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SPECIAL REPORT: COURAGE IN THE FACE OF COVID-19 / P. 3
SPRING/ ART WITH AN IMPACT HANGING TOUGH NO BULLIES ALLOWED
SUMMER A creative partnership One man’s fight for survival Putting an end to harsh
2O2O sets a healing tone/ p. 10 in the Burn Center/ p. 18 treatment of trainees/ p. 26
HOPKINSMEDICINE
TH E X
FAC TO R
Could advances
surrounding a
newly discovered
“X cell” hold the
clue to preventing
type 1 diabetes
from taking
hold in the first
place? / p. 30
IN FOCUS
FLYOVER SALUTE
The iconic Johns Hopkins Dome served as a fitting backdrop for a May 2 flyover by
the U.S. Air Force Thunderbirds and U.S. Navy Blue Angels — part of a Maryland-
wide Healthcare Heroes Day tribute to front-line staff members in response
to COVID-19. Read more about how Johns Hopkins faculty and staff members,
researchers, and students have responded to the global pandemic in our special
report, beginning on p. 3.
Photo by Loraine Imwold
2 • Hopkins Medicine • spring / summer 2020
CONTENTS
SPRING/SUMMER 2O2O
F E AT U R E S D E PA R T M E N T S
10 10 Art with an Impact 3 COVID-19:
Student works bring a spirit of well-being
to a local physician practice, thanks to a
Special Report
Gearing up for a surge, promise
creative collaboration with the Maryland
in plasma, a MESH of support
Institute College of Art.
for front-line staff, a “Go Team”
By Linell Smith
for nursing homes and more.
18 Hanging Tough 10 Medical Rounds
One night last fall, Pierre Gibbons
Statins as cancer starvers,
ran into a burning building to help a
aquarium escapes, a scarless
neighbor — and emerged with severe
solution for benign thyroid
burns and very slim odds for survival.
nodules, a window on blood flow
To give Gibbons a fighting chance,
to tumors, improved outlook for
specialists at the Johns Hopkins Burn
serious lung conditions and more.
Center tried a one-two punch they’d
never used before.
By Jim Duffy 16 Hopkins Reader
Kathleen Sutcliffe tells how
26 No Bullies Allowed nationwide patient safety efforts
have stalled and calls for new
In academic medicine, harsh treatment
collaborations between physicians
of medical students and trainees has
and safety researchers.
too often gone ignored or excused. That
culture is now changing, both at the
national level and at Johns Hopkins, 38 Class Notes
18 where new efforts are aimed at preventing
— and addressing — mistreatment,
News from and about our
graduates. Plus: How sharing a
harassment and discrimination. By Karen relaxed meal together is building
Nitkin bonds between medical school
students and alumni.
30 The X Factor
26 Could advances surrounding a newly 47 Second Opinion
discovered “X cell” hold the clue to Permanent changes at the federal
preventing type 1 diabetes from taking level are needed to provide a
hold in the first place? That’s the hope of permanent path forward for
a team of Johns Hopkins scientists whose telemedicine in neurology and
arduous bench-side journey might be other specialties.
close to paying off. By David Glenn By Justin C. McArthur
48 Post-Op
In the face of a global pandemic,
30 front-line faculty and staff
members and alumni have
stepped up to serve with
selflessness and courage.
By Dean/CEO Paul Rothman
Cover illustration
by Michael Glenwood
Hopkins Medicine • spring / summer 2020 •1
THANK YOU,
EDITOR Sue De Pasquale JOHNS HOPKINS
CLASS NOTES Neil A. Grauer
CONTRIBUTING WRITERS Richard Byrne, HEALTH CARE
HEROES
Saralyn Cruikshank, Sue DePasquale,
Jim Duffy, Lisa Eddy, David Glenn, Judith
Minkove, Karen Nitkin, Katie Pierce, Linell
Smith, Patrick Smith, George Spencer, Tracy
Vogel, Vanessa Wasta
DESIGN Max Boam, Lori Kirkpatrick
A staff appreciation gallery, created as part
PHOTOGRAPHY Will Kirk, Keith Weller of the Extraordinary People, Extraordinary
ADMINISTRATION
Paul B. Rothman, Dean, School of Moments campaign, includes portraits of
Medicine CEO, Johns Hopkins Medicine
Kevin Sowers, President of the Johns front-line Johns Hopkins health care providers,
Hopkins Health System, Executive Vice
President of Johns Hopkins Medicine a kudoboard with posts of appreciation and
Redonda G. Miller, M.D., President,
The Johns Hopkins Hospital
Suzanne Sawyer, Senior Vice President,
a video in which Johns Hopkins Medicine
Chief Marketing and Communications
Officer
employees share their experiences during the
ADVISORY BOARD
Steve Desiderio, M.D. ’78, Ph.D. ’81
COVID-19 crisis. View it at:
Director, Institute for Basic
Biomedical Sciences
Bit.ly/JHMHeroes.
David Hellmann, M.D. ’77
Vice Dean, Johns Hopkins Bayview
Argye Hillis-Trupe, M.D. ’95
Professor, Neurology
Thomas Traill, M.D., Professor, Medicine
Cornelia Trimble, M.D.,
Professor, Gyn/Ob
Hopkins Medicine is made possible
through the generosity of The Johns
Hopkins Medical and Surgical
Association, the organization
for every M.D. or Ph.D. whose training
or employment includes Johns Hopkins.
John T. Thompson ’80, President
Printed in the U.S.A.
©2020 The Johns Hopkins University
and The Johns Hopkins Health System
Corporation
Hopkins Medicine is published in the
fall, winter and spring by Johns Hopkins
Medicine, Department of Marketing and
Communications, 901 S. Bond St.,
Suite 550, Baltimore, MD 21231.
Send letters to Sue De Pasquale,
Editor, at the above address.
email: sdepasq1@jhmi.edu
Letters may be edited for clarity
and length.
Web address:
hopkinsmedicinemagazine.org
2 • Hopkins Medicine • spring / summer 2020
Special Report
Courage in
the Face of
COVID-19
We were close to finalizing the feature
stories in this issue of Hopkins Medicine
magazine when our world — seemingly
overnight — was turned upside down by
COVID-19, the global pandemic that has shut
down countries; caused untold anxiety,
suffering and death; and put health care
workers on the front lines of a grueling, life-
and-death battle that could stretch on for
months. In the special section that follows, a
late-breaking supplement to the other
content in this issue that had been completed
pre-pandemic, you’ll read about just some of
the ways that people at Johns Hopkins
Medicine are rising to the unprecedented
challenges posed by COVID-19: in the lab, at
the bedside and in the community.
