February 2014 Emory Surgery newsletter Department of Surgery of the Emory University School of Medicine

 

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Emory is leading site for living donor kidney transplantation

Dr. Turgeon (right) helping decorate the Donate Life float for the New Years 2014 Rose Parade in Pasadena, CA.
Dr. Turgeon (right) helping decorate the Donate Life float for the New Years 2014 Rose Parade in Pasadena, CA. Dr. Turgeon rode the float with Emory transplant patients Julie Allred (islet cell recipient) and Amy Tippens (liver recipient).

The living donor paired kidney exchange program of the Emory Transplant Center has successfully matched and subsequently transplanted 100% of the donor/recipient pairs enrolled in the National Kidney Registry (NKR), a national organization formed in 2008 to facilitate living donor transplantation. Emory is tied with Johns Hopkins for a 100% rate and first place among U.S. transplant centers with the highest match rates. However, Emory has been with the program a year and has transplanted more patients than Johns Hopkins, which joined several months ago.

In paired kidney donation exchange, people can donate a kidney to a friend or loved one despite incompatible blood matches. The process involves a donor and recipient being matched with another incompatible donor and recipient pair, and the kidneys being exchanged between the pairs. Emory's membership in the NKR has considerably widened the donor-recipient pool to encompass the entire nation, and allows participation in swaps or "chains" that involve multiple patients and transplant programs across the U.S.

The Emory program's perfect score is a remarkable achievement because no Emory patient has had to wait more than six months for a match. A quick and accurate match benefits transplant outcomes, extends kidney and patient survival rates, and improves the recipient's chance of a quality life.

"We are extremely fortunate to have a very skilled and dedicated team, including our transplant nephrology colleagues, coordinators, managers, physicians, and leaders," says Dr. Nicole Turgeon, surgical director of the paired donor exchange program. "Most importantly, we could not do this without patients who have been willing to participate in the NKR program." Nineteen patients have received kidney transplants through the NKR since Emory joined the network.

The NKR is the leader in paired donor exchange transplantation with the mission to save and improve lives by increasing the quality, speed, and number of living donor transplants in the U.S.

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Michael Konomos
Michael Konomos
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Andy Matlock
Andy Matlock
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Satyen Tripathi
Satyen Tripathi

Role of medical illustration expands in the SOM

The August 2011 hire of Michael Konomos, MS, CMI, as a medical illustrator for the Department of Surgery was the first appointment since the 1990s of a certified medical illustrator to an academic clinical department of the Emory School of Medicine. Michael went on to apply his experience in 3D animation, realistic 3D modeling and texturing, digital illustration, surgical anatomy, and visual medical education to a variety of electronic materials, including the patient education app "Come Clean: Stop Surgical Infections Before They Start" for Emory's Wound Infection Group (WIG), and the decision-making "iChoose Kidney" tool for patients regarding kidney failure treatment options, an app developed by a group led by Emory transplant and epidemiology researcher Dr. Rachel Patzer.

With the support of School of Medicine Dean Dr. Christian Larsen, Michael recently moved to the SOM to lend his expertise to other educational initiatives within the school, one of which will be managing the newly formed Visual Medical Education team (VME). "I think Dean Larsen and I share a vision for how a medical illustrator can teach medicine in the 21st century. We have exciting new tools like mobile apps, 3D animation, and ebooks at our disposal that allow us to reach a worldwide audience quickly," says Michael. "But at the end of the day, we are still focused on effective education. That is something that hasn't changed. We want to deeply engage patients, residents, and other learners in the content because our goal is to change outcomes."

The VME team was organized to increase the ability to provide visual design components to the increasing surge of electronic education projects that are being initiated by Emory SOM faculty. In addition to Michael, the team includes recently hired medical illustrators Andy Matlock, MS, and Satyen Tripathi, MA, CMI.

Satyen has assumed Michael's former role in the Department of Surgery. He was previously employed at Artcraft Health Education, which creates communication materials for healthcare professionals, patients, and caregivers. Satyen worked on such projects as the creation of a digital oncology resource for patients, brochures on diabetes education, and support visuals for a facial transplantation study. Examples of his work can be seen at www.stillustration.com. Since arriving at Emory, he is developing patient education materials for the Emory Transplant Center and surgical protocol packages for WIG.

