Alumni Profile Ezra Susser:
A Life in Epidemiology

BY PETER WORTSMAN
AN INJURY IN A SOCCER GAME IN SAN FRANCISCO IN 1974 LED Ezra Susser’82 to his true calling. The director of the Native American Health Center, a neighborhood clinic where the soccer player was taken for treatment, suggested that he might volunteer by way of payment. A bell rang in his brain. He was bursting with ideas on how to monitor and improve the health of the community, but he lacked the professional credentials to lend him credibility.
     Initially training as a nurse, he returned to Columbia, his undergraduate alma mater, to complete the required pre-med courses at the School of General Studies. He earned a joint M.D.-M.P.H. at P&S and the School of Public Health, to which he later added a Dr.P.H. (with distinction). And while he now enjoys soccer as an impassioned spectator, he became a world-class player in community care and epidemiology.
     Dr. Susser straddles multiple fields: He is the Anna Cheskis Gelman and Murray Charles Gelman Professor and Chairman of the Department of Epidemiology at the Mailman School of Public Health, professor of psychiatry at P&S, and head of the Department of Epidemiology of Brain Disorders at New York State Psychiatric Institute. He is equally well known for his research on the epidemiology of psychotic disorders, his interventional work with the homeless, his development of daring methods to alter sexual risk behavior in populations prone to HIV/AIDS, and, more recently, for his leadership role in the multidisciplinary study of the developmental origins of health and disease throughout life’s course.
     Asked to explain his astounding productivity and intellectual versatility, Dr. Susser breaks into an elfin smile: “I wanted to do something inspiring.”

Epidemiology: A Susser Family Affair
Inspiration was hardly lacking in his life. He is the son of renowned Columbia faculty members Drs. Mervyn Susser and Zena Stein, themselves living legends in their native South Africa, where they conducted one of the first studies of community health in the developing world, using health as a mighty weapon in the struggle against apartheid. In exile, first in England and then in the United States, they continued to battle for social justice back home. Both went on to become pioneers in epidemiology. Co-author, with anthropologist William Watson, of “Sociology in Medicine,” a landmark textbook, Dr. Mervyn Susser was an innovator in social epidemiology, among other fields. Sergievsky Professor Emeritus of Epidemiology in the Mailman School of Public Health, he served for many years as chairman of epidemiology. Professor Emerita of Public Health (Epidemiology) and Psychiatry, Dr. Zena Stein headed the Epidemiology Research Unit of the New York State Psychiatric Institute, where she co-founded, with Dr. Anke Ehrhardt, the HIV Center for Clinical and Behavioral Studies. Both Mervyn and Zena have done important work in HIV/AIDS research in the United States and South Africa.
     Other inspirations for Ezra Susser include his sister, Ida Susser, Ph.D., professor of medical anthropology at the CUNY Graduate Center, and his wife, Sarah Conover, M.P.H., a tireless advocate for the homeless.
     For the Sussers, the theory and practice of epidemiology are a family affair. They have for years worked in tandem, exchanging ideas, often collaborating on projects, papers, and books. Son and mother are, in fact, currently engaged in the completion of a history of epidemiology started by the father.
     “Everybody’s got their own role,” the son explains of the creative process. “My father is the deep thinker. My mother has the broadest range of imagination and ideas. My wife is probably the most connected to the frontline experience, focusing her efforts on the homeless. And I’m the crystallizer, distilling it all into communicable form.”

A Feeling for Outcasts and People in the Margins of Society
As a student at P&S, Ezra Susser promptly put theory to practice, helping to develop a course for fellow students to
Ezra Susser
Ezra Susser’82
learn about the Washington Heights community, so they “could get a sense of the cultural locale of the medical center.” Inspired by the scientific acumen of the late Dr. John Lindenbaum, former chief of hematology-oncology, and the clinical precision of the late Dr. Harold Neu, former chief of infectious diseases, among others, he finally opted for psychiatry, feeling great empathy for “outcast people in the margins of society.” And while some other students winced at the experience of their psychiatry rotation on the ward, he found it fascinating and enjoyed interacting with patients.
     In his fourth year, he took an elective in psychiatry in which he visited former psychiatric patients then living in single room occupancy hotels on the Upper West Side. The experience, including finding the first person he was scheduled to call on dead in her room, shook him to the core, but it also fueled his determination to do something about it and sparked his interventional work with the homeless.
     “I don’t think we would allow people with multiple sclerosis to live in the streets. It wouldn’t be morally acceptable,” Dr. Susser says. “So why is it acceptable for people with disabling mental illnesses to live in such conditions?”
     He pursued his residency in psychiatry at Albert Einstein-Jacobi Hospital in the Bronx, where he encountered a like-minded group of socially conscious young doctors. Combining his residency with an NIMH fellowship in psychiatric epidemiology back at Columbia’s school of public health, he started visiting the public shelters being created to house the homeless. Overwhelmed by the conditions in which he saw mentally ill individuals living in the shelter system, in 1984 he took a year off from his residency to document the problems and help develop solutions.
     A maverick in his field, Dr. Susser has never been averse to unorthodox methods. To earn the trust of formerly homeless women then residing in an SRO hotel near Times Square, he ran the bingo game, a popular weekly event. The women in the hotel taught him the basics of bingo and he, in turn, was able to bridge their resistance and deliver treatment. After finishing residency, he continued his projects during a spell at the Nathan Kline Research Institute in Rockland County, shuttling back and forth to Washington Heights and the Bronx, and finally moved his research to P&S. In 1991 he was appointed to the faculty in the Department of Psychiatry and joined forces with Alan Felix’83, founding medical director of the medical center’s psychiatry shelter program at the Fort Washington Armory Men’s Shelter. At the time, 1,000 men were bedded on the drill floor on any given night, many suffering from severe mental illness and drug abuse. There, in conjunction with longtime colleague Elie Valencia, Dr. Felix, his wife, Sarah Conover, and others, he developed an effective model for “Critical Time Intervention,” an intermediary treatment regimen to enhance the continuity of care after discharge and, thereby, to facilitate a smoother return to the community and prevent recidivism.
     HIV/AIDS was already taking a terrible toll among the city’s most vulnerable. In response, the same team developed a model program called “Sex, Games and Videotapes,” to teach sexual safety and reduce high-risk sexual behavior among homeless mentally ill men in the shelters.

