President Wagner visits Carter Center
programs in Africa

A delegation from the Carter Center that included Emory President James Wagner visited three countries in sub-Saharan Africa in September to call international attention to health needs among impoverished communities.

The delegation, which included James and Debbie Wagner, Jimmy and Rosalynn Carter, Carter Center Executive Director John Hardman, and Chair John Moores, visited Mali, Nigeria, and Ethiopia to meet with national leaders and ministers of health, assess existing Carter Center programs, acquire funding for continuing challenges, and explore areas of collaboration. The Carter Center has programs in thirty-five African nations working against illnesses such as Guinea worm, river blindness, and trachoma.

“We believe good health is a basic human right, especially among poor people afflicted with disease who are isolated, forgotten, ignored, and often without hope,” Carter said. “We have the tools and knowledge to stop future suffering from these crippling plagues of poverty and the moral obligation to do so.”

Carter pointed to the significant progress that has been made in Ethiopia against trachoma, a bacterial conjunctivitis that causes the eyelashes to turn inward and scratch the cornea. The disease is spread largely by flies and is the leading preventable cause of blindness in the world.

“We began our trachoma program in October 2000 with just a few people treated. This had increased to more than one hundred thousand by 2003, and our target this year is one million,” Carter said. “These efforts include teaching people to wash their faces, training health personnel to perform surgery on eyelids, distributing antibiotics, and encouraging the digging of latrines.”

Meeting with national leaders was productive, said Wagner, but the most inspiring part of the trip was spending time with local residents in a remote Ethiopian village.  

“Standing among the families of Mosebo, exchanging smiles and enjoying the dancing and music presented for our benefit, I felt gripped by an eagerness to help provide access to a better life,” Wagner wrote in an account of the trip. “Not an American or a Western life, but a better Ethiopian village life. To do so, it will be important to listen for the desires and needs of the people and to enable solutions without succumbing to the temptation to define needs in our own terms. Much remains to learn and to do.”— M.J.L.

Creating a “bold and imaginative”
medical school curriculum

Medical schools often teach the basic sciences first, approaching diseases and organ systems from the molecular level up. Only after a year or more of coursework are students finally allowed to hone their clinical skills by working with real patients.

Emory’s School of Medicine plans to flip that model on its head. After all, says Professor of Physiology T. Richard Nichols, doctors first encounter a patient, not a virus or a cluster of abnormal cells.

"We decided to be creative about it and to propose a new idea of giving medical students a conceptual coat rack on which to hang all of the information they receive," says Nichols, who served on a committee charged with creating a groundbreaking new curriculum for the medical school. "We will start at the level of societal and environmental concerns, of public health, bringing some of the greater global issues into the educational process. Then, following some case presentations, we will begin teaching the framework of the human body--the behavioral level down through the major regulatory systems, the organ systems and how they interact--and finally what is happening at the cellular and molecular levels."

In the fall of 2004, Dean Thomas Lawley issued a challenge to himself and others in the School of Medicine: to design a "bold and imaginative" curriculum that could serve as a model to medical schools worldwide and would use all of Emory’s strengths to produce "the type of graduates we desire."

Revising the medical school’s curriculum began with a simple question: "What do future doctors really need to know?"

Lawley and Professor of Medicine Jonas Shulman, senior adviser for curriculum development, held discussions with chairs and course leaders and visited other medical schools, including Harvard, Stanford, and the University of California, San Francisco. A steering committee was established and town hall meetings were held with students and faculty.

"We wanted to graduate not only good doctors but also leaders in their field who are broadly trained and able to see new connections," says Nichols. "We don’t want to kill creativity; we want to enhance it."

Medical school curriculums traditionally are defined by two stages--basic science years (M1 and M2) and clinical years (M3 and M4). But Emory’s new curriculum, which will be phased in beginning in 2007, will integrate basic sciences and clinical care throughout, says Professor Carlos del Rio, co-chair of the steering committee.

The proposed curriculum has four main components:                     

Foundations of Medicine: This fifteen-month phase will be heavily case-based, taught by both clinicians and scientists. Public and predictive health and small-group problem solving will be emphasized. Clinical experience will be included from the start, and students will work in healthcare teams that might include nursing students or physician assistant students. Volunteer service will be expected.