Sue De Pasquale, Editor
Hopkins Medicine • spring / summer 2020 •3
COVID-19
REPORT
‘A Beautiful Thing
to Be Involved In’
In mid-March, Johns Hopkins launched a
massive and ambitious initiative to repurpose
research facilities and allocate new financial
resources to projects that will advance
understanding of COVID-19, prevent its spread
and care for the sick.
“This is a university that lives and breathes
research; optimizing and maximizing research
is in the very fiber of our being,” says DENIS
WIRTZ , vice provost for research at Johns
Hopkins. “There are very few universities that
can contribute on this scale to addressing the
immediate needs of the global community. It’s a
beautiful thing to be involved in.”
To date, $6 million in university funding has
K EITH W ELLER
been redirected to support roughly 260 scientists
and researchers working on 25 projects grouped
under five complementary interdisciplinary
themes: understanding the virus, understanding
Gearing Up for a Surge
and mitigating transmission, understanding the
effects of COVID-19 on patients, helping patients
recover, and developing new ways to protect
E
health care workers and solve supply chain issues. ngineers, carpenters, painters and other facilities
The COVID-19 Research Response Program is
workers throughout the Johns Hopkins Health System worked
focused on supporting high-impact, foundational
at a frenetic pace to prepare Johns Hopkins hospitals for
projects that provide the framework and
resources — including data, assays and samples
COVID-19 patients throughout early spring.
— necessary to enable further COVID-19 They added ductwork and high-efficiency particulate air
research at The Johns Hopkins University. The filters to convert regular patient rooms to ones with negative air pressure
groups will share initial reports and relevant suitable for patients with the highly infectious coronavirus. They built
instructions for accessing shared resources in anterooms where clinicians can safely don and doff their protective gear
May. before treating patients diagnosed with COVID-19. They set up tents for
“The focus of these projects is on immediate COVID-19 testing and put up signs telling people which entrance doors
impact,” Wirtz says. “Are we thinking about are locked.
long-term solutions? Of course. But our main Because of such efforts, by late April, The Johns Hopkins Hospital was
concern is on immediately improving the health on track to add negative pressure capability to as many as 800 adult and
of patients, health care workers and our global pediatric patient beds, says GREGORY BOVA , senior engineering project
community.” manager for the health system. The other Maryland and Washington
SARALYN CRUICKSHANK, HOPKINS HUB hospitals — Suburban Hospital, Sibley Memorial Hospital, Howard
County General Hospital and Johns Hopkins Bayview Medical Center
— added more than 200 COVID-19 rooms between them.
READ MORE about When the coronavirus crisis ebbs, the modifications will remain,
the COVID-19 Research allowing hospitals to switch room pressure as needed. The anterooms will
stay as well, says Bova. But there will be a key difference: “We’ll open the
Response Program: Bit.ly/
doors so people can easily go in and out.” KAREN NITKIN
JHMCovid19Research
4 • Hopkins Medicine • spring / summer 2020
PA M LI / J O H N S H O PK I N S U N I V ER S IT Y
PROMISE IN PLASMA?
W
ith a vaccine for covid -19 still a long way from being
realized (see p. 9), Johns Hopkins immunologist
ARTURO CASADEVALL is working to revive a century-
old blood-derived treatment for use in the United
States in hopes of slowing the spread of the disease.
The technique uses antibodies from At Johns Hopkins, the FDA has
the blood plasma or serum of people who paved the way for researchers to proceed
have recovered from COVID-19 infec- with clinical trials to test convalescent
March 11
The first day that an in-
tion to boost the immunity of newly plasma therapy in people who are at high house coronavirus screening
infected patients and those at risk of risk of severe COVID-19 illness and have test, developed by Johns
contracting the disease. These antibodies been exposed to people who have tested Hopkins microbiologists
contained in the blood’s serum have the positive for the virus. K AREN CARROLL and HEBA
ability to bind to and neutralize SARS- “We’ve received many inquiries from MOSTAFA , was used at Johns
CoV-2, the virus that causes COVID-19. health care providers looking to ramp up Hopkins. Some 85 tests were
“Deployment of this option requires their ability to deliver this therapy,” says performed in the first three
no research or development. It could be Johns Hopkins pathologist EVAN days, and production ramped
deployed within a couple of weeks since BLOCH . In response, on April 7, Bloch
up rapidly, with tests quickly
becoming available at the Johns
it relies on standard blood-banking and colleagues published a clinical
Hopkins Health System’s five
practices,” says Casadevall, who pub- guidebook in The Journal of Clinical
Maryland and Washington
lished a paper on the proposal — “maybe Investigation to help hospitals rapidly hospitals. “This laboratory
the most important paper of my life,” he scale up their ability to deliver convales- has a history of rising to the
says — on March 13 in The Journal of cent plasma therapy. occasion,” says Carroll, who
Clinical Investigation. “This paper details the nuts and bolts directs the Division of Medical
On March 24, the U.S. Food and of how to deploy convalescent plasma, Microbiology at Johns Hopkins.
Drug Administration (FDA) began and this information should be very “We did it for H1N1 influenza
allowing researchers to request emergen- helpful to colleagues worldwide who are in 2009 and to support our
cy authorization for its use. Within three preparing to use this therapy against Biocontainment Unit here in
days, hospitals in Houston and New COVID-19,” says Casadevall. the hospital during the Ebola
York City started treatments, and now The guidebook also outlines a range crisis.”
under an FDA “expanded access pro- of clinical trials underway or planned at Watch a video:
gram,” soon “a very large number” of hospitals taking part in the Johns Bit.ly/JHCOVIDtest
U.S. hospitals will follow suit, says Hopkins-led network for convalescent
pathologist A ARON TOBIAN , director of plasma therapy.
the Division of Transfusion Medicine at KATIE PIERCE, GEORGE SPENCER
The Johns Hopkins Hospital. AND VANESSA WASTA
Hopkins Medicine • spring / summer 2020 •5
COVID-19
REPORT
A MESH of Support for Front-Line Staff
S
everal days a week, at 2:45 p.m., employees at The Johns Hopkins WU , professor of medicine. Before
TY CROWE leads a 15-minute Hospital and Johns Hopkins Bayview COVID-19, RISE received that many
meditation. He dims the lights Medical Center. calls in a month. “We’ve also started
and puts on soft music. Laptops click “People have stepped up to the plate rounding proactively on the units,
shut, phones are set aside. in an extraordinary way,” says CYNTHIA including some that are less visible, like
“We focus on our breathing, on our R AND , the Office of Well-Being’s laundry, food service and security,” Wu
bodies,” says Crowe, director of spiritual says. From mid-March to mid-April,
care for The Johns Hopkins Hospital. RISE served more than 600 people.
