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VOLUME 18 NO. 2
n
inside.dukemedicine.og
n
Feuy 2009
inquiry
Bd b
Get a peek inside the lie oa Dke research lab.
Pg 7
Beneits
ml d Mdl l
Ne leave reglations enactedon Jan. 16 aect Health Sstememploees.
Pg 13
Patient care
Ll cl
Drham Regional's team atLincoln orks together toprovide care or thosands.
Pg 6
Famed srger chairDavid Sabiston dies
David Coston Sabiston Jr., M.D., ormerchairman o the Department o Surgery atDuke and a legendary gure in the history oAmerican medicine, died Jan. 26.Sabiston, who was chair o Surgery or 30years, was truly a giantin the eld, trainingthousands o world-class surgeons, creatingone o the mostrespected surgicalresidency programs inthe world, andestablishing a level oclinical achievementthat earned him the respect o the globalmedical and research communities.As a medical educator, his training programswere extraordinarily successul and have beenemulated by medical schools around theworld. The 146 chie residents who servedunder him have gone on to become leaders atthe world’s great medical institutions and totrain uture generations o outstandingsurgeons. At the time o his retirement, 88 othe 146 were in academic medicine, 24 asdepartment chairs or division chies.As a researcher, Sabiston’s development osurgical methods to revascularize the heart andhis work to develop radionuclide scanning othe lungs or the diagnosis o pulmonaryembolus have saved and prolonged countlesslives. He was the chie investigator on an NIHproject on coronary insuciency andmyocardial revascularization or more than 30years. He was a pioneer in coronary arterybypass grat surgery, and was an architect o adepartment well-known or clinical excellence.Duke’s Department o Surgery is No. 1 in NIHresearch unding among departments osurgery in the country.Sabiston’s lie and work span a key era in thehistory o medical science and are evidence oa level o excellence rarely achieved. The chaino achievement connects the legendary AlredBlalock, M.D., under whom Sabiston studied,to a huge community o renowned Duke-trained surgeons.
see SABISTON, p.2
DaviD Costonsabiston Jr., M.D.
Duke Medicine’s distinctive new peditic cdiology ICU opens
From Dke Medicine Nes & Commnications
D
uke University Hospital opened its newpediatric cardiology intensive care unit(PCICU) with a well-attended ribbon cutting Jan. 5, ollowed by a move-in day Jan. 7.The $7 million, 13-bed acility is the rst o its kind in the state — a separate, distinct acil-ity wholly dedicated to young heart patientswho need intense, interdisciplinary care.At 6,200 square eet, it increases by 50percent Duke Hospital’s capacity to take careo the most critically ill children at a time o increasing need or space and demand orsurgical procedures. Duke pediatric cardiologysurgeons perormed 420 procedures in 2008 —10 percent more than in 2007 — and pediatriccardiac catheterization procedures have tripledover the last ve years.
A dedicated acilit
The fst o its kind in Noth Colin, the $7 million,13-ed cility t Duke Univesity Hospitl is dedi-cted to young het ptients needing intense,intediscipliny ce.
see HEARTS, p.2
More or
g
hearts
 
on the cover
Inside Dke Medicine
2
February 2009
INSIDE VOLUME 18, ISSUE 2
n
CONTACT uSCamps mail:
DUMC 104030
Deliveries:
2200 W. Main St.,Suite 910-B, Durham, NC 27705
Phone:
919.660.1318
E-mail:
editorinside@mc.duke.edu
CREDITS
 
