VOLUME 18 NO. 3 n inside.dukemedicine.
org n March 2009
A new home for the PA Program
Facility highlights commitment to new models of care
ABOVE: Duke’s Physician Assistant Program is now located at 800 S. Duke St. near downtown Durham. Photo by kelly malcom
F or the first time since its creation in 1965,
the Duke Physician Assistant Program has
a home of its own — at the former Blue Cross
and Blue Shield of North Carolina headquar-
ters near downtown Durham.
“We have four times the space we had in
our previous building and all of our spaces
are designed to meet the program’s needs,”
said Patricia Dieter, MPA, PA-C, director of
the PA program.
Last year, the announcement of Duke’s
agreement with BCBSNC to lease the building
came with Duke Medicine’s commitment to
inquiry
Research under pressure
Find out about the basic and
clinical research ongoing at
Duke’s Center for Hyperbaric
Medicine and Environmental
Physiology.
Page 11
Open House
The Duke PA program will host an Open House from 4-6
p.m. on March 12 at 800 S. Duke St. in Durham. Guided
tours and refreshments will be available.
gradual expansion plans for the program and
a greater commitment to innovations in health
care. Duke is the birthplace of the physician
assistant concept and, with Duke’s commitment
to new models of care, it’s only fitting that the
program now has a home to match its heritage.
see DUKE PA, p.2
now open
Knightdale clinic opens
Duke Medicine expands to
Eastern Wake County with
new facility.
Page 3
special section
Benefits
In this issue, 4 pages of news
about your Duke benefits
Pay for college
Although companies and other organiza-
tions are eliminating or reducing benefits
to tighten budgets during the recession,
Duke has expanded its employee tuition
assistance program for faculty and staff.
In January, the benefit expanded to cover
up to $5,250 in tuition reimbursement
and nine courses per calendar year.
Page 7
Stretch your dollars
Duke Credit Union seminars are free,
and they save you money by helping
you get a handle on household budgeting,
understand finances or receive timely
information on big financial moves, such
as housebuying.
Page 8
Stay up to date
The new Lynda.com program can help
you stay up-to-date on emerging Web
and multimedia technologies through
online tools and tutorials available
anytime, anywhere.
Page 9
events
What to do in March
The calendar moves to page
15 this month.
Page 15
2 Inside Duke Medicine March 2009

F RO M t h e c o v e r

DUKE PA, cont. All 3 hospitals

“It is no secret that this country is
facing a growing shortage of primary
care physicians, and we don’t yet
know how much worse this shortage
will become,” said Justine Strand,
DrPH, PA-C, chief of the physician
assistant division. “PAs are going to be
a key component in the evolution of
new models of care and will be needed
to ensure adequate access to care for
Americans in the future.”
“PAs are an efficient and flexible
component of the solution to the
shortage,” Strand said. “We can
graduate a PA in two years, whether
primary care or specialty.”
Brandon Wyche, first-year student,
said: “It’s good to know that you are
preparing to do something that will
ultimately fill an urgent need in the
community.”
Wyche, a former emergency
medical technician, was introduced to
the profession while working with PAs
in hospitals.
“The diversity of options available
to physician assistants is what initially
attracted me to the PA program, and
the options seem to be growing almost
every day,” Wyche said. “You don’t
have to choose just one area like
emergency medicine, surgery or family
medicine.”
Under the supervision of a physi-
cian, PAs take patient histories, perform
physical examinations, order laboratory
and diagnostic studies and develop
patient treatment plans. In all states,
including North Carolina, PAs have the
authority to write prescriptions.
Chinika Reynolds takes a standardized patient’s blood pressure during a clinical problem
evaluation. Photo by erin pratt
said. “The profession has doubled in
numbers in the last decade, and tripled
in the last 15 years.”
There were about 74,000 PAs
practicing in the United States in 2008.
In North Carolina, there is about one
practicing PA for every six practicing
physicians.
“I’m confident that PAs will play
an integral part in revolutionizing our
health care system and I am excited
about the prospects for the future,” said
Chinika Reynolds, a first-year student.
Importantly, PAs — like other
physician extenders on the modern
health care team — increase patient
access to health services by extending
the time and skills of the physician.
