The long and remarkable career of Leonard A. Fasano, MD
New Haven lost one of its hometown heroes when, on July 31, 2011, Leonard A. Fasano, MD died at the Hospital of Saint Raphael at the age of 84.
Fasano, who earned his medical degree from New York Medical College in 1955, was the husband of Camille Librizzi Fasano, father of Valerie Maribella and State Sen. Leonard Fasano (R-34), and brother of Judge Roland D. Fasano, Victor Fasano and the late Eugene Fasano. He is also survived by six grandchildren.
Fasano, who was associated with both Yale-New Haven and Saint Raphael’s hospitals, established the Fasano Center for Internal Medicine at 980 Whalley Avenue, where he practiced internal medicine for more than half a century. The practice, now known as the Center for Internal Medicine, is headed by Kandiah Sritharan, MD.
“My father was unbelievably supportive, no matter what you did,” says Len Fasano, the physician’s only son. “For my sister Valerie and me, he was always there whenever you needed him. I think he always believed that people are extraordinarily important, no matter what their background or part of society they came from, and he taught me this. I guess that’s why I went into politics — to help people.”
Fasano says his father loved New Haven and Yale University.
“He loved the traditions of Yale football,” notes Fasano, himself a Yale graduate who played football under legendary coach Carmen Cozza.
Fasano says his father didn’t mind that he chose law over medicine, though the younger Fasano was initially interested in medicine.
“He was always a frustrated lawyer,” says Fasano, noting that his own grandfather was a lawyer as well as his father’s brothers. “He always felt free to give legal advice because he felt he knew the law. He was part of that generation that had respect for society, for politics, for judges and for lawyers. He always told me that every judge he treated was never called by their first name. It was always ‘Judge So-and-So.’ He felt that they earned that title and that respect.”
The younger Fasano revealed his interest in medicine later, when as a state senator he sponsored and helped to pass legislation to create a Connecticut Umbilical Cord Blood Collection Board to establish a statewide umbilical cord blood collection program. The technology allows families and individuals to tap into rich nutrients provided by umbilical cord blood for future use in many treatments as well as a source of stem cells that is an exact genetic match to a baby, with no risk of rejection.
“He loved to play tennis nonstop, every day, but he wasn’t a golfer,” says Fasano. “He was always up for a game of touch football, even into his late 70s. He loved Matt Sanchez, who plays for the New York Jets, though he’d be very disappointed today, seeing that he didn’t pan out [the Jets finished their 2012 campaign with a 6-10 record]. He loved the New York Giants as well and always loved Yale football, especially when I was playing for Yale. He was very close to Carm Cozza, whom he considered a very dear friend.”
Fasano says his father’s gentle nature was something his patients admired.
“He was a doctor that people looked up to, maybe more so then than they do now,” adds Fasano. “But he never felt he was ever above anybody. He talked to anybody from any part of society and I marveled at that ability in him. I think he showed his patients those qualities.”
“He was a very thoughtful diagnostician,” says Edith W. Kufta of New Haven, who was a patient of Fasano’s from 1964 until his death. “One of his patients told me that he was on the phone with Dr. Fasano one day talking about his own illness when his wife began coughing in the background. Dr. Fasano wanted to know how long she’d been coughing and told the man to bring his wife in. The man said that Dr. Fasano diagnosed her and cured her. That was the kind of man he was.”
In one of her own experiences, Kufta’s daughter woke up with severe pain in her stomach so she took the girl to see her own doctor who then referred her to the emergency room at the hospital in New Haven. They failed to diagnose her condition so a friend recommended that Kufta bring her daughter to Fasano.
“He examined her and diagnosed her as having the grippe, an old-fashioned term” for influenza, says Kufta. “But he was right and after treating her, she was cured. He treated me for 47 years and always determined what was wrong with me. One time, I had a bad cough that went on for many days and went to see him. He examined me and discovered I had whooping cough. He actually reported it to one of the medical journals noting that several others of his older patients had it. He feared that it was an epidemic among elderly people. Eventually the journal editor agreed with him and alerted the rest of the medical community.”
“He was always interested in his patients’ concerns and talked to them about all aspects of their lives,” adds Kufta. “I’m sure that all of his patients will agree with me when I say he is sorely missed.”
Physician/entrepreneur Feuerstein thinks big. But his latest project is a minor miracle
If you knew Seth Feuerstein, you might have guessed BNH would select him as a Health Care Hero for his work in the local health care and biotechnology industries. He spends a lot of his time these days working with Cobalt Therapeutics with clinician researchers from several universities including Yale to improve access to mental health care in primary-care groups, the military and Veterans Administration, through insurers, health systems and accountable care organizations, and he has played roles ranging from co-founder to investor to board member at companies such as Affomix, Biorelix, Carigent Therapeutics, Cobalt Therapeutics, Elm Street Ventures, Hadapt, HistoRx and North East Life Sciences.
You might also guess we’d recognize him for his work as a member of the clinical faculty at Yale where he supervises and interviews residents and is much sought for his opinions and advice on complex legal matters where psychiatric illness may play a role.
It turns out we chose him for something else entirely: a non-profit he founded called Little Wonder that he hopes will improve the experience of those undergoing cancer treatment.
“Little Wonder grew out of some of my life experiences and a moment when I realized what I knew from each of those experiences might improve people’s experiences and those of their loved ones,” Feuerstein explains. “We have had great support from various local groups including Smilow Cancer Center and the clinicians there and athletic programs such as New Haven Open [as well as] Quinnipiac and Yale athletics.”
Through Little Wonder, those undergoing treatment for cancer at Yale-New Haven’s Smilow Cancer Hospital can receive tickets to attend local shows, performances, concerts and sporting events.
Smilow social worker Denise Armstrong calls the Little Wonder program a “Godsend” for cancer patients who come to radiation therapy every single weekday for weeks on end.
“Complimentary tickets to cultural and sporting events is a pleasant distraction from their illness that they can share with family and friends,” Armstrong says. She adds that the program will be expanded to other areas of Smilow in the near future, so not only patients receiving radiation can take advantage.
Long Wharf Theatre was among the first to sign on with the new program.