Cartoon:
Josh Taylor
STAFF
 
Editor:
Anton Zuiker
Managing Editor:
Mark Schreiner
Science Editor:
Kelly Malcom
Designer:
Vanessa DeJongh
Inside Online Editors:
 Bill Stagg and Erin PrattCopyright © 2009Duke University Health SystemInside Duke Medicine, the employeenewspaper or the Duke University HealthSystem, is published monthly by DukeMedicine News & Communications.Your comments, story ideas and photocontributions are always welcome andappreciated. Deadline or submissionsis the 15th o each month.
Department o Surgery Chairman Danny O. Jacobs,M.D., received the sad news rom Mrs. Sabiston onMonday morning. Dr. Jacobs described how Sabistonshaped the Duke surgical residency program into oneo the nest and most respected in the world.“His impact on the world o surgery was extraordi-nary,” Jacobs said.Sabiston, who was a native o Jacksonville, N.C.,received his M.D. rom Johns Hopkins School oMedicine in 1947. Ater Army service, he returned toHopkins as assistant proessor o surgery and becamean investigator in the Howard Hughes MedicalInstitute. In 1961, he received a Fulbright ResearchScholarship to study at two prestigious BritishInstitutions: the Hospital or Sick Children o theUniversity o London and the Nueld Department oSurgery at Oxord University. Within 10 years o joiningthe Hopkins aculty, Sabiston was promoted toproessor o surgery.In 1964, at age 39, Sabiston joined Duke University asthe James B. Duke Proessor o Medicine and chairmano the Department o Surgery. While at Duke hedeveloped a rigorous program that used his trade-mark attention to detail, relentless ocus onproessionalism and the patient and a dedication tobasic research as the best way to train gited surgeons.“David Sabiston was a visionary who could recognizeimportant uture opportunities,” said Barton F. Haynes,M.D., director o the Duke Human Vaccine Institute.“For example, he was the Duke administrative leaderto rst recognize the seriousness and importance othe AIDS epidemic in 1983 and responded by buildingthe Duke AIDS research building. He let Duke anenduring tradition o pursuit o excellence in bothbasic and translational science and outstanding patientcare that remains today.”Sabiston served as president o the American Collegeo Surgeons and was a member o virtually everyimportant surgical society around the globe. Hepublished widely. He was recognized time and againby his students, earning the Thomas D. Kinney Awardor Outstanding Teacher o the Year three years in arow in the 1980s.As a leader in medicine, Sabiston worked at imple-menting the then-new Medicare legislation and,working with others, he successully desegregatedDuke’s surgical clinics and wards.Although still relatively new to her position as Dean othe School o Medicine, Nancy Andrews, M.D., Ph.D.said she has known o David Sabiston or many years.“He was a hero in the eyes o the surgeons whotaught me in medical school in Boston,” she said.“With his passing, we close a major chapter in thehistory o our young school.”Sabiston retired rom Duke in 1994. A memorialservice or him was held on Jan. 29, at the DukeUniversity Chapel.
SABISTON, cont.
“Until now, a lack o ICUspace has orced us to cancelsurgeries almost every week,” said Joe St. Geme, M.D., chairman o the Department o Pediatrics. “Webelieve this expansion will helpus reduce those numbers and willallow us to serve all the amilieswho wish to bring their children toDuke or care.”In addition, patients areyounger and cases are increas-ingly complex. Five years ago, 10percent o patients were less thanone year old. Today, 50 percentare under age one; 25 percent areless than 30 days old.The new PCICU will be staedby 23 physicians; 75 nurses,respiratory therapists, social work-ers and pharmacists; and nearlytwo dozen mid-level providers.Focus will be on multidisciplinaryplanning and perormance. Theacility includes a video link to theoperating room.The PCICU team has alreadywon national attention and awardsor adopting “hand-o” protocolsthat have led to saer hospitalstays and a 50 percent reduction inmortality over the past ve years.Protocols have reduced time toreceive critical lab reports rom 13minutes to less than one minute;X-ray time reduced rom 30minutes to 5 minutes.“One o the most importantperiods in critical care is the‘hand-o,’ when the patient leavesthe operating room and enters theintensive care unit,” said JonMeliones, M.D., director o thePCICU. “It’s a time when patientscan quickly become unstable. Weborrowed rom military andaviation models in designing acommunications system that callsor regular reporting proceduresor every step o the way — andthe protocol begins when thepatient enters the OR, not whenhe or she leaves.”Added Susan Strasser, R.N.,clinical operations director orneonatal and pediatric criticalcare, “Studies show that oneo the things parents nd moststressul about the ICU is theeeling that there is a lack o coordination in planning or theirchild’s treatment. We understandthat, and believe that our singular,multi-disciplinary ocus will helpminimize that.”
n
Pediatrics sta John Meliones and Ssan Strasser help patient Gavin Baile and hismother, Denise, ct the ribbon commemorating Dke Hospital’s ne pediatric ICu. 
PHOTO BY MICHELLE GAILIUN
HEARTS, cont.
“We elieve this expnsion will llow us to seve ll the milies who wish to ingthei childen to Duke o ce.”
— Joe St. Geme, M.D., chimn o the Deptment o Peditics
 
caLenDar
learn
Feb. 3 2:30-4:30 p.m.
rCr Fum
“Internal and External Factors that AectResearch with Animal Subjects,” with speaker RonBanks, D.V.M., director, Oce o Animal Welare Assur-ance. Duke North, Room 2003.
Del: 681-4441
Feb. 11 12 p.m.
DUson reech Cfeece see
with EllieMcConnell, Ph.D. A series designed to stimulatediscussion and showcase emerging issues in nursingand research. Open to nursing school aculty andstudents, Duke Investigators, and DUHS nursesinterested or engaged in research.
Clpp reechbuldg, rm 1017
.
Feb. 19 4:30-6 p.m.
Uey sem  Gll Helh
DaltonConley, o New York University, will address “Malariaand the Demographic Transition in Arica.” The eventis ree, but registration is appreciated. John HopeFranklin Center. Free parking in Pickens Clinic lot.Light rereshments served.
rege: hp://gll-helh.duke.edu/ew-ee/cled/
Feb. 19 5:30-7 p.m.
Dec Ce: behl sege f Lfe-yle Chge
Learn how integrated health strate-gies can dramatically change the course o diabetes.Duke Integrative Medicine’s expert practitioners willdiscuss the proven benets o nutrition, acupunc-ture, mind-body therapies, yoga, and more. DukeIntegrative Medicine at Center or Living Campus.
Del: 416-3853
 
