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Our society sometimes comments that healthcare is too focused on science and technology—not on the person, resulting in a cold and impersonal healthcare experience. Several divisions in the Department of Medicine, however, actively counter this accusation by demonstrating their attention to patients, families and the community. At the University of Tennessee Medical Center Cancer Institute lives an interdisciplinary culture that combines use of the best technology with attention to the physical, emotional and spiritual needs of cancer patients. Highly trained cancer specialists, doctors and nurses offer a broad array of interdisciplinary, comprehensive services, including state-of-the-art surgery, radiation therapy and chemotherapy, as well as advanced technologies such as CyberKnife radiosurgery and implantable radioactive spheres. Yet, in this same building one might be greeted by a dog eager to have its ears scratched, thanks to the volunteers from the H.A.B.I.T. program (Human Animal Bond in Tennessee: http://www.vet.utk.edu/habit/index.php). One might also hear a string quartet, a harp or a violinist, courtesy of the Knoxville Symphony. Support groups, massage therapy, yoga, exercise and nutritional and psychosocial counseling are available. And finally, there is “ChemoBear,” a humble ambassador of the cancer institute. ChemoBear presides over the chemotherapy infusion room when not traveling with patients, promoting special events, or providing information about cancer prevention and early detection. To some, he is just fluff and fur, but to those who smile at his button eyes, he represents comfort, laughter and a caring human touch.

I often encourage my students to think about the greatest healers in human history. The next, somewhat rhetorical, question I pose to them is “How many of them were physicians?” As clinicians we must be cognizant of the much broader scope of healing and the fact that healing is of higher value than treatment. Treatment requires an accurate diagnosis and institution of appropriate therapies, but healing requires a deeper understanding of patients as individuals, their fears and apprehension.

Healing could involve a soothing touch, a hug, meditation, prayer, music, therapy with pets and many other measures that do not require laboratory tests or expensive medications or procedures.

I feel extremely frustrated and saddened when patients relate that they have been told by their physicians that there is nothing the physicians can do for them. A recent experience with one of my patients left an indelible impression on me. This patient was in severe pain, had no social support other than some concerned neighbors, was crippled by lung disease yet smoked heavily and had given up on life. When I first saw her, she had tried to commit suicide. Over a period of a few months, her faith has been restored by support from her friends and social workers. This has helped her to quit smoking, and medications have helped her to breathe without supplemental oxygen. Her lung function has improved to the extent that it is now safe for her to have much needed surgery. She has had an absolutely amazing transformation and is facing life with renewed vigor and hope! There is no doubt in my mind that many factors other than those related to her treatment contributed to her restoration. Her recovery reminds me that as clinicians we must not only treat the disease but also try to heal the person who has the disease.

Healing While Curing

Points of View

Rajiv Dhand, M.D., Chair

Grand Opening of the New Cancer InstituteA new expanded Cancer Institute opens this month on the campus of University of Tennessee Medical Center. This 108,000-square-foot, four-story building will offer comprehensive cancer care, including all Outpatient Services, under one roof. For more information about the grand opening, scheduled for October 16, visit www.utmedicalcenter.org/cancer.

Department of Medicine

ChemoBear brings more than a smile to the patients in the Cancer Institute. He represents a caring human touch.

Connect ing Technolog y, Educat ion and Discover y with Humanism in Medicine Vol. 1, Issue 2 Oct. 2012

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Investigating a way to hasten care for patients suffering from STEMI are Jeff Gregory, program director, UT

Lifestar; Jeanne Wohlford, M.B.A., BSN; Stuart Bresee, M.D.; Sarah Sennett, R.N.; and Christopher Brooks,

M.D., medical director UT Lifestar.

Thank You for Your SupportFor information about philanthropic giving to the UT Graduate School of Medicine Department of Medicine, please contact the development office at 865-305-6611 or development@utmck.edu.

Thank you.

John Callison, M.D.

