Shade Tree Trot–a fun event for a great cause

from Jessica Pasley:

The Shade Tree Trot has come a long way since it sauntered onto Nashville’s 5K scene in 2009.

What started as a sidewalk 5K directed mostly at Vanderbilt University School of Medicine students and friends, has expanded to a full-fledged race complete with road closures and chip timing, according to race organizers.

Now in its sixth year, the Trot is the single largest source of funding for Shade Tree Clinic, a free medical service that provides primary care to uninsured patients in East Nashville.

Last year’s event, combined with the Shade Tree Benefit Dinner, raised $41,000 to assist with the day-to-day operations of the clinic.

Who: Vanderbilt University School of Medicine students and community

What: 6th Annual Shade Tree Trot 5K

When: 8 a.m., Saturday, March 29

Where: Race to begin at the Vanderbilt University Football Stadium at the corner of Jess Neely Drive and Natchez Trace.

Elizabeth Berry and Andrew Medvecz, fourth-year medical students and co-organizers of the event, will be on hand to assist with any media questions.

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She doesn’t have cancer. She just doesn’t have hair

from Wayne Wood:

This is a story and video from The Tennessean about Hannah Grubbs, a Hendersonville fifth grader who has a medical condition that keeps her from growing hair. All her life people have assumed that she has cancer, even though she is healthy. That motivated her to begin a charity for children with cancer, and to donate caps and bows for cancer patients at the Monroe Carell Jr. Children’s Hospital at Vanderbilt. (Full disclosure: Hannah’s mom, Deanna, is a former student of mine).




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Thanks to Southwest Airlines, on behalf of Vanderbilt patients and families

from Wayne Wood:

Again this year Southwest Airlines has stepped up to provide free travel for Vanderbilt patients who may need some help paying for a trip home after a trauma, or help coming to VUMC for cancer treatment.

For the families helped, this is a very big deal, and Southwest deserves thanks for this program to aid people in need.

Here’s a news release about the progam from my colleague Jennifer Wetzel:

Southwest Airlines Provides Vanderbilt Patients with Free Flights

Vanderbilt University Medical Center is one of 73 nonprofit hospitals and medical organizations selected for the Southwest Airlines 2014 Medical Transportation Grant Program. It is the fourth year Vanderbilt has received a Southwest transportation grant.

The grant is administered by Vanderbilt LifeFlight and will help approximately 60 Vanderbilt patients reduce the burden of air travel expense during times of illness by receiving free roundtrip tickets.

“We have patients fly to Vanderbilt for treatment from all over the country,” explained Elizabeth Worsham, a supervisor with Vanderbilt LifeFlight Discharge Transport and administrator of the grant.

Worsham said many of the grant’s recipients are seeking cancer treatment at Vanderbilt. Others have been involved in motor vehicle accidents while traveling and could not afford the trip home.

Worsham works with Vanderbilt’s case managers to evaluate the needs of each patient and distributes the Southwest tickets accordingly. The tickets also allow one family member to travel as a caregiver if needed.

Nationally, more than $2.8 million is provided each year through Southwest’s Medical Transportation Grant Program to help people with health care-related travel expenses. Vanderbilt is the only hospital in Middle Tennessee, and one of only two hospitals in Tennessee, to receive the grant this year from Southwest.

“We are extremely grateful to Southwest Airlines for providing these tickets for these families during such a difficult time in their lives,” Worsham said.

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Andre Churchwell honored by Black Health magazine

from Wayne Wood:


Andre Churchwell, M.D., senior associate dean for Diversity Affairs, was honored in a feature in the new issue of Black Health. The magazine published a salute to 15 African American medical educators.

Here is Churchwell’s article from the salute:

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Jason Koger featured in Apple’s 30 years of Mac ad

from Wayne Wood:

About three years ago I worked on a story for House Organ about Jason Koger, a young man from Kentucky who was badly injured in an electrical accident that cost him both of his arms. Jason is a remarkable guy–with the help of his wife Jenny, the rest of his family, and an amazing medical team, he recovered from his burns and learned to use innovative artificial hands.

I reported last year that he was featured on an episode of Hawaii Five-O.

Now, Jason’s latest achievement is that he is one of the people featured in the advertisement released by Apple to observe the 30th anniversary of the release of the first Mac computer. He is show with one of his young children cracking an egg with one of his hands.







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Traveling exhibit traces medicine in Washington’s time

from Wayne Wood:

A National Library of Medicine traveling exhibit, “George Washington and Medicine,” is on display in the History of Medicine Room at the Annette and Irwin Eskind Biomedical Library at Vanderbilt University Medical Center.

The exhibit is augmented by items from the historical collection at the library, such as lancets, bleeding bowls and medical texts from Washington’s time.

