December 17, 1999

Top stories of 1999 highlight dynamic year

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Randy Blakely, Ph.D.

Top stories of 1999 highlight dynamic year

As 1998 draws to a close, the staff of the VUMC Reporter looked back and compiled a list of some of the year's top stories. The stories are recapped here in no particular order.

Historic alliance

Meharry Medical College and VUMC established a formal alliance to enhance the educational, scientific, and clinical programs at and between both institutions.

The alliance linked the two institutions in collaborative efforts for undergraduate and graduate medical education; the conduct of research and training; the utilization of shared research, teaching, patient care and library facilities; and enhanced interaction of students and faculty at both schools.

The two institutions are developing innovative approaches to medical education, address the challenges of the new health care delivery environment, capitalize on existing positive relations between each institution, enhance diversity at each institution, and produce positive effects on the Nashville community.

Fetal surgery

VUMC's groundbreaking fetal surgery program continued to make breakthroughs and attract national and international attention.

A first-of-its kind fetal brain surgery procedure to repair hydrocephalus was performed this year on a Knoxville infant. Congenital hydrocephalus, seen in about one in 2,000 deliveries, is a developmental defect of the brain in which an excessive accumulation of fluid dilates the cerebral ventricles. Babies born with hydrocephalus are usually severely brain damaged.

VUMC's Dr. Joseph P. Bruner, associate professor of Obstetrics and Gynecology and director of Fetal Diagnosis and Therapy, and Dr. Noel B. Tulipan, associate professor of Neurological Surgery, performed the procedure.

To date, the Bruner-Tulipan team has performed more than 50 open fetal surgery procedures to repair spina bifida lesions on fetuses still nestled in their mother's wombs. They began performing the procedure two years ago.

Also, the first comprehensive follow-up of 29 babies, born after undergoing fetal surgery here to repair spina bifida, shows a significant reduction in the need for shunts to relieve hydrocephalus.

The follow-up study was published in the Journal of the American Medical Association.

VUMC's fetal surgery efforts have been chronicled in newspaper, magazine and television stories across the country and throughout the world. They include Life magazine, USA Today, CBS Evening News, Dateline NBC, Wall Street Journal, British Broadcasting Corporation, Australia's Good Medicine and virtually every major daily newspaper in the country.

Cancer pledge

The family of the late E. Bronson Ingram pledged $56 million to the Vanderbilt Cancer Center — and his son, Orrin, announced he would lead the campaign to nearly double that amount — to advance the fight against the disease that killed Bronson Ingram in 1995.

In conjunction with the gift, the Vanderbilt Cancer Center was been renamed the E. Bronson Ingram Cancer Center at Vanderbilt in memory of Ingram and in recognition of his and his family's unwavering support of Vanderbilt, particularly its internationally known cancer research programs.

For the children

Ann and Monroe Carell Jr. announced a gift of $20 million to help build the new, free-standing Vanderbilt Children's Hospital.

Carell, chairman and chief executive officer of Central Parking Corp., is serving as chairman of the Campaign for Vanderbilt Children's Hospital. The Carell's gift launched the formal fund-raising campaign designed to raise $50 million toward the new hospital, which will be a comprehensive home for children's health services.

Carell, a longtime member and past chairman of the Children's Hospital board of directors, and his family have a long history of supporting Vanderbilt, including the endowment of the Ann and Monroe Carell Jr. Family Professor of Pediatric Cardiology.

End of an era

Dr. John E. Chapman announced that he is stepping down as the dean of Vanderbilt University School of Medicine — a post he has held for the last quarter-century — to take on a new role, that of associate vice chancellor for Medical Alumni Affairs.

Through not only his longevity in the position, but in his accomplishments and achievements, Chapman is synonymous with medical education at Vanderbilt. They are one and the same.

