Defeat Infection!

Robert J. O'Connell
Fall 2019
Tracking infectious disease up close.
At a research clinic in Thailand, study participants became familiar faces during twice-weekly visits for blood draws. The volunteers had self-identified as being at high-risk for HIV infection, but they hadn’t tested positive. During the course of the study, some participants became infected with the virus. The frequent blood tests indicated that they were in the throes of acute HIV infections, yet they otherwise appeared to be in good health. No symptoms to speak of. 
 
The scientists, including Colonel Robert J. O’Connell (MD ’97), were surprised. Previously, it was thought that people experiencing an acute HIV infection would present with clear symptoms. The team published its Thai clinic results, as well as results from clinics in East Africa, in the New England Journal of Medicine in 2016. “It was the very first time that [we] had the ability to so very carefully characterize what the virus was doing in the very beginning of human infection,” O’Connell says of the study.  
 
Inventing an HIV vaccine—and even a cure—was a primary assignment for Colonel O’Connell in his former role as director of the Armed Forces Research Institute of Medical Sciences (AFRIMS). The institute in Bangkok began when American and Thai armies worked together to stop a cholera epidemic in the 1950s. The partnership has grown into finding cures for infectious diseases that are of particular concern to soldiers. “When we do that and are successful, we generate products or knowledge that have broader public health benefits,” he says. 
 
As he served in this role, the military and civilian scientists in his circle studied not only HIV, but also malaria, dengue, and other tropical infections. He regularly travelled throughout Asia to oversee research projects in Nepal, Cambodia, and the Philippines and to speak at expert exchanges with military health services in such locations as China, Myanmar, Singapore, and Malaysia. 
 
In July, O’Connell moved on to a new assignment: deputy commander of the parent organization of AFRIMS, the Walter Reed Army Institute of Research in Silver Spring, Md. “We conduct infectious disease and brain health research,” he says. His new e-mail signature reflects the broader impact of his work: “Soldier Health. World Health.” 
 
O’Connell, born and raised a Minnesotan, earned his Pitt MD with assistance from the military’s Health Professions Scholarship Program, then trained in infectious diseases and internal medicine with the U.S. Air Force Medical Corps in Texas. His research career began at Walter Reed. He became chief of the Department of Retrovirology at AFRIMS in 2013. 
 
Today, AFRIMS has a partnership with Pitt, O’Connell notes with pride. The institute is working with John Mellors, who holds Pitt’s Chair for Global Elimination of HIV and AIDS, to investigate an immunotherapy treatment for HIV that involves removing a patient’s cells, priming them for a fight, and returning them to the patient’s body.  
 
When O’Connell reflects on his Pitt days, he says that on a practical level, he is most grateful for the medical training that guided him as a battalion surgeon during a one-year deployment to Iraq beginning in 2009. He’s also thankful that he attended a university with legends who continue to inspire his work. 
 
O’Connell remembers listening to talks by Jonas Salk as a visiting lecturer and Bernard Fisher on his first day of med school. “Jonas Salk pursued a product—[the polio vaccine]—that tangibly made an enormous impact on the world,” he says. “On the other hand, Bernard Fisher made an enormous difference in the lives of countless women [by conducting clinical trials on breast cancer treatments]. He used evidence-based medicine to change the world.” 
 
O’Connell hopes to do both—develop products and gather evidence for the best ways to defeat infection.

 

Photo: Puwanai Sangsri/Armed Forces Research Institute of Medical Sciences.
Photo illustration: Elena Gialamas Cerri 
   


We Knew You When, Donald Mercer

BY ADAM REGER

Donald Mercer (PhD ’68) wasn’t expecting a press conference. But when his boss told him to put on his best lab coat, he did so, joining representatives from the University of Pittsburgh School of Medicine and Montefiore Hospital in front of the cameras.
 
The year was 1975, and the occasion was the announcement of Mercer’s breakthrough cardiac research describing a quantitative blood test called CK-MB (cardiac isoenzyme of creatine kinase), which was capable of detecting heart attacks with nearly perfect accuracy.
 
Mercer’s blood test saved patients from unnecessary treatment and eliminated false positives from ailments such as indigestion.
 
And it all came about because Mercer, then an assistant clinical professor in the Department of Pathology, had lunch with a colleague, chief cardiologist Murray Varat.
 
“We were talking about the Steelers or something. And the conversation turned to his frustration about these inaccurate tests. I thought if we could do something about these tests, we could not only save the hospital a considerable amount of money, but save many lives by placing the patients in the correct rooms to receive the appropriate treatment,” says Mercer. 
 
Nearly 45 years later, Mercer’s test remains the benchmark for heart attack tests.
 
His paper on the test was featured as one of the top 40 of the 20th century in the 2006 volume of Landmark Papers in Clinical Chemistry.
 
After retiring from Pitt Med, Mercer in 1999 returned to his hometown of Wheeling, W. Va., where he was recently inducted into the city’s Hall of Fame. 
 
He dates his love of chemistry to working in the lab of a favorite professor at Wheeling Jesuit University, who steered him toward Pitt Med. 
 
“Working in the chemistry lab my junior and senior years helped me focus on a career in chemistry,” Mercer says. “I felt maybe I could take my chemistry skills and do something with them. 
 
“And I did.” 

