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Brother, can you spare a kidney?
Help for Atlanta hearts
Humanitarian effort
Tort reform a reality


Brother, can you spare a kidney?

A chance encounter, powerful Emory connections, and some incredible generosity all combined recently to give the gift of life to a young missionary, enabling him to continue his calling to serve the poorest of the poor.
     Last December, Joseph Baal, 26, a Brother with the Missionaries of the Poor, a Catholic monastic order based in Kingston, Jamaica, donated a kidney to fellow Brother Rolando Dioniflor, 27, in an operation performed at Emory University Hospital. The transplant might never have happened if not for the efforts of a group of nurses and doctors from across Atlanta and a friendship between Marla Salmon, dean of the Nell Hodgson Woodruff School of Nursing, and Vicki Moore, chief of nursing at Atlanta’s St. Joseph’s Hospital.
     The Missionaries’ founder, Father Richard Ho Lung, underwent open heart surgery at St. Joseph’s in November 2003 and confided in Moore about Rolando’s need for a transplant.
     All of the Brothers were willing to be tested to see if they could donate a kidney, he said. But the missionaries could hardly afford the expensive preparations and surgeries that would follow. So Moore contacted Salmon, who worked to get Emory Hospital’s transplant service involved.
     “Marla and I have collaborated over the years on nursing service and education programs, so I went to her for assistance in making this need known to the hospital administration and renal transplant team,” she says.
     Moore, Salmon, and Maureen Kelley, an Emory associate professor of nursing, worked together to get the needed health care services donated. St. Joseph’s provided some of the preoperative care for Brother Rolando. WellStar-Kennestone Hospital sponsored the donor testing, and Emory Hospital and surgeon Christian Larsen, provided the transplant operation and follow-up care.
     Fortunately, Brother Joseph proved to be an excellent donor. He and Rolando traveled to Atlanta, staying with a local host family for five months during the surgeries and post-operative care.
     Kelley, chair of the School of Nursing’s Department of Family and Community Nursing, frequently leads groups of students on international trips to provide needed medical assistance in underserved areas. On a previous trip to Kingston, she visited the Missionaries, observing the shelters where they provide care for vulnerable homeless people, many of whom are terminally ill.
The transplant, she points out, will benefit many people beyond Brother Rolando.
     “When I visited the Missionaries of the Poor, I was awestruck at the compassion and care that the Brothers provide for the destitute and sick in Jamaica,” she says. “People like Brother Rolando make a profound difference in these people’s lives, and I’m thrilled that we at Emory were able to make a difference in his.”
     Following a quick recovery, both Brothers returned to Jamaica last February to resume their work and to pursue studies for the priesthood.
     “When I think about what Brother Joseph did for me, it really inspires me to be more generous in my life, since he has shown such love and generosity,” said Rolando shortly before leaving Atlanta for home. “I just want to live the best life that I can, to take this gift of a new life and use it.”


Did You Know?
Each year, Emory surgeons perform more than 150 kidney transplants on both adults and children, 25 to 30 adult heart transplants, approximately 100 liver transplants, and more than 10 lung transplants.