“The other thing I emphasize is to Chaplain and spiritual care team
remember to be grateful, even members have also seen a
for small things.” quadrupling of staff encounters,
The participants are the particularly in units that have
people in the Unified transitioned to caring for
Incident Command COVID-19 patients, says
Center who are leading PAULA TEAGUE , senior
Johns Hopkins Medi- director of spiritual care and
cine’s response to the chaplaincy. In one recent
coronavirus outbreak. week, she says, her team
K EITH W ELLER
Their daily respite is met with more than 150
part of a robust and individuals and coun-
connected effort to seled more than 100
support all Johns groups of three people or
Hopkins Health System more across the health
employees as they cope system.
with the COVID-19 Being part of MESH
I M R SQ U I D / G E T T Y
pandemic, which can add gives her office even more
stress to employees who may power to help them, Teague says.
be learning new roles, worrying “We really are a first filter for
about their own health or struggling referrals,” she says. “We have lots of
with the requirements of social isolation, informal opportunities to say to
says Johns Hopkins psychologist someone, ‘That was really hard,
GEORGE EVERLY. what you just did. How are you
Enter MESH (Mental, Emotional interim chief wellness officer. “Those doing?’ Usually, you can see the relief in
and Spiritual Help), an initiative led by who are not on the front lines caring for a person’s face, and you know they feel
Johns Hopkins Medicine’s Office of patients want to support their colleagues better. But when we see a person who is
Well-Being that weaves together several who are, and there are efforts all over the not recovering like that, we can refer
Johns Hopkins services that support institution to do that.” them to mySupport [an employee
mental and emotional health for RISE (Resilience in Stressful Events), assistance program] for counseling. For
employees. The groups have teamed with which delivers peer support to health the first time, I feel like spiritual care
the Department of Psychiatry and care workers coping with stressful has been integrated with other services.
Behavioral Sciences, where more than 30 patient-related events, has 34 trained It’s very satisfying to be part of a true
psychiatrists and psychologists have volunteers who provide peer support. partnership.”
volunteered their time to provide timely They are getting five to 15 calls a day, KAREN NITKIN
mental health care to health system says the group’s co-founder ALBERT
6 • Hopkins Medicine • spring / summer 2020
An
Unmatched
Match Day
This year, the beloved rite
of passage known as Match
Day had a COVID-19 twist:
Rather than gathering
together at the Anne and
Mike Armstrong Medical
Education Building with
friends and family to tear
open their assignment
envelopes at the stroke
of noon on March 20,
members of the Class of
Michelle 2020 individually logged
Azotea, into a site to reveal
on-site with
their match results, then
MEASURE TWICE,
volunteers
followed up with video
chats and social media
CUT ONCE posts to celebrate the
joyous moment. Some
students hiked to the top
I
n normal times, Johns Hopkins either created the face shields or assem- of Federal Hill or Patterson
medical student ISABEL LAKE would bled personal protection packs that will Park in Baltimore to share
be in class. Instead, on an afternoon help clinicians reuse their surgical masks the big reveal with friends
in March, the second-year medical and N95 filtering respirators. — at a social distance, of
student sat in a large room in the Johns “This is about preserving the supply course.
Hopkins Health System Consolidated of personal protective equipment,” says Of the 120 graduating
Service Center measuring and cutting MICHELLE AZOTEA , director of project medical students, 117
straps for face shields that will help management and implementation for the matched at institutions
protect Johns Hopkins health care health system. across the country, and
workers from coronavirus infection. About 250 volunteered in the first 24 students matched at
“We were looking for something to week, making between 2,000 and 6,000 Johns Hopkins-affiliated
programs. n
do and ways to help out,” says Lake, who face shields per four-hour shift. By
arrived at the storage facility with March 24, more than 25,000 shields had
classmates JOE BRODERICK and LYLA been made, putting the volunteers well
ATTA . Like others in the warehouse, on their way to the goal of making
they sat at least six feet from each other 50,000 such kits for all Johns Hopkins
as they worked. clinicians in Maryland and Washington,
The medical students were among D.C. KAREN NITKIN
dozens of Johns Hopkins volunteers who
Hopkins Medicine • spring / summer 2020 •7
COVID-19
REPORT
WEB
TRAFFIC:
BY THE For COVID-19 Survivors:
NUMBERS Rehab in the ICU
P
hopkinsmedicine.org atients with COVID-19 are staying for weeks in the ICU, putting them
Covid-19 Traffic Snapshot at great risk of developing post-intensive care syndrome (PICS): physical,
Jan. 27–May 22, 2020 cognitive and psychological changes that occur after surviving an illness
or injury that requires ICU treatment.
TOTAL VISITS
The syndrome can affect a person’s ability to perform activities of daily living,
25 Million
TO ALL driving and work, and impact family members who must adjust to their loved ones’
CORONAVIRUS new normal, notes DALE NEEDHAM , a Johns Hopkins critical care physician who
CONTENT
is renowned for advancing PICS research.
When a patient is in an unfamiliar environment, under sedation and working
overtime to fight infection or recover from an injury, delirium can set in, says JOE
BIENVENU , a Johns Hopkins psychiatrist who studies survivors of critical illness-
es and intensive care. He describes delirium as a brain malfunction that makes it
hard for patients to interpret what is going on around them. Their bodies seem to
know that something is terribly wrong, but their brains can misinterpret what that
is. Patients often describe frightening, nightmarelike experiences, sometimes with
themes of betrayal by doctors and nurses, sometimes even loved ones.
The prevalence of delirium in patients with COVID-19 in the ICU is especial-
ly high, likely due to the amount of sedation
needed to keep patients on ventilators for an “Very few ICUs in
extended period of time, says MEGAN HOSEY, the country
a rehabilitation psychologist in the ICU at The provide patients with
Johns Hopkins Hospital. the amount and
VISITS TO Unfortunately, the effects of delirium can
“WHAT IS intensity of early
linger. “Even after it resolves,” Bienvenu says,
CORONAVIRUS”
ARTICLE (THE “the memories can lead to mental health ef-
rehabilitation that we
FIRST RESULT fects downstream: increased symptoms of anx- provide
ON GOOGLE
SEARCH) iety, depression or post-traumatic stress disor- at Hopkins.”
der. Patients find themselves wanting to avoid —MEGAN HOSEY,
REHABILITATION PSYCHOLOGIST,
8.2 Million
hospitals and becoming very fearful that they THE JOHNS HOPKINS HOSPITAL
will get sick again.”
Because delirium can also cause cognitive changes in attention, thinking and
memory that last beyond hospitalization, Hosey talks to patients about getting in
touch with a mental health provider who understands PICS.
In addition, in an effort to help patients with COVID-19 manage their health
VISITS TO in the ICU as early as possible, many physical, speech and occupational therapists
COVID-19 SELF-
CHECKER from Johns Hopkins rehabilitation facilities have been reassigned to The Johns
Hopkins Hospital. “Very few ICUs in the country provide patients with the amount
270,000
and intensity of early rehabilitation that we provide at Hopkins,” says Hosey.
