WORK IN PROGRESS

OUR NEW LOOK IS *ALMOST* COMPLETE. IT’S TAKEN A BIT LONGER THAN EXPECTED BUT AS THEY SAY: GOOD THINGS COME TO THOSE WHO WAIT. I HOPE YOU’LL CHECK BACK IN THE COMING WEEKS. THANKS FOR YOUR PATIENCE!

Luck, good and bad

Dr. Tom McDonald

I’ve been thinking a lot lately about luck, maybe because one of my close friends died recently.

His name was Tom McDonald, and he was an incredibly well-respected internist at the Palo Alto Medical Foundation. We were roommates in college and in medical school, and our families grew up together here in the Bay Area. Up until the moment he collapsed while biking in the hills near his home on the Peninsula, Tom was the healthiest contemporary I knew. He climbed mountains in crampons in Nepal, snow-camped in the Sierra, and rode his bike up the steepest hills he could find. But unbeknownst to him or anyone else, he had an atherosclerotic plaque in one of his coronary arteries, which thrombosed suddenly one Sunday afternoon, while he was out biking alone. A stroke of bad luck.

By contrast, my father had good luck.  He had much the same thing happen to him one evening at the airport in San Francisco. But I was standing next to him, and fortunately was able to resuscitate him. To make a long story short, he had heart surgery at Mills-Peninsula shortly thereafter and lived for almost another decade. Which he spent telling people how lucky he was that I had not gone to law school, as he had initially hoped.

They say that luck is the residue of design, but I don’t think any of us can ensure that someone who knows CPR will be nearby if we are unlucky enough to have a cardiac arrest. I do feel fortunate to be able to wish all of you Happy Holidays, with my sincere best wishes for 2013.  May we all have a healthy and joyful year, with more than our share of  luck—by which I mean good luck—thrown in for good measure.

*Note: As this year wraps up, I will be taking a break from my blog to work on an exciting new look for 2013.  I hope you’ll check back here in March as I look forward to sharing more musings about CPMC and all that the new year will bring.

We really have been here a long time

Spiral Staircase

We just celebrated another centennial this month—the 100^th anniversary of CPMC’s historic Health Sciences Library. If you’ve never been inside the Library (located on Sacramento Street, near the corner of Webster), you really should pay it a visit. I find the Library especially comforting on a miserably rainy day, but it’s also beautiful when the afternoon sun is streaming through its west windows. Climb the spiral staircase to enjoy the collections of some of CPMC’s illustrious physicians.

Vestibule

Designed by Albert Pissis, a Mexican-American architect who moved to San Francisco as a small child (his father was a doctor in the City), the Library is CPMC’s finest building. Its Beaux-Arts style  features many wonderful architectural details and murals. Pissis was the architect for several other well-known buildings in San Francisco, including the Sherith Israel synagogue (on California and Webster Streets, also worth a visit), the Hibernia Bank downtown, and the dome for the original Emporium Department Store, which was subsequently incorporated into the Westfield Centre on Market Street.

Mayor Ed Lee has issued an official proclamation honoring the Library’s centennial, in recognition of its architectural and historical significance, as well as it ongoing importance as the Library that supports both CPMC and the University of the Pacific Arthur A. Dugoni School of Dentistry. You can see more pictures of the Library on either our intranet or the internet.

Anne Shew

Our sincere congratulations to Anne Shew, the Health Sciences Library director, and her staff (Carol Brendlinger, Florence Cepeda, Terryl Gregg, Kathy Kimber, and Tilly Roche).

(Fewer than) six degrees of separation

Many CPMC’ers, especially those at the Cal campus, have met Dr. Oded Herbsman, our Vice-Chair of Pediatrics and a cherished pediatrician.

Oded & Cheryl Herbsman

Some of us know that he received his M.D. at Duke University. A few have heard how he met his wife at summer camp in North Carolina, when they were both much younger, especially Cheryl. Some of us know that she wrote a book for young adults about a girl who develops a summer crush on an older boy (Breathing, by Cheryl Renee Herbsman).

And now we have some very special news: Cheryl’s dad, Dr. Robert Lefkowitz, a Professor at Duke, recently won the Nobel Prize in Chemistry for his groundbreaking research on cell receptors. That work has led to a new understanding of how adrenergic signaling works—think epinephrine (adrenaline), as well as medications that activate those receptors (to treat asthma and COPD), or block them (to treat cardiac problems). Click here to read about Cheryl’s response to her father’s award.

Also, Oded worked in Dr. Lefkowitz’s lab while he was at Duke, even writing a research paper with his father-in-law and other colleagues: Collins S, Altschmied J, Herbsman O, Caron MG, Mellon PL, Lefkowitz RJ. “A cAMP response element in the beta 2-adrenergic receptor gene confers transcriptional autoregulation by cAMP.” J Biol Chem. 1990 Nov 5;265(31):19330-5. I wonder how he got that job?

Congratulations to Cheryl and Oded (who are heading off next month to Stockholm), and of course, to Dr. Lefkowitz, from all of us at CPMC.

