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Through the Active Citizenship program at #WMed, students from the Class of 2024 found innovative ways to impact th…

In this month’s installment of Dean Termuhlen’s Take On …, our dean Dr. Paula Termuhlen discusses how working as a…

WMED SPOTLIGHT

FACULTY SPOTLIGHT
As an accomplished physician and scientist, Thomas L. Rothstein, MD, PhD, has long been intrigued and fascinated by the story of Henrietta Lacks and the role Lacks’ HeLa cell line has played in numerous scientific and medical breakthroughs since her death in 1952. Thomas L. Rothstein, MD, PhD “I feel it’s a wonderful story that re-emphasizes our human interdependency,” Dr. Rothstein, chair of the Department of Investigative Medicine at WMed, said. “HeLa cells are responsible for so many advances and I think it is so important to speak about the true history of interdependency and how we all can work together to advance medicine and science.” Dr. Rothstein got the opportunity recently to discuss HeLa cells and the history behind them when he gave the keynote address, “HeLa Cells: The legacy and misappropriation of Henrietta Lacks,” on November 20 at the Radisson Plaza Hotel & Suites in downtown Kalamazoo. His presentation was part of the Henrietta Lacks Traveling Museum, which was on display in Kalamazoo November 20 and 21. The traveling exhibit was created by Jermaine Jackson, a Kalamazoo Public Library employee who is Lacks’ great nephew. The important role that HeLa cells would play in medicine and science began in 1951 when Henrietta Lacks went to Johns Hopkins Hospital in Baltimore to be treated for cervical cancer. Dr. Rothstein said Lacks died six months after her cancer diagnosis but some of her cancer cells were collected at the time and were used in research. In his presentation on November 20, Dr. Rothstein discussed the origin and use of HeLa cells, notably that they were the first cells ever identified that were capable of living outside of the body for an extended period of time. They are also simple to maintain and sturdy, provide a good model for normal cells, and are easily transfected, among other things, he said. “HeLa cells are the go-to cells for an enormous number of experiments that have taken place in the past and are continuing to take place,” Dr. Rothstein said. Indeed, HeLa cells played a major role in the development of the Salk vaccine, the first effective agent against polio. More recently, the cell line has been used to study how coronaviruses like COVID-19 enter and leave cells and the cell line has also been integral in the research of several Nobel Prize winning scientists who discovered HIV, as well as human papilloma viruses that cause cervical cancer. At WMed, Dr. Rothstein said HeLa cells are used in his lab as part of his team’s work to study how cells deal with stress and avoid toxicity from protein aggregation. “I enjoy history and I have enjoyed trying to figure out where HeLa cells have played a role,” Dr. Rothstein said. “It’s history that we are living with all the time.” According to the National Institutes of Health (NIH), a recent analysis showed that there were more than 110,000 scholarly publications between 1953 and 2018 that cited the use of HeLa cells. The NIH said the analysis “further highlights the persistent impact of HeLa cells in science and medicine, proving that they have been a consistent, essential tool that has allowed researchers to expand the knowledge base in fields such as cancer biology, infectious disease, and many others.” The story of Henrietta Lacks is well-known today thanks in part to the traveling museum that came to Kalamazoo in November, as well as BBC documentary in 1997 and the publication in 2010 of the bestselling book, “The Immortal Life of Henrietta Lacks.” However, her family did not learn about the use of her cell line in research until 1971 and there is controversy that remains around the taking of her cells for use in research without her knowledge or consent. According to the NIH website, there were no federal regulations or restrictions on the use of patients’ cells in research at the time of Henrietta Lacks’ death. In his presentation on November 20, Dr. Rothstein discussed the history of HeLa cells and their discovery, including the mass production of the cells in 1952 at Tuskegee University, their use to test batches of polio vaccine in 1953, and the administration of the Salk polio vaccine in 1954. As it would turn out, one of Dr. Rothstein’s classmates in his MD class at Duke University School of Medicine – Dr. Georgeanna Jones – is the daughter of Dr. Howard W. Jones Jr., the first physician to see Henrietta Lacks when she went to Johns Hopkins Hospital in 1951. While Dr. Rothstein said he takes pride in sharing Henrietta Lacks’ story and the immortal role her cell line has played in medicine and science, he noted that it is also important to take a moment and understand that those advances came about as part of a tragic outcome with Henrietta Lacks’ death in 1952. “It’s very awkward to stand up in front of a crowd of people and talk about how useful HeLa cells are when you stop and think that it’s those same characteristics that took the life of Henrietta Lacks,” he said. “So, it’s important to temper how we talk about HeLa cells and remember the fatal outcome that these same cells imposed on the person from whom they arose.”
