Dr. Arnold Strauss listens to the heart of patient Annah Mobus, 4, in Vanderbilt Children's Hospital last week during rounds with students and residents. (photo by Dana Johnson)
Strauss focuses on kids, future of new hospital
There are those who were surprised when Dr. Arnold W. Strauss left Washington University in St. Louis after 34 years to chair the Department of Pediatrics at Vanderbilt University Medical Center.
He came to St. Louis when he enrolled in medical school in 1966, served an internship, residency and fellowship there, then worked his way up from assistant professor of pediatrics to the Alumni Endowed Professor of Pediatrics and director of the Division of Pediatric Cardiology 21 years later. To Strauss, Wash U. was like a favorite chair – reliable and comfortable.
But last year, when Vanderbilt began looking for someone with outstanding academic and clinical credentials to chair its Department of Pediatrics, Strauss was ready for a challenge.
Strauss, James C. Overall Professor and Chair of the Department of Pediatrics, Pediatrician-in-Chief and Director of Vanderbilt Children’s Hospital, assumed the post Aug. 1. He and his wife, Pat, a committed volunteer, are finding Nashville and Vanderbilt a good fit, he said. The couple has two daughters: Natasha, 26, the director of a computer education school in St. Louis, and Lara, 23, a law student and world-class rugby player in Los Angeles.
Strauss said there’s much to do in the department, but the important groundwork has already been laid by those in the position before him. His goals are lofty – placing the department and Vanderbilt Children’s Hospital in the top 10 in the country.
“I think it can easily be done in the next three to five years. I came to Vanderbilt because I think it’s one of the few places where there’s an opportunity to develop a national presence in academic pediatrics,” Strauss said. “Vanderbilt is an institution with the right attitude and values. Now, it’s just a question of bringing in the right people and investigators to establish that national presence.”
Strauss said the longtime emphasis on maintaining excellence in clinical care has resulted in a respected faculty and a new Children’s Hospital currently under construction that will be one of the most family-friendly children’s hospitals in the country when it is completed in three years.
Strauss will also place an emphasis on recruiting academic scientists who can bring strength in research to the department. A search is currently underway for eight new faculty members, six of whom will focus on laboratory research in various divisions.
“Laboratory research in pediatrics has declined, not just at Vanderbilt but everywhere,” Strauss explained. “For a period of time, NIH funding was very poor and that took away five to 10 years worth of young investigators. That really hit pediatrics very hard.”
Strauss said it is important to strengthen Vanderbilt’s commitment to pediatric research.
“Kids are sort of the developmental biology of human beings,” Strauss said. “Understanding how the heart and brain form is something pediatric physician-scientists focus on, along with human genetics. Because of the human genome project, there are going to be huge opportunities. It’s going to become a lot easier to find out about genes causing disease and genes affecting how diseases occur.”
Strauss’ own research interest has been in pediatric cardiology, focusing on fatty acid metabolism. Fat is the major source of energy for the heart. Strauss’ group originally described a variety of human genetic disorders that cause heart-muscle disease. Four of Strauss’ group came with him to Vanderbilt.
“We’re interested in understanding how the genes are regulated so we know what turns them on and off, why the brain is different from the heart and why certain types of muscle are different from other types of muscle in the way they use fat. All of that is involved in how the genes are turned on,” Strauss said.
Strauss became interested in this area of research 15 years ago when his laboratory was studying mitochondria, the part of the cell that makes energy.
“One of the people in my laboratory wanted to do something that was relevant to patients, and the focus had to do with some of the genes in this pathway,” he commented. “When it became clear that this was extremely interesting, I switched my whole laboratory to this area of investigation.”
Dr. Larry J. Shapiro, W.H. and Marie Wattis Distinguished Professor and Chairman of the Department of Pediatrics at the University of California, San Francisco, has known Strauss for 30 years. He’s an “extraordinary individual,” Shapiro said.
“He has had considerable success as a scientist, making important contributions to the fields of fatty acid metabolism and clinical disorders associated with defects in these pathways,” Shapiro said. “He is a highly skilled clinical cardiologist who has effectively built and led a Division for many years. He is a superb teacher, a great communicator, and a wonderful mentor in the truest sense of the word. He has a generosity of spirit that is not often matched.”
Strauss said the reason he chose pediatrics as a specialty is because “children get well.”
“It’s so rewarding to be able to take somebody critically ill and do something for them so they can walk out of the hospital,” Strauss said. “Children are also straightforward. They tell it like it is and that makes a big difference when you’re treating a patient.”
In addition to developing a strong base of physician-scientists, Strauss is also prepared for other challenges ahead as the medical center continues to deal with the financial constraints brought about by managed care and TennCare. He will also be heavily involved as planning continues on the new family-centered Monroe Carell Jr. Children’s Hospital at Vanderbilt.
“The idea that the family is involved in the health of a child is so obviously true that it shouldn’t have to be talked about, but it needs to be talked about,” Strauss said. “It’s important to make this hospital a place that takes into consideration not only the needs of our patients, but their families as well. That’s a critical part of what we’re all about.”
Strauss said it is important that the department develop strength in all areas – clinical care, clinical investigation, laboratory investigation, education, patient advocacy and community relationships. “All of these have to become important,” Strauss added. “There’s no reason why we can’t do them all.
“I think the attitude of service is something we need to focus on. Academic medical centers don’t traditionally do that, but especially in pediatrics, we need to be more integrated into the community. Pediatrics has done that extraordinarily well here within the community of pediatricians, but maybe not as well in the lay community.”
Strauss said the department should become an advocate for the safety of children. “Advocacy for kids, stressing car seats and vaccinations and making kids sleep on their backs has saved more life than heart surgery,” he said.
He also hopes that the department and its faculty will become more politically active so the legislature and the lay public understand the importance of taking care of children.
“We just can’t do it for nothing,” he said. “It’s obvious that taking care of children is something that everybody agrees is important, but it’s not something that people want to pay for. That money has to come from somewhere, so bringing that message to the people and to the governmental agencies involved has to become important. We have a lot to do, but it’s doable.”