Nancy L. Holmes is a long-standing patient of the Internal Medicine Center. Resident physician, Soham Patel, M.D.

(left), and Center Director, Juli Williams, M.D., provide expert care for Ms. Holmes.

Each year, almost 250,000 Americans experience an ST-elevation myocardial infarction (STEMI). This is a potentially lethal form of heart attack caused by an occlusion of one of the arteries that supplies the heart muscle with oxygen. Percutaneous coronary intervention (PCI) is a procedure used to open the occluded vessel and reestablish oxygen delivery. Many patients do not have ready access to this intervention, and even more do not get it in a timely manner. Delays, if not fatal, can lead to loss of cardiac function with attendant disability and compromised quality of life. A team at the UT Graduate School of Medicine and University of Tennessee Medical Center is working to eliminate these delays by establishing a process that minimizes the time it takes to move a patient directly to a medical center such as University of Tennessee Medical Center, where PCI is available around the clock. For the past eight years, Stuart Bresee, M.D., a clinical associate professor in the Department of Medicine and chief of the Cardiology Division, has led a multidisciplinary team in an initiative to improve the care of patients in our area who experience a STEMI. This team was initially formed with the guidance of Jeff Gregory, program director of UT Lifestar, and is now managed by Jeanne Wohlford, RN, director of Cardiovascular and Pulmonary Services for University of Tennessee

Medical Center Heart Lung Vascular Institute, and Sarah Sennett, RN, STEMI coordinator. It has witnessed a dramatic 61 percent fall in the “door-to-balloon time” (the time from a patient’s arrival to when a catheter guidewire crosses the culprit lesion) and myocardial infarction mortality at University of Tennessee Medical Center. Through grants received from the American Heart Association and Duke Clinical Research Institute, Bresee and his team are leading an effort to unite the East Tennessee region into a cohesive system of STEMI care that may serve as a model statewide and help more patients get cardiac care more quickly and effectively.

As long as there has been an Internal Medicine residency program at the UT Graduate School of Medicine, there has been a teaching patient-care center. This center provides an outpatient setting in which residents, supervised by attending physicians, care for patients one afternoon per week for the entire three years of their residency. For the resident, the center provides an opportunity to develop good practice habits, learn about outpatient care and serve the community. For patients, it is a place to receive quality healthcare. Resident education is important, and comprehensive care of patients is paramount. Penny Reagan, administrative director of the center says, “The Internal Medicine Center attempts to treat the ‘whole’ person by including patients and their caregivers in disease management.” Christine Berry and her son have been patients in the Internal Medicine Center for a decade. In a letter written to Center Director Juli Williams, M.D., an assistant professor, Berry says she appreciates being able to depend on the doctors and nurses to respond when she calls. The clinic has a fully implemented electronic medical record (EMR) system that can be accessed from the hospital or home. This makes patient care safer and faster for patients like Berry, because her chart is ready even when the doctor is not in the clinic. During the academic year 2011-2012, the clinic handled 3,650 patient visits representing 29 different counties in Tennessee. For information, contact 865-305-9410.

Saving Time. Saving Lives.

Patient-Care Center Serves the Community New Faculty

John Callison, M.D., a clinical assistant professor, joined University Pulmonary & Critical Care, where he will serve as a pulmonologist and critical care physician. Callison completed his residency in Internal Medicine as well as his fellowship in Pulmonary and Critical Care Medicine at Vanderbilt University. He is board certified in Internal Medicine and Pulmonary Disease and is board eligible in Critical Care.

Department of Medicine faculty, residents and fellows share their knowledge and experience by publishing and presenting across the world. For a list of our most recent accomplishments, visit http://gsm.utmck.edu/internalmed/scholars.cfm.

Presentations, Publications, Awards

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The UT Center for Advanced Medical Simulation offers high- and low-fidelity technology for use by medical professionals, including Medicine faculty such as

Janet Purkey, M.D., (left), who is instructing Mehul Patel, M.D.

