Teach Once, Learn Twice

Summer 2020

Johnston (right) with Duker—both beloved professors emeriti at Pitt Med.

If a professor can have a hit lecture, James “Jamie” Johnston’s is definitely “Running the Nephron.” 

“Students will come up to me on clinical services and say, ‘Run the nephron for us,’” says Johnston (MD ’79), nephrologist and professor emeritus of medicine, who retired in June 2019. “I still have former students tell me it’s gotten them through exams or helped solve a clinical problem.”
Johnston’s famous lecture imagines the kidney as an automobile factory with workers performing specific tasks—transporters handling salt and potassium, for instance—who work in harmony to turn out a product. (In this case, urine.)
“One of the things I enjoy the most is being able to take my really kind of dense area of specialty and make it fun for medical students,” says Johnston. By all accounts, Johnston has succeeded in that regard. He’s nearly a perennial nominee for the Golden Apple Award given by a medical school class for excellence in teaching. He won the award seven times (not including the National Golden Apple Award he was given in 2004). He won the Excellence in Education Award for preclinical education more than 20 times.
Roderick Tan (MD ’07), assistant professor of medicine at Pitt, who trained under Johnston during his fellowship and later worked beside him, recalls being struck by Johnston’s diligence.
“You think professors are just great teachers, but he works really hard to keep his lectures up to date and engaging,” says Tan. 
Johnston’s wife, Georgia Duker, has also received several Pitt Med teaching accolades. Through the years, they’ve been sounding boards for each other’s teaching practices. Duker (PhD ’82), an assistant professor in the Department of Cell Biology, retired in 2018 after 31 years at Pitt Med.
Cary Boyd-Shiwarski (MD ’12), a Pitt assistant professor of medicine who also trained under Johnston, recalls his care in training fellows at patients’ bedsides. “He always took the time to teach very small nuances,” she says. For instance, examining a patient’s fingernails for clues to hidden illnesses, including those typically far outside a nephrologist’s scope.
“He had enough clinical experience to think outside the kidney,” Boyd-Shiwarski says. “He really treated the whole person.”
As highly regarded as a nephrologist as he is as a teacher, Johnston has received numerous recognitions for his clinical work. “Teaching makes you a better physician,” he says. “Teach once, learn twice.” 
Johnston began his studies at Pitt Med in 1975 and spent almost all of a nearly 40-year career here. With Thomas E. Starzl, he coauthored the first study on the drug tacrolimus, used to lessen the risk of organ rejection. His contributions to medical education range from cofounding Pitt’s Academy of Master Educators to assisting Pitt with helping a Kazakhstan university establish its own medical school. Nationally, he served on the American Society of Nephrology’s executive committee for renal fellowship program directors. 
“Always try to learn and teach as much as you can,” Johnston says. “If I had to get a tattoo, that’s what it would be. Maybe next to my Avengers tattoo.”
Science-fiction novels, bird-watching, and grandchildren are on his retirement priority list. He will teach occasionally at Pitt Med. “It’s extremely important to me to continue to teach,” he says. Asked if he plans to give his “Running the Nephron” talk, he laughs and says, “Medical students are already requesting it.”
Photo: Courtesy J. Johnston
Photo Illustration: Elena Cerri

When Genes Overlap



When Martina Brueckner (Res ’87) established her Yale University laboratory in 1990 to study congenital heart disease (CHD), only 67% of CHD patients lived past their first year. Today, she says, 90% of patients survive into adulthood, but many of them struggle with “major challenges” that aren’t properly diagnosed or understood. “Some CHD kids,” she notes, “fall under the radar screen for whatever else is going on with them, because everything that’s bothering them is blamed on their CHD.”
Brueckner, professor of pediatric cardiology and genetics at Yale, is using large-scale genome sequencing to parse out the genetic underpinnings of CHD—work that has yielded insights into the disease’s related challenges, too. Brueckner is a primary investigator with the national Pediatric Cardiac Genomics Consortium. In 2017, the group reported in Nature Genetics that a number of genes overlap between patients with CHD and those with autism. (The autism data was collected by the Simon Foundation.) When Brueckner and her colleagues compared the data sets, the overlap was undeniable, but logical. “The same [genetic materials] needed to build your brain,” she says, “are also needed to build your heart. It’s like a house—you need drywall, bricks, wood for all the rooms of your house. And if those are abnormal, you’ll have issues with your kitchen, bathroom and roof.”
Drawing a genetic connection between CHD and autism could mean increased diagnostic attention for CHD patients, improving their quality of life, says Brueckner. She maintains a clinical practice in pediatric cardiology. “We need to pay attention to the whole patient—not just the scar on their chest.” 
Besides “cranking out large sequencing data” with the Yale Center for Genome Analysis, Brueckner’s lab is investigating cilia, antennae-like organelles that assist in the heart’s development. 
Her plan is to keep working to “understand the genetics and biology of CHD  . . . and translate those findings into improved care for CHD patients—one gene, and one patient, at a time.” 


Photo: Courtesy Brueckner 


Barbara Ann Cohen Levey

MARCH 7 1935—OCT. 29, 2019

"They said our class was about a third women, the highest percentage ever at Pitt,” says endocrinologist Patricia Bononi (MD ’85). “I remember commenting that it was probably because of Dr. Levey.”