“Several patient satisfaction studies
“more spacious and more conducive to
teaching and learning.”
The Duke Endowment helped sup-
port the start-up cost of the expansion
of the PA Program. BCBSNC provided
the renovations, and worked closely
with Duke to transform the historic
building into an energy-efficient and
user-friendly facility.
The new facility has a master
classroom that can accommodate 90
students. The master classroom in the
former on-campus location at Hanes
House accommodated 66 students.
The facility, at 800 S. Duke St.,
also offers four physical diagnosis
suites, where students conduct physical
diagnosis through clinical problem
evaluations with standardized patients.
now Magnet status
Duke Raleigh Hospital has achieved Magnet
designation for excellence in nursing by the
American Nurses Credentialing Center (ANCC).
Only 5 percent of the nation’s hospitals have
earned this designation, the highest level of
national recognition to health care organizations
that demonstrate sustained excellence in
nursing care.
“It is an honor to receive such prestigious
recognition for our hospital and a testament to
the extraordinary nurses and entire hospital
team who work together every day to provide
the very best care to our patients,” said Doug
Vinsel, chief executive officer of Duke Raleigh
Hospital. Duke University Health System is the
only hospital system in the Triangle with all
hospitals receiving Magnet designation. Go to
http://inside.dukemedicine.org to watch
video featuring chief nursing officers from each
of the hospitals.
“This is the highest honor a U.S. hospital can
receive for its nursing program and further
supports the exceptional skill and dedication of
Duke nursing” said Victor J. Dzau, M.D.,
chancellor for health affairs and president and
chief executive officer of the Duke University
Health System. “For all three of our hospitals to
receive this distinction truly signifies the
world-class care available to all of our patients.”
The Magnet Recognition Program recognizes
health care organizations that demonstrate
excellence in nursing practice and adherence to
national standards for the organization and
delivery of nursing services. Applicants undergo
a rigorous evaluation that includes extensive
interviews and review of nursing services. Duke
Raleigh Hospital was notified of Magnet
recognition on Feb. 13 after a three-year-long
application process. Durham Regional Hospital
received Magnet designation in November after
completing as similar lengthy process. The
designation was given to Duke University
Hospital in 2006.

Their job descriptions are as
diverse as those of their supervising
physicians, and may include patient
education, medical education, health
administration and research.
“PAs work in all of the specialties
of medicine,” said Perri Morgan,
Ph.D., PA-C, director of physician
assistant research.
Nationally, 37 percent of PAs
work in primary care. Other specialties
where PAs are most common include
cardiovascular and orthopedic surgery,
dermatology and emergency medicine.
“Recent growth of the PA
profession has been dramatic,” Morgan
have shown that patients are as satisfied
with care provided by PAs and nurse
practitioners as they are with physician
care,” Morgan said.
At Duke, the program is growing.
The traditional incoming PA class size
was 45 students. The class beginning in
August will have 70.
The continued gradual expansion
of the program is dependent on avail-
able clinical rotations within Duke
University Health System and avail-
ability of PA scholarships through
the School of Medicine to recruit top
students, Dieter said.
She described the new location as
The visits are recorded and given to the
students for self-evaluation.
Other features of the new location
include a diagnostic methods lab, study
rooms and lounges for students, faculty
and staff offices, conference rooms, and
two kitchens available to students.
The layout of the new location
brings students, faculty and staff
together.
“Before, we were spread out over
multiple floors and now we are all in
our own space together,” Reynolds said.
Her fellow student, Wyche, said
the new facility “feels worthy of the
reputation of the Duke PA program.” n
“We are so appreciative of the more than 225
employees who were directly involved in this
process,” said Mary Graff, director of nursing
special projects and the Magnet program at
Duke Raleigh Hospital.
“Our nursing staff are so deserving of this
designation, and I am so proud to be the
nursing leader of this amazing group,” said
Rosemary Brown, chief nursing officer.
Research shows there are clear benefits to
hospitals that are awarded Magnet status and
to the communities they serve in consumer
confidence, recruitment and retention and in
maintaining quality of care. Magnet designation
is maintained for four years. During that period,
the ANCC monitors facilities to ensure high
standards of care continue to remain.