Applications of Medical Sciences: This year-long phase will be divided into four or five major blocks, each preceded by a one-week intersession focusing on basic knowledge and clinical skills specific to the discipline. A scholarly approach to patient care and faculty/student interactions will be maximized. Students will spend time with clinical teams at Grady, the Veterans Affairs Medical Center, Emory University Hospital, or Crawford Long Hospital. Board exams will take place at the end of this phase.

Discovery: This five- to ten-month phase will be dedicated to scholarly pursuits, including basic research, clinical research, or public health research. Students will be able to choose to complete the discovery phase at Emory, at other facilities in Atlanta (such as the Centers for Disease Control and Prevention or the Carter Center), or at institutions such as the National Institutes of Health. A scholarly manuscript will be required, and students will be encouraged to present at national meetings and publish in peer-reviewed journals.

Translation of Medical Sciences: This four- to nine-month phase will include three required clinical rotations: a subinternship in medicine, pediatrics, surgery, or obstetrics and gynecology; an emergency medicine rotation; and a critical-care unit rotation. A mandatory "capstone course" will come after students are matched with their residency programs and will provide instruction in recent advances in medical science. The course will address working with other health professionals as well as medical, legal, ethical, and economic issues.

The new curriculum is highly collaborative, from inception to execution. Joint degrees such as the MD/MPH or the MD/MBA will continue to be possible, especially when combined with a fifth year of study.

"This curriculum offers a highly individualized experience for every student," Shulman says. "For example, let’s say a student is interested in intra-urban care. She can work at a clinic and take courses within the School of Public Health. Or, if a student is interested in vascular biology, he can spend time in the lab, perhaps even going for a Ph.D."

Close contact with faculty members is achieved through mentoring and observation in a clinical setting.

"You learn professionalism by example," says Associate Professor William Eley, an oncologist at the Winship Cancer Institute and associate dean for medical education. "We want students to keep high on their radar that we are a place that treats patients humanely. The relationships built between doctors and patients are essential to the joys of medicine."

The curriculum’s case-based approach to teaching, Eley says, is the best way for students to remember the massive amounts of information they are expected to retain.

"Medical knowledge is increasing exponentially. No one could keep it all in their brain," he says. "But talk to physicians, and they’ll remember patients they saw twenty-five years ago and talk about their cases as if it were yesterday."

Kate Heilpern, assistant dean of student affairs and associate professor in emergency medicine, says, "medicine is transitioning from a paternalistic view to a more inclusive, collaborative approach." A new curriculum is vital "if we want to skate where the puck is going."

Service to the community--be it global or local--is emphasized. All students will spend at least three weeks providing care to people without access to adequate health services.

"Whether that means participating in a medical clinic in rural Georgia or in rural Uganda . . . the students aren’t just observing, they are part of the process," says Assistant Professor Neil Lamb of the Department of Human Genetics. "It’s just a tantalizing taste of the benefits and responsibilities of working with underserved populations. Hopefully, they will continue this type of work."

The proposed switch to the revised curriculum coincides with completion of the new $55-million medical education building, set to open in June 2007. --M.J.L.

Candler School of Theology’s rare commitment to the teaching of evangelism has been recognized with a second endowed chair, the Daniel and Lillian Hankey Chair in World Evangelism, established last summer by the Hankeys with a gift of $2.5 million.

"The Hankeys’ remarkable gesture secures Candler’s leadership place in evangelism and mission," says Dean Russell E. Richey.

The Hankey Chair is the first given to Candler by a living donor in twenty years, joining the Arthur J. Moore Chair in Evangelism. The holder of the chair will teach courses in evangelism, lead a contextual education group, and work closely with the World Methodist Evangelism Institute (WMEI), a cooperative ministry of Candler and the World Methodist Council that trains evangelism leaders.

The Hankeys have longstanding ties to the University. They met for the first time in the rather unromantic setting of an Emory biochemistry lab; Lillian was working in the Department of Biochemistry in 1948 when Daniel came to Atlanta and Grady Hospital as a medical resident. Daniel was chief resident of internal medicine at Grady from 1950 to 1951, served in the Korean War from 1951 to 1953, and returned to Atlanta to practice medicine until 1980.

