American patients for a number of years and was known as Grady's Emory division until a new hospital facility opened in 1958. It's quite fitting that we dedicate our new building in 2004, the same year that we celebrate the SOM's 150th anniversary.

A lasting legacy

You would think that anyone who has spent 30 years of his life at Emory, taught more than 90 surgical fellows, and surgically repaired more than 15,000 hearts has given enough. Not so, says cardiothoracic surgeon Dr. Joseph Craver. Even with retirement looming ahead, he and his wife have established the Joseph M. Craver and Amelia W. Craver Charitable Remainder Trust to support teaching in cardiothoracic surgery. The Emory portion of the Craver endowment is valued at about $2.2 million and will provide annual lectureships and financial awards to outstanding faculty surgeons. The Cravers also hope to create an endowed chair in clinical adult cardiac surgery with emphasis on the clinical teacher. "I want a person teaching my future surgeon and physician-a person who's committed to teaching, so that future students and fellows don't depend on machines, video files, computers, or other impersonal learning methods," Dr. Craver says.

He believes that the trust is a way to thank Emory for the opportunity he has had to live out his life's passion. He also hopes that this gift will help motivate others to do the same. For more about Dr. Craver, see the Winter 2004 issue of Momentum magazine, available online at http://whsc.emory.edu/mzine_momentum.cfm.

Research milestones

From DNA to the latest technology, research at Emory is making life better for all of our patients. Here are a few recent research breakthroughs:
  • Yerkes announced in January it will collaborate with PETNET Solutions to research and develop new molecular probes that will help doctors better diagnose, treat, and monitor diseases such as Alzheimer's and cancer. Emory will help develop new isotopes for PET (positron emission tomography) imaging. "Working with PETNET is especially advantageous because of the company's expertise in the development and application of molecular probes," remarks Yerkes Director Dr. Stuart Zola. "By using PET technology, together with nonhuman primate animal models, we can identify earlier and more accurately the pharmacological effects of the compounds we test."
  • Two types of DNA damage that befall most cells every day can lead to the creation of damaged proteins that may contribute to neurodegeneration, aging, and cancer, according to research by SOM scientists published late last year in the journal Molecular Cell. Dr. Paul Doetsch (Biochemistry), lead author Dr. Damien Bregeon (Biochemistry), and their colleagues discovered the cause of transcriptional mutagenesis (TM) in Escherichia coli cells. TM occurs when cells with damaged DNA produce bad messages during transcription that lead to the creation of mutant proteins. Until now, most research has focused on cell replication. This study is particularly important because it focuses on nonreplicating cells. Most cells within organisms are no longer replicating and manufacture proteins instead.


"A number of studies, culminating in this one, show that DNA damages leading to TM are an important event that may account for the deleterious effects of unrepaired genetic damage," says Dr. Doetsch. "Although our study was in E coli, very similar systems operate to repair genetic damage in human cells. This is a very important model for helping understand the mechanisms in non-dividing cells that can cause the manufacture of mutant proteins as a result of genetic damage to cells."

In memoriam

We lost a great friend in Dr. Carmella Gonnella (Rehabilitation Medicine Emerita), who died March 1 following a lengthy battle with cancer. A physical therapist, Dr. Gonnella was a leader in rehabilitation and research. One important research project early in her career was serving as a field investigator in the gamma globulin vaccination field trials during the polio epidemic. Dr. Gonnella also served as President of the American Congress of Rehabilitation Medicine. She joined the SOM in 1972 as Associate Professor and later served as Director of the Regional Rehabilitation Research and Training Center. She retired in 1992.

Memorial contributions may be sent to the Carmella Gonnella Research Fund, Physical Therapy Association of Georgia, c/o G. Sanders, 60 Chevaux Court, Atlanta, Georgia 30342.

Thomas J. Lawley, MD








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