Schizophrenia, Roots and Treatments
Adept at intellectual multitasking, Dr. Susser simultaneously continued work on an international study of schizophrenia he had initiated in partnership with the World Health Organization. Following up on pre-existing WHO data suggesting that people with schizophrenia and other severe mental illnesses seemed to do better in developing countries than in developed countries, he speculated that traditional societies with strong family structures were better equipped to help patients get better than industrialized societies where institutionalization was the norm. “Your social ties aren’t broken in the same way when there’s a place in the family, I think that’s a big part of getting better.”
     Meanwhile, Dr. Susser became increasingly interested in possible risk factors for schizophrenia. Following up on a historic study originated by his parents on the effects of malnourishment on the intelligence level of children born to a cohort of Dutch women who had been pregnant during a famine in World War II, he tested and confirmed the hypothesis that early prenatal exposure to acute food deprivation is a risk factor for schizophrenia.
     He also engaged in establishing studies of schizophrenia that combined genetics and epidemiology. One of the findings from these studies, in work led by Dolores Malaspina, was that the father’s age at the time of conception is a factor in the incidence of schizophrenia in the offspring, just as a mother’s age is a factor in Down syndrome. The older the father, the higher the risk.
     Dr. Susser questions the overemphasis on medication in the current standard treatment for schizophrenia. “If you look at the way treatment is actually delivered in the U.S. today, it’s mostly pharmacological. Yet we have well-established approaches involving changes in social environment that have been shown to have as much impact as medication, but are not being used.” He argues for a broader social framework in which to consider mental
illness.

The Health of Inner-City Populations and Developing Countries
In 1996, Dr. Susser took on the additional responsibilities of director of the Center for Urban Epidemiologic Studies at the New York Academy of Medicine. A few years earlier, in 1990, a New England Journal of Medicine report said the survival rate of males in Harlem was lower than that in Bangladesh. Dr. Susser was called in to bring an epidemiological perspective to the gap in life expectancy between classes and races in New York City.
     “The city was just then beginning to recognize,” he says with a hint of disbelief, “how social inequalities and consequent health outcomes had gotten worse, instead of better.” He firmly believes that epidemiology and politics are inextricable. “If you allow yourself to ask, as you must, Why do we have such inequalities in health in populations and across populations? the solution has to involve social and political change.”
     Always looking at the big picture, Dr. Susser sees the worldwide AIDS pandemic as “another clear example of the link between effective epidemiology and politics. You can’t address the medical dimension without addressing the stigma of the disease, without mobilizing concerned citizens to assert the right to health of people in developing countries — in Africa, in particular.” He has been outspoken in urging government authorities to recognize AIDS as a public health priority. He also has helped establish pivotal international partnerships in the fight against AIDS and spearheaded collaborative research initiatives and training programs for foreign researchers and health care professionals. Arguing for the fortification of public health infrastructures worldwide, he also has called attention to the mental health dimension of the ever- burgeoning crisis.

Tapping Collaborative Birth Cohorts: A Long-Term Living Laboratory
In recent years, Dr. Susser’s research focus has shifted more and more to the developmental origins of mental illness and other diseases throughout the life course. He founded the Imprints Center for Genetic and Environmental Life Course Studies at the Mailman School. Coordinating data gathered from numerous large international birth cohorts, some established as early as the 1940s and 1950s, was a monumental task, but Dr. Susser and his team of investigators are reaching back throughout the life course in an attempt to establish the causes of various diseases and health outcomes, including psychiatric and neurodevelopmental disorders, obesity, cardiovascular disease, reproductive performance, and breast and ovarian cancers. This ongoing multidisciplinary project examines the interplay between genes and environment in early development and the consequences for health over the life course.
     “You have to follow people a long time to learn these things,” he points out, “but ultimately, the findings have enormous implications for public health. The key is to find out what you can do very early on, even in the prenatal period, to reduce risk.”
     But there are some risk factors not even the most farsighted science can foresee.

Public Health in the Wake of 9/11
When the hijacked planes hit the World Trade Center and the Pentagon on Sept. 11, 2001, America gasped at the staggering number of casualties. In the aftermath of this unprecedented event, Dr. Susser sought to document and analyze lingering strains on the public’s mental health. Writing in Scientific American, as well as other publications, he dissected the intended function of terrorism, establishing as one of its primary ulterior motives the dissemination of terror long after the attack. He tried but failed to coordinate a unified response among local government authorities.
     Tragedies of such magnitude may sometimes have a silver lining. In the sobering wake of 9/11 and the heightened awareness of the AIDS pandemic, Dr. Susser sees “a positive spin-off for public health.” A higher profile and increased funding for AIDS-related initiatives and preparedness for the threat of future bioterrorist attacks inevitably “help build up the public health infrastructure, thus benefiting society.”