Long Wharf spokesman Steve Scarpa says that when Feuerstein approached the theater with the idea, it seemed very much like something the regional theater would want to participate in. “One of the things that theater provides among many things is respite to take your cares away, or in this case, to empathize and see the world through a different prism,” says Scarpa. “If we can provide for a moment for these people something positive or good or thoughtful in some way, we’re delighted to be able to do it.”
“The team at Long Wharf Theater has been incredibly supportive as we built the website and got things rolling,” says Feuerstein. His wife Sharon also volunteers with the organization, making sure tickets and patients are getting linked, and their children recently committed donations to Little Wonder (and other charities) in lieu of receiving some Hanukkah gifts.
“Cancer treatment is an often rigorous, disruptive and all-consuming period,” Feuerstein. “Patients often go on a nearly daily basis for weeks and weeks. They are often so focused on their treatment that everything else — including planning enjoyable, distracting experiences with loved ones — gets drowned out.
“Many of these patients will survive; some will not,” he adds. “My hope is that in all cases they will share powerful experiences and create lasting memories with those they care about. I also do it because I believe and hope it helps people do better to be able to smile and enjoy some of their time during the process.”
Feuerstein had the idea to start Little Wonder several years ago when two of his jobs collided.
“When I was in medical school I had two part-time jobs,” he recounts. “One was working in the student activities office at NYU. We had tickets to everything ranging from Broadway shows to the Metropolitan Opera to Knicks games.”
It was there that he learned that cultural institutions and season ticket holders are often unable to use their tickets. In the case of NYU they would be donated and students would be able to attend events otherwise beyond their means. Other experiences exposed him to the rigors that patients and their loved ones face while enduring cancer treatment: dealing with insurers, scheduling appointments, balancing family and friends, figuring out who to tell, what to tell them.
“The list goes on and on,” he says. “Carving time out and purchasing tickets when each day is an unknown is generally not occurring.
“I believe people are generally interested in helping others but often need a little help or facilitation to make it easier for them,” Feuerstein adds. So he designed the site to allow venues such as Long Wharf to make patients aware of tickets they are generously offering and facilitate access on short notice for them and loved ones.
“In a perfect world, a patient might be completing a treatment and log in at the hospital and see four tickets for that evenings performance at, let’s say, Long Wharf,” Feuerstein explains. “They can call their spouse, get the kids and in a couple of hours be enjoying an evening at a world-class venue and performance.”
Long Wharf Theatre, the Shubert Theater, Yale athletics, Quinnipiac athletics are among the venues that have already signed on with Little Wonder, but Feuerstein is on the hunt for more.
Three families receiving care at Smilow were able to see Shrek: The Musical at the Shubert over the holiday break, and since the Yale and Quinnipiac hockey teams were both ranked in the top ten in the nation early this season, his efforts are allowing patients to see many future NHL hockey players in the coming months.
“If people out there know of venues who might be willing to participate or season ticket holders who sometimes have extra seats, please send them our way so we can facilitate access,” Feuerstein says. He also hopes to sign up other cancer centers in Connecticut.
“The value of this is a way for people in the entertainment industry to give back in a very small way,” says LWT’s Scarpa. “It’s a way to fulfill a primary function of arts and sports. It’s a way for us to bring people in and give them a night out. That can’t be underestimated sometimes. We know it’s not everything, but it’s a way to give people a break, a way to just take their mind off of things.”
Little Wonder lets people live like people for a bit, and not like patients.
In pioneering a new model of patient care, Griffin Hospital is a trailblazer
Griffin Hospital, a not-for-profit, tax-exempt subsidiary of the Griffin Health Services Corp., is a 160-bed acute care community hospital serving more than 100,000 residents of the lower Naugatuck Valley. It also serves as the flagship hospital for Planetree Inc., an international leader in patient-centered care that has received national recognition for creating a facility and approach to patient care that is responsive to the needs of patients. Griffin has more than 280 active and courtesy physicians who have admitting privileges. It is affiliated with the Yale School of Medicine and accredited by the Joint Commission.
Griffin is recognized for having industry-leading patient satisfaction ratings and has received numerous quality and clinical excellence awards. It is the only hospital to be named on Fortune magazine's “100 Best Companies to Work For” list for ten years running, and was the only Connecticut hospital named a "Top Quality Performer" on key quality measures by the Joint Commission in 2011.
Planetree is a consumer health-care organization dedicated to humanizing health care. The planetree, or sycamore tree, is the tree under which Hippocrates, the founder of modern medicine, sat when he began teaching his medical students in ancient Greece. In 1992, the hospital instituted Planetree, an innovative model of health care that puts patients' needs first.
In Planetree’s patient-centered approach to health care, providers partner with patients and their family members to identify and satisfy the full range of patient needs and preferences. The program counts several hundred hospitals and health-care organizations in the U.S., Canada, South America and Europe among its members.
“I’ve seen a lot of changes since the Planetree program began,” says William Richter of Oxford, a former member of the hospital’s Community Advisory Council and a volunteer there for the past 14 years. “With the council, we got together once a month to talk about what we observed, what patients may have told us or what we heard around the hospital. We look at the feedback to see if something works or doesn’t work. We’ve gotten good feedback on the program.”
Richter says the council sees patient comments received by various means, including his own observations in his role as an ambassador for the volunteer program, in which he greets people at the door and guides them to their destination in the hospital. He says the hospital is well-received in the community. He says Griffin keeps up with the bigger hospitals but they are more like “home” and very patient focused.
“Customer service here is great,” he adds. “If we find something on a survey that doesn’t look great, we bring it up at our council meeting and at the next meeting, they’ll have it all squared away.”
Susan Frampton, president of Planetree, which is headquartered at Griffin, says the program is one of the reasons Griffin remains one of the best places to work and that it has had many positive effects on the way the hospital treats its patients and conducts business.
“Probably, the most important influence of Planetree has been on the organizational culture,” says Frampton, who earned her bachelor’s degree from Rutgers and her Ph.D. from UConn, both in medical anthropology. “We’re involved in working with hospitals and long-term care settings to help to transform their cultures from a provider-centered culture to a patient- and family-centered culture.” She notes that the process begins with input from the hospital staff, patients and families of patients to get a sense of the existing culture.
Frampton says the best way to understand the benefits of Planetree is to visit one of its member hospitals. There, the visitor will find a culture that begins with music in the parking lot, greeters at the door and staff eager to please and make a patient’s stay comforting as well as keeping the patient informed about every aspect of his or her treatment.
