Spring 2019
In the early 1990s, many pediatricians figured kids whose symptoms pointed to HIV lacked the emotional maturity and resilience to cope with a fatal diagnosis—so they opted not to even test for the disease.
Bret Rudy (MD ’85) thought otherwise. As a fellow in pediatrics at the University of Pennsylvania, he launched a dedicated clinic at Children’s Hospital of Philadelphia (CHOP).
“Being quite frank, there was a juxtaposition of the kids who were infected through transfusions and perinatal exposure and an emerging group of teens who acquired HIV through sexual transmission,” says Rudy, now a professor of pediatrics at New York University. “There were still people talking about ‘innocent’ and ‘noninnocent’ victims.”
Funding was nonexistent, so Rudy recruited volunteers—including social workers, nurses, psychologists, and fellow physicians—to stay after hours to staff the clinic a few evenings each week. Rudy was intent on providing comprehensive care in a setting where every kid felt safe and dignified—including those counting on survival sex to secure such necessities as food or housing and those whose outlook had been profoundly altered by their experiences as survivors of violent crime. “Our job was to find resources so that we could help them break down the social barriers that would prevent them from taking care of their health and looking forward to their future,” says Rudy. “We never gave up on anyone, no matter how bad the situation.”
Rudy later joined the Centers for AIDS Research, served on the Ryan White Title IV Strategic Planning Committee, and joined the White House Advisory Committee on Adolescents for the Office of National AIDS Policy. As chair of Project ACCESS, he led development of a national social marketing campaign promoting HIV counseling and testing in teens. And, all the while, he ran clinical trials to develop treatment protocols tailored to teens and young adults. Recent papers he’s coauthored include a comparative analysis of partner notification programs for youth living with HIV, an overview of the continuum of care available to them, and a report on the biomarkers that distinguish effective viral suppression among young people.
Now executive hospital director and senior vice president for NYU Langone Hospital–Brooklyn, Rudy credits his early experiences launching CHOP’s Adolescent HIV Initiative, which is celebrating its 25th year, with propelling him into other leadership roles. “You start to see the bigger picture to impact more lives and give other people opportunity.”
Since 2016, Rudy has overseen a transformation of operations at NYU’s Brooklyn outpost, intent on matching quality of care in the borough with what patients receive from NYU’s flagship medical center in Manhattan. “By 2020, Brooklyn will be the third largest city in the country,” he says, “about the same size as Houston.” Already, the hospital has added ambulatory pediatric and surgical oncology services as well as trauma and stroke centers; it has also implemented an electronic health records system that unites the hospital with the Family Health Centers at NYU Langone’s 35 school-based clinics and affiliated homeless health-care centers. “It’s amazing to see some of the young physicians and nurses who are really committed to what we’re doing in Brooklyn,” says Rudy, “who really love the diversity of patients we serve, who bring so much energy and creativity to their jobs.”
Rudy traces his own leadership style to the example set by the late, beloved Pitt professor Charles Watson. “When he walked ... through a hospital, his whole emphasis was on how you’re respectful to the patient, the staff, the aides. That’s something I’ve taken with me: Set the bar high for yourself, so everyone around you sets their bar a little higher.”
Mary Poppins knows how to sweeten a raw deal. “Just a spoonful of sugar,” she trills as she spins across the stage.
Molecular neurobiologist Peihua Jiang (Neurobiology PhD ’01, Neurology Fellow ’02) intends to best that umbrella-twirling nanny. Since 2016, Jiang has studied the perception of bitter flavors, intent on short-circuiting the sensation. “There are a lot of very effective drugs, but because of the awful taste, children will refuse to take those pills,” he says. “If we can eliminate or reduce the bitter taste from pharmaceutical active ingredients—anti-malaria and anti-HIV drugs, for example—we may be able to help pediatric populations to take their life-saving pills more rapidly.”
Now an associate member of the Monell Chemical Senses Center in Philadelphia, Jiang got his start in gustation—the study of taste—as a postdoc at Mount Sinai, working in the lab of Robert Margolskee. He was drawn toward the field because taste is the sense least studied. So far, he has untangled the structure and function of taste receptor proteins and genes. And he discovered the identity and function of certain adult taste stem cells; an ongoing five-year, $1 million NIH-funded grant supports that work.
Jiang has also tackled the causal relationships among taste receptor structure, dietary choice, and metabolism. Modern humans may have been spared the imperative to experiment with novel—and potentially toxic—fare, but other species aren’t so lucky. In a 2018 paper in Molecular Ecology on the array of bitter taste receptors found among Myotis bats, which live on every continent except Antarctica, he notes the hazard of overconsuming potentially toxic insects.
The giant panda’s sweet tooth was the subject of a 2014 report in PLOS ONE. “We tried to compare the panda receptor to the human receptor,” he explains. “If we understand [the human sweet tooth], perhaps we can develop a way to reduce sugar intake.”