Following Daniel’s retirement, the couple began a twenty-three-year leadership involvement with the WMEI. Daniel has attended some forty of the institute’s regional and international seminars and has worked with thousands of emerging church leaders. Hundreds of students from Candler and other theology schools have participated in WMEI programs around the world.

Soon after the Hankey Chair was announced, Candler received another, unexpected gift from the estate of Fletcher and Evelyn Rodgers, a couple with no close tie to Emory other than a nephew who graduated from Oxford and the School of Medicine. Unbeknownst to any beneficiaries, Rodgers left $3.1 million to twelve United Methodist-affiliated institutions, including Candler, which is to receive nearly a half-million dollars.--P.P.P.

Art is one thing viewed in the pages of a book or as a slide on the wall, but it’s quite another to see it up close. That’s why art history professor James Meyer took his entire class on “The Art of Robert Smithson” to visit the Smithson exhibition at the Whitney Museum in New York City last fall.

“In teaching art history, there is no substitute for the experience of actual works of art,” Meyer says. “Smithson is best seen in person. It’s sculpture, something that needs to be experienced with your body and eyes.”

Meyer, who co-teaches the Smithson course with comparative literature professor Claire Nuve, planned the class in conjunction with the Whitney show and used the exhibition catalogue as a course book. The class trip was funded by Emory College, the Center for Teaching and Curriculum, and the art history department.

“It’s all part of a broader endeavor to bring students to art and art to students, to overcome the limitations of being far from centers of art,” Meyer says. “I’m pleased that the College understands the importance of this and backs us up.”—P.P.P.

There’s a new Eagle soaring at the George W. Woodruff Physical Education Center, and it carries a fresh sense of energy and excitement that’s infusing the athletic programs from varsity basketball games to salsa cardio classes.

The renewed Emory Eagle athletic logo was developed last year in conjunction with several sweeping changes at the “WoodPEC”: a new director of athletics, Betsy Stephenson, arrived in July (see Emory Magazine, Winter 2005), and an 80,000-square-foot top floor transformed the facility inside and out. In addition to keeping out the rain (the old roof leaked), the addition offers four permanent indoor tennis courts, as well as an area that can serve for basketball, volleyball, or tennis. But one of the most significant physical changes is the relocation of all exercise equipment to the fourth floor, to a new “fitness corridor” lined with TVs.

The result, says Myra Sims, assistant director of athletics and recreation, is that the fourth floor “has become the hub of all non-varsity activity in the building.”

Riding the wave of enthusiasm that accompanied the renovation and Stephenson’s arrival, a committee of representatives from all over campus was charged with developing a more modern Eagle logo that better represented the high quality of Emory’s NCAA Division III athletics program.

The eagle was originally chosen as Emory’s mascot in 1960 by student David Kross 62C , then sports editor of the Emory Wheel . Failing to drum up significant interest in the process from fellow students, Kross chose the majestic bird himself because “it was just alliterative, and it sounded good,” he told Emory Magazine in 1996. “Also, it was short, and it was almost the same number of letters as in [Emory], so it looked good, too. It didn’t take up a lot of room, it was easy to say, and eagles can be reasonably hostile, even though we were not very hostile in those days as athletes. But eagles can be reasonably mean when they are provoked.”

The current logo committee also sought a design that was aggressive but not mean. They enlisted the help of Philadelphia-based Joe Bosack Designs to develop a look that was consistent with Emory’s identity and conveyed the seriousness of University sports. Bosack took the assignment so seriously that he visited eagles in zoos to study their appearance.

“We were interested in having the eagle capture the attributes of Emory athletics, what makes our athletes distinctive, and the high quality of the program,” says Jan Gleason, who chaired the committee. “A big part of this was about getting a stronger look and creating more excitement for athletics on campus.”

The bold, sleek new logo, which packages the Emory name into the design, already has sparked school spirit among Emory athletes and spectators. Students have developed a new “E-rewards” program, similar to a frequent flyer offer, through which students who attend games get a card punched a receive prizes such as T-shirts and hats—featuring, of course, the new Eagle. A “pep band” also has formed to play at competitions.