“During Washington’s life (1732-1799), medicine in America followed the practices of England,” the first of the six large posters that comprise the exhibit notes. “These practices were defined by speculative hypotheses, domestic remedies and the beginning of scientific investigation and formal education.”

Photos of portraits include several of Washington and family members, as well as views of his home, Mt. Vernon, and medical implements and devices of the time, including a medicine chest, such as was carried by physicians of that era. The library display includes an English physician’s medicine kit from the 19th Century, as well as a copy of the 1763 book, “The Art of Cookery Made Plain and Easy,” which contains recipes for home remedies.

The exhibit is open in the Special Collections area of the library Monday through Friday, 8:30 a.m. to 5 p.m., and runs through Jan. 31.

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“Between Hallmark and heartache”: Vanderbilt psychiatrist offers tips for how to have a pretty good Christmas

from Wayne Wood:

During the holidays, the goal should be to set the course somewhere “between Hallmark and heartache,” a Vanderbilt psychiatrist says. In other words, don’t strive for the perfect (you won’t achieve it), and recognize and deal head-on with some of the stressors of the season.

Judith Akin, M.D., assistant clinical professor of Psychiatry at Vanderbilt University Medical Center, says that for most of us, holiday time does not reflect a Hallmark card image: a tastefully decorated house filled with happy people exchanging perfect gifts and enjoying a wonderful meal while a beautiful snowfall settles gently outside.

In fact, Akin says, for some people, the combination of holiday time and the winter solstice that comes about the same time can combine for a period of stress and unhappiness.

“This is a time of year where individuals can be more aware of sadness,” she says. “We can be stressed because we are away from our families; we can be stressed because we are WITH our families; we can be aware of money problems.”

And combined with that, this Saturday, Dec. 21, is the Winter Solstice, the shortest day (and longest night) of the year in the Northern Hemisphere, which Akin says contributes to the sadness and even clinical depression that many people experience this time of year.

“A lack of light may be an even bigger factor in stress and depression than the holidays,” she says. “Weather is bad, we stay inside, and a lot of us go to work in the dark and come home in the dark.”

While typical holiday stress or seasonal affective disorder comes and goes with the season, depression symptoms tend to be the same whatever the time of year. Some of these symptoms include people commenting that you seem different; a slip in occupational or academic performance; a feeling of being overwhelmed or overextended most days; changes in weight or sleep cycle; increase in alcohol consumption when alone; feeling helpless or more isolated; or a preoccupation with death and dying.

Since stress and sadness around this time of year can come in gradations, Akin offers tips for dealing with some of the common problems of the season.

For Those Celebrating Alone:

  1. Fix a special meal (or plan ahead and get some special takeout).
  2. Enjoy non-traditional holiday fun: go for a long walk, go to the movies, spend the day on an art or house project that you can enjoy.
  3. Let co-workers and friends know that you are alone; often an extra person at a holiday gathering can make it more fun for everybody.
  4. Check online for local agencies that need help and give part of your day to help others.
  5. Even if you can’t be there in person, connect with family and friends by phone, email or text and pass along love and good wishes.

For Those Celebrating with Family:

  1. Don’t try to do too much—strive to keep expectations in balance.
  2. Don’t try to match some ideal of the “perfect” holiday. Look for happiness in what you are able to do and keep your expectations realistic.
  3. At gatherings, try to find common ground with those with whom you might disagree, and avoid conversation topics of obvious conflict.
  4. Don’t overspend on gifts or make gift-giving the centerpiece of the celebration. Be sensitive that some people may be facing financial challenges.

For Those Feeling Stressed or Who May Have Seasonal Affective Disorder (SAD):

  1. Avoid being a couch potato—inactivity and staying indoors can add to the problem.
  2. Avoid consuming too much alcohol or caffeine.
  3. Stay physically active—even if it’s cold, bundle up and go for a walk.
  4. Expose yourself to light. An artificial light source with full spectrum light of 10,000 lux works to relieve signs of depression or seasonal affective disorder in many people.
  5. Strive to eat in a healthy manner. Often a carbohydrate craving strikes during the darkest time of the year, and resisting it can help with feelings of sadness.
  6. Seek counseling to address stressors and help find solutions to problems.
  7. Have a regular physical exam to rule out physical causes such as anemia, thyroid problems, or a diminished vitamin D level.
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Wall Street Journal covers VUMC’s post-ICU delirium research

from Wayne Wood:

Wes Ely, M.D., MPH, professor of Medicine, and his colleagues have been leading the way in describing the effects on patients of being in intensive care, specifically delirium. Here’s a great story from reporter Laura Landro at The Wall Street Journal about that work:

Hospitals Take On Post-ICU Syndrome, Helping Patients Recover
Especially at Risk Are Those Who Treated for Sepsis and Who Experience ‘ICU Delirium’

Dana Mirman, a patient advocate who experienced post-ICU syndrome after treatment for sepsis, with her sons, Zachary, 5, left, and Jesse, 8. Nearly two years after her release from the ICU, she says she feels 'about 75% of myself.' Photo by Dania Maxwell for The Wall Street Journal

Hospitals are doing more to help the growing number of patients who receive treatment for serious illness in the intensive-care unit—only to find their release is the start of a whole new set of problems.