“We look for every opportunity to make it a better experience for the patients and their families,” adds Frampton. “It fosters transparency for the patients and allows patients to view their own medical histories and patient records” to answer questions about their condition.
“It’s very much a model that engages patients and their families in their own care process,” notes Frampton.
Patrick A. Charmel, president and CEO of Griffin Health Services Corp. and the hospital, began his association as an intern in 1979 while attending Quinnipiac University. He served in a variety of administrative positions and rose to become president in 1998. He also serves as president of Planetree Inc., a not-for-profit subsidiary of the corporation that supports an alliance of more than 170 hospitals in the U.S., the Netherlands, Canada and Brazil, and over 180 long-term care facilities and ambulatory care centers that are committed to patient empowerment and the delivery of patient-centered care.
During his tenure, Charmel has earned the hospital a reputation as an award-winning innovative organization, recognized as an industry leader in providing personalized consumer-driven health care in a healing environment. Under his leadership, Griffin was selected as the 2008 Top Leadership Team in Healthcare in the nation for community and mid-size hospitals by Health Leaders Media.
Griffin has earned numerous quality, value and patient experience awards from various national organizations that measure and monitor hospital performance. It is the only Connecticut hospital named a 2011 Top Quality Performer by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), which accredits health care organizations in America. The hospital was also recognized by Premier Healthcare Alliance as a winner of the 2010 Premier Award for Quality, placing it in the top one percent of the nation’s hospitals.
Charmel is also president of the board of governors of the Quinnipiac University Alumni Association and a university trustee. In 2011, he received the Distinguished Alumni Award from the Yale School of Public Health. He is a recipient of the 2009 Planetree Lifetime Achievement Award.
Charmel is co-author of Putting Patients First: Designing and Practicing Patient-Centered Care (Jossey-Bass, 2003), which received the American College of Healthcare Executives health care book of the year award in 2004. A second edition of the book was published in October 2008.
“I’ve known Patrick since he was my student intern when he was a junior in the health-care program at Quinnipiac,” says William C. Powanda, the hospital’s vice president. “He’s a humble, self-effacing natural leader who leads by example and his personal values dictate how he manages. He’s passionate about excellence and providing a patient-centered, exceptional experience for every patient Griffin serves.”
Powanda notes that Griffin’s employees, physicians and his colleagues respect him because he is truthful and straightforward.
“Even if you don’t agree with him, you appreciate his candor and the rationale for his position,” adds Powanda. “He would never ask anything of an employee that he wouldn’t do himself. I’m proud to call him a colleague and friend.”
Charmel, who’ll celebrate his 15th year as president in February, says he never imagined he’d one day become the CEO of the very hospital where he had worked as a college intern. He figured he’d work there for several years, then move on to a different organization and work his way up the corporate ladder.
“That’s the typical career progression,” says Charmel, who next month also will mark 33 years at Griffin. “You start in a small- or medium-sized hospital in a junior position and you move up and take on more responsibility because there’s more prestige associated with that. In this organization, I’ve had opportunities to take on additional responsibilities, be progressive, be creative, try new things and, once they’re implemented, actually see some results.”
By contrast, Charmel adds, “In a larger organization, you can exert a lot of effort and not see a lot of positive movement. And that’s a little frustrating, if you’re results-oriented as I am. This is the kind of place where you have committed people who embrace change and are willing to try new things. You can actually turn the dials here and watch things happen. In a large place, you can turn the dials and see no response. From my point of view, this is the ideal place.
“For folks that are really dedicated to caregiving, this is the place that allows them to practice it,” says Charmel. “The model here gets stronger over time as because people are drawn here to work because they are committed to that type of approach.”
Charmel says that Griffin’s employees are prepared to make personal sacrifices to insure that patients get the best possible care in an environment that’s conducive to healing.
“It’s not only in direct caregiving, but also it’s an effort to create an environment for caregiving and that takes a lot of effort,” Charmel explains. ”It’s resulted in our folks getting a real sense of satisfaction because they know that they’re meeting or exceeding the expectations of their patients. Our folks have a great deal of pride in what they give to their patients, and that’s what makes us a great place to work.”
“We’ve got a national reputation and we’re a model for the industry but we’re intimate and a group of committed caregivers that really see themselves as a family,” adds Charmel. “So it’s the best of both worlds.”
Doctors Without Borders nurse volunteer Kelly Grimshaw has traveled the globe to help those who can’t help themselves
Heroism can often be characterized by the willingness do something for others in the face of danger. That much can safely be said of those who volunteer far and wide for Doctors Without Borders.
The privately-funded organization was started in France in 1971 (official name Médecins Sans Frontières [MSF]) as an impartial medical humanitarian organization providing care to people caught in the turmoil of armed conflicts, epidemics, malnutrition, natural disasters or simply dearth of available health care.
The group earned a Nobel Peace Prize in 1999, the same year Kelly Grimshaw joined. Currently a nursing educator in transplants at Yale-New Haven Hospital (YNHH), the 47-year-old Grimshaw always knew she wanted to be a nurse. She earned her bachelor’s and master’s in nursing from the University of Connecticut (in 1988 and 1995, respectively), and was a nurse at YNHH —first on the surgical trauma floor and then the surgical intensive-care unit from 1989 to 1999, when she was struck by the urge to join something larger than herself.
“The drive was partially selfish,” Grimshaw recalls. “An adventure spirit is in many who come to work for the organization. If you want adventure and want to get to know an area, you might as well get to be productive while you’re there. I could just backpack around the world and do my own thing, but I have a skill set that can help somebody else, so why not help out?”
It was while packing to volunteer in the Amazon rainforest for a small organization in Peru that she got the call for what would be her first MSF mission: a year-long stint working at a tuberculosis clinic in Turkmenistan.
“I called my mother and told her, ‘Mom, I’m going to Peru for three weeks, I’m coming home for a day, and then I’m going to Turkmenistan for a year. Can you pack up my house?”
Grimshaw would take part in nine missions as an active volunteer with MSF through 2009, ranging in length from six weeks to nearly 18 months (spent as a medical coordinator in Angola), and visiting countries as far out as China, Indonesia and many territories in Africa, assisting with civil and ethnic conflicts, the HIV pandemic, and outbreaks of cholera, Marburg Hemorrhagic Fever, meningitis and measles.