Needham agrees. “We’ve got an extraordinary program that routinely provides
psychological help and physical, occupational and speech therapy on top of med-
ical care in the ICU. During the pandemic, this program continues.”
Soon, patients recovering from COVID-19 will have a convenient resource to
report and monitor their health, including PICS. ANN MARIE PARKER is creating
a virtual clinic for COVID-19 survivors. LISA EDDY
8 • Hopkins Medicine • spring / summer 2020Q&A
Q: Is COVID-19
Lung Damage
Reversible?
G E T T Y I M AG ES
A: After a serious case of
COVID-19, a patient’s
lungs can recover, but not
overnight.
“Recovery from lung damage ‘Go Team’ Helps Nursing Homes
N
takes time,” says PANAGIS
“ ursing homes are struggling right now. We’re trying to be proac-
GALIATSATOS , director of
tive in helping them manage their ill patients and make the hard
the Tobacco Treatment Clinic
at Johns Hopkins. “There’s decisions about when to send them to the hospital,” says CHRISTINA
CATLETT, director of the Johns Hopkins Go Team, a disaster response unit
the initial injury to the lungs,
followed by scarring. Over time, formed a decade ago to provide clinical and logistical support to communities
the tissue heals, but it can take that are reeling from hurricanes, earthquakes and other catastrophes.
three months to a year or more In mid-April, the Go Team began offering assistance to nursing homes in
for a person’s lung function to Maryland, whose residents account for about half of the state’s COVID-19
return to pre-COVID-19 levels.” deaths. On April 29, Maryland Governor Larry Hogan mandated COVID-19
He notes that doctors and testing for all residents and staff members in Maryland nursing homes. As of
patients alike should be prepared early May, at least six nursing homes in the state had each reported 100 or
for continuing treatment and more cases.
therapy. “Once the pandemic The Go Team team tests residents for COVID-19, assesses the health of those
is over, there will be a group who have the disease, talks with staff members about infection-prevention
of patients with new health strategies and provides moral support. “What [nursing home employees] really
needs: the survivors. Doctors,
need and want is testing and also just support. So many are overworked and
respiratory therapists and other
feeling alone. The strike teams give them a little morale boost, let them know
health care providers will need
we’re looking out for them,” says MORGAN K ATZ , director of antimicrobial
to help these patients recover
their lung function as much as stewardship at Johns Hopkins Bayview Medical Center. KAREN NITKIN
possible.”
18 Months
The amount of time it could take to develop a vaccine
for the new coronavirus and move it into human trials,
say two Johns Hopkins researchers, who began work
on a vaccine in February. TZY Y-CHOOU “T.-C.” WU
and CHIEN-FU HUNG , who run the Cervical Cancer
Research Lab at Johns Hopkins, studied severe acute
respiratory syndrome, or SARS, in 2002 and 2003 and
are drawing on their experience to research this new
coronavirus. They aim to do that, they say, either by
making a DNA-based vaccine that contains genes that
Tzyy-Choou “T.-C.” Wu and Chien-Fu Hung
produce the virus’ protein or by making a vaccine that
includes a portion of the actual protein. Watch a video
interview: Bit.ly/JHMVaccineEffort
For ongoing updates about Johns Hopkins
Medicine's response to COVID-19, visit:
www.hopkinsmedicine.org/coronavirus/
Hopkins Medicine • spring / summer 2020 •9MEDICAL
ROUNDS
ART WITH AN IMPACT
Student works bring a spirit of
well-being to a local physician practice.
BY LINE LL S MITH
I L L U S T R AT I O N B Y L A U R E L S T E W A R T
J
oe riggs recalls the moment he stepped into a pa- MICA created by faculty member Gina Gwen Palacios
tient’s distressed frame of mind. He was working in and associate dean Michael Weiss, which enabled stu-
his office at Johns Hopkins Community Physicians dents to imagine their work through the eyes of patients
(JHCP) when he heard a loud voice, sharp with anx- they would never meet.
iety, in the hall. An expectant mother was refusing Which is why Riggs told them the blackbird story. “It
to enter the sonography room for an ultrasound. When was important for students to understand the impact that
Riggs asked if he could help, she pointed to the photo em- art can really have on a unique audience,” he says.
blem of a blackbird on the room panel. “The biggest thing for me was thinking about the view-
“She told me, ‘I’m not going in there. Look what bird er and the impact our artwork can have on someone,”
you have on that door! It’s bad luck!’” says MICA student Marisol Ruiz. “Take the rooms with
After listening to her concerns, Riggs invited her into the birds: Those birds are being seen by a lot of expect-
his office to search the internet for stories about the bird’s ant mothers. My classmates and I talked about what kind
symbolism. They found that blackbirds represent wisdom, of feelings we want to give to them while they’re waiting
power and beauty, as well as the hope expressed in the Bea- for some news.”
tles’ classic song “Blackbird.” The blackbird/sonography room now features a “tree
Reassured, the patient went ahead with her appoint- of life” painting rendered in soothing shades of blue and
ment. And Riggs, assistant director of operations at JHCP, white, with clusters of red berries. Ten tiny blackbirds
gained a deeper appreciation of the need to consider multi- perch on its branches. MICA student Laurel Stewart has
ple points of view when designing and decorating a health created a piece that is fanciful, welcoming and reassuring.
care environment. It’s one of many paintings that elicit praise, according
The JHCP practice at Remington, which opened in to Riggs. “Every day, patients comment on how wonderful
2016, stands as an innovative model of patient-centered the art is and how it makes them feel,” he says. “We also
design. There are no individual providers’ offices. All care get great feedback from our own team. Our staff members
providers work together in a centralized area, to promote are providing care to patients in the exam rooms all day
teamwork and trim patient wait times. To make the expe- long, and their work environment and sense of well-being
rience feel more patient-friendly, each examination room is really important. They say having artwork in their work
is named after a Baltimore landmark or a bird portrayed environment has brought life to our practice.”
in a photo on the exterior door. “This is a win for everyone,” Riggs adds. Plans now call
And thanks to a recent partnership with the Mary- for commissioning artwork from MICA students for addi-
land Institute College of Art (MICA), the exam rooms tional Johns Hopkins Community Physicians practices. n
in the practice now feature works by student artists. Pa-
tients entering the internal medicine examination rooms
will find art depicting familiar Baltimore landmarks —
such as the Domino Sugars sign, Patterson Park Pagoda,
Fort McHenry and Camden Yards — while the 14 Gyn/ WATCH A SLIDESHOW
Ob rooms display robins, flamingos, owls, cranes and oth- of other artwork on display at
er birds that suggest the beauty of nature. the JHCP practice in Remington:
The artwork was the result of a semesterlong class at
Bit.ly/JHMArt
10 • Hopkins Medicine • spring / summer 2020Hopkins Medicine • spring / summer 2020 • 11
MEDICAL
ROUNDS
for example, that statins block a liver enzyme that
AT THE BENCH makes cholesterol, but the drug also blocks the cre-
Statins as Cancer Starvers ation of a small molecule called geranylgeranyl pyro-
phosphate, or GGPP, which is responsible for con-
necting cellular proteins to cellular membranes.