With medical advances, even the sickest patients now often survive potentially life-threatening conditions after a stay in intensive care. Many experience aftereffects, not only of the illness but also of the very medical care that may have saved their lives.

Doctors call it “post-intensive care syndrome” and say it is becoming more common. In the ICU, patients may be heavily sedated and hooked up to a ventilator, keeping them immobile, breathing and free of pain. But they can develop a temporary brain injury known as “ICU delirium,” that is linked to later problems with memory and thinking. As many as 80% of ICU survivors have some form of cognitive or brain dysfunction, according to the Society of Critical Care Medicine, and some never recover. Many experience post-traumatic stress symptoms, depression, fatigue and prolonged muscle weakness.

More than five million patients are admitted to an intensive care unit each year for conditions such as respiratory failure and heart failure, and for monitoring after invasive surgery.

Especially at risk of developing post-ICU syndrome are patients who have sepsis. Often referred to as “blood poisoning,” sepsis is the body’s toxic response to infection and the most common life-threatening illness leading to ICU admission world-wide. It can arise from a seemingly benign cut or scrape, or set in as a complication of pneumonia, urinary tract infection or burst appendix.

Sepsis can rage through the body and restrict blood flow to vital organs including the brain. It kills 258,000 people a year and leaves about 1.4 million survivors at risk for long-term disability, according to the nonprofit Sepsis Alliance, an advocacy group. It was the most expensive condition treated in U.S. hospitals in 2011, costing more than $20 billion; between 2000 and 2009, the number of hospitalizations with a principal diagnosis of sepsis increased 148%, accounting for 1 out of every 23 patients, according the federal Agency for Healthcare Research and Quality.

Researchers are studying the link between delirium and sepsis as well as other causes, such as powerful sedatives. Septic patients are most likely to develop delirium, and they are at higher risk of developing post-ICU disabilities than those with other illnesses who develop delirium, research shows.

Now, many hospitals are starting to modify standard ICU practices, such as giving patients breaks from constant ventilation, avoiding over-sedation, monitoring them closely for signs of delirium and getting them out of bed to walk as soon as feasible. They are adopting protocols to treat sepsis aggressively.

Because much ICU care is necessary and many complications unavoidable, critical-care experts also are focusing on post-ICU rehabilitation, including educating patients, families and primary-care doctors about recovering from intensive care.

E. Wesley Ely, professor of medicine and critical care at Vanderbilt University, which opened an ICU Recovery Center last year, recommends “hard-core physical and mental rehabilitation” for people recovering from ICU treatment. “Right now they essentially go home and become couch potatoes, their life is terrible, and they often end up back in the hospital,” he says. “We need to restructure critical care to handle the needs of ICU survivors.”

In December 2011, Dana Mirman who had recently moved to Naples, Fla., from New York with her husband and two young sons, spent a week in the hospital, half of it in the intensive care unit, being treated for sepsis. It had developed from an infected bump on her shoulder that she presumed was a bug bite.

She wasn’t on a breathing machine, but Ms. Mirman says she felt intense pain and head-spinning weightlessness—”almost like an out-of-body experience,” she recalls. After being discharged, Ms. Mirman says she struggled with confusion, insomnia, fatigue and swelling from the fluids she had been given to treat the infection, as well as vertigo and intense migraines. And she had trouble finding a doctor who understood or could help.

Her husband, Russell Mirman, found the Sepsis Alliance online. The group’s chairman, James O’Brien, vice president of quality and safety at Riverside Methodist Hospital in Columbus, Ohio, assured her this was normal for sepsis survivors and acted as an advisor while she researched treatment options. She began volunteering with the group and joined its board last spring.

Ms. Mirman, who turns 39 on Dec. 11 and whose sons are now 8 and 5, says she has been helped by acupuncture, and she found a local primary-care doctor who referred her to specialists. She says she is operating at “about 75% of myself,” and “living as actively as possible given some lingering constraints.”

The Sepsis Alliance is developing handouts on post-sepsis issues for patients to provide to physicians, and it is using Facebook and other social media to help patients connect with each other. “Just knowing that they are not out on an island and others have felt similar experiences is very empowering,” Dr. O’Brien says.

Theodore Iwashyna, a critical-care physician and researcher at the University of Michigan Health System, is studying survivorship after critical-care illness. He says post-ICU patients need the same kinds of occupational and physical therapy as heart attack and stroke survivors. “We can do better at figuring out who we can help, so functional and cognitive impairments don’t become permanent disabilities,” Dr. Iwashyna says.