In Turkmenistan the MSF team was able to convert a derelict former hotel into a makeshift tuberculosis hospital. Even such makeshift infrastructure as that isn’t always available, and sometimes a tent or simply the back of a pickup truck would have to make do as a facility. She’s worked with as many as 30 fellow expatriates, or as few as four.
She points to her work treating HIV as an example of how MSF has been able to diagnose and treat infections in settings with few resources.
“It used to be that we couldn’t diagnose HIV,” she explains. “Now it’s under every mango tree we can diagnose this disease. We’re bringing more and more of the high-tech [medical devices and procedures] to resource-poor settings, looking at telemedicine and bringing a full-on operating room. There are ventilators, surgical kits, sterilization rooms — it’s all there.”
But MSF volunteers often find themselves in unstable parts of the world, often in the middle of a conflict. The key to safety in most cases, Grimshaw says, is to be aware of what you’re doing and where you are at all times.
“It’s your own behavior” that’s key, she notes. “There are always pockets of suspicion and fear, and they have to be dealt with accordingly with patience and transparency. [Let] people know who you are, where you are, why you’re there. Apologize for making mistakes; all the things you would do to let the community know you’re an honest person.”
Grimshaw recalls an instance shortly after 9/11 when she was working with victims of an ethnic conflict in Indonesia where people in town commonly wore “I Love Osama Bin Laden” T-shirts.
“There I was, an American citizen helping people who were not well-liked in the area. I wasn’t physically threatened, but it was mentally exhausting with people saying things to you constantly,” she says.
But reaction to her as an MSF worker has mostly been overwhelmingly positive, and she’s been rewarded with gratitude and generosity in most cases, whether in the form of an appreciative Thai police officer, a helpful Parisian taxi driver, or a Turkmen grandmother extending an invite for breakfast and vodka.
“It took me three days to tell my parents I was going to Sierra Leone, and then I’m not sleeping because I think I’m going to get shot as soon as I get there, that it will be complete chaos, and then I get to the airport and someone hands me a soda and says ‘Welcome to Sierra Leone,’” she recalls with a laugh.
Eventually, traveling on missions to dangerous destinations became routine: “I came home from Zambia, would take two days off and come back to work and people ask, ‘How was Zambia?’ and I’d just say, ‘Oh, it was fine.’ What else do you say?”
While Grimshaw went on her last mission with MSF in 2009, she remains a member of the organization’s board of directors, even as she enjoys being more stationary these days, enjoying her home in Cheshire.
“I do sometimes miss the issues around tropical medicine; it’s an interesting field of study,” she allows. “But trauma and transplant are also very interesting to me, so here I am. Whatever anyone’s facing is the most important issue to them; it’s always the patient in front of you who matters most. You just do the best you can where you are.
“Over time I found I wanted to be home,” says Grimshaw. “Now I have a house, a pet, and I feel really fortunate that my good friends have stayed my good friends through this decade, and my parents are still here and healthy.”
There are typically between 27,000 and 30,000 Doctors Without Borders volunteers in the field at any given time, and in 2011 they offered assistance to patients in 67 countries. Grimshaw says the typical American physician who volunteers is either young, has little or no school debt, and hasn’t joined a practice yet, or is on the other side — debts paid, their own children through college, etc.
Grimshaw says MSF will continue to emphasize certain diseases — particularly HIV, tuberculosis, and malaria — and provide care for those infected, especially as funding sources come under stress.
“We’ve treated thousands of people [with HIV], and we’ve got big projects in Myanmar, South Africa, and Zambia’s program was handed over to their ministry of health. The funding for HIV seems to be diminishing at a time when the medical profession has just really proven that treatment is prevention.”
The Global Fund to Fight AIDS, Tuberculosis and Malaria, which raises money from donors every three years, pulled in only about half of its budgeted $20 billion for funding through 2013, and froze grants until after 2014 after uncovering a misuse of funds in 2011.
Grimshaw notes that every mission MSF dedicates itself to is based on first-hand account of the need for action. Nothing happens unless they’ve seen it for themselves, and oftentimes being there is key simply to maintain awareness, particularly when fighting diseases like HIV.
“Our hope is that [research and development] in the world is driven by what needs are out there, and not by other entities,” she says. “One of the ways we can advocate for that is to be there on the ground.”
Public health advocate Jeannette Ickovics works to shower her clientele with CARE
New Haven residents have been studied, and studied and studied again. In the past it’s been somewhat of a sticking point between Yale University — a major researcher — and its host city, with town-gown relations at times strained by the ongoing microscopic inquiries, examinations and analyses of Elm City residents and their communities.
Enter CARE. The acronym stands for Community Alliance for Research & Engagement. And therein, says Director Jeannette Ickovics, lies the difference between CARE studies and traditional research projects involving the New Haven community.
“One of the reasons it’s different is, we really initiated this with a sense of community-university partnership. The partnership is at the heart [of the research],” says Ickovics. “So this is about a new way of working collaboratively that frankly we didn’t think existed. We feel that we’ve created a kind of unique partnership.”
That “unique partnership” is built on a positive relationship that’s been developed over time.
“We spent the first few years building the engagement,” Ickovics says. For example, CARE staff members spent time with New Haven residents, getting to know their thoughts, concerns and ideas regarding health and health-care issues.
“Literally, we were knocking on doors and sitting on stoops,” Ickovics says.
The result is a program designed to directly benefit the community by providing tangible, comprehensive solutions to health needs. To date, projects such as tobacco-cessation initiatives, increasing amounts of healthy foods at corner stores, school-based Weight Watchers, a museum food exhibit and community gardens have been established through CARE. And that’s just the tip of the iceberg.
“CARE has really pushed us to be responsible and responsive to community needs,” says Ickovics.
A program of the Yale School of Public Health, CARE was launched in 2007 to assess and improve New Haven residents’ health needs.
“Now we’re in the productivity cycle of using the evidence to make change,” Ickovics says.
Among the results is a public exhibit, titled Big Food: Health, Culture and the Evolution of Eating, that debuted at the Yale Peabody Museum of Natural History. Ickovics served as its curator.