Coming from the NIH's National Library of Medicine (NLM), Andy is now the medical illustrator for the Thalia and Michael Carlos and Alfred A. Davis Center for Surgical Anatomy and Technique (CSAT), which is led by Dr. Keith Delman, the Carlos Professor of Surgical Anatomy and Technique. At NLM, Andy was involved with art direction, video production, and video editing, and contributed to documentaries and website development. Prior to NLM, Andy was the first staff medical illustrator for the Atlanta-based WebMD. For CSAT, Andy is focusing on generating digital tools that will teach medical students, residents, and physicians about the critical role surgical anatomy plays in the operating room. His current projects include an iPad app based on pelvic anatomy, and a common surgical procedures app referred to as a video atlas that will feature step-by-step video presentations shot in the OR.

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Dr. Stacy Dougherty
Stacy Dougherty
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Dr. Anu Subramanian
Anu Subramanian

TEAM to continue at Grady with new educators

Dr. Pettitt (center) conducting the assessment segment of the TEAM course.
Dr. Pettitt (center) conducting the assessment segment of the TEAM course.

The patient is unconscious, his face smeared with blood. An attending surgeon scans the trauma team gathered around the gurney. "Time is flying, people," she says. "Where do we start?" Two team members respond simultaneously. The attending raises her hand. "One at a time," she says.

This is a classroom, not a trauma bay. The patient is an actor encircled by a group of medical students, and the attending is Dr. Barbara Pettitt, director of medical student education for the Emory Department of Surgery. The course is Trauma Evaluation and Management, or TEAM, which was developed by the Advanced Trauma Life Support Committee of the ACS Committee on Trauma. TEAM is structured to introduce the concepts of trauma assessment and management to medical students during their clinical years. The course is offered once per term for Emory M3 students at Grady Memorial Hospital, the home of one of Georgia's finest Level I trauma centers.

Dr. Pettitt initiated TEAM at Grady in 2002 with former Emory trauma/surgical critical care surgeon Dr. Jeffrey Salomone. Emory trauma fellows also assist with the instruction. For the didactic portion of the class, case examples from the instructors' own experiences are discussed and ACS-produced PowerPoint presentations and videos depicting both appropriate and incorrect approaches to trauma care are reviewed. Afterwards, the students break into small groups and conduct initial injury and condition assessments of patients played by actors that have been transformed by a makeup artist to exhibit bruises, cuts, and other typical signs of trauma.

Dr. Pettitt has taught the course for 11 years. Following the arrival of several new trauma and surgical critical care faculty at Grady over the past two years and Dr. Salomone's departure in April 2013 to be chief of trauma/surgical critical care at Maricopa Medical Center in Phoenix, she decided that now was the time to transition TEAM to new educators. "The new faculty are very interested in becoming involved with medical student education, and leading the TEAM course is an excellent way to kick off that type of interaction," she says. "As of the next course on March 5, Dr. Anu Subramanian and Dr. Stacy Dougherty will begin running the class."

Dr. Dougherty joined the Department of Surgery in 2013 after completing her general surgery residency at Wake Forest University Baptist Medical Center. She also did her surgical critical care fellowship at Wake Forest. "When the word got around that I was looking for new teachers for TEAM, Dr. Dougherty was one of the first people to contact me," says Dr. Pettitt. "Her desire to be involved combined with her firm grasp of the tried and true principles of decisive trauma surgery, emergency general surgery, and surgical critical care will make her an excellent guide for medical students as they move through this introduction."

Dr. Subramanian completed her trauma/surgical critical care fellowship at Grady in 2007, after which she joined the Baylor College of Medicine in Houston. She returned to Grady in 2012 to be associate director of the Surgical Intensive Care Unit and associate program director of the Trauma/Surgical Critical Care Fellowship, and was promoted to medical director of Grady's SICU in March 2013.

"I was the director of medical student education for three years for the Department of Surgery when I was at Baylor. But in my positions here at Emory, I haven't been able to consistently work with medical students," say Dr. Subramanian. "Teaching the TEAM course will allow me to use my enthusiasm for and experience in the acuity of trauma to show medical students how wonderful and fulfilling a career in surgery can be."

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Douglas Murphy
Douglas Murphy

New arrivals:

Dr. Douglas Murphy

FACULTY

Division of Cardiothoracic Surgery

(Professor of Surgery) Douglas A. Murphy, MD, received his medical degree at the University of Pennsylvania School of Medicine in 1975 and did his internal medicine residency and general surgery residency at Massachusetts General Hospital. After completing his cardiothoracic surgery fellowship at Emory in 1983, he joined the faculty of the Emory Department of Surgery. Four years later, Dr. Murphy was appointed director of cardiac transplantation at Saint Joseph's Hospital. He became section chief of cardiothoracic surgery at the hospital in 1995, and chaired Saint Joseph's Heart and Vascular Institute from 2007-2009.