In the past two years, a Critical Care Survivorship pilot program developed at Indiana University, helped more than 100 ICU survivors and their caregivers. Malaz Boustani, chief innovation and implementation officer at Indiana University Health, says more than 88% had evidence of cognitive impairment and 40% suffered from depression. The program enhanced post-ICU care and reduced the number of emergency room visits and hospital readmissions, Dr. Boustani says.

In a Vanderbilt study, patients who survived critical illness and completed 12 weeks of in-home cognitive and physical rehabilitation scored better on tests of their ability to plan and perform tasks with multiple steps, compared with survivors who didn’t undergo rehabilitation. Dr. Ely and his team plan to study whether early patient interventions in the ICU, such as memory exercises and puzzles, can help reduce problems later.

Millie Camp, 63, was admitted to an ICU at Vanderbilt in March with acute respiratory distress syndrome with suspected sepsis. After more than two weeks immobilized on a ventilator, she could barely sit up in bed or push a button to call a nurse. The ICU Recovery program helped design a rehabilitation program and referred her to the university’s Voice Center, where she could overcome aftereffects from the breathing machine and resume singing in a barbershop chorus. She is vigilant about exercise, at first taking classes while toting an oxygen tank. “You have to see each step as an accomplishment and a blessing, and not be burdened about what you can’t do,” Ms. Camp says.

The Aftereffects of Critical Illness
Among some five million patients admitted to intensive care units each year, as many as 80% of survivors of critical illness have impaired thinking, judgment or memory months or years later.

One in three patients who require a breathing machine show post-traumatic stress symptoms for up to two years.

As many as 50% of patients may suffer depression after an ICU stay.

ICU-acquired muscle weakness takes up to a year of recovery and occurs in

33% of all patients on ventilators

50% of all patients admitted with severe infection known as sepsis

Up to 50% of ICU patients who stay for at least one week

Source: Society of Critical Care Medicine; Johns Hopkins University

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Next Steps graduate to receive 2013 Self-Advocate Award

from Jennifer Wetzel:

Elizabeth Turner, Communications Program Coordinator for the Vanderbilt Kennedy Center, sent over the news that the Down Syndrome Association of Middle Tennessee (DSAMT) honored Will McMillan with the 2013 Self-Advocate Award on Saturday, Oct. 19, during DSAMT’s annual Buddy Walk festivities.

McMillan is a 2013 graduate of Next Steps at Vanderbilt, a two-year postsecondary education program for young adults with intellectual disabilities. While at Vanderbilt, he completed internships with Vanderbilt Athletics, Libraries, and the Department of Leadership, Policy, and Organization. He has presented eloquently on his life with Down syndrome to educators, parents, and medical professionals on behalf of DSAMT. He participates in a variety of activities including Next Chapter Book Club and Best Buddies.

McMillan played an active role in promoting the successful passage of Tennessee’s STEP UP Scholarship legislation, which expanded the Tennessee Lottery Scholarship to include students with intellectual and developmental disabilities entering eligible postsecondary education programs.

His speech to the Tennessee House of Representatives at Down Syndrome Day on the Hill in 2013 resulted in a full standing ovation from the House.

“Since I have been in college, I’ve learned how to be more independent,” McMillan shared. “Now, I will have the tools for life that will help me prepare for work, independent living, and traveling.”

He continued and urged legislators to pass the bill, “This is important because it will grant the opportunity for students like me to gain career and leadership skills and therefore become more self-reliant adults within our society. We want to work just like everyone else.”

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Former House Organ writing winner has novel published by Penguin Press

from Wayne Wood:

Former VUMC nurse Jeff High, who was published three times in the VUMC House Organ Writing Contest, has just had his first novel, “More Things in Heaven and Earth: A Novel of Watervalley,” published by Penguin Press. This book is the first of a projected series, and follows a fictitious graduate of Vanderbilt School of Medicine who moves to a rural area to practice.

During his time at Vanderbilt, Jeff was a nurse in Cardiothoracic Surgery. He was the 2008 winner in the Poetry Category of the House Organ Writing Contest with his poem “The Alzheimer’s Patient,” the 2009 Fiction winner with his story “Tachycardia,” and a 2010 Honorable Mention for his poem “Toy Story.”

When he wrote recently to tell me about his novel, he ended his note, “Thank you and the House Organ for giving me my start!”

That was a nice and generous thing for Jeff to say, and I’m proud of the years of quality employee writing we were able to showcase in House Organ over the years it was published. But Jeff deserves all the credit, and I hope “More Things in Heaven and Earth: A Novel of Watervalley” is a great success.

To read more about the book, go to

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