“It helped us as a neighborhood to expand our notion of public health. It’s not only the physical, but emotional well-being and public safety,” says CARE advisory board member Ann T. Green. The exhibit sought to improve observers’ food choices and consumption by highlighting the effects of processed and fatty foods, portion sizes and lack of exercise on weight and health. A nationwide tour is planned.
Green began her work with CARE as a community surveyor in 2009 for New Haven’s West River neighborhood. She believes CARE’s success is due to “the willingness to really apply principles of public health in Yale’s own backyard” and its “long-term commitment” and holistic approach.
Neighborhood leaders such as Green play an important role in CARE’s success, Ickovics says.
“It’s not work we do alone,” she says, adding that the input of entrenched community residents is key to “understanding what the community priorities are.”
Ickovics’ ability to understand needs and priorities stems from the personal — her parents survived the Holocaust and instilled in her a sense of social justice, she says — as well as the professional.
A native of Philadelphia, Ickovics earned a BA in psychology from Pennsylvania’s Muhlenberg College (magna cum laude) in 1984 and a master’s degree in applied social psychology from George Washington University in 1987. Two years later she was awarded a Ph.D. in that field, also from GWU. She came to Yale as a fellow in 1989 and has been there ever since, holding a succession of academic and administrative positions. The 49-year-old lives in Madison.
In addition to Green and other local leaders, there are dozens of community partners, institutional collaborators and neighborhood supporters in the form of various schools, health facilities and social-service organizations that work with CARE.
“We have a program called ‘Health Heroes’ in the schools,” notes Ickovics, adding that participants “made a commitment to eating better and being more active.
“We’ve been very fortunate to work with other leaders in the city,” she says. That is buoyed by “really respecting that they care about the kids so much that we’re able to work together.”
Maurice Williams, CARE’s community outreach coordinator, agrees.
“It’s hard to make behavioral changes, and a lot health [improvements] require behavioral change,” Williams observes. New Haven’s wealth disparity is a contributing factor, studies suggest.
“It’s challenging, in the social and economic times we live in, for people to make health an important part of their lives,” says Williams.
It’s easier to pay $10 for a fast-food meal for a family of four than spend time shopping for, planning and cooking meals that include fresh fruit and vegetables and other healthy items, Williams notes. Plus, he says, society tends to “market bad food more than we market good food.”
The challenge for CARE, he says, is to emphasize “an education process that’s kind of been left out of the mainstream of education.”
“We’re really working on a grassroots level,” adds Alycia Santilli, CARE’s director of community initiatives.
Over the next five years or so, Ickovics would like to see results of the work coming out of CARE to impact public policy.
“Policy initiatives, so we can create change that would be more sustainable,” Ickovics says. “I think what we’re doing is making a difference.”
In the shadow of the Sleeping Giant, Bruce Koeppen is building a med school out of whole cloth
Bruce Koeppen discovered his love of teaching at the University of Chicago in the mid-1970s.
“There was a course offered in the second year of the curriculum, and faculty would choose fourth-year medical students to help teach it,” recalls Koeppen, who was among the chosen.
As a result, he says, “I made the decision to go into academic medicine.”
Several decades later, in 2010, Koeppen was selected as founding dean of a medical school at Quinnipiac University. Its principal mission is to train primary-care physicians.
“The other piece is to work collaboratively with the schools of nursing and health sciences, and teach them in an interprofessional curriculum,” says Koeppen, 61, whose experience makes him especially suitable to spearhead the effort.
The first in his family to attend college, Koeppen grew up in Elgin, Ill., about 40 miles northwest of Chicago. “I was always interested in science,” he says. “What I really liked was understanding the function of the human body.”
Koeppen majored in physiology at the University of Illinois/Urbana, where he earned a BS in 1973 and began a lifelong interest in the workings of the kidney.
After graduating, he says, “Instead of getting an internship, I got advanced research training.”
Koeppen got his MD (1977) at the University of Chicago and Ph.D. (1980) at the University of Illinois, then spent two years at on a research fellowship with renal physiology expert Gerhard Giebisch.
Koeppen has since co-authored several textbooks and dozens of articles about physiology and the kidney.
His first faculty appointment came in 1982, as an assistant professor in the departments of medicine and physiology at the University of Connecticut School of Medicine in Farmington. Over the next decade Koeppen conducted research at UConn while becoming an associate professor and professor in the departments of medicine and cell biology. Working with Peter J. Deckers, then dean of the UConn Medical School, Koeppen also revamped the medical school education program.
“We implemented a totally new curriculum that was system-based rather than subject-based, which was pretty controversial among faculty and still is at some schools in America,” says Deckers, whose current title is dean emeritus of the UConn School of Medicine and professor of surgery. “Bruce was completely responsible for implementing that at all levels and exemplary in making it happen.”
In the early 1990s, Koeppen was named associate dean for preclinical education at the UConn Medical School. Over the next decade and a half he held a variety of administrative titles, culminating in dean for academic affairs.
“I was responsible for administrative oversight for all education programs, from medical students to residents to continuing education, and also had administrative responsibility for facilities,” he explains.
Along the way, he earned a slew of UConn and national awards, including the American Society of Physiology’s Arthur C. Guyton Teaching Award (1995), the Association of American Medical Colleges and the Alpha Omega Alpha’s Robert J. Glaser Distinguished Teaching Award (1998) and the University of Chicago Pritzker School of Medicine’s Distinguished Service award (2002). In 2009, he became an inaugural member of the University of Connecticut’s Academy of Distinguished Educators.
In February 2010, Koeppen began to contemplate a different future.
“I picked up the Hartford Courant and saw a story about Quinnipiac University’s plans to build a new medical school,” he recalls. He quickly applied for the job as founding dean of the Frank H. Netter School of Medicine.
“I did initial interviews in June,” Koeppen says. “I made it to the short list and did second interviews in July and August. In mid-September I got the phone call from Mark Thompson (now Quinnipiac University’s executive vice president/provost) and officially started on November 1, 2010. At that time I was the only employee of the School of Medicine.”
Building a medical school from scratch wasn’t such a stretch for Koeppen, who had plenty of experience evaluating other institutions going through the process. A member of Liaison Committee on Medical Education [LCME], the accrediting authority for medical education programs leading to an MD degree in the U.S. and Canada, he had been on accreditation teams for more than a dozen universities. He was chair of the accreditation team for the preliminary accreditation for the Hofstra University North Shore-LIJ Health School of Medicine and the Charles E. Schmidt College of Medicine at Florida Atlantic University.