Building on the foundation of his early advocacy of minimally invasive cardiac surgery, Dr. Murphy developed into of the most experienced robotic heart surgeons in the world. In 2002, he led one of the first U.S. cardiac surgery teams in clinical trials of the use of the da Vinci® Surgical System for atrial septal defect repair and coronary bypasses prior to FDA approval. In 2004, St. Joseph's was named the exclusive southeastern training center for the da Vinci® System, and Dr. Murphy's training sessions attracted physicians from around the globe.

Following the finalization of the partnership between Saint Joseph's and Emory Healthcare in 2013, Dr. Murphy rejoined the Emory faculty as a professor of surgery. He retains his membership on the cardiothoracic surgery team at Saint Joseph's and is maintaining his focus on performing, researching, and teaching robotic heart surgery.

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Trish Shawver
Trish Shawver

Patricia Shawver

STAFF

Office of Surgical Education

(Surgical Clerkship Coordinator) Patricia ("Trish") Shawver has joined the Emory Office of Surgical Education as clerkship coordinator, assuming the position formerly occupied by Jennifer Peters, who left Emory at the end of November 2013. Trish is coming from Emory's Office of Medical Education and Student Affairs (OMESA), where she had served as program coordinator for student affairs since October 2012. At OMESA, her duties included coordinating elective courses for 3rd and 4th year medical students, grade submissions and registrations, and record keeping for the MD program. Trish has a Master's Degree in education.

As clerkship coordinator, Trish will work closely with Dr. Barbara Pettitt, the director of medical student education for the Department of Surgery. Her primary responsibilities will be to manage M3 students during their surgery rotations and act as a staff liaison for faculty mentors, those interested in mentoring, and faculty who would like to engage with medical students in other ways.

During the gap between Jennifer's departure and Trish's appointment, the surgical education team smoothly maintained the day-to-day operations of the clerkship. Thanks and appreciation are due to Nena Buie, residency program coordinator; Johanna Hinman, associate director of education; Cyndi Painter, administrative manager, Carlos and Davis Center for Surgical Anatomy and Technique; and Susan Ratliff, program business manager.

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Upcoming events

EVENT DATE/TIME LOCATION
SURGICAL GRAND ROUNDS
Immortality, Immorality, and the Price of Progress
Presented by Jennifer Avise, MD
– Chief Resident, Department of Surgery, Emory University School of Medicine
7:00 - 8:00 a.m., February 6, 2014 EUH auditorium
Healthcare Innovation Symposium IX: Teaching Hospitals and Health Services Research
Presenter:
Steven Lipstein
– President and CEO, BJC Healthcare
– Vice-Chair, Patient-Centered Outcomes Research Institute
– WHSC trustee
4:30 - 6:30 p.m., February 6, 2014 EUH auditorium
More info.
Winship Cancer Institute's 2014 Melanoma Conference
Course Directors:
David Lawson, MD, Suephy Chen, MD, MS, Keith Delman, MD, Mohammad Khan, MD, PhD
Experts in the field will discuss recent advances in the diagnosis and prevention of cutaneous malignancies, including diagnostic challenges in the community setting. Optimal strategies for administration of regional therapy and management of nodal and in-transit disease will also be addressed.
8:00 a.m. - 4:00 p.m., February 8, 2014

Emory Health Sciences Research Building Auditorium, 1st Floor

More info. and registration

SURGICAL GRAND ROUNDS
J. C. Thoroughman Visiting Professorship
Lynch Polyposis

Presented by Miguel A. Rodriguez-Bigas, MD
– Professor, Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center
7:00 - 8:00 a.m., February 13, 2014 EUH auditorium
SURGICAL GRAND ROUNDS
Developing Surgery Residents into Surgeon Scientists: The Role of the Resident Research Sabbatical
Presented by Peter W. Thompson, MD
– Chief Resident, Department of Surgery, Emory University School of Medicine
7:00 - 8:00 a.m., February 20, 2014 EUH auditorium
SURGICAL GRAND ROUNDS
The Impact of Non-Technical Skills on Operative Performance and Patient Safety
Presented by Steven Yule, PhD
– Assistant Professor of Surgery, Harvard Medical School
– Director of Education & Research, STRATUS Center for Medical Simulation, Brigham and Women's Hospital
7:00 - 8:00 a.m., February 27, 2014 EUH auditorium
Georgia ImmunoEngineering Consortium (GIEC) 1st Annual Symposium
Presented by George Georgiou, PhD, Member NAE, IOM
– Cockrell Family Regents Chair in Engineering, The University of Texas at Austin
February 28, 2014 Starvine Ballroom, Emory Conference Center and Hotel
More info.
     
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