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RESIDENT SPOTLIGHT
A group of four emergency medicine residents used teamwork and their medical training to win a simulation competition in October. Drs. Stephen Godfrey, Henry Higby, Erik Loescher, and Joshua Recknagel beat out eight other teams from across the state and captured first place at the Emergency Medicine Residents’ Association of Michigan (EMRAM) SimWars Competition. Emergency medicine residents Drs. Stephen Godfrey, Henry Higby, Erik Loescher and Joshua Recknagel captured first place at the Michigan College of Emergency Physicians Emergency Medicine Residents’ Association of Michigan SimWars Competition. The team faced several simulated situations, including a patient with a vitamin D overdose, a patient demanding opiates whose family member became aggressive and pulled a gun, a patient who overdosed on toluene, and an infant who suffered injuries after being thrown off a balcony. In the final round, the team faced a multi-casualty incident with more than a dozen patients, where they had to triage and treat the patients and manage the disaster incident. “All the teams showed that the key to success for managing simulated cases as well as real patients is a combination of teamwork and communication skills as well as the basic knowledge of emergency medicine,” said Dr. Richard Lammers, a professor in the Department of Emergency Medicine and the medical school’s former assistant dean for Simulation. WMed’s residents had experience in managing disaster scenarios going into the competition, which allowed them to practice their skills against teams that may not have had that experience, said Dr. John Hoyle, the medical school’s assistant dean of Simulation and a professor in the departments of Emergency Medicine and Pediatric and Adolescent Medicine. WMed’s Emergency Management residency holds Wilderness Medicine Day in September, which includes working a mock mass casualty incident. Residents also take a course called Advanced Disaster Life Support, where they have to triage several patients in a disaster situation, figure out how to treat them and how to transport them for more treatment. WMed’s team was comfortable managing multiple ill and injured patients because of the emphasis of EMS in the Emergency Medicine residency, and the residents expertly handled individual patients in the simulated hospital rooms because they spend a day every month training in simulations involving pediatric cases, adult critical care cases, trauma cases, and obstetrics and gynecology. “If you don’t have any prior experience with simulated cases, the exercise may seem a little artificial, and that can interfere with decision making and your ability to function in that setting,” Dr. Lammers said. “Once you get past the inherent limitations in realism, you perform like you would in an actual clinical environment.” It was the first year the medical school sent a team to the competition, and the fact that WMed’s team, comprised of three second-year residents and one first-year resident, beat out other teams of third-year residents was not lost on their leaders. Dr. Lammers and Dr. Hoyle also served as judges. “A lot of this shows the strength of the clinical, didactic and simulation education our residents get,” Dr. Hoyle said. “In the case that I judged, they showed some really fine polish and really good clinical skills.” WMed’s team seamlessly worked each situation as they have been trained to do, from splitting up duties on the fly while managing to resuscitate a child, talking to family members and taking a patient history while helping a crashing patient, said Dr. Recknagel, a first-year resident. While teamwork under pressure isn’t foreign during an emergency medicine residency, Dr. Recknagel said he appreciated having multiple scenarios back-to-back to be able to practice skills that need to become second nature. “It was a privilege to get to practice advanced teamwork with some talented doctors,” Dr. Recknagel said. “It feels like you learn exponentially more in those complex scenarios where you don’t know what’s coming.” Second-year resident Erik Loescher said participating in the competition showed him how unique WMed’s training opportunities are, from shifts with West Michigan Air Care to the medical school’s robust simulation center to MSU-1, the resident-staffed Medical Support Unit that responds to major EMS incidents. The training prepares residents to tackle complex, evolving situations outside of the Emergency Department, he said. “I learned how strong the WMed Emergency Medicine residency is and how well prepared it’s making us,” Dr. Loescher said. “This isn’t just my experience, but I also saw this watching my co-residents in the same situations. I was really proud of how we all did together as a team.”