“Bruce had done many site visits and had been executive secretary on a lot of those visits,” Deckers says. “Therefore, he knew the strengths and weaknesses of medical schools. Some are clinically focused; some are research-focused and spend more time on that than education. So Bruce was extremely well prepared to implement a new curriculum in a new medical school — probably better than anyone else.”
From 1999 to 2005, Koeppen served as a member of the Graduate Medical Education Advisory Council at the state of Connecticut’s Office of Health Care Access.
“To start a new medical school you really need two things,” adds Decker. “One is to know all the demands of the groups that license and accredit you. No one knew it better than Bruce, who had lived through and knew all the issues that had to be on the table. You also have to know how to recruit good faculty with a commitment to education.”
Koeppen’s qualifications were perfect for Quinnipiac.
“Bruce is just an ideal dean for our school, says university President John L. Lahey. “In addition to just getting through the process and knowing what to do, he has the temperament and experience to accomplish our medical school’s mission, which is to try to encourage as many of our graduates as possible to practice primary medicine, and to do this working with schools of health science and nursing.
“Bruce is brilliant, yet you’d never know it to interact with him,” adds Lahey. “His personality is very welcoming, and he’s got great interpersonal skills you don’t always find it in geniuses.
The U.S. is in the midst of a new medical school boom.
“The last round of new medical schools was in the 1960s and ’70s, and that round was sparked by impending physician shortages,” Koeppen explains. “The feds helped these schools get off the ground.
“This round also is being fueled by impending physician shortages. But this time they are being funded by states, clinical entities or private universities, and hopefully will provide additional physicians to address the shortage of about 100,000 physicians by 2020 and 150,000 by 2025.”
At least 16 new medical schools have obtained initial accreditation, including three in Florida and three in Michigan, and half a dozen others are in the works.
“Health care increasingly is a team sport, with everyone working together for the care of the patient,” Koeppen says. “Quinnipiac said that’s clearly the future of health care, so why not train our students to be better team players when they get into the workforce?”
Koeppen has been hiring and seeking “master teachers who have a track record of as excellent medical school educators, or junior faculty who have the potential.”
“Our model is not traditional,” he says. “We are not going to be a research-intensive medical school or have a faculty practice. We hope our graduates go out and practice in the trenches.”
For a medical school to be accredited, Koeppen explains, “You’ve got to document that you have all resources in place to be successful, including the faculty, staff and clinical placements, so students you admit will get a quality education and that they’ll be able to finish. Our documentation was eight inches [thick] of paper.”
On October 3, 2012, Quinnipiac received approval from the state Board of Education to award medical degrees, shortly after received preliminary accreditation from the Liaison Committee on Medical Education. The first class, which will matriculate this fall, will have 60 students, a number projected to grow to 125 by 2017.
St. Vincent’s Medical Center in Bridgeport will be the school’s primary clinical partner, with other training sites at MidState Medical Center in Meriden and Middlesex Hospital in Middletown.
Slated for completion in March 2013, the 145,000-square-foot Quinnipiac medical school will include offices, 16 exam rooms, a human anatomy facility, a clinical skills assessment facility, two simulation operating rooms, a library, a lounge space with a yoga studio and a fitness center.
“Bruce has developed a curriculum, designed a medical school building and hired faculty and administrators all in about a year’s time,” says Lahey, who adds that to accomplish preliminary accreditation “in less than two years is just phenomenal.
Koeppen’s extraordinary competence comes as no surprise to Deckers, who was “delighted” when his former colleague landed the founding dean’s job.
“Bruce is very much a professional,” Deckers says. “He takes being in a position very seriously. He manages times impeccably and has a sense of duty that transcends that of other people. He wants to instill in the generation of students that he’s going to be responsible for the same kind of personal and professional pride.
“I know that that school is going to be successful, and I’m absolutely sure they’ll recruit outstanding people to the classroom, because Bruce wouldn’t have it any other way.”
How Yale‘s Jon Soderstrom became a technology-transfer superstar
Jon Soderstrom once thought he would become a minister. Instead, his career path led to Yale University, where he became managing director of the Office of Cooperative Research (OCR), overseeing the commercialization of inventions stemming from faculty research.
“It’s a rather improbable journey,” acknowledges Soderstrom, who is widely recognized as heading one of the most successful university technology-transfer initiatives in the country.
Along the way he has had a hand in the creation of more than two dozen ventures, including Molecular Staging, Genomic Systems, Achillion Pharmaceuticals, Protometrix, Iconic Therapeutics, Applied Spine Technologies, HistoRx, Affomix and Kolltan Pharmaceuticals.
And done his best to start and keep those companies in New Haven.
Soderstrom’s journey began far from Yale, in Sparta, Mich., a tiny town 17 miles north of Grand Rapids.
“It’s Lake Wobegon [Garrison Keillor’s fictional Minnesota town] and I’m not kidding,” he says, “with three Lutheran churches — one for the Swedes, one for the Germans and one for everybody else.” Soderstrom’s grandfather arrived there in 1882, fleeing the potato famine in his native Sweden.
Soderstrom adored his father Edward, a bomber pilot during World War II, who received the Distinguished Flying Cross and saved fellow pilot George McGovern [later a U.S. senator and 1972 Democratic presidential nominee], when both were shot down on a mission.
After the war his father, an engineer, helped run the family hardware business until the late 1960s, then designed warehouse systems for a firm with clients including Federal Express and Wal-Mart.
“He was my hero because he could design anything and make it work, and traveled all over the world solving problems,” Soderstrom says. “That’s what I’ve tried to emulate.”
While growing up, Soderstrom baled hay, trimmed trees and picked apples and peaches at local farms. He graduated from Hope College, a Christian liberal arts school in Holland, Mich., in 1976 with an undergraduate degree in psychology.
“Originally I thought I would be was a minister.” Soderstrom says. “God was calling me. He’s still there, at the center of my life, but had a different plan for me and how I was going to serve.”
Soderstrom went to graduate school at Northwestern, where he studied operations research and focused on the management of innovation and productivity. He earned a Ph.D. in 1980, the same year the Bayh-Dole Act was enacted, allowing universities and small businesses to own inventions created using federal funding and to commercialize those inventions.