Eco-Epidemiology: The Future of the Discipline
Epidemiology, in Dr. Susser’s view, constitutes “the core of public health.” Yet he fears that the field is “losing its unifying principle” through fragmentation into multiple sub-specialties linked to genetics, infectious disease, chronic disease, the study of risk factors, and others.
     In an attempt to re-integrate the disparate strands into a single cohesive discipline, in 1996 Dr. Susser and his father came up with the concept of “eco-epidemiology,” by their definition “an epidemiology that looks at multiple levels of causation.” This includes the study of genetic variance and molecular genesis as it impacts the individual and the interaction between individuals in a society, “to look at individual and societal differences in the incidence of disease.” A second key factor is time: “Looking across time, at the evolution of a disease in the individual and in the society from the beginning of the life course.”
     “Of course you can’t be an expert in everything,” he acknowledges, “but epidemiologists do have to bear the whole picture in mind when we choose which part to focus on.”

Psychiatric Epidemiology: The Book
At the time of the interview with Dr. Susser, he had just put the finishing touches on his magnum opus, “Psychiatric Epidemiology: Searching for the Causes of Mental Disorders” (by Susser, Schwartz, Morabia and Bromet, to be published this year by Oxford University Press). Much of it was written with Sharon Schwartz, who has won multiple awards at Columbia for her teaching of epidemiology.
     “A huge effort,” he heaved a sigh of relief at the work of close to a decade. “It’s the first textbook of its kind, I think, to consider the application of principles of epidemiology to psychiatric disorders. And certainly, it’s the first in the field to have a big section on genetics and epidemiology and how they integrate. It’s both trying to bring epidemiology to psychiatry and to bring what psychiatry has to contribute — which is a deeper understanding of social processes and of the brain — to epidemiology.” A foreword written by Sir Michael Rutter, a towering figure in psychiatric epidemiology, says of the book: “Anyone, whether clinician, researcher, or science writer, who makes use of epidemiology will find this book invaluable as a guide on how to think about epidemiology.”

Epidemiology is Alive and Well in Westchester and Washington Heights
Several generations of Sussers live together in a great old house north of the city, a veritable intellectual incubator of ideas. Zena and Mervyn tend the garden and the hearth, swapping notions and insights with Ezra and Sarah, while Ezra takes time out to cheer on the Manchester United soccer team on TV with son, Eli, an aspiring comic and filmmaker. Daughter Leah is considering medical school.
     Back at Washington Heights, on his office wall sits a framed letter from Nelson Mandela to Dr. Susser’s parents. “It was always heartening to know,” Mandela writes, “that, albeit under different circumstances and many miles from home, your commitments and active contribution to struggle for democracy remained undiminished.”
Inspiration?
     “A reminder,” Dr. Susser smiles, “of what epidemiology is really about.”


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Profiles in Giving
Award Perpetuates the Spirit of a Fallen Classmate

BY PETER WORTSMAN
WHEN DONALD PALATUCCI’66, A DISTINGUISHED SAN FRANCISCO-based neurologist and by all accounts one of the most popular members of his medical school class, succumbed to colon cancer in 2002, at age 62, his classmates were
Donald Palatucci
  Donald Palatucci
devastated. Email messages of grief whizzed back and forth between far-flung friends. He was the first of their tight-knit group to die and his passing hit hard. But the shared sadness brought them all together again for a common cause.
     “We felt a need to do something special as a group to honor his memory and our bond of friendship and to keep his spirit alive at P&S,” said Robert Baratta’66, an ophthalmologist and medical entrepreneur based in Stuart, Fla. Dr. Baratta credits another classmate, Harry Richardson Jr.’66, an oncologist from Santa Rosa, Calif., with the idea for creating a fund at P&S in their friend’s name to support the studies of a current student who shares Dr. Palatucci’s talents and values. By unanimous consensus, the class proposed to establish the Donald M. Palatucci’66 Humanism in Medicine Award. His widow, Blanid, and children, Susanna, Nicholas, and Marc, gave an enthusiastic thumbs-up. The first recipient will be named this year. The friends hope to transform the award into a scholarship as the fund grows.
     A neurologist in private practice, Dr. Palatucci served as clinical professor of neurology at the University of California Medical Center at San Francisco, where he settled following military service. He was affiliated with several hospitals in the Bay Area, including St. Mary’s Hospital, serving for two decades as chief of neurology. Esteemed for his teaching skills as well as his clinical prowess, Dr. Palatucci was the recipient of numerous awards, notably the 1997 J. Elliot Royer Award in Neurology and the 2000 Dr. Charlotte C. Baer Memorial Award of the University of California School of Medicine. A member of the board of directors of the American Academy of Neurology, he spearheaded the creation of its State Affairs Committee. He was the founding president of the Association of California Neurologists and the California NeuroAlliance, an organization of neurological practitioners and patient advocacy groups.
     Friends and patients alike cite his warm heart and infectious sense of humor. Dr. Baratta fondly recalls his old friend’s charm. “The patients on our medical rotation invariably asked me ‘Do you know Dr. Palatucci?’ because he’d made such a vivid compassionate impression. In addition to his consummate command of the medical information, he had an almost uncanny ability to interpret what the patient was trying, but was not always able, to express.” Dr. Richardson summed it up in a eulogy delivered at his funeral: “He was the one you sent your family and friends to see, the ultimate compliment to a physician.”
     Another friend, Ronald E. Drusin’66, professor of clinical medicine and interim senior associate dean for education at P&S, will head the award selection committee. For more information on the award, contact Anke Nolting, associate dean and executive director for alumni affairs and development, at 212-305-3498 or aln1@columbia.edu.