Barbara Levey, an MD, was the associate dean and director of admissions at the University of Pittsburgh School of Medicine from 1979 to 1991. She was the only woman in her own med school graduating class at SUNY in Syracuse. She served on committees supporting women in medicine for the Association of American Medical Colleges. Levey died in October. 
The percentage of women enrolled in classes before Levey’s time at Pitt is less clear, pointing to another of Levey’s key contributions as admissions director.
“She kept much better records than anybody before her,” says Beth Piraino, Pitt Med associate dean of admissions and financial aid and professor of medicine. Levey helped to usher in a more rigorous and systematic approach to the admissions process.
“She was instrumental in making sure there was a thorough vetting of everybody,” Piraino says. 
Levey’s chosen discipline was clinical pharmacology, a field she championed at Pitt and during the rest of her career, most of which was spent at UCLA. There she received numerous National Institutes of Health grants. She also served as associate vice chancellor at UCLA and, from 2002 to 2003, as president of the American Society for Clinical Pharmacology and Therapeutics.
She is fondly remembered as part of a dynamic and influential team with her husband, Gerald Levey, who served as Pitt Med’s chair of medicine from 1979 to 1991, and later as dean of the David Geffen School of Medicine and vice chancellor of medical sciences at UCLA. 
“They were a wonderful team, she and her husband,” says Piraino. “They left a very important stamp on the system here. They did a lot for Pitt.”   —Adam Reger

Michael J. Painter

NOV. 30, 1939—OCT. 17, 2019

An expert diagnostician, neurologist Michael Painter picked up on the subtlest clues to a patient’s underlying condition. That was true whether the patient was an infant, incapable of describing symptoms, or an adolescent whose condition Painter suspected to be rooted in psychiatric causes.

Patricia Crumrine, Pitt professor of pediatrics, recalls Painter seeing patients admitted with nonepileptic seizures. “He would go to the ER and see this supposedly unconscious young person lying on a table, and he’d peel back their eyelids and say, ‘I know you’re in there.’ And the person would burst out laughing,” says Crumrine, who also trained with Painter at Columbia University.
Painter served as chief of child neurology at Children’s Hospital of Pittsburgh from 1978 to 2002, and as professor of neurology and pediatrics at Pitt Med until his retirement in 2013. He died in October. 
“There was no situation so adverse that he couldn’t dispel some of the adversity with humor,” says Nina Schor, deputy director of the National Institute of Neurological Disorders and Stroke, who succeeded Painter as division chief. 
As a teacher, Painter modeled the same painstaking attention to detail he used in observing patients.
“He would spend time with you and your patients but, as he realized your capabilities, he would give a lot of leeway,” says Robert Safier, clinical director of the Division of Child Neurology at Children’s.
“He had a knack for building community and treating his division as a family,” says Schor. “We all feel somehow related to one another because of our link to him.” 
In 2002, Pitt created the Michael J. Painter Award for Excellence in Child Neurology in recognition of his contributions as a teacher and mentor. In 2006, Painter won the Hower Award, given by the Child Neurology Society to a member esteemed by colleagues as both an outstanding scholar and teacher.
“He loved neurology, and he had a way of conveying it,” Safier says.   —AR

Jan D. Smith

FEB. 6, 1939—SEPT. 6, 2019

Jan Smith, emeritus professor in Pitt’s Department of Anesthesiology and Perioperative Medicine, was “the conscience and soul of the department,” says colleague Mark Hudson.
Smith was born in Pretoria, South Africa. He earned his medical degree from the University of Pretoria and trained in critical care medicine, pulmonology and internal medicine at Pitt, first joining the Pitt Med faculty in 1971. From 1974 to 1985, Smith served on medical school faculties in Iowa, Texas, Nebraska and Ohio.  
In 1987, Smith returned to Pitt and was appointed chief of anesthesiology at UPMC Presbyterian, a role he held until 1996. He then became chief of anesthesiology and medical director at UPMC Beaver Valley until 2000, when he moved to help develop ISMETT, the UPMC transplant and major surgical center in Sicily. 
At ISMETT, Hudson says, “Jan was instrumental in the creation of the academic environment for the institution.” Smith used his love of travel for good, Hudson says, “helping to improve the medical care in many places.” 
Smith again returned to the Pittsburgh campus in 2002 as vice chair for clinical operations until his retirement in 2006 as professor of anesthesiology, internal medicine and critical care medicine.
In his emeritus role, Smith continued teaching and, in 2009, assisted with the development of UPMC Beacon Hospital in Dublin, Ireland, as its associate medical director. 
Volunteering as a teacher in sub-Saharan Africa, he also was appointed an Extraordinary Professor of Medicine at the University of Pretoria. 
In 2013, his department’s Education Office named a classroom in his honor. 
Smith “really influenced the educational program for our residents,” Hudson says. “He was a remarkable gentleman anesthesiologist.”  —Marty Levine
© 2019 University Times. Reprinted with permission and adaptations.


For more news from our alums, read this issue's Class Notes. >