■ ■ I N S I D E V olume 1 8 , I ssue 3
Inside Duke Medicine, the employee
newspaper for the Duke University Health
System, is published monthly by Duke
Medicine News & Communications.
Your comments, story ideas and photo
contributions are always welcome and
appreciated. Deadline for submissions
is the second Friday of each month.
Contact us
Campus 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 Pratt
Intern: Sara Portoghese
Copyright © 2008
Duke University Health System
March 2009
C
Q ALEN
& A D AR
Beknighted – Duke Medicine
opens clinic in Eastern Wake County
In and around the Triangle, no area is growing
as fast as Wake County. The population of
Wake County grew by 32.6 percent— adding
204,744 people— between 2000 and 2007,
according to state government estimates.
Comparatively, Durham County grew by 14.1
percent and Orange County by 10.2 percent.
The March 2 opening of
Duke Medicine in
Knightdale, a state-of-the-
art facility with primary
care and urgent care
services, is the latest
example of how the Duke
University Health System
doug vinsel, ceo
continues to make
investments in Wake
County. The Knightdale clinic now gives Eastern
Wake County the same world-class specialty
services available to patients in Durham, Raleigh,
Morrisville and other communities.
We asked Doug Vinsel, CEO of Duke Raleigh
Hospital, to elaborate on Duke Medicine’s Wake
County strategy and explain how the new Duke
Medicine in Knightdale answers the growing
need for health care services there.
Why open a clinic in Knightdale?
The establishment of a Duke Medicine
presence in Knightdale at the intersection
of Interstate 540 and US 64-Business is
consistent with our strategy of trying
to create a presence along the I-540
corridor. In looking at opportunities
within Wake County, Knightdale stood
out as a high-growth community with
minimal existing medical services.
Locating our new building at the
intersection of I-540 and 64 makes
access for patients in the northern and
northeastern tier of Wake County very
convenient. And, the new building is
on 16 acres, which certainly creates the
opportunity for future evolution of this
facility into a health campus.
I would be remiss if I didn’t
mention the communications from
the university and the health system
on March 2 that provided a clear
update on how Duke is being impacted
by the current financial crisis. Within
the Health System, current efforts
to manage expenses and achieve a
sustainable financial structure for
the future are critically important.
But, as pointed out in the email to
Duke Medicine employees, expense
management is only one component
that will drive our long-term success.
The other driver will be strategic,
well-designed, fiscally disciplined
investments in projects that can drive
growth — the Knightdale project is a
good example of this and is consistent
Inside Duke Medicine
Duke Medicine in Knightdale
opened for business Monday,
March 2, 2009
Location: 162 Legacy Oaks Drive, Hwy 64
and I-540, Knightdale, NC 27545
Primary Care: Family medicine for all ages.
Mon-Fri 8 a.m. – 5 p.m.
Urgent Care: Open seven days a week,
8 a.m. – 8 p.m.
Specialty Care: Gastrointestinal medicine,
pulmonary medicine, cardiology and
orthopedics.
Appointments: 919-232-5205 or
1-888-ASK-DUKE (375-3853)
with our two-track approach to
long-term success.
How are Wake County residents
responding?
The early response is encouraging;
there were more than 25 appointments
scheduled during the first day that the
appointment line was open. Bottom
line: I think this is a location that will
be successful short and long term and
one that will allow for a synergistic
relationship between Duke Raleigh
Hospital, which is just 7 miles away.
What’s special about the facility?
The facility itself is spacious, attractive
and easily accessible. I think the thing
that is most special about the location
is the fact that it’s a 40,000-square-
foot building that, when fully ramped
up, will accommodate 25 physicians
— 14 specialists and 11 primary care
doctors. The critical mass of primary
and specialty care will be a beacon for
both existing residents and newcomers
to Wake County seeking a single site
where they can receive virtually all of
their physician care.
What specialty care physicians will
be located at Knightdale?