“That’s what opened the floodgates,” says Soderstrom, who had spent a semester at Oak Ridge National Laboratory in Tennessee and was hired there following graduation.
“I started with social impact analysis — how you define the impact of technology on society,” he explains. “It was exactly the same stuff I’d been doing at Northwestern but funded by the Department of Energy. One of the programs, an energy-related inventions program, gave small grants to inventors for proof of principle and proof of prototype, to try to commercial them and see what worked and what didn’t.”
He later became director of technology licensing and director of program development at Oak Ridge, which was operated by Union Carbide until 1984, when Martin Marietta Energy Systems took over.
In the mid-1990s, Martin Marietta merged with Lockheed Corp.
“I was starting to feel restless and antsy,” Soderstrom says. “Then the phone rang and there was a recruiter asking about the tech-transfer program at Yale.”
His first reaction was lukewarm. But he changed his mind after meeting Gregory Gardiner, who then headed OCR, which had opened in 1982 with one person and few resources.
The situation radically changed, Soderstrom says, when Richard C. Levin became Yale president in 1993.
“What they wanted to do was transformative,” he says. “They really wanted to leverage the intellectual capital, to transform it and to change the world.
“Rick also wanted to use the office to build the economy of New Haven,” Soderstrom adds. “Who wouldn’t want to do that?”
He joined the office in 1996.
“Greg and I set ourselves a goal of six ideas that could be funded,” Soderstrom recalls. “Of those, three got financed. One became Molecular Staging, another Qiagen, and the third polyGenomics. Each one raised around $5 million in Series A funding, and it got to a point where we had the money. ‘What are we going to do with these things?’ One of the conditions was we had to do them in New Haven.”
Finding suitable real estate, however, was not Soderstrom’s forte.
It was familiar territory for Bruce Alexander, then a Yale alumnus working with Levin on economic-development issues. Soon he and Soderstrom were collaborating.
“When I first came to New Haven, a company, Gene Logic, was going to Gaitherburg, Md. and taking jobs,” says Alexander, now Yale’s vice president for New Haven and state affairs and campus development. “Jon and I figured out there was no wet lab space available in New Haven. The two of us worked together to get Winstanley [Enterprises] involved. They were in Connecticut and when they expressed some interest in 300 George Street [the former SNET headquarters]. The university agreed to take about 50,000 square feet [ten percent of the building’s total] in order to provide them with some cash flow if they purchased it. They also had a relationship with one of our endowment managers. That gave the developer some comfort.”
In 2000 Winstanley acquired 300 George from Matthews Ventures for $27.5 million and retrofitted it for bioscience use.
“Molecular Staging became the first biotech tenant, closely followed by a bunch of others,” Soderstrom says.
Winstanley went on to manage a lab and office building at 25 Science Park and renovate part of the former Winchester firearms building for Higher One, a financial services company for colleges and universities founded by Yale students. The developer currently is working on plans for 100 College Street, a new 400,000-square-foot mixed-use building to which Alexion Pharmaceuticals will relocate. The building is a centerpiece of the Downtown Crossing project, which aims to convert part of Route 34 into an urban boulevard.
“I think with Downtown Crossing and Alexion coming back into town [the company started at 25 Science Park before moving to Cheshire], it’s going to spark a whole lot of stuff,” Soderstrom says. “We’ve got a bunch of companies that are positioned to transform New Haven into a biotech hub. Venture capital funding is just really hard right now, but we’re exploring new financial approaches that are project-based, instead of doing companies.
“We’re never going to be that big,” he allows. “We never aspired to be the new Cambridge.”
Alexander calls Soderstrom “a great colleague with respect to efforts to partner with and strengthen New Haven.
“In the university community he is regarded as absolutely tops in his field,” Alexander says. “He’s also very civic-minded.”
In 1990, President George H.W. Bush honored Soderstrom as the 87th “Point of Light” for his volunteer work building and rehabilitating low-income housing in Tennessee. He had been organizing churches in Appalachia to address problems of the poor. Aid to Distressed Families of Appalachian Counties [ADFAC] grew out of the effort, and Soderstrom was board president in its early years.
“I think the most important thing about Jon is what you see is what you get,” says Mike Sherman, a serial entrepreneur and partner at Elm Street Ventures who started five companies based on Yale research and who has known Soderstrom for more than two decades. “He’s a very down-to-earth individual, trustworthy, has a lot of integrity and he is experienced enough and good enough at his job that he knows how to make things happen.
“One of the interesting things is that what Jon and his predecessor Greg Gardiner did, collectively, was to create a real spirit of entrepreneurship among Yale faculty,” Sherman adds. “When I started in this game, the pharmaceutical industry was a dirty word to a lot of academic investigators, and it was very difficult to get academics engaged. What Jon and Greg did, among others at Harvard and MIT, was helped the faculties to appreciate, not necessarily the financial aspects of developing their discoveries, but how important they could be at helping their discoveries be translated to real-life applications to help real people. That’s one of the reasons why Yale was always a good place to go to find technology. The academic personalities were really enthusiastic.”
Sherman describes his relationship with Soderstrom as “more of a partnership” than mere licensee/licensor.
“And that’s one of the things that makes Yale’s technology-transfer [office] stand out,” Sherman says. “They really do look it at as a cooperative venture to try to make the technologies successful. When you set up a company, you need to work out a business plan to translate something that’s done at the bench level in a commercial mode. You need to have to the scientists, and Jon is good at facilitating that.
“And then, of course, there’s the onerous task of raising money,” continues Sherman. “Jon was always helpful putting me in touch with investors. I would run companies for a time, then move on and find another opportunity. He often sat on the board of these companies, was helpful in finding permanent members and in a number of ways of providing extra benefits, other than just someone to look to as a source of acquiring rights to intellectual property.”
Soderstrom “is widely recognized by his peers to be a thought leader in the technology space,” says Todd Sherer, director of technology transfer at Emory University and president of the Association of University Technology Managers.
“He’s broadly regarded as an expert in the business and has always been viewed as being more progressive in the ways to think about tech transfer and the laws and issues that direct it.”
Sherer also says Soderstrom is “one of the few experts in the country, and probably the world, people will turn to [for advice].”
Soderstrom also is a leader in fostering new sources of innovation.