“It’s been very well received,” says Sims. “We’ve seen a real increase in the number of fans and the excitement at games.”

The new Eagle “is a great legacy for Emory athletics,” Gleason agrees. “People like the look of it and feel good about wearing it on a shirt.”

In addition to varsity sports, the WoodPEC has a thriving community of non-varsity athletes, from students taking yoga classes to faculty swimming laps in the Olympic-size pool. Alumni are eligible to join the WoodPEC and take advantage of a wide range of fitness classes, as well as play in intramural sports leagues. To learn more, visit http://www.emory.edu/sports_recreation.cfm. —P.P.P.

In the waiting area of Cleopatra’s Beauty Spa in Atlanta’s South DeKalb Mall, alongside the hairstyle photo books and celebrity magazines, is a stroke-prevention guide.

“Salons are an untapped area in terms of educating African American women about their health,” says Sharion Smith, an Emory research nurse based at Grady Memorial Hospital. “If you’re sitting there for an hour doing braids, why not spend that time talking with women about something meaningful?”

The Beauty Shop Stroke Education Program is a pilot study designed to inform African American women about the risk factors and warning signs of strokes, the third-leading cause of death behind cancer and heart attacks.

Strokes claim about 162,000 lives each year; African American women have almost twice the risk of white women.

Stylists who have been trained to take part in the program speak with customers about risk factors—age, ethnicity, high blood pressure, smoking, and diabetes—and warning signs. Clients are given cards with a list of symptoms (numbness, weakness, or paralysis of the face, arm, or leg, especially on one side of the body; confusion, trouble speaking or understanding speech; dizziness, difficulty walking, or vision problems; a sudden severe headache), as well as other educational materials like posters, cookbooks, and the current issue of Stroke Connection magazine.

“We wanted a comfortable, non-clinical environment to get the information out to women, who then take it home to their families,” says Smith.

Michael Frankel, chief of neurology at Grady, is leading the Atlanta project, and Smith is the stroke research recruitment coordinator. A dozen hairdressers in Atlanta, Decatur, and Stone Mountain are involved.

One of the participants, Carolyn Moreland, owner of Hair Sculpture in Atlanta, suffered a stroke in 2001.

“I’m a living witness for my clients,” Moreland says. “If it can happen to me, it can happen to them. Now, they know the signs and that they should go to doctors to have themselves checked out.”

The program is funded by a two-year, $60,000 grant from the Hazel K. Goddess Foundation. Even after the study e nds, the researchers hope beauticians will keep spreading the word about how to prevent strokes.

“When you know better,” Smith says, “you do better.”—M.J.L.

“We have an opportunity through the Ellmann Lectures to bring one of the world’s finest novelists into our company,” says Goodrich C. White Professor of English Ronald Schuchard. “I feel certain that in the next few years Mario Vargas Llosa will be named a Nobel laureate. What he’s done for Peruvian and Latin American literature is phenomenal.”

Vargas Llosa joins a notable list of previous Ellmann lecturers that includes Seamus Heaney, A.S. Byatt, David Lodge, Wole Soyinka, and Salman Rushdie--a group that Schuchard says practically comprises “the pantheon of the best literary minds of our time.”

On the heels of these lofty predecessors, Vargas Llosa continues to expand the intellectual scope of the lecture series. His appearance is of particular interest to students of Latin-American Studies and members of the Latin-American community in Atlanta, both because the bulk of his work originally was written in Spanish and because he came very close to winning the Peruvian presidential election in 1990.

Vargas Llosa was born in Arequipa, Peru, in 1936 and lived with his mother and her middle-class family until the age of ten, when his mother fled to Lima to reunite with his father, to whom she was married, but who had abandoned her during her pregnancy.

After studying English and law at the National University of San Marcos and receiving a Ph.D. in 1959 from the Complutense University of Madrid, Vargas Llosa embarked on a writing career in which he explored issues of social and ethnic identity. His first novel, The Time of the Hero , was published in 1962 and immediately launched him into the vanguard of Latin American writers. Other notable novels include The Green House (1966), Conversation in the Cathedral (1969), The War at the End of the World (1981), and, most recently, The Way to Paradise (2003).