St. Luke’s Chapel Centennial Celebration

The Chapel at St. Luke’s

It always brings me great pride to tell people that CPMC has been providing great hands-on care for more than a century. This week, we’re celebrating one of the visual reminders of our rich history: the Chapel at our St. Luke’s Campus, dedicated 100 years ago.

It’s hard for those of us who care for patients in the 21^st century to realize what it was like here in 1912. Perhaps a few quotes from a St. Luke’s publication from that time period will help.

The hospital’s rules about who could be admitted were very clear: “No case of a contagious nature will, under any circumstances, be admitted to the Hospital.” Of course, there was a good reason for that—there were no effective treatments for contagious diseases.  So, although this was an Episcopal facility, patients were “allowed every facility for receiving the consolation of their own churches,” which they most likely needed.

Stained glass window in St. Luke’s Chapel

The hospital was proud to announce that “The corps of Attending Physicians and Surgeons is composed of men of known reputation and ability.”  On the other hand, the nurses were all women. Fortunately, Dr. Charlotte Brown and her colleagues had built an all-women medical staff across town at the Children’s Hospital, now our California Campus.

There were three classes of patients: those who could pay for their hospital stay and their physicians; those who could pay for their hospital stay—but not their doctors; and a third class, “composed of those who are unable to pay anything to the hospital, and are admitted to the free beds.”

Transportation-wise, we’ve moved backwards. One hundred years ago, St. Luke’s was on several trolley lines, and described as “easily accessible by the Valencia Street cars, which pass the door; also by the Mission Street line and the San Francisco and San Mateo electric cars, which pass within a block.”

Choir loft at St. Luke’s Chapel

Not only was it easy to get to the hospital, the costs of care were quite reasonable.  Ward beds were only $17.50 per week, whereas private suites with bath were $70 per week, including “board, lodging and the attention of a nurse on general duty.”  However, there was an extra charge of $25 per week for a graduate-nurse, as opposed to a student-nurse.  Of course, this was before the days of health insurance, so all “Fees must be paid weekly in advance.”

But some things never change. The hospital’s marketing literature bragged that St. Luke’s “is situated on Valencia Street, near the junction of Mission Street, surrounded by well-kept grounds.  It is free from the cold winds, fog and noise of other portions of the city.” It still is. And I hope it will be for at least another 100 years.

Remembering Jack

Dr. Martin Brotman and Jack Bailey

As most of you know, our former Executive Vice President, Jack Bailey, died last week, here in the hospital he loved.

Jack came to CPMC at a time when we were struggling; many were concerned whether the medical center would even survive the changes that were occurring in health care. When he retired 15 years later, at the end of 2009, we were one of the most successful medical centers in the country, with vibrant clinical programs that remain the envy of many university hospitals. In partnership with Dr. Martin Brotman, Jack accomplished this with a unique mix of intelligence, effort, knowledge, and a relentless emphasis on doing what was best for our patients.

L-R: Jack Bailey, Grant Davies, Linda & Eric Horodas

Jack understood that by encouraging excellence, he could change the world. Jack’s profound insights, his attention to detail, and his deep knowledge of hospitals helped teach a generation of health care leaders, including me.  Jack was direct, even tough when he thought it necessary, but he had a heart as big as his beloved state of Texas.  I will miss the way he would shake his head while grimacing “wb, WB, WB—you can’t be serious” when one of my ideas struck him as particularly ludicrous. And I will miss his broad smile and teary eyes when one of his many mentees made him proud.

All of us who work in hospitals know about life’s end.  But rarely, we meet someone whose inner force looks inextinguishable, whose vitality appears invincible, who seems immune to the mundane laws of biology and the universe that govern the rest of us.  Jack was such a person, which perhaps explains why those of us who had the privilege of knowing him are grappling with his absence.

Our sincere condolences to Jack’s wife, Dr. Marsha Nunley of our medical staff, and family, including our own Craig Vercruysse, Jack’s son-in-law and the father of his youngest grandchild.

In Blackwater Woods (by Mary Oliver)

CPMC’s Olympic Ties

Like many of you, I suspect, I watched more of the Olympic Games this summer than I thought I would.  Though my personal athletic skills are best described as “under-developed,” I was still absorbed by the drama of the competition and, I hesitate to admit, the daily medal count.  My favorite moment occurred when the tiny nation of Bahamas (population: 316,000) won the men’s 4 x 400 meter relay, beating us (meaning, the U.S.; population: 314 million) on the last lap.  I was OK with that victory because I knew that we had already passed China on the medal leader board, though Australia (population: 23 million) won on a medals per capita basis (we were eighth).

Shannon Rowbury

But did you know about our (meaning CPMC; population: around 7,000) connection to the London games? Shannon Rowbury, whose mom Paula Rowbury is program supervisor for CV, Diabetes and GI Services, finished sixth overall in the 1,500 meter race, in a time of 4:11:26, only about one second behind the gold medalist. Her finish was the highest by an American, and bested her own performance in the 2008 Olympics in Beijing, where she placed seventh. Although many Olympians begin their careers at an early age (3, in the case of some gymnasts!), Shannon didn’t start her running career until high school. She hasn’t slowed down since, and there’s hope that she’ll compete again in the 2016 Games in Rio de Janeiro. Congratulations to Shannon and her proud mom Paula.