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SIMULATION CENTER SPOTLIGHT
In early August, while working with first-year Emergency Medicine residents in the Simulation Center at the W.E. Upjohn M.D. Campus, Dr. Emily Rozin used a short break in her teaching to learn something new of her own – how to perform an advanced intubation technique known as the ice axe method. In early August, Dr. John Hoyle, left, and Dr. Emily Rozin, practiced the ice axe intubation technique in the WMed Simulation Center. “We had some down time and he said, ‘Do you want to learn something cool?’” said Dr. Rozin, referring to Dr. John Hoyle, the medical school’s assistant dean for Simulation. “So, he used that opportunity to share this advanced technique with me.” The interaction that day was a spur-of-the-moment training session as Dr. Hoyle demonstrated the ice axe method and Dr. Rozin observed. Then, she got the chance to hone her skills at the face-to-face intubation technique several times. Side-by-side photos capturing the impromptu training were shared that day on the WMed EM Residency & EMS Fellowship Facebook page. As it turned out, her time that day with Dr. Hoyle equipped Dr. Rozin, a co-chief resident in the Emergency Medicine residency program at WMed, with a new skill she would use less than 24 hours later to save a patient’s life. That next day, Dr. Rozin was working a shift with West Michigan AirCare when she responded to a call in the region for a patient with severe facial injuries. She was part of a team that boarded an AirCare helicopter and flew to a rendezvous point where they met up with EMTs and began treating the patient in the back of an ambulance. “It was by far one of the worst potential airways that I’ve ever encountered,” Dr. Rozin said. “I won’t be surprised If it ends up being one of the worst I see in my career. It’s not something you see very often.” Additionally, Dr. Rozin said the limited space in the ambulance proved challenging as she and the flight nurse, Chris Mullen, assisting her assessed the patient. As it turned out, Mullen had spotted the photos on the EM Facebook page of Dr. Rozin practicing the ice axe technique. Mullen hadn’t used the technique since his time in the military but he believed Dr. Rozin could put the method to use to help the patient. After they laid the patient down, Dr. Rozin knew they only had so much time to secure the patient’s airway. The flight nurse sat at the head of the stretcher and Dr. Rozin straddled the patient’s chest, doing her best not to put her weight on the patient. “We both had a fantastic view from above to secure the patient’s airway,” Dr. Rozin recalled. “With most airways, you have time and other backup things you can do if you don’t get it the first time. In this case, because of the way the injuries had occurred, that was not an option. It was a lot of pressure but I did exactly what Dr. Hoyle taught me, and it was helpful that the flight nurse was familiar with the technique and trusted me, and we were able to work together as a team and do what was best for the patient.” Dr. Rozin said she has no doubt that using the ice axe method that day saved the patient’s life. “The teaching in ATLS (Advanced Trauma Life Support) is airway, breathing, circulation,” Dr. Rozin said. “Airway is the most important thing and you use that for every trauma that comes into the emergency department. The patient’s airway was at such high risk of deteriorating that it was so important to secure it. It was one of those things where having the experience we had and knowing what could go wrong, we didn’t have a choice. Once we had committed to getting that airway, if we couldn’t have gotten it for any reason, the patient would have died.” Dr. Rozin said that after the AirCare helicopter landed at a local Level 1 trauma center, she texted Dr. Hoyle to let him know how she had used the ice axe method to help the patient in need. “We do a lot of stuff in the simulation lab and many of those things I’ve ended up doing in real life in the field,” Dr. Rozin said. “I’m incredibly appreciative for the training. That was one of the things I looked for when I interviewed at Emergency Medicine residency programs. Some places would say they used their simulation labs once or twice a year but here at WMed, we use the Simulation Center monthly in addition to tons of other trainings we take part in.” For Dr. Hoyle, who was named the new assistant dean for Simulation at WMed in July, Dr. Rozin’s story serves as a real-life, tangible example of why the types of trainings that take place in the WMed Simulation Center are so important for residents, medical students, and faculty. “The whole idea behind simulation is giving trainees – whether they’re students, residents, or faculty – the opportunity to deal with rare cases and procedures, as well as common cases and procedures, in a safe environment where they can practice repeatedly,” Dr. Hoyle said. “It helps your confidence and when you’re thrown into a real-life situation, you say, ‘I’ve done this.’” Dr. Hoyle said he was overwhelmed with joy and pride after he received the text message from Dr. Rozin in early August and then, later, as he got the chance to debrief with her over the phone. “I was really proud of her,” Dr. Hoyle said. “There’s definitely an extreme sense of pride in what they were able to accomplish for that patient. I really was floored after getting the text and then hearing the story from her and how well the technique worked.”