More than 35 million Americans take statin drugs When the researchers added pitavastatin and
daily to lower their blood cholesterol levels. Now, in GGPP to human cancer cells with PTEN mutations,
experiments with human cells in the laboratory, Johns they found that GGPP prevented the statin’s killing
Hopkins researchers have added to growing evidence effects and the cancer cells survived, suggesting that
that the ubiquitous drug may kill cancer cells, and GGPP may be a key ingredient to cancer cell
uncovered clues to how statins do it. survival.
The findings enhance previous evidence that statins Next, looking under a microscope at cells engi-
could be valuable in combating some forms of cancer, neered to lack the enzyme that makes GGPP,
says cell biologist PETER DEVREOTES , whose team Devreotes and his team saw that as the cells began to
recently reported results of the new research in die, they stopped moving. Under normal circumstanc-
Proceedings of the National Academy of Sciences. es, cancer cells are a bundle of moving energy, con-
Devreotes and his team began the new study with suming massive amounts of nutrients to maintain
an unbiased screen of about 2,500 drugs approved by their unchecked growth. They maintain this break-
the U.S. Food and Drug Administration to see which neck pace by creating strawlike protrusions from their
ones had the best kill rate of cells genetically engi- surface to drink up nutrients from the surrounding
neered to have a mutation in a cancer gene called environment.
PTEN. The gene codes for an enzyme that suppress- Suspecting that the unmoving cancer cells were
es tumor growth. Among the thousands of drugs, literally “starving to death,” Devreotes says, the sci-
statins — and, in particular, pitavastatin — emerged entists then measured the statin-treated cells’ intake
as a top contender in cancer-killing ability. Most of by adding a fluorescent tag to proteins in the cells’
the other drugs had no effect or killed normal and environment.
engineered cells at the same rate. Equal concentra- Normal human cells glowed brightly with the flu-
tions of pitavastatin caused cell death in nearly all of orescent tag, suggesting that these cells ingested pro-
the engineered cells but very few normal cells. tein from their surroundings regardless of whether
The researchers then looked at the molecular path- the scientists added statins to the mix of nutrients and
ways that statins were likely to affect. It’s well-known, cells. However, human cancer cells with PTEN mu-
tations took in almost no glowing proteins after the
scientists added statins. The inability of the statin-
treated cancer cells to make the protrusions needed
to take up proteins leads to their starvation.
Our patients have no idea that e-cigarettes can Devreotes says his team plans further research on
cause refractory asthma or any pulmonary disease the effects of statins in people with cancer and com-
pounds that block GGPP. VANESSA WASTA
out there. They are coming in to our clinic
feeling like they have been duped. And they
have been!”
PEDIATRICS
— PANAGIS GALIATSATOS , director of Johns Hopkins’ Tobacco
Treatment Clinic, who says he has growing concerns about Aquarium Escapes
the health risks of secondhand smoke from e-cigarettes. In a
case study published in March in BMJ, he and his colleagues With the help of telepresence robots, busy executives
documented the first case of secondhand smoke from can tour a factory halfway across the country, and
e-cigarettes causing pulmonary disease. doctors can make virtual rounds at a clinic located
hundreds of miles away. Now the same technology is
helping critically ill and injured children at the Johns
12 • Hopkins Medicine • spring / summer 2020Hopkins Children’s Center escape for a day of fun at time chatting with the friends they make.”
the National Aquarium without leaving their hospi- The WeGo Foundation targets patients who have
tal beds. been in the hospital for weeks, perhaps months, for a
Working with Johns Hopkins Telemedicine, sec- variety of reasons, such as waiting for a heart trans-
ond-year medical students GALEN SHI and PAVAN plant or adapting to life in a wheelchair after severe
SHAH oversee these virtual outings from the Chil- injury. One mother said the aquarium trip was the
dren’s Center. For half an hour at a time, children most she had seen her child smile since he had been
ages 5 to 18 have the opportunity to learn about black- in the hospital, Shi says. Another parent said she and
tip reef sharks, Atlantic stingrays, horseshoe crabs and her daughter loved having a way to get out of the
many other underwater creatures. “The telepresence room.
robots really break down the walls and help distract Currently, the program has three robots — two
the kids,” says Shi. “Through the robot, the [kids] can were donated, and one is borrowed — and also oper-
have fun outside of the hospital.” ates in the University of Maryland Children’s Hospi-
Shi started this program, entitled WeGo Founda- tal and Mt. Washington Pediatric Hospital. In addi-
tion, in 2016 after he completed an internship with a tion to visiting the aquarium, the robots have already
company testing telepresence robots in health care. Pa- taken patients on virtual trips to the Maryland Sci-
tients at the Children’s Center use a robot named RAE ence Center and to theater productions at Baltimore
— short for Remote Aquarium Explorer — that is sta- Center Stage. LISA EDDY
tioned at the National Aquarium. RAE’s stick figure-
like body is a sturdy, 3-foot-tall stand connected to a
base with four wheels. Its head is a tablet-sized screen
with a built-in camera, speaker and microphone. OTOLARYNGOLOGY
Hospital patients use a laptop and special software
to drive the robot, like a remote-controlled car, on a
A Scarless Solution for
virtual trip through the aquarium. While they expe- Benign Thyroid Nodules
rience real-time sights and sounds, aquarium visitors
can also see and hear them via the robot’s screen and Thyroid nodules are ubiquitous — an estimated 80
speakers. percent of Americans have these typically benign
“Time and time again, we see kids make friends growths, says JONATHON RUSSELL , a Johns Hop-
with other kids,” says Shah. “Sometimes, the kids kins otolaryngologist–head and neck surgeon. But in
aren’t interested in the aquarium and spend all their a fraction of individuals, thyroid nodules expand to
Hopkins Medicine • spring / summer 2020 • 13MEDICAL
ROUNDS
a size that becomes problematic, leading to troubles with nerable anatomic structures, such as nerves critical for swal-
swallowing or breathing, or changes in appearance that pa- lowing and speaking, explains Tufano. With better tech-
tients find unsightly. nology and more refined techniques, he adds, RFA has
“Several years ago, the choice on how to respond to become a popular way to treat benign thyroid nodules else-
benign thyroid nodules was binary: either perform surgery where in the world. Johns Hopkins’ leadership in “scarless”
or not,” Russell says. “Because these growths typically aren’t techniques to treat thyroid and parathyroid nodules and
life-threatening, many patients chose to live with them cancers made it a fit to be a pioneer for RFA in the United
rather than deal with the recovery and scars of surgery.” States.