More recently, Jiang has looked beyond the tongue, to chemosensors in the throat, sinuses, and even the gut, where they seem to detect parasitic infections and mediate inflammatory disorders. “If we identify these extra-oral receptors,” he says, “we could target them to improve treatment of those diseases.” —Sharon Tregaskis
OBITUARIES
Sheldon Adler
July 13, 1934–Nov. 15, 2018
On the first day of class, a roomful of Pitt medical students waited for their professor, a renowned kidney expert, to start lecturing. Instead, the expert, physician Sheldon Adler, handed out a case study involving a patient suffering from an allergic reaction following a kidney transplant. Their tasks? In small groups, determine learning objectives, consult medical librarians, share research, and collaborate to make a diagnosis and design treatments. He’d provide some guidance, but mostly it was up to them.
Adler was embracing a new trend in medical education in the 1980s called problem-based learning, which focused on self-directed learning, critical thinking, and teamwork—not the typical rote memorization and competition for grades that med students expected.
“Students were no longer passively fed information, and they could understand material better,” says Charles Reynolds III, geriatric psychiatrist and Pitt professor emeritus who worked with Adler to champion the pedagogy. Adler, then senior associate dean, spearheaded full implementation of the curriculum by 1992. Well liked among the professors, he still met resistance to change—from faculty and students. He responded with grace and humor; he would crack jokes about needing a hearse to haul away outdated ideas.
“We experienced a profound culture change thanks to Shelly’s efforts,” says Reynolds.
Adler also knew when to take a break from the tension for a stroll in the park, where he could name all the birds and trees.
Adler died in November, but his legacy continues. Since 2002, the Sheldon Adler Award for Innovation in Medical Education has recognized other teaching pioneers at Pitt Med. —Liberty Ferda
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Robert Connamacher
Dec. 20, 1933–Nov. 28, 2018
A prof would stitch a cut on a frog’s belly to demonstrate suturing techniques for a group of local high school students. Next, he would pass the needle to one of them, saying, Imagine you’re a surgeon. This is your patient.
This was a typical moment in Robert Connamacher’s time at Pitt from 1967 until his retirement in 2016. The PhD associate professor of family medicine wanted these teens—mostly African Americans—to see themselves as potential doctors. There weren’t many health professionals who looked like them, and he was dedicated to changing that. He ran the after-school Medical Explorers program (now Health Professions Prep), in which high schoolers took mini science courses and attended lectures by faculty of various ethnic backgrounds.
Connamacher supported a similar program for college graduates, the Summer Pre-medical Academic Enrichment Program (SPAEP).
“I had some doubts in college, but his encouragement solidified for me that I was on the right path,” says Yunuen Valenzuela (MD ’02), who attended SPAEP in 1995, landed admission to Pitt Med, and now practices in Florida, where fluent Spanish speakers like Valenzuela are invaluable.
Also active with the Student National Medical Association (SNMA), Connamacher showed support for that group by attending conferences all over the country—but only by train. He hated to fly, and sometimes uncertain rail schedules had him arriving a week early. He was eventually inducted into the national organization’s Hall of Heroes.
J. Nadine Gracia (MD ’02), a first-generation Haitian American and SNMA national president emeritus, met him when she was a first-year Pitt Med student and an officer in the med school’s chapter of SNMA. Together they mentored Pitt undergrads through the Pre-Medical Organization for Minority Students. She fondly remembers walking across campus for meetings as he inquired about her studies and her life.
“You knew he was invested in your success,” recalls Gracia, who later became deputy assistant secretary for minority health during the Obama administration. “He cared for students and considered them part of his extended family.” —LF
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Henry Mankin
Oct. 9, 1928–Dec. 22, 2018
Whether instructing a classroom of fidgety elementary schoolers or Harvard medical students, Henry Mankin (MD ’53) taught bone physiology the same way—assigning each cell type a theme from Sergei Prokofiev’s Peter and the Wolf. “Every time you see this cell, you sing it this way,” his son Keith Mankin (MD ’88) remembers his father saying. Before long, the room would be in chorus.
Mankin, who died in December at age 90, was a world-renowned orthopaedic surgeon and chair of orthopaedic surgery at Massachusetts General Hospital and Harvard Medical School.
Kurt Weiss (Res ’08) recalls being treated by Mankin for osteosarcoma as a kid. “When you were in the room with him as his patient, you were his whole universe,” Weiss says. After Weiss pursued orthopaedics himself, he learned of his doctor and mentor’s significant contributions to the field. “I remember thinking, Holy mackerel. This guy is brilliant.”
Those contributions included research on Gaucher disease and spinal disorders, as well as the active, dynamic nature of cartilage. Mankin also cofounded the Musculoskeletal Tumor Society and was a champion for women and underrepresented groups in medicine, winning the 2004 Diversity Award from the American Academy of Orthopaedic Surgeons.
Freddie Fu (MD ’77) remembers his friend and mentor Mankin, who grew up in Squirrel Hill, as “really a true, blue-collar, down-to-earth, funny Pittsburgh person” who loved to teach.
“You teach someone, they continue to teach what you say, and you never disappear,” Keith Mankin recalls his father saying. “You live forever.” —Prachi Patel