In 2007, he became instrumental in founding the Yale Entrepreneurial Institute [YEI] after noticing Yale students were moving elsewhere to start new companies.
“We’re trying to build an entrepreneurial ecosystem around New Haven,” Soderstrom says. “That’s what Greg Gardiner and I talked about in 1996.”
Recently some eight percent of new Yale ventures were in the life sciences. “Nowadays, because of the students, we’re starting to see things growing up in other areas, particularly clean technology and computer sciences,” Soderstrom says. “I suspect that the students will always be a more diverse portfolio of opportunities than research.”
Soderstrom credits Yale President Levin with setting the stage for the university’s entrepreneurial growth. “It all started at the very top with Rick. He has never wavered in his support, and has been one of the biggest cheerleaders.”
Soderstrom expects the support to continue and “grow even further” under Yale’s incoming president, Peter Salovey.
“The stronger New Haven is, the easier it is for us to retain the brightest and best faculty and students,” he says. “And the stronger Yale is the more opportunities we have to build the economy. It’s a very virtuous cycle.”
In 1905 St. Vincent’s was founded by the Daughters of Charity — which has remained its watchword ever since
St. Vincent’s Medical Center’s mission to improve its hospital safety undertaken a few yeas ago is an illustrative indicator of the kind of service-oriented management style in which it drapes itself. For precedent, the hospital consulted the rigorously precise nuclear power industry.
“Health care needs to learn some lessons from other industries that have significantly improved safety” says medical center CEO Susan Davis. When Davis arrived at the Bridgeport hospital ten years ago, one of the primary attractions for her was the dedication to providing service to indigent populations while continuing to strive for improvement.
“What was great was the hospital’s commitment and incredible caring for the poor and vulnerable,” says Davis. “There were opportunities I saw to improve the patient experience, and strengthen safety and quality of care.”
That stress on compassionate and quality patient attention is what has earned St. Vincent’s a solid reputation as a leader in health care. Consumer Reports has recognized it as being among the top three Connecticut hospitals for safety, Professional Research Consultants named it a National Excellence in Healthcare GOLD Award recipient in 2010, and in 2012 the Connecticut Hospital Association gave the center its John D. Thompson Award for safety, among other accolades.
St. Vincent’s is a member of Ascension Health, the country’s most expansive Catholic non-profit health-care system. It opened in 1905 after the Daughters of Charity, a women’s religious group, conducted a needs-assessment.
With 473 beds in its Bridgeport hospital and 76 beds at a Westport inpatient psychiatric facility, St. Vincent’s also maintains specialty and satellite offerings that include urgent care/walk-in centers. behavioral health services, specialty needs services, St. Vincent’s College, the Michael J. Daly Emergency Department and the new Elizabeth M. Pfriem Swim Center for Cancer Care.
An exciting development for administrators is the medical center’s partnership with Quinnipiac University. Last year the center was named primary clinical partner with Quinnipiac’s new Frank H. Netter MD School of Medicine, which will matriculate its inaugural class this September.
“That’s something I personally spearheaded,” says St. Vincent President Stuart Marcus, MD. “Quinnipiac chose us as their primary teaching hospital. Having medical students here will allow us to expand our community focus. There’s nothing more important than training tomorrow’s physicians.”
“That’s really exciting, to think that we’ll have a role in training medical students,” adds Davis. “The focus with Quinnipiac is really primary care.”
The center is determined to keep tabs on its quality of care. To help do this, a Patient & Family Advisory Board was established in 2007. The group is charged with ensuring that care is focused on patients and their families, that there’s open communication between patients and staff about issues and concerns, maintaining an atmosphere of respect and building patient satisfaction, and strengthening community ties, among other responsibilities.
General governance of care is guided by the medical center’s adherence to the National Council of Catholic Bishops’ Ethical and Religious Directives for Catholic Health Care Services guidelines. In its mission statement the center stresses its commitment to “the healing ministry of Jesus.” It aims to “provide quality, holistic care to all faiths with special concerns for those who are poor, vulnerable and underserved.”
That was a major draw for Marcus when he considered joining the St. Vincent’s staff.
“One of the reasons I came to St. Vincent’s is the community focus regardless of the [patient’s] ability to pay,” he says. “The mission drives the strategy and the operations and the culture at the hospital.
“Each person is a person. Bridgeport is the largest city in Connecticut and the poorest city in Connecticut. It’s a very diverse community,” says Marcus, who admires “St. Vincent’s ability to treat all patients along the spectrum of that diversity.”
Marcus holds a unique administrative perspective. Like Davis — a registered nurse — Marcus, a physician, brings a practitioner’s viewpoint to medical center decision-making.
“I came here in 2006 because of the cancer center,” Marcus says. “Another draw here is the holistic care,” he adds, citing the Swim Across the Sound fundraiser as particularly impacting.
“It’s an example of how St. Vincent’s offers holistic care — mind, body and spirit. Therapeutic massage, yoga, aquatherapy, all are offered because of funds raised by the Swim.”
Following in line with that first needs assessment by the Daughters of Charity, St. Vincent’s continues to gauge community needs through regular surveys.
“We look at some of the most pressing needs in the community and put services in place to meet the needs,” says Marcus. Most urgent maladies have included diabetes, heart disease, cancer and asthma.
A high level of breast cancer, as well as disparities among minority patients, prompted the health center to augment its preventive-care offerings. A mobile mammography screening, for example, increases screening access for underserved populations, according to Marcus.
Community assessments sometimes uncover surprises. Marcus says he underestimated the behavioral needs of the community until they were brought to light through analyzed surveys.
After that, says Marcus, “We certainly put more resources into place.” For example, “We opened up a separate behavioral health section in our emergency department. That was very difficult because behavioral health patients require different types of attention — a different skill set to help them.”
Being able to measure success tangibly is one of the rewarding aspects of being part of St. Vincent’s administration, notes Davis. Take, for example, those safety improvements. In situations where so much can happen and so many variable are involved, even incremental changes can be crucial.
“I wanted to change the notion that it was given that a patient on a ventilator gets pneumonia” — a not uncommon development in hospitals. “In three and a half years,” says Davis, “we haven’t had a patient on a ventilator get pneumonia.
“There’s something called birth trauma [mechanical injury during the birth process] that happens to babies,” Davis adds. She proudly notes, “We haven’t had a birth trauma in over four and a half years.”