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Rx for Travel
Wanderlust in Westchester:
Alumnus Launches Travel Health Website

BY PETER WORTSMAN
WHAT DOES A BUSY INTERNIST WITH A COMBINED GENERAL internal medicine and infectious diseases practice in Scarsdale, N.Y., and a hankering for faraway climes do before turning out the light at night? In lieu of flights of fancy, David Goldberg’81 flies vicariously to faraway places via mdtravelhealth.com, the Web site he launched in 2000.
     “The site was born out of a frustration with trying to get the information I needed,” Dr. Goldberg recalls. “As a
David Goldberg
  David Goldberg
specialist who sees a lot of traveling patients with pretty much the same questions — ‘This is where I’m going, what vaccinations and pills do I need?’ — it made sense that there should be a single site on the internet where you can just press on the name of any country and get the health information you need.” But no such site existed.
     Creating the site was truly a labor of love. “My children were quite young, so part of the joy of it was that I could sit there in my basement working on the Web site and travel vicariously to Vietnam and Thailand, but still be there if my kids needed help with their math homework.” Having listened and responded for years to the concerns of his traveling patients, Dr. Goldberg “had a pretty good idea of the kinds of things people wanted to know.” He devoted most of his free time over the course of a year culling material from various sources, including the Web sites of WHO, CDC, Health Canada, and others, compiling and presenting the information in lucid, jargon-free English geared to the educated public at large as well as M.D.s in the field. He hired a designer to give his site a graphically appealing, user-friendly face, and voila! mdtravelhealth.com was born.
     The site provides health-related listings, including vaccines and medications recommended for travel to some 200 countries. Filling an evident need, it has proved immensely popular, attracting some 30,000 to 35,000 visits in an average month. The site also attracted the attention of World Access, a research company that leases use of the material, and the Lonely Planet Company, which subsequently commissioned Dr. Goldberg to write the travel health sections of the company’s updated guidebooks for South America, Central America, and the Caribbean region. E-mail responses have included queries from high school students for their international health-related research projects and a request from a physician in Jordan for permission to translate the Saudi Arabian section into Arabic for pilgrims on their way to Mecca, a request Dr. Goldberg was happy to grant.
     While taking care of his patients remains his No. 1 priority, Dr. Goldberg puts in several hours a week fine-tuning the format and keeping the information up to date. He added a section for travel during pregnancy and traveling with children and recently decided to upgrade the contact information on health facilities abroad.
     He is a member of the International Society of Travel Medicine, the American Society of Tropical Medicine and Hygiene, and the Wilderness Medical Society.
     Travel medicine is an offshoot of tropical medicine, a field in which P&S has a distinguished tradition going back to the late Dr. Harold Brown, a renowned parasitologist who helped launch a program for training and research in tropical diseases. And while Dr. Brown was long gone by the time Dr. Goldberg got to P&S, the latter found inspired mentors in the Division of Infectious Diseases, notably the late Drs. Harold Neu and Glenda Garvey’69.
     Whether you’re headed to Scarsdale or Swaziland, mdtravelhealth.com is only a few keystrokes away.


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Alumni Association Activities

Alumni Council
eft: Morris Freeman and son, Neil Freeman; right: Guest speaker James T. Goodrich with Jacqueline B. Bello and Alumni Association President Jay Lefkowitch
  left: Morris Freeman’51 and son, Neil Freeman’85; right: Guest speaker James T.
  Goodrich’81 with Jacqueline B. Bello’80 and Alumni Association President Jay
  Lefkowitch’76
Alumni Association President Jay Lefkowitch’76 welcomed all to the Nov. 16, 2005, council dinner, noting the presence of Neil Freeman’85, a radiologist based in Denville, N.J., in the company of his proud father, retired oncologist Morris Freeman’51, a frequent participant in council activities. A member of CoSMO — Columbia Student Medical Organization — described the work of the volunteer student group in providing free physical examinations to indigent individuals in the Washington Heights community. The evening’s guest speaker, James T. Goodrich’80, professor of clinical neurosurgery, pediatrics, plastic and reconstructive surgery and director of pediatric neurosurgery at Children’s Hospital at Montefiore Center/Albert Einstein College of Medicine, gave a run-through of the history of surgery to separate conjoined twins as a prelude to a thrilling account of his own much publicized successful surgical separation of a set of craniopagus twins — twins connected by the skull — in which, for the first time, both children survived. “These are two children with two birthdays,” he said, “the day they were born and the day they were separated.” The five-stage operation, which cost a total of $2.25 million, was the single most reported medical media event ever, Dr. Goodrich said, doubling admissions to Montefiore Children’s Hospital and netting an estimated $70 million in income.
On Jan. 18, 2006, Dean Gerald Fischbach hosted the traditional dean’s council dinner and delivered his annual “State of
  left: Gerald Fischbach; right: David T.W. Chiu, P. Roy Vagelos, and Ronee I.
  left: Gerald Fischbach; right: David T.W. Chiu’73, P. Roy Vagelos’54, and Ronee I.
  Herrmann’54
the School” address. “This is my last dinner as dean,” he said with mixed emotions. A renowned neuroscientist, he is stepping down to return to his research but promised to remain an active adviser to the dean’s office. On an optimistic note, he reported that the medical school “is predicting a balanced budget for the coming year.” The leadership of the capital campaign is in good hands, he said, saluting campaign chairman, Roy Vagelos’54, “my most significant recruit of all time,” who was in attendance. The campaign is ahead of schedule, he said. During Dr. Fischbach’s tenure, the number of endowed professorships rose from 123 to 160 and the number of donors rose from 7,500 to more than 18,000. Among the school’s greatest successes, he touted the recently invigorated program in interventional cardiology and the student body. Again last year, P&S ranked as one of the most selective medical schools in the country. As to his future, Dr. Fischbach announced his plans to become scientific director of the Simons Foundation, a foundation devoted to the study of autism.