But recently, says Russell and his colleague thyroid sur- Russell, Tufano and their colleagues use ultrasound
geon RALPH TUFANO, Johns Hopkins began offering a guidance to insert the RFA probe into a nodule, creating
third option: radiofrequency ablation (RFA), a technique a pattern of damage that’s visible under imaging. Depend-
that destroys unwanted tissue using heat generated from ing on the size of the nodule, this procedure takes as little
medium-frequency alternating current. as 30 minutes to complete, Russell says. Over the next sev-
RFA has been used for decades to treat conditions af- eral weeks and months, the damaged tissue shrinks and
fecting the heart, liver and other areas. But its use in the disappears, leaving patients with markedly reduced nod-
neck has been limited due to the close proximity of vul- ule size and related symptoms.
Because RFA is minimally invasive and extremely tar-
40
geted, says Tufano, there are no scars, and patients can
avoid the long-term consequences of surgery, such as the
need to take thyroid hormones for life.
Right now, he adds, the procedure is limited to benign
nodules, in which patients have at least two confirmed bi-
opsies showing no malignancy. But eventually, RFA may
be an option for patients with small cancerous tumors. In
time, Russell says, he and Tufano plan to also offer this
procedure under local anesthesia, performing it right in
the clinic. CHRISTEN BROWNLEE
The number of Johns Hopkins faculty
members who have been named primary
appointees in the newly established TECHNOLOGY
Department of Genetic Medicine — a
designation announced in late January in recognition A Window on Blood Flow
of the rapidly growing importance of genetics in
medicine.
to Tumors
The new department, which evolved from the Johns Hopkins Medicine researchers have created a com-
McKusick-Nathans Institute of Genetic Medicine, puter program for scientists at no charge that lets users
joins 31 other departments in the school of readily quantify the structural and functional changes in
medicine that focus on excellence in clinical care and the blood flow networks feeding tumors. The team recent-
the biomedical sciences. “This new department ly published a link to download the new program, called
designation underscores our continuing HemoSYS, and an accompanying manual with instruc-
commitment to excellence in genetic medicine,” tions on how to use it in Nature Scientific Reports.
says Paul Rothman, dean of the school of medicine “Compared to blood flow in healthy tissues, tumor blood
flow is abnormal,” creating a huge hurdle to effective de-
and CEO of Johns Hopkins Medicine. “The new
livery of therapeutics, says radiologist and biomedical en-
structure will help our researchers and clinical staff gineer ARVIND PATHAK . “HemoSYS enables scientists to
do their jobs even more effectively.” quantify these abnormalities from imaging data acquired
from tumors in live animals.”
Studying the architecture of blood vessels and their flow
dynamics in tumors could provide insights into cancer pro-
14 • Hopkins Medicine • spring / summer 2020gression and metastasis, says JANAKA SENARATHNA , a research
fellow in Pathak’s lab and lead author of the paper. This approach
could accelerate development of new therapies that target a tu-
mor’s blood vessels in order to limit its supply of nutrients and
oxygen. HemoSYS could also lead to more effective delivery of
already available drugs by mapping blood flow fluctuations in
the vessels feeding the tumor, the researchers say.
The scientists caution that the research tool is not directly ap-
plicable to human tumors yet. But, says Pathak, “as our ability
to obtain high-resolution images in the clinic improves, we hope
that this tool can be adapted to provide a noninvasive way to an-
alyze the blood flow fluctuations in an individual patient’s can-
cer and help to customize their therapy.”
J O H N WOO DCOC K / G E T T Y
PULMONARY
Improved Outlook for
Serious Lung Conditions
By the time many patients find their way to Johns Hopkins pul-
monologist KEIRA COHEN , they have seen doctor after doctor sorts of infections, one that occurs frequently is NTM, which is
to treat their lung ailment, but they only seem to get sicker. why the new center focuses on both conditions.
“Many of our patients have been misdiagnosed and misman- Crucially, says Cohen, “when patients come to our multidis-
aged,” she says. “They have bounced from specialist to specialist ciplinary center, it’s a one-stop affair.” At the Friday morning
and have almost gotten whiplash from the different messages clinic in Johns Hopkins Bayview Medical Center’s Asthma and
and treatments they have received.” Allergy Center, they’ll see a pulmonologist, an infectious disease
The outlook for these patients has improved dramatically with specialist and a physical therapist knowledgeable about airway
the launch of a multidisciplinary center at Johns Hopkins — co- clearance techniques. The center’s nurse practitioner, MEGHAN
created by Cohen, fellow pulmonologist MARK JENNINGS and RAMSAY, sees patients in clinic, acts as a bridge between these
infectious diseases specialist JONATHAN ZENILMAN — that is different specialists and communicates with patients between
specifically aimed at managing and studying two lung condi- visits. The center also works with a chest radiologist and has re-
tions that doctors are seeing with more frequency: bronchiecta- lationships with specialists in rheumatology, allergy and immu-
sis and nontuberculous mycobacterial infections. nology, gastroenterology, and otolaryngology. The in-house Clin-
Nontuberculous mycobacteria (NTM) are a category of or- ical Mycobacteriology Laboratory at Johns Hopkins allows
ganisms occurring in the environment, such as in water and soil. physicians to quickly and accurately assess test results.
In most people, these bacteria do not cause health problems, but “As a multidisciplinary team, we meet to come up with a uni-
in some cases these bacteria can infect the airways and lung tis- fied treatment plan that is individualized according to the needs
sue or organs outside the lungs. It can take years and multiple of each patient,” says Cohen, who notes that the center has been
antibiotics to clear the infection. While related to tuberculosis, designated a Johns Hopkins Precision Medicine Center of
these infections are not thought to pass from person to person. Excellence.
“We hear a lot about TB, but we have more than 10 times as Research is a crucial element of the multidisciplinary center.
many cases of NTM disease than TB cases in the United States Patients who come to the clinic have the option to donate bio-
these days,” says Cohen. specimens (blood and mucus) to the team’s biobank and to have
Bronchiectasis, a scarring of the airways, can develop from mul- data from their medical chart added to an ever-growing data-
tiple causes. If not managed well, bronchiectasis can lead to wors- base. One goal, she says: “to see if we can determine blood-based
ening lung function, repeated lung infections and increased hos- predictors of who might respond better to a particular medica-
pitalizations. While patients with bronchiectasis are at risk for all tion or treatment plan.” SUE DE PASQUALE
Hopkins Medicine • spring / summer 2020 • 15HOPKINS
READER
Catch and Correct
P
atient safety exploded into “There hasn’t been enough effort to be more
public consciousness on Nov. 29, systematic,” observes Sutcliffe, “and to develop
1999, when two popular evening TV interdisciplinary expertise and sustained
newscasts made their top story a partnerships. Interdisciplinarity is really tough
leaked report from the National to do. People speak different languages.” The
Academy of Sciences’ Institute of Medicine. authors note that fundamental reform will
The study — To Err Is Human — argued that require “substantive and equal co-partnerships
medical errors were a significant factor in with safety scientists.”