By late spring, Duke Medicine in
Knightdale will include orthopedics,
p r i vac y a l e r t
What to do about
lost, stolen data
cardiology, gastroenterology and
pulmonology. Then, over the next 12
to 18 months, other specialties will be
added. The mix of specialists was based
on the demographics of the area and
the gaps in specialty care that currently
exist and are projected to continue to
exist over the short to intermediate
term. Many of the specialists who will
initially work at the Knightdale clinic
will also continue to have a presence on
the Duke Raleigh Hospital campus in
the Duke Medicine Plaza.
Will the quality of care match the
high quality across Duke Medicine?
Absolutely! Protocols and evidenced
based care practices will be consistent
at this site with those at other Duke
Medicine locations. We’re proud to be
bringing even more of Duke’s world-
class care closer to Wake County’s
residents.
Did Duke Medicine recruit new
physicians, nurses and staff to fill
the facility?
All of the physicians who will occupy
the Duke Medicine of Knightdale site
will be Duke PDC Physicians (specialty
care) or Duke Primary Care Physicians
(primary and urgent care). Many of
these physicians are new recruits,
although some will be redeployed from
within the Health System. Similarly,
many of the staff who will support
the practices are new Duke Medicine
employees, while others are existing
employees who have chosen to transfer
to this new location. n
3
Laptop computers, thumbdrives,
personal digital assistants, and other
mobile devices make accessing
electronic information easier and
often more efficient.
These portable devices may also
be easily lost or stolen. If patient
information or other sensitive
information (Social Security numbers,
personal financial information, etc.)
is stored on these portable devices,
patient’s identity and Duke could
be at risk.
To prevent the
loss of data:
• Do not store sensitive information
on laptops or mobile devices.Use
remote
access
services like
the Duke
Medicine
VPN service,
virtual PIN
and other
Citrix
services to
access the needed information.
Information saved on these servers
is secure and backed up nightly.
• If you must store information on
mobile devices, encryption of the
information is required. Contact
your technical support person for
assistance.
If your laptop or mobile
device is lost or stolen:
• Contact your information security
officer or the DHTS Service Desk at
684-2243.Security support personnel
are listed at https://www.iso.duke.
edu/iso/isop/isl.php. Contact Duke
Police at 684-2444 and Risk
Management at 684-3277.
• Provide the last known location of
the device.
• Identify all patient health informa-
tion or sensitive information stored
on the device.
4 Inside Duke Medicine
AT A G LAN C E
“
I’m impressed with how people here can take an idea … and turn it
into something big. People here are overachievers in the sense that they
can make big things happen starting with relatively modest resources.
— Nancy Andrews, M.D., Ph.D., dean of the the School of Medicine, in her inaugural State of the School address
■ ■ I N S I D E view
■ ■ pi c t u r es
Hospice center opens with ceremony, gifts
M oney raised by the Duke
Hospital Auxiliary again is
benefiting Duke Medicine’s facilities,
patients and families.
A donation from the auxiliary
will provide flat screen TVs for all
12 patient rooms — plus TVs for the
family room and the nurses area — at
Duke HomeCare & Hospice’s new
facility on North Roxboro Road
in Durham. The facility, called the
Hock Family Pavilion, had its ribbon-
cutting on Feb. 24.
“Providing the funding to buy
the TVs allowed hospice to use their
funds for other areas of the facil-
ity,” said auxiliary director Renea
Hunnings.
“We would not have been able
to provide that level of amenity
without a committed sponsor like the
Duke Hospital Auxiliary,” said Starr
Browning, executive director of Duke
HomeCare & Hospice. “They have been
a strong partner in the work we do.”
The auxiliary has helped sponsor a
wide range of projects at Duke Hospital
since 1950, with particular emphasis
on patient and family needs. It raises
■ ■ i t fi g u r es
Participating in the Feb. 24 ribbon-cutting at the new Hock Family Pavilion hospice inpatient
facility were, left to right, Mary Ann Black, Duke University Health System assistant vice
president for community affairs, Deborah and Jim Hock, Gary Hock, DUHS CEO Victor J.
Dzau, M.D., and state Sen. Vernon Malone. Not pictured are Starr Browning, executive
director of Duke Home Care and Hospice, Duke University President Richard H. Brodhead
and Paul Newman, DUHS vice president for ambulatory care. Photo by nancy shambley
money through three gift shops, a
volunteer office and fund-raising events.