Dale Wortham, M.D., is leading a team trained in the TAVR procedure.

“The best thing about the simulation center is the ability to make mistakes that you never forget while learning on a ‘dummy,’” says Janet Purkey, M.D., an associate professor, who has served as a teacher of medical students in the UT Center for Advanced Medical Simulation over the past five years. “We all learn in different ways, but most of us remember our mistakes so as to not repeat them,” she says. The UT Graduate School of Medicine’s UT Center for Advanced Medical Simulation is a 6,500-square-foot multidisciplinary facility providing computerized mannequins, 3-D virtual reality trainers, interactive technologies and low-fidelity trainers for virtually all healthcare specialties in the region. Located at the University of Tennessee Medical Center, the center uses a comprehensive curriculum that meets the needs of today’s medical and dental professionals. While Purkey’s responsibilities have expanded to teaching interns, Mark Rasnake, M.D., an assistant professor and Internal Medicine residency program director, uses the simulation center to teach residents sterile technique and insertion of central venous lines. The results are significant reductions in central line-associated bloodstream infections. “In the simulation center, I practiced central lines and gained expertise that made me comfortable being able to help my patients,” said Dhanu R. Bhat, M.D., PGY-2, Internal Medicine resident. In addition to teaching ultrasound-guided central venous line placement, Rasnake, Purkey and others teach residents to gown and glove and remain sterile, intravenous catheter placement, foley catheter placement, thoracentesis, lumbar puncture and paracentesis. For more information on the UT Center for Advanced Medical Simulation, visit http://gsm.utmck.edu/simulation/main.cfm.

Using Simulation to Learn and Teach Lloyd Discusses Proper Prescribing

Stephen Lloyd, M.D., an associate professor of Internal Medicine, Quillen College of Medicine, Johnson City, Tenn., presented “The Doctor Wrote It; It Must Be OK” for grand rounds August 14, 2012. His lecture about proper opioid prescribing practices was supplemented at noon conference with a discussion of difficult cases presented to him by house staff using patients currently admitted to the house staff medicine service.

Stephen Lloyd, M.D.Quillen College of Medicine

The University of Tennessee Medical Center Heart Lung Vascular Institute and UT Graduate School of Medicine are hubs of activity aimed at curing and simultaneously improving the quality of life of suffering patients. This is evidenced by the efforts of a multidisciplinary team led by Dale Wortham, M.D., a professor of Medicine in the Division of Cardiology, the director of Cardiac Catheterization Laboratories and program director of the Cardiovascular Disease fellowship. The team is investigating a new procedure called Transcutaneous Aortic Valve Replacement (TAVR). This is a minimally invasive procedure designed to treat severe aortic stenosis, a common result of valve degeneration, which, when untreated, causes heart failure, angina, syncope and ultimately, death. The results of a clinical trial studying TAVR in a cohort of patients too ill to withstand open heart surgery was very successful. The Food and Drug Administration recently supported the expanded use of a valve used in TAVR to include patients who are at very high risk for the traditional open procedure. Final approval is still pending. Someday, the TAVR program may provide patients with the alternative of replacing their diseased aortic valve without having open heart surgery. In preparation for this expanded use and in an effort to improve the quality of life of cardiac patients who are otherwise too ill to withstand the traditional surgical aortic valve replacement, Wortham and his team have already dedicated a Heart Valve Center and completed the initial training necessary to implement the TAVR procedure. For more information, call 865-305-5223.

Ready to Act: Approval of New Heart Valve Pending

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Wahid Hanna, M.D.

Mark Rasnake, M.D., and Dean Jim Neutens, Ph.D.

Eddie Moore, M.D., and Robert Overholt, M.D.

Benjamin Helms, D.O.

Alan Solomon, M.D.

Shane Kelley, M.D.

Karen Wells, M.D.

Jon Wall, Ph.D.