American mortality. As an example of how safety science can
News of the report reached more than 100 make a difference, Sutcliffe points to how
million people within a week, and the uproar advances in surgical procedures have not
spurred a frenzy of proposals for patient safety always registered across institutions.
reform, including calls for a 50 percent “Surgical mortality rates vary widely,” she
reduction in medical error. Yet two decades observes. “Most people would say, ‘Well, it’s
later, KATHLEEN M. SUTCLIFFE says, those complication rates.’ But high- and low-mortal-
STILL NOT SAFE: PATIENT reforms are now “becalmed,” and medical ity hospitals have the same rates of complica-
SAFETY AND THE
MIDDLE-MANAGING OF errors remain a leading cause of death in the tions. What’s different in low-mortality
AMERICAN MEDICINE United States. hospitals is something called ‘the ability to
Kathleen M. Sutcliffe and How reform stalled is the subject of her rescue.’ High-mortality hospitals are ‘failing to
Robert L. Wears. new book, Still Not Safe: Patient Safety and the rescue.’”
Oxford University Press
Middle-Managing of American Medicine, which Organizational studies can identify best
was co-authored with ROBERT L. WEARS . An practices in such rescues. “What kinds of daily
alumnus of both The Johns Hopkins Universi- habits do people engage in?” asks Sutcliffe.
ty and its school of medicine, Wears died in “What do they do in order to be more alert
2017, shortly after the manuscript was and aware about what’s happening in the
finished. context in which they’re working?”
Still Not Safe is a comprehensive history of Sutcliffe — who also holds an appointment
patient safety. Yet is also offers a call for at Johns Hopkins’ Armstrong Institute for
substantive improvements through collabora- Patient Safety and Quality — says better
tions that draw deeply from the expertise of collaborations between physicians and safety
both physicians and researchers. researchers aim to identify not only failure but
The book itself models such collaboration. also ways to bounce back from it, with
Sutcliffe is a Bloomberg Distinguished evidence-based strategies that can be promul-
Professor of Medicine and Business at Johns gated and widely adopted across the industry.
Hopkins, and her research focuses on organi- “We need to understand our failures,” she
zational theory, while Wears was a physician observes, “because it gives us a sense about the
“WE NEED TO and a professor at the University of Florida health of our systems, right? So that’s critical.
UNDERSTAND College of Medicine – Jacksonville, specializ- But we also need to acknowledge the fact that
OUR FAILURES ing in emergency medicine. in the course of doing work, people are
BECAUSE IT GIVES The authors note that over the past 20 constantly making mistakes. And they’re
US A SENSE ABOUT years, the health care industry’s obsession with catching them and correcting them.
THE HEALTH OF costs and desire for control has slowed reform “Basically,” concludes Sutcliffe, “we need to
OUR SYSTEMS,
efforts, yet “dramatic and poignant accounts understand what we can do to help people be
RIGHT?”
—KATHLEEN M. SUTCLIFFE
of medical harm” in popular media keep the more resilient in the moment. To be able to
issue in the spotlight. Sutcliffe and Wears adapt and catch and correct better. We need to
identify competing narratives about patient understand both how things are going right
safety from physicians and researchers as the — and how they go wrong.” n
heart of the problem. RICHARD BYRNE
16 • Hopkins Medicine • spring / summer 2020HOPKINS
IN FOCUS:
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Hopkins School of
Medicine $34.95 hc/ebook 1-800-537-5487 press.jhu.eduHANGING
One night last fall,
Pierre Gibbons
ran into a burning building
to help a neighbor —
and emerged with severe burns
and very slim odds
for survival.
In their efforts
to give Gibbons
a fighting chance,
specialists at the
Johns Hopkins Burn Center
tried a one-two punch
they’d never used before.
BY JIM DUFFY
I L L U S T R AT I O N B Y M I C H A E L W O L O S C H I N O W
TOUGH
Hopkins Medicine • spring / summer 2020 • 19The Gibbons family enjoyed an idyllic day together before
their trial by fire began. Like most families, they don’t gather
as often as they’d like. When they do, things don’t always
go smoothly. But that Sunday afternoon in September was
different, which is one reason siblings Jeremiah and Taylor
Gibbons remember it so vividly.
“It was kind of surreal,” says Jeremiah, the birthday- in the rowhouse on fire, he saw his 77-year-old neigh-
boy center of attention that day. “For whatever weird bor, Mary Sterling, waving for help.
reason, every little interaction seemed totally heartfelt.” In a scene captured in a grainy cellphone video that
A second reason that memory looms so large is that soon went viral online, Gibbons marched inside the
the family’s life turned upside down the following day. burning rowhouse. He almost made it back out with
When Taylor’s phone rang at 10:30 p.m. that Monday, that elderly neighbor in his arms, collapsing just short
Sept. 22, 2019, she did a double-take: Why in the world of the front-door finish line. Both were alive when fire-
would one of her father’s friends be calling? fighters reached them, but barely. Sterling would die
“Taylor, your Dad’s been burned. He’s at Johns Hop- several weeks later.
kins Bayview. You should go there.” Johns Hopkins Burn Center surgeon JULIE CAFFREY
She lives an hour away. She alerted Jeremiah, who is didn’t sugarcoat things when she talked with Jeremiah
much closer. He and his wife, Rachel, had missed calls and Taylor that night. After some basic triage work
from that friend while taking advantage of a brief sleep- — intubating the patient, cleaning wounds and
ing window that opened when their newborn son dozed surveying damage — she reported that burns covered
off. Jeremiah raced over with no idea what was going on, 65 to 70 percent of their father’s body. In such cases,
but as a Baltimore City firefighter, he grasped the grav- burn specialists run an algorithm that tallies historical
ity of the situation when he saw how the brotherhood
After sharing survival numbers for patients with similar ages, burns
the long
had gathered. A fleet of ambulances and fire trucks were and lung damage. The mortality rate for Gibbons
odds their
outside the Emergency Department of Johns Hopkins father faced, approached 90 percent.