The new hospice facility
features 12 private patient rooms,
24-hour skilled nursing care and
an interdisciplinary team of nurses,
social workers, chaplains, nursing
”
6,288
The number of hours worked in
calendar 2008 by hospice volunteers
at Duke Home Care & Hospice.
Source: Duke Home Care & Hospice
assistants, bereavement counselors
and volunteers.
In another gift, the auxiliary
donated $10,000 to provide heart pa-
tients with pillboxes uniquely designed
for easy opening by anyone who has
arthritis or gripping problems. n
March 2009
B ULLETINS
■ ■ a c c oun t in g
Health care receipts
due by April 15
Faculty and staff who enrolled in 2008 health
or dependent care reimbursement accounts
must submit receipts for services provided from
Jan. 1 through Dec. 31, 2008 to WageWorks
by April 15, 2009, for reimbursement.
Claim forms and supporting documentation
must be post marked or faxed to WageWorks
by April 15. Claims for 2008 submitted after
this date will not be reimbursed.
Claim forms are available online at http://
hr.duke.edu/forms, or at the Human
Resources office, 705 Broad St. in Durham.
■ ■ min d + b o d y
Register: Spirituality and
health research workshops
The Duke University Center for Spirituality,
Theology and Health is offering two five-day
research workshops on July 20-24 and Aug.
17-21 that compress a two-year post-doctoral
fellowship into five days.
They will be the only
places in the world
where specific training
on religion, spirituality
and health research can
be obtained from faculty
active in the field for
nearly 25 years.
In each of the past four years, the workshops
have been over-subscribed, so it is important
to register now. The courses are strongly
recommend for graduate students, researchers
early in their careers, and seasoned researchers
wishing to shift work into this area. There are
no degree requirements for participation.
Tuition scholarships are available for students
with extreme financial hardships and
exceptional academic potential. Because of the
intense nature of this training, which includes
individual mentorship with Harold G. Koenig,
M.D., and other workshop faculty, the
workshops are limited to 25 participants each.
For any questions, write koenig@geri.duke.
edu, or go to: http://www.spiritualityand-
health.duke.edu.
■ ■ wo r k + f a mil y
Find a summer camp
for the kids
Are you a Duke University Health System
employee and already wondering what to do
with the kids thus summer?
It’s never too early too plan.
Check out the list Duke University Staff &
Family Programs has compiled of summer
camps and programs taking place in Durham,
Orange and Wake counties. The list includes
athletic and academic camps sponsored by
Duke as well as other arts and recreation
camps in the area.
Find all the details here: http://hr.duke.edu/
family/camps.php
March 2009
■ ■ P e r son a l fin a n c e
How to obtain
a duplicate W-2
The 2008 W-2 forms needed to file tax
returns were distributed in late January.
In an effort to better serve faculty and staff,
Duke University has standardized the
process for requesting duplicate tax forms.
An employee must complete a Tax
Document Request Form to request a
replacement of a lost or misplaced W-2
form. This form is available on the Corporate
Payroll Services Web site: http://www.
payroll.duke.edu/forms/forms.php.
This change is necessary to obtain an
original employee signature authorizing the
request. The fees associated with this
request are stated on the Tax Document
Request Form and remain unchanged from
prior years.
For more information about W-2 forms,
talk with your department payroll represen-
tative, visit the Corporate Payroll Services
Web site, or call 684-2642.
■ ■ h ono r s
Fulkerson among 6
‘Sammie’ award winners
William J. Fulkerson, M.D., senior vice
president of clinical affairs for the health
system, is among six people recently selected
for the 2009
“Sammie” awards,
named for distin-
guished political
scientist, educator
and human rights
activist Samuel
DuBois Cook.
FULKERSON The winners were
announced at the
12th annual dinner and awards ceremony
held at the Washington Duke Inn & Golf
Club. All were chosen in appreciation of
their work in furthering Cook’s legacy.
Fulkerson, head of the Duke Hospital
Diversity Leadership group, was cited for
providing leadership in the area of diversity
and inclusion, helping enhance diversity
education, and encouraging all members to
consider the connection between diversity
and patient care.