Minority Students and Alumni Dinner
 left: Kenneth A. Forde’59 and Mrs. Forde right: Guest speaker Ohenaba Boachie-Adjei’80
  
left: Kenneth A. Forde’59 and Mrs. Forde right: Guest speaker Ohenaba Boachie-Adjei’80
On Nov. 7, 2005, Alumni Association President Jay Lefkowitch’76 welcomed a record turnout of alumni and students to the annual Black and Latin Students and Alumni Dinner at the P&S Faculty Club. Lester W. Blair’74, chairman of the Committee on Minority Affairs, reviewed the history of BALSO — the Black and Latin Students Organization — which members of his class had a hand in creating. Dr. Blair welcomed special guests, Dr. Margaret Haynes, former director of the Office of Minority Affairs at P&S, and Dr. Hilda Hutcherson, associate dean for diversity and minority affairs. He added: “We want to ensure that black and Latino students are well represented among the next generation of P&S students, that we have faculty who are black and Latino, and that they go on to do great things in medicine.”
     Brenda Aiken’81 followed Dr. Blair to the podium, reporting on the progress of the Campaign for Diversity, an effort to raise scholarship funds for minority students at P&S. BALSO president Kemi Oni’08 gave an update on the recent activities of the organization, including a pre-orientation welcome for new first-year minority students.
     Next on the agenda was a special salute to Kenneth A. Forde’59 on the occasion of his retirement from teaching. The salute included a stirring tribute and a lively Powerpoint presentation prepared by Dr. Lefkowitch. Enumerating a “short list” of Dr. Forde’s accomplishments, Dr. Lefkowitch called him a great “clinician, teacher, surgeon, expert, adviser, mentor, administrator, leader, alumnus, historian, family man, and, of course, a purveyor of wisdom and an inspiration.” A native of Barbados, Dr. Forde is the Jose M. Ferrer Professor Emeritus of Surgery at P&S, and the department’s recent vice chair for external affairs.
     The author of more than 120 papers and 17 book chapters, he is a world-renowned gastrointestinal endoscopic surgeon. As a gift from the Alumni Association, Dr. Forde received “the Columbia Chair.” “I’m embarrassed, but pleasantly so,” Dr. Forde said. “You’re here today not just to celebrate me, which I truly, truly, truly appreciate…but remember, we still have work to do.”
     The evening’s guest speaker was Ohenaba Boachie-Adjei’80, professor of orthopedic surgery at Weill Medical College of Cornell University and chief of the scoliosis service at the Hospital for Special Surgery. Dr. Boachie-Adjei, a native of Ghana, recounted the path his career followed to become a celebrated spine surgeon who repairs spinal deformities. He is also active with a foundation he created some years ago to help the underserved populations of Africa and the Caribbean with their spinal problems. “My pastor said,” Dr. Boachie-Adjei recalled, “that life is 10 percent what happens to you and 90 percent how you react to it.” Realizing in the course of his preliminary training in orthopedic pathology at the Hospital for Special Surgery that there had not been a textbook written in spinal pathology since 1936, he proceeded to specialize in spinal orthopedics. He designed an experiment never before attempted to remove the total spine in cadavers for the purpose of studying its structure. Pursuant to his research he wrote the definitive color atlas on the spine and, in time, became one of the country’s top spine surgeons. “Your focus is your future,” he concluded, “and I believe that the No. 1 reason people do not reach their goals is that they lose sight of them. You can be the ordinary thread in the tunic or you can be the purple which gives distinction to the rest.”



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Class News
BY MARIANNE WOLFF’52

Class of 1938
John K. Lattimer’38
John K. Lattimer’38
On Nov. 11, 2005, (Armistice Day in Europe) JOHN K. LATTIMER was made a Knight of the French Legion of Honor; this recognition was based on Dr. Lattimer’s service as a U.S. medical officer helping to liberate France and drive out the Germans at the time of the Normandy invasion. He previously was honored for these activities with the Croix de Guerre and another French citation. In addition he served as a medical officer at the Nuremberg trials and later as an investigator of the shooting of President Kennedy. Best known in the field of urology, Dr. Lattimer served for six years as president of the International Society of Urologists, a French society, while also serving as president of the American Urological Association. Dr. Lattimer has represented the United States in the World Health Organization. Longtime chairman of the Department of Urology at P&S, he wrote three textbooks and 375 scientific papers. Perhaps not as well known are Dr. Lattimer’s athletic achievements: He held the AAU 200 meter hurdles record for 14 years; in addition, he participated in several “Championships of America” as a member of Columbia and/or New York Athletic Club teams. At the end of the war he won the 200 meter hurdles in the “G.I. Olympics” for the U.S. 7th Army in Germany. Dr. Lattimer has sustained a variety of injuries, which prevented him from traveling to participate in Normandy invasion anniversaries. Similarly, instead of going to France to receive his latest award, the French ambassador, at the direction of President Chirac, came to New York City to confer the knighthood of the French Legion of Honor upon him.