Help for Atlanta hearts

When discussing heart attacks, cardiologists often refer to their own created proverb, “Time is muscle.”
     Prompt access to coronary angioplasty offers the best chance of preventing permanent damage, but not all hospitals have the capability to provide immediate angioplasty, and too few patients receive treatment in time.
     “About 1 million people a year will have a heart attack,” says cardiologist Doug Morris, director of the Emory Heart Center. “About half of them will die, almost 400,000 before they even get to the hospital.”
     A new joint effort by Emory Healthcare and Grady Health System may help change that. Operating with the motto: “911 to cath lab in under 90 minutes,” the Heart Attack Rescue Team (HART) program allows early diagnosis of heart attacks in the field and faster treatment once patients reach the hospital.
     Emory has provided portable electrocardiography machines to all Grady ambulances, allowing EMS personnel to transmit ECGs taken in the field to either Emory University Hospital or Emory Crawford Long. Both facilities can provide angioplasty 24 hours a day, seven days a week. An emergency medicine physician at the hospital determines whether the patient is having a heart attack and whether angioplasty or therapy with clot-dissolving drugs is appropriate.
     If angioplasty is an option, the cardiac catheterization team is notified and prepares to take the patient. The patient is then asked whether he or she prefers to be transported there for angioplasty or to another hospital. If the patient chooses another hospital, Emory calls to inform doctors there that the patient has an abnormal ECG and will require rapid treatment.
     “HART is a completely voluntary program,” emphasizes Arthur Kellermann, chair of the Department of Emergency Medicine at Emory.” The patient can choose to go to Emory or Crawford Long or another hospital. If they choose us, we are preparing the cath table while they still are on the way to the hospital. If the patient opts out, we still call ahead and advise the other facility of the patient’s condition. Either way, this program will reduce the lost time in getting that person lifesaving treatment.”
     HART is part of Emory’s ongoing push to improve and standardize cardiac care in the Atlanta region, says Morris. Earlier efforts to encourage the use of field ECGs across the metro area have met with some resistance. But if data from Grady and Emory’s effort shows improved outcomes, more hospitals and other EMS systems may be willing to adopt this strategy.
     The hope is that the HART program will serve as a public health model for improving survival rates, says Kellermann.
     “We are trying to do for heart attacks what we have done for trauma,” he explains. “We want to provide rapid, organized, high-quality response to a life-threatening event.”


Humanitarian effort

Brandon Kohrt, in his fifth year of MD/PhD training in medicine and anthropology, has been recognized by the group Physicians for Human Rights for his work with immigrants who have survived torture in their home countries. He is the recipient of the 2005 Navin Narayan Award recognizing his ongoing commitment to health and human rights activism.
     In 2003, Kohrt helped found the Atlanta Asylum Network, which recruits medical professionals to document evidence of abuse so that survivors can apply for refugee status.
     “For many people who have survived physical or mental torture, their primary concern has been getting to safety,” Kohrt explains. “When they get here, they may still be in shock. Or, wanting to put the past behind them, they may be reluctant to talk about what has happened to them.”
     “If we are able to document psychological signs—such as post-traumatic stress disorder—or physical injuries consistent with abuse, then our documentation as medical professionals can be used as evidence in immigration proceedings,” he says.
     Kohrt became interested in this issue after traveling to Nepal on a Fulbright scholarship and meeting people who had been kidnapped and tortured there. After college, he also worked on a project providing mental health services to immigrants in Los Angeles.
     His experiences convinced him of the need to document the effects of torture on survivors, both to prevent their deportation and also to help them obtain counseling and assistance.
     The asylum network plans to expand its services and is always in need of new volunteers, says Kohrt. More information can be found on the Physicians for Human Rights’ website or Emory’s Institute for Human Rights.


Tort reform a reality

By Linda Womack

The Woodruff Health Sciences Center (WHSC) had a productive session at the state Capitol this year, successfully achieving much of its legislative agenda.

On February 16, Governor Sonny Perdue signed into law Senate Bill 3, better known as civil justice or tort reform legislation, which establishes new limits on medical malpractice awards in the state. Passage of this legislation has been our No. 1 goal for the past three sessions of the Georgia General Assembly. The new law’s provisions include the following:

Elimination of the joint and several liability rule in favor of
proportional liability.
Under proportional liability, a defendant is responsible only for his or her share of the damages.

Strengthening of expert witness qualifications by requiring experts to have either practiced or taught in the area of practice or specialty at issue for three of the five years preceding the alleged negligence.

A total limit on awards for non-economic damages of $1.05 million, with a $350,000 cap on licensed physicians and other health care providers and a $350,000 per facility cap for up to two facilities.

A stipulation that offers of settlement, statements of apology and benevolence, or statements indicating regret, mistake, error, or sympathy are prohibited from being admitted into evidence as an admission of liability.

No liability for claims arising from the provision of emergency care unless it is proven by clear and convincing evidence that the provider’s action showed gross negligence.

Removal of hospital liability for community physicians who provide services under independent contractor arrangements.