Also recognized were Peter Klopfer, Ph.D.,
emeritus professor of biology at Duke and
civil rights advocate; Martha Shumate
Absher, associate dean for education and
outreach at Pratt School of Engineering;
the Rev. Mel Williams, senior pastor at the
Watts Street Baptist Church and founder of
Walltown Neighborhood Ministries Inc. and
Duke seniors Dinh Phan and Flint Wang.
Named for the first African-American
faculty member at Duke, the Cook Society
was founded in 1997 to recognize and
celebrate the African American presence at
Duke. For more information and to find a
list of past award recipients, go to http://
www.duke.edu/web/cooksociety.
Inside Duke Medicine
Q: How do you jumpstart performance?
A: A Quiz Bowl!
By Melissa Schwarting
I
t’s 6:45 a.m. on a frigid Wednesday
morning. Twelve wide-eyed
neurosurgery residents sit around a
conference room table as Michael
Haglund, M.D., Ph.D., program
director of the neurosurgery training
program, steps up to a podium at the
front of the room.
But this isn’t a typical lecture.
Haglund transforms into a referee as
teams are formed and the room is sud-
denly filled with a competitive energy
that could rival a Super Bowl match up.
This event is called Quiz Bowl,
an idea conceived by Haglund, who
used an experience with his children
as inspiration. “This concept was
something I’d seen when my kids
participated in a junior Bible quiz,”
he explains. “It makes learning fun …
[the residents] get into it.”
Quiz Bowl is not just fun and
games. What started as an experiment
to make the learning process more
interesting, has turned into a successful
teaching model.
“[The residents] seem to pay
more attention and enjoy the friendly
competition,” Haglund explains.
“We’ve also seen the scores come
up a lot since we started doing this,”
Haglund says. He estimates that quiz
scores improved from an average of 24
percent in 2007 to around 83 percent
since the Quiz Bowls began in 2008.
Haglund is careful to note that part
of the improvement can be attributed
to other recently launched efforts in
the department to encourage resident
participation and make them feel more
engaged in the design and implementa-
tion of the residency training program.
As the game kicks off, teams of
two are formed. Chief residents are
paired with more junior residents and
mid-level residents join together.
All eyes are fixed on a large projec-
tion screen as questions, photographs
and diagrams begin to appear asking
questions like, “Name a neuropeptide
neurotransporter.”
The room fills with clicking sounds
as the residents begin pounding small,
remote controlled buzzers in their
hands signaling their desire to answer
the question.
The questions keep coming, along
with the enthusiastic responses of the
residents, as team after team comes to
the front of the room for their turn in
the hot seats. The format is single round
elimination comprised of five rounds.
Three correct answers in round one
meant one team was moving on to face
their next opponent and one team was
out of the competition.
The initial concept started two
years ago when Cory Adamson, M.D.,
Ph.D., assistant professor of surgery
and neurobiology, started administering
weekly quizzes to the residents. Those
with the top scores at the end of the
year were eligible to be named “resident
scholar” and win a cash prize.
When Haglund took over as
program director last spring, he wanted
to build upon Adamson’s creative
approach. He soon introduced Quiz
Bowl, which takes place every three
months and includes questions from the
weekly quizzes administered during the
prior 12 weeks.
On this morning, the champion-
ship round has Renee Reynolds, M.D.,
and Hamid Aliabadi, M.D., squaring
off against Betsy Hughes, M.D., and
the incumbent winner, Ciaran Powers,
M.D., Ph.D. Following an intense
round of questioning, Powers and
Hughes are the victors.
No rings or trophies are awarded
to the winners. Instead the winners and
a guest are taken to dinner, at a restau-
rant of their choosing, by Haglund and
another member of the faculty. n
5
■ ■ poli c ies
Human Resources
policies updated
Duke Human Resources has updated the
Duke Staff Handbook, which gives an
overview of policies and procedures. The
handbook, which is distributed to newly
hired staff during orientation, includes
several updates that have been incorporated
into the HR Policy Manual. More information
about these changes, as well as an electronic
copy of the handbook, can be found at
http://hr.duke.edu/policies.