In 1990, after years of severe economic hardship for Peru, Vargas Llosa ran for the presidency, but lost ground to his opponents in the last months of candidacy. He won the largest percentage of the general election, but lost in a run-off to Alberto Fujimori. In 2000, Fujimori, amid mounting scandal, resigned and fled to Japan; he is currently detained in Chile as Peru attempts to extradite him on charges related to corruption, human rights violations, and his 1992 dissolution of the Peruvian congress.

Consistent with Vargas Llosa’s political interests, his lecture series, “Three Masters: Cervantes, Borges, and Ortega y Gasset,” will address a major Spanish philosopher alongside two writers.

“I think its good to have a person come in like Vargas Llosa who makes us look up out of ourselves, beyond our daily academic concerns and territories, and see how he cuts across so many fields,” says Schuchard.

In this sense, Vargas Llosa lives up the legacy of Richard Ellmann, the prominent literary critic and visiting Emory lecturer in whose honor the lecture series was founded.

“Each year he came to Emory he always brought a new lecture on some modern figure. And they were always wonderful lectures that drew people out not just from literature and the humanities, but from all over the University, because he was able to speak about serious literature elegantly and with no jargon to general audiences,” says Schuchard.

“When many colleagues from around the country heard that we were bringing Vargas Llosa here, they were in disbelief,” says Schuchard. “The Ellmann lectures are known as one of the great venues for writers to speak in.”--D.M.S.

Around the world, children work in sweatshops, are sold into brothels, and are forced to take up weapons and fight in armed conflicts. They lack proper health care and are among those most vulnerable to disease, starvation, poverty, and abuse.

Despite heroic efforts, children remain the most “voiceless, voteless, and vulnerable” members of society, said John Witte Jr., director of Emory’s Center for the Study of Law and Religion (CSLR). “Katrina made it shockingly clear that these children are our neighbors. We intend to ask a number of hard questions about children’s rights.”

In the fall, the CSLR convened a conference on the theme of   “What’s Wrong with Rights for Children?” to address these issues. The conference brought to the School of Law a high-powered gathering of human rights advocates, politicians, lawyers, and academics, including law professor Jaap Doek, chair of the United Nations Committee on the Rights of the Child; Canadian Senator Landon Pearson, who guided the preparation of that country’s national plan for children; and former President Jimmy Carter, Emory distinguished professor.

Much of the discussion was centered on the U.N. Convention on the Rights of the Child—an international treaty that guarantees certain universal rights for children. Every country in the world except Somalia and the United States has ratified the convention, even though the U.S. played a leading role in drafting it.

In America, the international treaty fell victim to misunderstandings and “culture wars,” said Jeremy Gunn, a senior fellow at the CSLR and director of the Freedom of Religions and Belief Program at the American Civil Liberties Union.

“Some believed it would undermine the rights of parents,” Gunn said. “It was largely a reaction of fear rather than one where all the issues have been thought through carefully. People wondered if children were going to be able to sue their parents, or if parents would be able to discipline their children.”

Entrenched resistance, said former President Carter, came from groups with strongly held religious convictions and from our country’s reverence for autonomy and aversion to “any interference by foreign governments or organizations,” including the U.N.

Carter, keynote speaker at the conference, says he is hopeful that children’s rights advocates can enthusiastically work together to help the world’s children by implementing parts of the agreement, whether or not it is ratified.

“I was surprised when I reread the convention this morning as to how broad and far-reaching it is,” Carter said. “I would encourage every parent and grandparent to read it.” (The document may be viewed here.)

The convention stipulates not only that every child has the right to be free from abuse and exploitation, but that children also should have freedom of expression, social and economic rights, and a minimum standard of health care, education, and nourishment.

“Unnecessary suffering can be helped. Diseases can be eradicated,” Carter said. “The approach we must take is peace, justice, generosity, respect, and active help for little children who are in need.”—M.J.L.

Emory is making progress in accommodating mothers who wish to work while continuing to feed with breast milk, with plans underway to place lactation rooms within walking distance of all university employees.

The staff concerns committee of the President’s Commission on the Status of Women (PCSW) decided to highlight lactation support for the 2004-05 academic year when they learned Emory lagged behind corporations and other educational institutions in providing support to nursing mothers.