Second-year medical students learn how to intubate a mannequin “patient” under the guidance of William McIvor (Res ’94), WISER’s  associate director for medical student programs.
Older Wiser

BY RACHEL MENNIES

The Peter M. Winter Institute for Simulation, Education, and Research (WISER) is 25 years old and in its prime. A leading simulation center, WISER has grown from a medical-student training hub into an educational powerhouse for providers at all levels of experience, specialty, and discipline. WISER’s resources, says its director, Paul Phrampus (Res ’00), “allow people to immerse in whatever they’re learning.” Students, he notes, “can practice over and over, applying their knowledge in a safe environment” before working with actual patients. 
 
WISER’s founding director, anesthesiologist John Schaefer, recognized the need for simulation-based education in 1994 and reached out to Pitt Med’s legendary Peter Safar in the hopes of building the center. Their passion—coupled with a generous financial commitment from Peter Winter, chair of Pitt’s Department of Anesthesiology at the time and the center’s namesake—ultimately made WISER possible. Says Phrampus of Winter’s commitment, “He put his neck on the line.”  
 
Photo: Max Leake  

OBITUARIES

Peter F. Ferson

AUG. 30, 1948–JUNE 30, 2019

When the news broke that Peter Ferson (MD ’73, Res ’79) died this June, his former student Marcus Hoffman took to Twitter, calling for fellow alums to share #DrFersonMemories. “Everyone I knew had a Dr. Ferson story,” Hoffman says. “He hammered home basics of surgery and operative approaches in a way that became enlightening.” 
 
Ferson, a cardiothoracic surgeon, professor emeritus of surgery, and the Charles Gray Watson Professor of Surgical Education, remained at Pitt for his entire career, educating more than four decades’ worth of medical students and surgical trainees while primarily treating lung and esophageal cancer patients as a surgeon. 
 
After Hoffman’s initial invitation, #DrFersonMemories grew, filling Twitter with anecdotes both humorous and somber—a balance, according to many who contributed, that often characterized Ferson himself. “Things Dr. Ferson taught me:” wrote Temple Ratcliffe (MD ’03)—“How to write admit orders. Simultaneous handshake/pulse check. … Most importantly: what loving your patients, learners, & profession looks like.” 
 
“[A]ll of us who were heavily influenced by him,” says Hoffman, “can essentially hear him in our minds from time to time.”   —Rachel Mennies  
 

Charles Fitz

MAY 6, 1937—FEB. 22, 2019

Charles Fitz, or “Chuck,” was a father of pediatric neuroradiology, as well as “a terrific colleague,” remembers Geoffrey Kurland, Pitt professor of pediatrics and the medical director for the pediatric lung transplantation program. “He carried a gruff exterior, beneath which beat a gentle heart.” 
 
Fitz was a professor of radiology at the University of Pittsburgh, as well as a practicing interventional radiologist and onetime UPMC Children’s Hospital of Pittsburgh radiologist-in-chief. His colleagues recall him treating every trainee interaction as a “teachable moment.” 
 
Kurland fondly recalls how “[Fitz’s] interaction was designed to teach residents to think more about each clinical situation, and to better formulate their questions in the first place,” which often meant an easy answer to a student’s question wasn’t forthcoming. However, notes Kurland, “almost invariably, the resident would personally learn how great a teacher and colleague Chuck was.” 
Fitz’s wife, Anna, also recalls his lifelong commitment to inquiry. “He wouldn’t stop working until the day his colleagues would stop asking him questions,” she says.
 
During his first faculty appointment at the Hospital for Sick Children in Toronto in 1976, he coauthored—alongside fellow faculty member Derek Harwood-Nash—the three-volume textbook Neuroradiology in Infants and Children. The textbook is one of the first for pediatric neuroradiology. Before his time in Toronto, he served as a physician in the air force.
 
“Many of us hope to leave behind a legacy: students we taught, papers we wrote, talks we gave, friends we made,” says Kurland. “Chuck most certainly did all of that and then some.” —RM
 
Donations may be made to Children’s Hospital of Pittsburgh Foundation, Radiology Research Fund. For information: Rachel McCune, rachel.mccune@chp.edu.  

 

James R. Zuberbuhler

AUG. 7, 1929–JUNE 24, 2019
 
Dr. Zube,” as he was called, brought warmth and irreverent humor to the University of Pittsburgh for more than 40 years. Though he trained as an adult cardiologist, his passion for children drew him to pediatric cardiology “in an era,” says his longtime colleague and friend Lee Beerman (MD ’74), “when it was not even a specialty in its own right.” Zuberbuhler “helped make pediatric cardiology and the care of children and adults with congenital heart disease what it is today,” adds Beerman. He notes that Zuberbuhler had “boundless curiosity and passion for delivering the highest quality of care to his patients and families.” 
 
The former air force captain served as both a Pitt Med educator and, for nearly 30 years, director of pediatric cardiology at UPMC Children’s Hospital of Pittsburgh. He “raised the use of the stethoscope, cardiac physical exam, and bedside approach to an art form,” recalls Beerman. He authored more than 100 publications, including the 1981 Clinical Diagnosis in Pediatric Cardiology, still used today. When Zuberbuhler retired from his position as chief in 1994, Children’s established the annual James R. Zuberbuhler Lecture.
 
In retirement, he built a collection of 900 photographs of wildflowers indigenous to Western Pennsylvania. For his online gallery, the ever-curious Zuberbuhler posted that he, of course, welcomed “comments and constructive criticism.”   —RM
 

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