■ ■ r e c o g ni t ion
Stroke Association
honors Goldstein
Larry Goldstein, M.D., professor of medicine
(neurology) at Duke and the Durham VA
Medical Center and director of the Duke
Stroke Center, was honored February by the
American Stroke Association with the
William Feinberg
Award for Excellence
in Clinical Stroke.
The award honors
“significant achieve-
ment in the clinical
investigation and
management of
goldstein stroke.”
Goldstein is a senior fellow in Duke’s Center
for Clinical Health Policy Research, and
principal investigator of Duke’s American
Stroke Association–Bugher Foundation
Center for Stroke Prevention Research.
Read more about the honor and Goldstein’s
work at http://inside.dukemedicine.org.
Search “Goldstein.”
■ ■ c on t inuin g e d u c a t ion
Save 40 percent on
Fuqua business courses
All Duke faculty and staff are eligible for a
40 percent tuition reduction on all non-
degree executive education programs at the
Fuqua School of Business.
Fuqua is a premier provider of business
education for working professionals. A range
of programs are available, designed
specifically for professionals in all stages of
career development.
Eight executive education programs are
available throughout the year. Two new
programs available in fall 2009 are:
Fundamentals of Management (for first-time
managers, and experienced managers without
formal training) and High Potential Executive
(for mid-level managers and executives).
Programs are held at the R. David Thomas
Executive Conference Center on Duke’s
campus and also at the Washington Duke
Inn & Golf Club.
To learn more, visit http://www.ee.fuqua.
duke.edu, contact a client relations
coordinator at (919) 660-8011 or e-mail
execed-info@fuqua.duke.edu.
6 Inside Duke Medicine March 2009

Arou nd th e hospitals

Durham rehabilitation institute:

A team approach to recovery
D urham Rehabilitation Institute
(DRI), located on the seventh floor
of Durham Regional Hospital, provides
a comprehensive, multidisciplinary
approach to recovery. The rehabilita-
tion team is dedicated to helping each
patient regain independence and reach a
higher standard of living.
DRI staff treat patients with a
variety of traumas and disorders,
including strokes, spinal cord injuries,
amputations, joint replacements and
neuromuscular disorders. The DRI team
and rehabilitation nursing staff will tell
you that it’s the team approach that
makes this possible.
“In the gym, we have a multidisci-
plinary team that creates a personalized
rehabilitation plan for each patient
and makes sure that he or she is able
to take advantage of all the technology
and resources available,” explains
Raphael Orenstein, M.D., medical
director of DRI.
A Multi-Disciplinary Approach
Kristen Tell and Kim Dao, physical therapists at the Durham Rehabilitation Institute, work with a patient at the parallel bars.
Teamwork is essential for positive Photo by tom wooters
outcomes at DRI. The care team is
comprised of physicians, physical The Latest Technology ferent and exciting. “Our main
therapists, occupational therapists, Several of the latest advances goal is to help patients learn
therapy aides, speech therapists, reg- in rehabilitative technology are how to do things for themselves.
istered dieticians, nurse practitioners, available at DRI, including the This is different than many of
care managers, referral coordinators, Biodex De-Weighing System — the other units. It requires a lot
rehabilitation nurses, certified nurse a fully adjustable harness system of teaching and a different type
assistants, a licensed assistant therapist that allows patients to practice of care. We consider at every
and a recreational therapist. walking but removes as much of turn how much we are supposed
The teamwork starts every morning their weight as necessary. This to help our patients versus how
with a group meeting at 8:30 to review system gives patients opportuni- much they are supposed to do
each new patient being admitted. The ties for exercise and also speeds for themselves.”
charge nurse, nurse manager, nurse recovery and enhances ability. On 7-3, each patient receives
practitioner, physician, therapists, care Other tools are practice full nursing care with the same
managers and referral coordinators dis- rooms and an automobile Angela Webb, an occupational therapist at the Durham medical acuity as on other
cuss each patient and become proactive Rehabilitation Institute, helps a patient. Photo by tom wooters units, but in addition they must
simulator. There is also a practice
about the resources needed for them. A kitchen and a practice living complete at least three hours of
primary nurse is assigned to each new room so patients can experiment gym. Unit 7-3 is the inpatient unit for therapy at the gym a day. “There
patient. This is unique to rehab. with tasks such as food preparation and DRI, and the bed capacity was recently is a lot of coordination that happens
The DRI care team also meets wheelchair maneuvers. expanded from 22 to 30 beds. between nursing and therapy — it’s kind
weekly to discuss each patient’s short The technology, combined with the The Unit 7-3 care team includes of like a dance,” says Perry.