Class of 1945
Board-certified surgeon and Fellow of the American College of Surgery GRAY C. BUCK has published a booklet defending the primary role of surgery in the treatment of breast cancer. Strongly influenced by his mentor, Cushman D. Haagensen, Gray feels that oncologists and radiologists should be considered consultants rather than the main caregivers for this disease.

Class of 1953
JOHN H. BRYANT and his wife, Nancy, have been working with U.N. Habitat in Kenya, addressing the problems of orphans and vulnerable children in the urban slums of Africa. Supported by a Fulbright grant, Jack’s mission is to assist in the development of Orphan Care Support Systems for the urban slums of Africa. In addition to employing the usual public health measures such as immunizations and confronting malnutrition, Jack devotes his efforts to teaching simple steps like handwashing and caregiving relationships.

Class of 1958
THOMAS Q. MORRIS, P&S Alumni Professor Emeritus of Clinical Medicine, has been named chairman of the Board of Trustees of the New York Academy of Medicine.

Class of 1959
Still practicing psychiatry/psychoanalysis, BENNETT SIMON tells us he is gradually cutting back. Aside from his practice he continues to teach residents in psychiatry as well as humanities to undergraduates at Harvard and Harvard affiliates. Their nine grandchildren keep the Simons busy traveling, and in early 2006 they took a trip to Israel and South Africa.

Class of 1968
BENNETT SIMON has been with the Reproductive/Urology Drug Division of the FDA for the past nine years; last year his division moved to Silver Spring, Md. His current work revolves around the new Ortho patch, testosterone patches for women, and the Nuva ring, among other products for women. He loves the work, his flexible hours, and the absence of night and weekend call.

Class of 1972
MICHAEL F. MCGUIRE is chief of plastic surgery at St. John’s Health Center in Santa Monica, Calif., and associate clinical professor of plastic surgery at UCLA. Having previously served as president of the California Society of Plastic Surgeons and president of the American Association for Accreditation of Ambulatory Surgery Facilities, Mike was elected secretary of the American Society of Plastic Surgeons. In that position he will be a member of the executive committee of the Board of Directors. The ASPS is the largest organization of board-certified plastic surgeons in the world and has a membership of more than 6,000. Mike is also a Fellow of the American College of Surgeons.

Class of 1974
JANE M. ORIENT, who is in solo private practice of internal medicine in Tucson, Ariz., is on the faculty of the University of Arizona College of Medicine and managing editor of the Journal of American Physicians and Surgeons. The third edition of her book, “Sapira’s Art and Science of Bedside Diagnosis,” was released in July of 2005. The book is published by Lippincott Williams & Wilkins.

Class of 1976
DANIEL B. CARR has been promoted to CEO at Intrac Inc. and Innovative Drug Delivery System. He continues as chief medical officer at Intrac. Dan is an anesthesiologist, with a particular interest in pain management.

Class of 1977
MARC D. GRODMAN, founder of Bioreference Laboratories, has been chairman of the board and CEO since its inception 24 years ago. The lab is the largest independent regional clinical facility of its kind in the Northeast. Its main focus is diagnosing leukemias and lymphomas. It has web connections to 100 hospitals throughout the United States and connects thousands of physicians with more than 100,000 patients. Marc is assistant professor of clinical medicine at P&S and assistant attending physician at New York-Presbyterian Hospital. He was recently appointed to the board of the American Clinical Laboratory Association and also serves on the Technical Expert Panel for Competitive Bidding at the Center of Medicare Services. His latest accomplishment is receiving the honorary degree of Doctor of Humane Letters from the New York College of Podiatric Medicine.

Class of 1981
GUS DEGREEF is a psychiatrist who chose to move to India following completion of his residency. He and his wife live on a type of commune; he provides medical care for the community.
JON GERTLER, a vascular surgeon, heads the life sciences practice at a large investment bank. His goal is to fund, grow, and merge biotechnical and medical device companies.
DAVID GOLDBERG: See “Rx for Travel,” page 41.
Internist ROB GOLUB is on the faculty of Northwestern Medical School in Chicago. He is currently senior editor of JAMA.
JOEL ZINBERG practices general surgery, as well as law; he received a law degree from Yale School of Law after graduating from P&S.

Class of 1992
  The “Prescriptions”
  The “Prescriptions”
ANTHONY J. CLAPCICH, a pediatric anesthesiologist at P&S, and MICHAEL MARVIN, a liver transplant surgeon at Westchester Medical Center, have re-formed their band, the Prescriptions, along with Tony’s brother, general dentist Dr. Robert Clapcich. In July 2005 they performed at Children’s Hospital of New York-Presbyterian (with 90s pop star Lisa Loeb). Another performance planned for the spring of 2006 will be a benefit concert for retinal research.





Class of 1993
GARY SCHYNOLL has joined the faculty of Albany Medical College as associate professor of medicine. He will be involved in the school’s internal medicine residency training program. He and his wife, Eleni, and children, Tatiana and Maximilian, live in Saratoga Springs, N.Y.

Class of 2002
CLARA HOLT KEEGAN, having completed her family medicine residency at the University of Massachusetts-Worcester, has entered private practice in Dracut, Mass. Clara and her husband, Mark, became the proud parents of Timothy Michael in July 2005.