“If you look at a lot of our benchmark institutions, they’re doing this,” says PCSW Junior Chair-Elect Susan Carini 04G, executive director of University Publications and former chair of the staff concerns committee.

Interest in providing better accommodations for breastfeeding was widespread within the Emory community.

“When we started talking about this topic, there were a number of people who wanted to join the commission and join this specific effort,” says PCSW Chair Allison Dykes, senior associate vice president of the Association of Emory Alumni “So we felt we had touched on something that made a lot of sense for the Emory community.”

At the time, two lactation rooms were in place at Emory, one at the Women’s Center and one at the School of Nursing—but with Emory’s large central campus and array of outlying campuses, the rooms were not close enough to most employees to be of practical daily use.

Jennifer Leavey ’01G, who was a postdoctoral fellow in the Division of Endocrinology when she had her child, was lucky enough to be close to the lactation room at the Center for Women.

“Returning to work after having my first child was a scary and taxing time,” says Leavey. “Adjusting to my new responsibilities as a mother while resuming my tasks in the workplace often left me feeling inadequate. It was an indescribable relief to have a dedicated location at work where I could not only pump breastmilk for my baby but also grow into my role as a working mother.”

PCSW Secretary/Treasurer Lisa Newbern (left), chief of public affairs for the Yerkes National Primate Research Center adds, “This was a very immediate issue for me at the time because I was breastfeeding my daughter.” Thanks to the commission’s efforts, there is now a lactation room at Yerkes.

The new Human Resources Lactation Support Program sets the goal that “nursing mothers are able to find a lactation room within reasonable proximity to all areas on campus.” It additionally stipulates that lactation rooms must at least be considered in planning any new structure or major renovation.

With the support of Executive Vice President for Finance and Administration, Mike Mandl, the University has pledged physical space for lactation rooms and a grant of $25,000-30,000 to make necessary renovations.

By autumn 2005, six lactation rooms were in place at Emory, and while the PCSW had not yet conducted a publicity campaign to encourage use of the facilities, an estimated twenty mothers already are taking advantage of the rooms.

Although this accomplishment directly affects only a small group, members of the PCSW take a long-range, pragmatic view of their work, believing that such initiatives ultimately benefit the entire Emory community. If other institutions have better support systems for women, Emory risks missing out on female talent.

“After all of the resources that go into training staff and faculty members, it seems like a waste to have women quit working because they are unable to fulfill fundamental requirements for their babies and work at the same time,” Leavey says, “Lactation programs are a great way to show women their skills are valued and to help them manage a balance between work and family.”

While the Commission has made progress in its mission of enhancing the status of women at Emory and studying issues pertaining to female staff and faculty, Junior Chair Nadine Kaslow—like other members of the commission—ultimately is interested in the health of the broader Emory community.

“If policies are going to be friendly to women it will only be true if they’re friendly to everybody,” says Kaslow. Building upon this idea, the commission will use this year to focus on a theme of work-life integration—an issue where the needs of men and women frequently overlap.

“The work-life integration theme gives us a chance to really, if not stay current with out peers, leap ahead,” says Carini. “The whole idea for the president is to make Emory a destination university. The idea for the commission if to make Emory a destination university for women.”

Nationally, about one in five coronary bypass operations are now done on beating hearts.

Known as “off-the-pump” surgeries because they don’t require rerouting the patient’s blood through a heart-lung machine, the technique—and Emory heart surgeon John Puskas—were featured in Newsweek in July 2005.

“It’s a beautiful operation,” says Puskas, who has performed the procedure nearly two thousand times since 1996. In a beating-heart bypass, as in a traditional bypass, the surgeon takes arteries from the patient’s arms or legs, connects them to the aorta, and bypasses blocked coronary arteries. But only the tiny area of the heart being worked on is immobilized.  

Whether to go on or off pump is hotly debated in the field, with some cardiac surgeons standing by the traditional method.  

In a review by Puskas of nearly two hundred cases, off-pump patients lost less blood during surgery, had less damage to their hearts, left the hospital one day sooner, and recovered more quickly than their on-pump counterparts.

Nearly 140,000 bypass operations were performed last year—21 percent of those on a beating heart.