W. Jeremy Mahlow, M.D.

Daphne Norwood, M.D.

Valerie Berthelier, Ph.D.

The University of Tennessee Medical Center recently was named in U.S. News & World Report as one of just two hospitals in Tennessee and the only one in Knoxville to be nationally ranked. Based on its patient-care performance, the medical center ranked second in the state behind Vanderbilt Medical Center, and two of its specialties, Gynecology and Pulmonology, were ranked 31st and 34th, respectively, in the nation. Ten specialties, including Endocrinology and Nephrology, were noted as high performing. For more information on the report, visit http://health.usnews.com/best-hospitals/area/tn.

Wahid Hanna, M.D., a professor of Medicine and a hematologist/oncologist at the University of Tennessee Medical Center Cancer Institute, has been named Man of the Year for the Knoxville region by the Leukemia & Lymphoma Society. Donations in honor of his service and in support of his nomination raised money for the society to fight blood cancers. Hanna has been treating patients with blood cancers for 40 years.

Mark Rasnake, M.D., assistant professor and Internal Medicine residency program director, recently added the Spirit of the Graduate School of Medicine Award to his collection of honors, highlighting again his excellence in patient care, education and quality improvement. The award recognizes faculty members who uphold and promote the institution’s mission to colleagues, residents, students, staff and the community. Rasnake also has received the Department of Medicine’s London Teaching Award and the Graduate School of Medicine Excellence in Teaching Award.

Robert Overholt, M.D., a clinical assistant professor and chief of Division of Allergy, won the Excellence in Teaching for Volunteer Faculty Award during the recent UT Graduate School of Medicine’s Faculty Awards Presentation. He is a previous recipient of the Department of Medicine’s London Teaching Award. Overholt has been a volunteer instructor in the Department of Medicine since 1971.

Benjamin Helms, D.O., and Shane Kelley, M.D., Internal Medicine residents, won the Freeman Rawson Award given annually to experienced residents who embody the spirit of teaching and possess excellent clinical skills. This award is given in fond memory of Freeman Rawson, M.D., Clinical Professor Emeritus and a founding member of the Knoxville Cardiovascular Group. Rawson was a physician known for his compassion and clinical expertise. He practiced medicine in Knoxville for 47 years and was one of the first teaching faculty in the Department of Medicine in 1956. Rawson passed away in 2003.

W. Jeremy Mahlow, M.D., a Cardiovascular Disease fellow, won third place in the annual UT Graduate School of Medicine Academy of Scholars Resident and Fellow Research Day. His research, “A Peri-Operative Device Management Algorithm for Cardiac Implantable Electronic Devices: The PACED-OP Protocol,” examined the safety and effectiveness of using a unique protocol developed and implemented by physicians at University of Tennessee Medical Center. The protocol was developed for the management of patients with pacemakers and other implanted devices who are undergoing surgery. Mahlow’s findings support that this protocol allows patients to undergo surgery in a safer and more convenient manner.

Daphne Norwood, M.D., associate professor of Medicine, was selected for a four-year term on the American College of Physicians (ACP) Board of Governors. She recently served as chair of the scientific committee for the upcoming annual conference of the Tennessee ACP.

Alan Solomon, M.D., a professor in the Department of Medicine and director of the Human Immunology and Cancer Program, and Karen Wells, M.D., an assistant professor in Radiology, received the Pfizer Amyloid Fellowship, a two-year grant for the study of peripheral amyloid. Solomon and Jonathan Wall, Ph.D., a professor in the Department of Medicine Human Immunology and Cancer Program, received a patent for a monoclonal antibody (11-1F4) that is used for the treatment and imaging of patients with AL amyloidosis.

Valerie Berthelier, Ph.D., an assistant professor of Medicine and director of Conformational Diseases and Therapeutics Research, received a two-year award from the Alpha-1 Foundation to support her research in treatments for alpha-1 antitrypsin deficiency. This research is conducted in collaboration with the University of Tennessee, Knoxville, and the Spallation Neutron Source/Oak Ridge National Laboratory.