To India and Beyond, Memoirs of a Missionary SurgeonAlum’s Memoir Recounts Missionary Surgeon’s Life of Service
BY PETER WORTSMAN
In his recently published memoir, “To India and Beyond, Memoirs of a Missionary Surgeon,” (Xlibris, 2005), Archibald G. Fletcher Jr.’42 gives a spirited account of a life of medical and spiritual service in India. Born in Taegu, Korea, where his father, Dr. Archibald Grey Fletcher, had established a 75-bed hospital under the auspices of the Presbyterian Church (USA) that has since grown into a major medical center, the son followed his father’s call to service. In 1950, after a surgical residency at the University of Pennsylvania, Dr. Fletcher was sent by the Presbyterian Church to practice at the Wanless Hospital in Miraj, India.
     He was appointed professor, chief of surgery, and medical director of the institution that blossomed under his direction into the Miraj Medical Center, a 500-bed teaching hospital. Retiring in 1977, Dr. Fletcher returned to the United States to teach in the Department of Surgery at the University of Washington in Seattle. But spiritual wanderlust soon drew him back to the field in Kathmandu, Nepal, the Cameroon, and finally his beloved India. The missionary medical bug likewise bit his son, Dr. John R. Fletcher, a surgeon at the Good Shepherd Hospital in Tshijaji, Zaire.


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From the Classes

Class of 2006: Eva Turek Delgado
BY REBEKAH HOFSTRA’06
Eva Turek Delgado
Eva Turek Delgado is a fourth-year medical student who grew up in Danbury, Conn. She was a biochemistry/molecular biology major at Dartmouth, where she developed a passion for research, teaching, and medicine. Eva’s initial interest in research as a Presidential Scholar focused on the effects of various chemicals on neurotransmitter release in crayfish. Explaining her research quickly evolved into a passion for teaching, and she held several teaching assistant positions at Dartmouth.
     After arriving at P&S, Eva immediately became active in many organizations. The Transition Committee has been particularly meaningful to her. The late Dr. Steve Miller was one of her mentors and role models and influenced both her decision to pursue pediatrics and her decision to pursue academic medicine with an emphasis on teaching.
“I think I became interested in academic medicine while working with Dr. Miller on the Transitions committee. I saw how involved he was with students, residents, and faculty and how he helped make that whole process from student to doctor flow so nicely. I then decided to take on the clinical correlations project with Dr. Paul Lee as a fourth-year medical student. This was an amazing opportunity to show students that they can apply their knowledge to a clinical setting, and it made me realize that I really do love to teach. I know now that this is something I want to do for the rest of my life.”
     Eva’s interests have also grown at P&S to include HIV. During the summer after the first year of medical school, Eva received a grant to go to the University of Puerto Rico to explore the effects of anti-retrovirals on perinatal transmission of HIV.
     “I went to Puerto Rico to work in a clinic dedicated to the prevention of perinatal HIV transmission, and I was immediately impressed by how this can be achieved by instituting the right medications early in pregnancy. I was then fortunate enough to be accepted to go to South Africa as a fourth-year medical student, a place where HIV infection has reached epidemic proportions. I worked in pediatric HIV clinics filled with patients whose mothers had not had the benefit of the medical intervention available to the women in Puerto Rico. This will probably remain an area of interest for me and I would not be surprised if I become an advocate for HIV education some day.”
     In March, Eva matched at the Stanford University pediatrics program. Her husband, Kit Delgado’06, matched at the Stanford emergency medicine program. Together, they are looking forward to beginning their married life in a location new to both of them.

Class of 2007: Martin F. Epson
BY MARK MANN’07 AND IRENE LO’07
Martin Epson Martin Epson is not your typical cookie-cutter medical student. He has been described as one of the brightest students — yet humble — and always quick with an uplifting word for a down colleague. He has a heart of gold appreciated not only by his classmates and the fish in his bathtub-sized fishbowl (which he built himself), but also by his patients in their darkest hours.
     Martin hails from a Navy family in which it was assumed that he would enter the Naval Academy as did all his forebears. While being brought up by his single mother and living in Spain, Sardinia, and Puerto Rico, he proceeded to fulfill expectations. Although he never became a Navy man, he did row crew at Georgetown University’s School of Foreign Service, for which he was granted a full athletic scholarship.
     After college, he continued to fulfill his naval destiny by competing in four national championship regattas and racing internationally in Canada and England. However, Martin’s achievements are far from limited to the athletic realm. While completing his undergraduate degree in culture and politics, his life met with tragedy as his mother fell ill and passed away. As a direct result of that loss, Martin began exploring various aspects of medicine. While his mother was ill, he learned about the patient’s perspective of medicine.
     Through his coursework, he studied the philosophy, ethics, and interplay of spirituality, healing, and, ultimately, death.
He followed his college experience by circumnavigating the globe in one summer before he began both a post-baccalaureate program as well as a master’s degree at Harvard’s divinity school. There he had the honor to study with some of the most lauded minds of our class, such as the esteemed Jeff Devido, BA, MA, who expects to get his M.D. in 2007. After completing his divinity degree, Martin graced P&S with his presence and embarked on a new quest of knowledge in medicine.
     His studies at P&S have led him to explore a potential career in academic psychiatry, in the area in which law and medicine overlap. He is also interested in public health policy to work to prevent many of the problems that turn into medical problems. One of his most interesting ideas has been “in-house psychiatry.” An in-house psychiatrist is essentially a specialist trained specifically to help with dealing with the pressures, demands, and time-constraints of being a physician. Martin, true to his reputation, continues to care for his classmates’ inner sense of well-being and will ultimately make all of us at P&S proud in his chosen profession.