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STUDENT SPOTLIGHT
After his team from WMed finished the 19th Annual Midwest Medical Wilderness Adventure Race (MedWAR), M2 Kevin Stehlik took a seat on the ground, physically spent from the 18 miles he and two of his classmates had covered on foot during the event. Two teams of students from WMed competed in the 19th Annual Midwest Medical Wilderness Adventure Race (MedWAR) on October 2 at the Pinckney Recreation Area in Pinckney, Michigan. He could barely stand on his sore feet and he had pulled both of his quads, Stehlik recalled recently. The state Stehlik found himself in that day – October 2 – came after the seven-hour MedWAR Challenge at the Pinckney Recreation Area in Pinckney, Michigan. The unique competition combines wilderness medical challenges with adventure racing and tests each three-person team’s knowledge, skills, and techniques of wilderness medicine while promoting teamwork. “It was a really fun experience and it was super cool to take part in,” said Stehlik, who completed the race with M2s James Burton and Cruz Gutierrez. “It was also pretty exhausting physically.” A second team from WMed – M2 Peter Awad and M1s Noemi Mangiamele and Mallory Wright – also took part in the competition. The event presented both teams with numerous challenges and scenarios meant to depict a post-apocalyptic atmosphere. They carried supply packs and equipment they were able to rent from the WMed Simulation Center. They got the chance to use their orienteering skills to navigate their way through the vast Pinckney Recreation Area. Along the way, they treated a patient for a snake bite, triaged numerous patients injured in an airliner crash, intubated a patient, and splinted a patient’s leg and then transported them from the scene via canoe. There was also a scenario involving an active shooter and a gunshot victim, as well as a dirty bomb. In between the different scenarios, they were presented with clinical questions to test their medical knowledge. They also were challenged by inclement weather as they battled rainfall during the second half of the competition. Wright, who recently completed her Medical First Responder course at WMed along with Mangiamele and their classmates in the MD Class of 2025, said she felt like the seven weeks of MFR training prior to the MedWAR Challenge prepared them to take on the tasks they faced with confidence even though they are only in their first year of medical school. “I feel like, because of MFR, we were able to have answers to 90 percent of those difficult tasks we faced, whether it was intubating a patient in the field or triaging patients at a disaster site,” Wright said. “MFR really instilled in me that teamwork and collaboration are essential, and during MedWAR we couldn’t have succeeded without collaboration, knowing our limitations, and asking each other for help. … It was an amazing experience.” A total of 11 teams competed in this year’s Midwest MedWAR Challenge, with a team of Emergency Medicine residents from Ohio taking first place. Both teams from WMed performed well at the event, with Stehlik, Burton, and Gutierrez finishing fourth and within the allotted seven-hour time frame to complete the course. Meanwhile, Wright, Mangiamele, and Awad came in sixth and just missed finishing within the seven-hour window. “With us never having done the MedWAR Challenge before, I was super proud of our team,” Stehlik said. Meanwhile, Mangiamele said her experience at the MedWAR Challenge is one she won’t soon forget. She said she enjoyed the opportunity to work as a team along with Wright and Awad. “I’m definitely going to do it again next year,” she said. “It’s an experience I’ll never forget, it was just a really fun competition.” Like Mangiamele, Wright and Stehlik said they also plan to take part in next year’s MedWAR Challenge and hope to improve on this year’s finishes.
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DONOR SPOTLIGHT
We formally recognize Mr. William D. Johnston and Mrs. Ronda E. Stryker alongside Mr. William U. Parfet and Mrs. Barbara A. Parfet for their leadership in co-chairing the medical school’s tenth anniversary gala WMed Live: A First Decade Celebration. Their leadership played an instrumental role in honoring Dean Emeritus Hal B. Jenson for his decade of leadership as the founding dean of Kalamazoo’s premier medical school and in welcoming our new dean, Dr. Paula Termuhlen. We appreciate their ongoing enthusiasm to celebrate the achievements of the medical school and our future Clinicians, Leaders, Educators, Advocates, and Researchers of tomorrow. Bill and Ronda have been tireless in their advocacy to encourage members of our regional community to support medical education diversity, equity, and inclusion initiatives. Bill and Barbara have shown generous support for the mission of the medical school, the development of the medical school’s physical facilities, and encouraging philanthropy through the WMed Philanthropy Advisory Council, the Dean’s Circle Leadership Giving Society, and the planned giving programs of the medical school. We proudly recognize these two couples for their bold leadership, inspiring vision, and generous financial support to advance the mission of WMed and its place in the field of global medical education.
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