Feb. 25 and 26 7:30 a.m.-5 p.m.
the imge f nug; oh Hw  h Chged!
 This year, the 50th Angus M. McBryde Symposium andthe 5th ICN Spring Conerence unite. Keynote speakeris Tim Porter-O'Grady, a leader in health care or 37years, noted or work on shared governance models,clinical leadership, confict and health utures. William& Ida Friday Center, Chapel Hill. Registration deadlineis Feb. 10.
Del d reg: 681-2553
Feb. 25-27
Ge-techg iee: a Pcpe Le-g Expeece (P 1)
The Center o Excellencein Geriatric Nursing Education (CoE-GNE) at DUSONinvites nursing aculty, clinical instructors, preceptorsand clinicians interested in gerontology or teachingto attend this conerence. Two-part conerence isdesigned to help nurse educators build a toolbox oteaching strategies customized or their particulareducational settings. Core teaching-learning contentsessions, small group tutorial sessions and breakouts.Registration deadline is Feb. 4. At the Duke UniversitySchool o Nursing. Part 2 held June 3-5. Cost or two-part session is $250.
Del: 668-2347
do
Feb. 7 8:30 a.m.-3 p.m.
Dcg f  Helhe He: a red Deaff
Join Duke heart and women’s healthspecialists or a celebration o women’s heart health.Hear rom survivors o heart disease and learn how todeend yoursel against the No. 1 killer o Americanwomen. Health air, heart disease risk-actorscreenings, breakast, luncheon, and perormancesby Triangle dance groups. Tickets are $30 and canbe purchased at the door. Raleigh Convention Center.
rege: hp://www.dukehelh.g
Feb. 9 10 a.m.-4:30 p.m.
nl Ge blck  Wx
Museum waxgures are on display in the Duke MedicalCenter Library. Each gure represents an importantArican-American in the eld o medicine.
Del: 660-1125
Feb. 9 2:30-4:30 p.m.
te wh tllze: dcu pel
DannyJacobs, M.D., chair o the Department o Surgery,and Haywood Brown, M.D., chair o the Departmento Ob-Gyn, speak about their experiences as Arican-American trailblazers at Duke. Duke Medical CenterLibrary, First Floor stacks.
Del: 383-2653
Feb. 9 4:30-5:30 p.m.
recep d uelg f “opeg D:Cempy afc-amec suge”
 Danny Jacobs, M.D., and Haywood Brown, M.D., willparticipate in a reception and unveiling o this nationaltraveling exhibit, developed and produced by theNational Library o Medicine and The Reginald F. LewisMuseum o Maryland Arican American History andCulture. The exhibit honors contemporary Arican-American surgeons and will be on display until April26. Duke Medical Center Library, mezzanine level.
Del: 383-2653
give
Feb. 12 9:30 a.m.-3 p.m.
Duke Uey Hpl’ vlee’ Dybld De
Searle Center Lecture Hall. Donorsreceive a ree T-shirt.
Del d ppme:hp://www.duke.geld.g
Feb. 28 6 p.m.-12 a.m.
2d aul blue Je bll
beneting the DukeGlobal Women’s Health Initiative. The evening beginswith a silent auction open to the public. Auction itemsinclude sports memorabilia, Americana, git baskets, jewelry, art, git certicates, sporting event tickets andmore. Dinner and dancing at 9 p.m. Tickets (requiredor dinner) are $100 each. Hilton on HillsboroughRoad in Durham.
Del: 660-2378  hp://lue- jell.mc.duke.edu.
 
Read an article about the current initiative in Tanzania on Page 15 of this issue.
 
caLenDar
3
February 2009
Inside Dke Medicine
How to sumit:
Send calendar listings to
edde@mc.duke.edu
Wnt moe ino?
Visit us online at
hp://de.dukemedce.g
 The Calendar is a monthly selection oevents that eature the best ohappenings at Duke and Duke Medicine.
Febrar
You inside's guide to wht'shppening t Duke Medicine
Don a red dress, celebrate omen's heart health, and learn health heart tactics at“Dancing or a Healthier Heart: A Red Dress Aair.”
 
ILLUSTRATION BY VANESSA DEJONGH
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agotini

There are interesting articles in this newspaper.

reply12 / 07 / 2009
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