     The WHSC also led a successful effort to reform the process used by the Composite State Board of Medical Examiners to grant medical licensure to physicians in training. While the positions of intern, resident, and fellow are often used interchangeably when designating a physician in graduate medical education, Georgia law previously recognized only board-approved internship and residency positions as eligible for medical licensure in the state.
     Provisions of House Bill (HB) 608, signed into law on May 2, add the categories of fellowship or other postgraduate medical training positions that are approved by the Accreditation Council for Graduate Medical Education, the American Osteopathic Association, or the state medical board eligible for a license to practice medicine in Georgia. The board is also given the discretion to consider an applicant’s certification by a member board of the American Board of Medical Specialties as evidence that the postgraduate medical training has satisfied requirements for licensure.
     A number of study commissions and committees were created during the 2005 session. Of particular importance to the WHSC is the new law (formerly HB 390) that created a State Commission on the Efficacy of the Certificate of Need (CON) Program.
     In 1979, Georgia’s legislature passed the CON law to combat over investment in health services in wealthy areas and to ensure access to health care for both the state’s rural and urban populations. Georgia’s law followed passage of a 1974 federal law that established a network of state health planning and development agencies that monitor the equitable distribution of health care resources.
     This state commission is in the process of conducting a comprehensive review of the CON program, examining its effectiveness, studying the costs associated with the program, and looking at the potential impact of continuing or discontinuing it. The commission has until June 30, 2007, to issue a report to the governor and General Assembly announcing its findings.
     For additional information on any of these legislative issues, please contact Linda Womack at 404-727-5306 or
Linda Womack is the director of state government affairs for the Emory University Office of Governmental and Community Affairs.

Linda Womack is the director of state government affairs for the Emory University Office of Governmental and Community Affairs.



New rankings from the National Institutes of Health show that Emory University School of Medicine continues to be one of the fastest-growing medical schools in the country in terms of federal research grant support. Emory researchers received more than $178 million in NIH grant support last year, with the school ranking 19th among all U.S. medical schools. Emory has climbed four places in the rankings since 2003 and 12 places since 1996, the second-greatest increase among schools of medicine in the country during that time period.
     Meanwhile, researchers in the Rollins School of Public Health ranked 10th among all U.S. schools of public health, up from 12th the previous year. The $20.8 million in funding that the school received last year was a 37% increase over 2003 NIH funding of $15.2 million.
Researchers in the Nell Hodgson Woodruff School of Nursing ranked 19th among all U.S. schools of nursing in NIH funding, maintaining a top 20 ranking for two years in a row. Including the $2.32 million in NIH money, the school received a total of $3.2 million in external funding for research and training last year.



The School of Medicine
has already raised $31 million of the $55 million needed to complete construction of a new home adjacent to the Woodruff Health Sciences Center Administration Building (WHSCAB).
     The school’s 150th Anniversary Gala, held on May 13, netted more than $300,000 for the project. In addition, the school has recruited nine members of the “150 Society,” a group of donors who have given $150,000 or more to the new building.

     The planned three-building complex will include a new 116,000-square-foot teaching and administration building
connecting the existing Anatomy and Physiology buildings. Those buildings are now empty and awaiting renovation.
     When complete, the complex will feature wireless computer networking throughout the facility, extensive space dedicated to simulation, a state-of-the-art dissection lab, clinical exam rooms equipped with TV cameras for standardized patient testing, as well as new classrooms, meeting rooms, lecture halls, and space for the school’s administrative offices. The new building is slated for occupancy in June 2007.

National Heart, Lung and Blood Institute (NHLBI) at the NIH has awarded researchers from Georgia Institute of Technology and Emory University $11.5 million to establish a new research program focused on creating advanced nanotechnologies to analyze vascular plaque formation at the molecular level and detect plaque at its early stages. Plaques containing cholesterol and lipids build up during the life of blood vessels. When these plaques become unstable and rupture, they can block vessels, leading to heart attack and stroke.
     The new multi-disciplinary program, part of NHLBI’s Program of Excellence in Nanotechnology, is headed by Gang Bao, a professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory. The program includes 12 faculty investigators from both institutions and is based at Emory.
THE NATIONAL INSTITUTE ON AGING  (NIA) has awarded a highly coveted Alzheimer’s Disease Research Center designation to Emory University, along with $7.4 million in research funding over the next five years. The Emory Alzheimer’s Disease Research Center is the only NIA-funded center in Georgia and one of only 32 in the United States to attain this top status. Comparable to the National Cancer Institute’s Comprehensive Cancer Center designation for excellence in cancer research and community outreach programs, the Alzheimer’s Disease Research Center designation signifies the highest status an institution can receive in Alzheimer’s research and care.



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