Awards and Honors

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Jonathan Wall, Ph.D. Carol Ellis, M.D.

Jonathan Wall, Ph.D., a professor in the Human Immunology and Cancer Program and director of the Preclinical and Diagnostic Molecular Imaging Program, has been appointed director of Basic Science Research. Wall obtained a Ph.D. in membrane biophysics from

the University of Essex, Colchester, UK. Later, he moved to the UT Graduate School of Medicine, where he has studied amyloidosis. His work led to the “first-in-human” clinical trial studying the biodistribution of a novel radio-iodinated amyloid fibril-reactive monoclonal antibody in patients with light chain amyloidosis by using PET/CT imaging. Wall leads an NIH-funded team developing novel imaging agents for amyloid disease, Type 2 diabetes and cancer.

Carol Ellis, M.D., an assistant professor in the Department of Medicine, has been appointed director of Clinical Research. After graduating from the University of Pennsylvania School of Medicine, Ellis completed

Internal Medicine training at the

University of New Mexico and the University of Tennessee Health Science Center, where she later served as a faculty member. Ellis also worked at McNeil Pharmaceutical (a Johnson and Johnson affiliate) as an assistant director of clinical research and SmithKline Beckman. After moving to Knoxville, Ellis served in clinical research at Thompson Cancer Survival Center before joining the UT Graduate School of Medicine.

Department of Medicine Grand RoundsOctober 9: Transplant ImmunobiologyNovember 13: Pelvic Pain and Integrative MedicineNovember 27: Pharmacotherapeutic Management of the Obese PatientDecember 11: State of the DepartmentJanuary 8: Transcutaneous Aortic Valve Insertion

Morrison’s Conference Center, University of Tennessee Medical Center, Knoxville

Approved for AMA creditVisit www.tennessee.edu/cme for a complete schedule.

Ninth Annual Hematology Conference: An Update on Selected ASH TopicsJanuary 19, 2013University of Tennessee Conference Center, KnoxvilleApproved for AMA, AAPA, ACPE credits and CEUswww.tennessee.edu/cme/Hematology2013The annual update occurs as soon as possible after the American Society of Hematology (ASH) international conference, while allowing time for the featured speakers to develop unique presentations combining their areas of expertise with new information garnered from the ASH presentations.

Appointments

Continuing Education Opportunities

In Touch Volume 1, Issue 2: Oct. 2012

Publishers James Neutens, Ph.D., DeanRajiv Dhand, M.D.

Managing Editor Amanda F. Johnson, APR

Editor Ronald Lands, M.D.

Administrative Director Susan Burchfield, CAP-OM

Contributors Susan Burchfield, CAP-OM Rajiv Dhand, M.D. Amanda F. Johnson, APR Ronald Lands, M.D.

Design J Squared Graphics

In Touch is produced by the University of Tennessee Graduate School of Medicine Department of Medicine. The mission of the newsletter is to build pride in the Department of Medicine by communicating the accessible, collaborative and human aspects of the department while highlighting pertinent achievements and activities.

Contact Us In Touch UT Graduate School of Medicine

Department of Medicine

1924 Alcoa Highway, U-114

Knoxville, TN 37920

Telephone: 865-305-9340

E-mail: InTouchNewsletter@utmck.edu

Web: http://gsm.utmck.edu/internalmed/main.cfm

The University of Tennessee is an EEO/AA/Title VI/Title IX/Section 504/ADA/ADEA institution in the provision of its education and employment programs and services.

The University of Tennessee Graduate School of Medicine offers the following educational courses this fall and winter. To register or for more information, call 865-305-9190 or visit www.tennessee.edu/cme.

Mark Your Calendar!Medicine CME Update • March 1-2, 2013 • University of Tennessee Conference Center, Knoxville