Bayview Medical Center. He spotted two deputy chiefs, surgeon Listening, the siblings tried to get their heads around
one from fire, another from emergency medical services. Julie Caffrey two big things: Their dad had played the role of hero,
“I got out, didn’t even think about where I was park- gently and he was probably going to die because of it.
ing,” Jeremiah recalls. “Everyone was like, ‘Oh my God, advised his “Go home and get some sleep,” Caffrey said. “You’ve
oh my God.’ They were all crying.” adult got some long days ahead.”
Jeremiah started crying too. When he found his fa- children:
ther — burned body wrapped in blankets, eyes glazed “Go home DISMAL ODDS
and get
S
but open — he put a gentle hand on his forehead and
said the only words that came to mind. “Hey, Dad, I’m some sleep. trange as it may sound, Gibbons got
here for you, man.” Later, a paramedic would tell Jer- You’ve got lucky that night. Located seven minutes from
emiah how his dad had shouted, “Jeremiah Gibbons! some long his home in the Patterson Park neighborhood
Engine Six!” over and over during the ambulance ride days ahead.” of Baltimore City, Johns Hopkins Bayview
to Johns Hopkins Bayview. houses an elite academic burn center where
The patient was wheeled away to the ICU in the Johns three surgeons and a small army of specialists across
Hopkins Burn Center. Taylor arrived. The siblings were many disciplines — nursing, psychology, intensive care,
directed up to the Burn Center to await word on their chaplaincy, social work, nutrition and physical thera-
dad’s condition. Talking with first responders that night, py among them — take on the most daunting cases
Taylor and Jeremiah started to piece together what had the specialty has to offer. The center treats about 800
happened. burn patients a year, half of whom are admitted to the
Pierre Gibbons, 57, had been watching Monday hospital. Its physicians also provide outpatient treat-
Night Football with his friend. Hearing a ruckus out- ments and surgeries for scarring and skin infections re-
side about flames in a nearby house, both went to in- lated to other wounds besides severe burns.
vestigate. While his friend checked out back, Gibbons “The charge here, and really all across an institution
headed out front where, through an open front door like Johns Hopkins, is to define new standards of care,
20 • Hopkins Medicine • spring / summer 2020not just follow the existing ones,” says SCOTT HULT- Good Samaritan Hospital.
MAN , the center’s director. “What that means in prac- As a father, Pierre could be demanding. His chil-
tice is that we’re always pushing the boundaries, look- dren say they never doubted his love, but they also nev-
ing for new and better strategies.” er doubted that he would expect them to meet the chal-
Gibbons put that mission to a stiff test. Burn Cen- lenges and disappointments of life head-on.
ter surgeon MOHAMMED ASIF ticks off a fast-and-fu- “He is the toughest person I know, the scrappiest,
rious run of complications that arose in the days that hard-headed-est, old-school-est guy you’ll ever meet,”
followed Gibbons’ arrival, including kidney failure, says Jeremiah, 34. “Everybody else is like, ‘I can’t be-
multiple strokes, skin graft rejection, drug-resistant lieve he ran into a burning building.’ I’m like, ‘Oh, I
pneumonia and pancreatitis. By the time of that last can totally believe it.’”
mishap, the dial on his mortality algorithm was up Looking back, Jeremiah and Taylor, 25, feel like
around 98 percent, Asif says. those childhood lessons in toughness had been deliv-
“The thing is, algorithms like that are informative ered in preparation for the moment when they had to
for populations of patients, but individuals are all dif- summon up their courage, look their father in the eye
ferent,” Hultman says. “We can’t really predict who’s and ask him a life-or-death question. First things first,
going to live and who’s going to die at that individu- however: They told him they loved him. He mouthed
al level, which is why we can’t ever let those numbers their words back at them around his intubation tube.
get in the way of going all out for patients like Pierre.” Then Jeremiah put the question on the table: “Dad,
do you really want to do this?”
Pierre’s eyes were clear. He understood. He nodded
‘ O U R FAT H E R I S A F I G H T E R ’
T
his head. Soundlessly, he uttered a single word, “Yeah.”
he gibbons family grabbed hold of The Gibbons children told Burn Center physicians to
this distinction like a lifeline. When Tay- go all out. Caffrey was struck during that exchange by
lor and Jeremiah had met with Caffrey the the family’s confidence: “They were saying, ‘You don’t
morning after their dad arrived at the Burn know this guy. Our father is a fighter.’”
Center, the surgeon had warned that the On top of that run of strokes and organ failures,
ordeal ahead would be arduous, perhaps six months in “The Pierre would undergo 24 surgeries over five and a half
intensive care followed by two to five years of rehabil- charge here months in intensive care at the Burn Center. Every
itation, much of it spent as a full-time inpatient. Pierre is to define time the human body gets invaded by a scalpel, Caf-
might regain a reasonably full measure of physical and new frey notes, it goes into an inflammatory overdrive that
mental functioning, but that best-case outcome was far standards sends waves of high-alert stress out in every biologi-
from a sure thing. of care ... cal direction.
The talk culminated in a stark question: Did Pierre’s we’re “Here’s a guy in his late 50s, and basically what’s
children want doctors and nurses to go all out to save always happening with his injuries and those surgeries is his
him? pushing the organs are running a marathon nonstop for five or six
The middle child of five, Pierre Gibbons had grown boundaries, months,” she says. “It takes a special person, with a spe-
up outside of Washington, D.C. The family moved looking for cial will to live, to survive that. There’s an element in-
to Santa Fe, New Mexico, during Pierre’s high school new and side of Pierre that’s a big part of his success.”
years. His father, Dave Gibbons, describes that as a better One week into their family’s ordeal, Taylor and Jere-
challenging period — the kids weren’t exactly on board
strategies.” miah rushed to the Burn Center in response to an emer-
SCOTT
with the move. But he was proud of the way Pierre HULTMAN gency summons. Their father had slipped into a coma.
moved forward in the face of that disappointment. Organ transplant teams were on standby. Technicians
“It was quite something to see, how this Anglo kid were scanning for brain activity to see if the fight was
from the East Coast who didn’t want to move found already over.
a way to fit in so quickly with all the Indian and His- The wait to see if Pierre would emerge from the coma
panic kids,” he says. “Pierre has always had a remark- stretched past two weeks and into a third. By this point,
able ability to meld with other people.” the relatives who had driven or flown in from distant
Pierre spent four years in the Navy after high school. locales to offer support to Taylor and Jeremiah had re-
In the years that followed, he would marry, divorce and turned to their lives.
eventually move back to the Washington, D.C., area “We came to a point,” Jeremiah says, “where we’re
and establish himself as a facilities manager for com- thinking, ‘Should we have done this? Would it be better
mercial properties. Career opportunity brought him to to just let dad be in peace?’” He invited a fire de-
Baltimore, where he most recently worked at MedStar partment chaplain to come pray with the family.
Hopkins Medicine • spring / summer 2020 • 21You can also read