Class of 2008: Matthew Erlich
BY BRAM WELCH-HORAN’08
Matthew Erlich “Life throws us some strange curveballs,” observes second-year medical student Matthew Erlich. One of the latest heirs to a P&S tradition of welcoming students who have journeyed along circuitous paths, Matt seems to have a happy knack for transmuting each of his experiences into something that can enrich his future efforts. Born in Manhattan at Mount Sinai Hospital, Matt grew up in Edgemont, N.Y., and attended high school there. At Bowdoin College, his great love was history, but after graduating in 1997, he took a job at MTV. He soon switched to a company that, in his words, “made tchotchke.”
     However, a far more lasting change was already under way. In 1999, Matt’s father, Steven R. Erlich, D.M.D., who trained in orthodontics at Columbia, was diagnosed with lung cancer. As the illness progressed, the son became primary caregiver to the father, as well as his companion at doctor visits. “I went to over 28 chemotherapy appointments with him,” Matt recalls. “It’s extraordinarily hard to become a parent to your parent when you’re young.” Despite aggressive treatment at Mount Sinai, Dr. Erlich passed away in January of 2004. He continued seeing patients until a week before he died.
     Matt describes this ordeal as both the loss of his “best friend” and the “main catalyst for where I am right now.” The experience brought the combination of an intense sharing with his father, a time for introspection, and an enhanced awareness of medicine in a positive light. In this spirit, he entered Columbia’s post-baccalaureate pre-med program in 2001. While taking courses, he also worked as a research assistant on a breast cancer study at Mount Sinai. During his “lag year” after taking the MCAT, Matt worked with Dr. Etah Kurland and Dr. John Bilezikian in the Division of Endocrinology at CUMC on a study of male osteoporosis.
     Columbia proved to be the right fit for Matt when it came time for medical school; P&S’s emphasis on humanism and interdisciplinary work strongly appealed to him. “I like applying the liberal arts to medicine and humanizing the science,” he says. Last summer, Matt was the recipient of an Arnold P. Gold Foundation research fellowship. He worked with Drs. John Saroyan, William Schechter, and Mary Byrne on a study of symptoms and reporting of pain in chronically ill children. Matt was thrilled to do so in association with the Gold Foundation, whose mission is to foster humanism in medicine.
     Matt and his wife, Kristin Witty, who works as a strategic planner at Saatchi & Saatchi Health Care, live in Morningside Heights. Matt hopes to stay in New York for his residency; he is considering a career in pain management, either through anesthesiology or internal medicine. Whatever his career path, he hopes to apply the tools of both humanism and the humanities to his chosen field. “Medical language and concepts can be very intimidating to patients,” he says. “It’s so important in any discipline to make the inaccessible accessible.”


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Doctors In Print: ‘Marker’ by Robin Cook’66

REVIEW BY JUDITH P. SULZBERGER’49
Dr. Robin Cook is famous for his medical thrillers. His newest novel, “Marker,” is another page-turner, one that kept me glued to its 500+ pages. Once again, Dr. Cook makes use of his extensive medical knowledge; his protagonists, Dr. Laurie Montgomery and Dr. Jack Stapleton, are graduates of P&S and medical examiners in New York City. They, and their colleagues, perform autopsies on all persons having violent or unexplained deaths.
     “Marker,” Dr. Cook’s 25th book, is not a book for the faint of heart; graphic descriptions of the various corpses
Laurie begins to suspect foul play. Is there a serial killer at work in the hospital?
abound. Even I, who had a residency in pathology and worked with the Westchester Medical Examiner in the early 1950s, was made a bit queasy. However, I was interested to note how different the autopsy procedures are today. The examiners in “Marker” wear protective gear called a “moon suit” — “... with attached hoods and full facial masks.” Back in my time, before the advent of AIDS and other lethal infections, a gown with rubber gloves and apron sufficed. Only when infectious disease was known or suspected was a mask worn over mouth and nose.
    Laurie and Jack are more than co-workers in the autopsy room. When the novel begins, they are lovers sharing Jack’s small apartment but an argument, incited by Laurie over the future of their relationship, ends with her moving out. When she gets to work that day, her first autopsy is of a young, seemingly healthy man, who had died suddenly a day after a minor surgical procedure. There is no abnormality she can find to account for his death, and the laboratory studies are negative too.
    After she performs several similarly negative postmortem examinations on young, healthy adults, also admitted for minor procedures, Laurie begins to suspect foul play. Is there a serial killer at work in the hospital?
    She tries to warn the hospital administration and is strongly admonished not to continue spreading these notions, for which she has no proof.
    Meanwhile, Laurie’s relationship with Jack continues to deteriorate. Although each appears to love and need the other, they are unable to make amends. Laurie is beset with more bad news delivered by her father: Her mother has just been diagnosed with a genetically transmitted type of breast cancer. He urges Laurie to have her DNA tested for the cancer gene, which, if present, will make her a strong candidate for breast or ovarian cancer. She tests positive and is faced with the dilemma of whether to protect herself by having a bilateral mastectomy and removal of both ovaries or take the risk of doing nothing in order to have children.
    Despite her personal problems, Laurie continues to add patients to the list of sudden unexplained deaths in the hospital. Her suspicions gradually become conviction, and she is finally able to find some support from an attractive, new physician, who also seeks to become her suitor.
    The forces of evil are represented by a nefarious, trigger-happy nurse, who threatens all those investigating the deaths. The tension mounts steadily to an increasingly violent finish. Hold on to your chairs!

Dr. Cook, a 1966 graduate of the College of Physicians & Surgeons, dedicated “Marker” to P&S.

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