Not only has he conferred medical degrees to two-thirds of the living graduates of VUSM, appointed essentially every one of Vanderbilt University Medical Center's more than 1,000 faculty members and been part of the appointment process for every current department chair, he has also overseen the initiatives that have led the medical school to be consistently ranked number one in the nation in terms of student satisfaction.

"John Chapman is truly a giant of American medical education. He has guided the school to the forefront of medical education programs in the nation. His insight, dedication, compassion and devotion to students and medical education are a credit both to him and to Vanderbilt.

"We look forward to John bringing that energy and experience to his new role as Associate Vice Chancellor for Medical Alumni Affairs, and I know he will be as successful in that arena as he has been during his tenure as dean."

Chapman will continue as dean of the School of Medicine until his successor is named and in place. A national search for the institution's eighth medical school dean is planned, but no timetable has yet been set.

Research efforts

Major initiatives in genetics and structural biology were launched that span the medical center and university. The initiatives, part of the Strategic Plan for the Academic Enterprise, include:

• The creation of a new Division of Genetic Medicine within the Department of Medicine to help position the institution as a world leader in the emerging discipline of genetic medicine. Leading this effort is Dr. Alfred L. George Jr., who was also named the Grant W. Liddle Associate Professor of Medicine and director of the Division of Genetic Medicine.

• Vanderbilt's designation as one of the initial three Genetic Epidemiology Centers in the world. The designation is part of a large-scale plan by pharmaceutical giant Glaxo Wellcome to harness the power of genetics for drug development and discovery. VUMC's Program in Human Genetics, led by Jonathan L. Haines, Ph.D., will play a central role in efforts to identify the genes involved in common diseases.

• The formation of the new Structural Biology Program, a major initiative intended to put Vanderbilt on the map as a premier site for structural biology research. It is being led by Walter J. Chazin, Ph.D., who joined the faculty as professor of Biochemistry and director of the new Structural Biology Program. The program includes two main elements consisting of a core of approximately 12 investigators focusing on atomic resolution structural biology — getting molecular structures down to the atom level — and a resource center to promote molecular research across the campus.

Transplant anniversary

The Vanderbilt Transplant Center celebrated its 10th anniversary. U.S. Sen. Bill Frist and internationally known organ donation advocate Reg Green were on hand for the festivities, which included a day of scientific presentations and a dinner event attended by more than 1,000 people.

The first transplant procedure performed at Vanderbilt University Medical Center took place in 1962 and within nine short years, the institution was celebrating its 100th kidney transplant.

Other milestones followed: the first pancreas transplant in Tennessee in 1985; the first successful heart/lung transplant in the Southeast in 1987; the formal establishment of the Vanderbilt Transplant Center in 1989; the first single-lung transplant in 1990; and the first liver transplant in 1991.

Hospital leader

Mark L. Penkhus, a health care executive with broad experience dealing with the myriad challenges facing academic medical centers, was named chief executive officer of Vanderbilt University Hospital.

Penkhus came to VUH from Ernst & Young LLP in Washington, D.C. As CEO, he will be responsible for all aspects of the hospital's operation and financial performance.

Financial strain

The financial cloud cast by TennCare and cuts in Medicare reimbursement continue to loom over Tennessee's health care system.

The situation is dire, especially for teaching hospitals such as Vanderbilt University Medical Center. Teaching hospitals make up only 6 percent of the hospitals in Tennessee, yet they account for a whopping 40 percent of all charity care performed.

At VUMC, the costs of TennCare are staggering — for the past four years, the medical center has been losing an average of $15 million per year. And these losses don't include the losses incurred by the physicians treating the patients.

TennCare is only part of the financial threat facing VUMC. The institution is also dealing with the impact from continuing cuts in Medicare reimbursement mandated by the 1997 Balanced Budget Amendment. These cuts are also severe. It's estimated that over the next five years, VUMC will have to absorb the loss of $41 million in reduced Medicare funding.

At both the state and federal level efforts are under way to alleviate the strain, but it remains unclear how the situation will be resolved.