and long term goals, and their progress comprehensive, team-oriented approach registered nurses, certified nursing Ask any team member what his
to date. to rehabilitation, has led to DRI’s being assistants, dietitians and health unit or her favorite part of working at DRI
“We talk about how we are going recognized by the Uniform Data System coordinators. In addition, the Food & is, and he or she will tell you “it’s my
to get the patient where they need to be, as being in the top 10 percent nationally Nutrition and Environmental staff are patients.” Physical therapist Kristin Tell,
which is functioning independently and in patient outcomes. often commended for their customer- relays an experience that is common
ready to go home, and then together focused service in letters from 7-3 at DRI, “A patient’s grandma told me
we do what’s needed to get there,” says Care Outside the Gym patients. ‘thank you for giving me my grandson
Sherri Pearce, BSN, MSN, director of An additional team of professionals Regina Perry, RN, describes how back.’ Moments like this are what I love
Adult Health. provides care outside the Rehabilitation nursing for Rehabilitation is both dif- about this profession.” n
Benefits
Stan Jones, a utility worker with Duke’s Housekeeping Operations, is using Duke’s employee assistance program to work
toward an associate’s degree in electrical technology from Durham Tech.
Paying for College
Employee tuition program expands skills, advances professional development
S itting in a classroom at Durham
Technical Community College, Stan
Jones studied a blackboard filled with
algebra, fractions and word problems.
Jones, a utility worker with
Duke’s Housekeeping Operations,
paused for a moment, recalled the
math formulas he reviewed over the
week, then picked up a pencil and
started scribbling in a notebook.
“Good job,” Durham Tech math
instructor Richard Noble told Jones, as
he looked over Jones’ work.
Jones is participating in Duke’s
employee tuition assistance program
to work toward an associate’s degree
in electrical technology from Durham
Tech. He’s among 1,000 staff and
faculty members who have enrolled in
the tuition benefit in recent years for
career-related courses and degrees at
accredited North Carolina schools.
As part of his job at Duke, Jones
cleans floors in East Campus buildings
and hopes the new skills he learns in
school will open doors to become an
A Quarterly Supplement to Inside Duke Medicine
hr.duke.edu n inside.dukemedicine.org n March 2009
va l u i n g t e a m w o r k
Coach K: Remember you’re part
of the team.
Page 8
financial planning
Duke University Federal Credit
Union seminars can help
you stretch dollars during
“When I’m done, I’ll have an associate’s
degree and be a registered nurse
the recession.
Page 8
without having a lot of loans to pay off.”
Daniel Rudd, clinical staff assistant at The Preston Robert Tisch
H e a lt h y l i v i n g
Brain Tumor Center. Rudd is taking evening classes at Alamance
Community College.
electrician at Duke. “When I heard work location is in another state.
about the program, I jumped on the The tuition assistance is available
opportunity,” said Jones, 48. “I’ve to full-time staff and faculty with at
wanted to learn more about wiring and least two years of continuous service
circuit boards for a while.” at Duke. Since 2007, Duke has reim-
Although companies and other bursed employees nearly $1.5 million
organizations are eliminating or reduc- for tuition.
ing benefits to tighten budgets during Lois Ann Green, director of
the recession, Duke has expanded its Duke Benefits, said the program
employee tuition assistance program for supports Duke’s long-term staffing and
faculty and staff. In January, the benefit professional development strategies by
expanded to cover up to $5,250 in expanding the internal pool of talent to
tuition reimbursement and nine courses fill positions at Duke.
per calendar year. Employees can also “It helps us to build a more
request a waiver to take courses at skilled workforce and boosts retention The Mobile Farmers Market
accredited schools in other states if because employees can grow and have makes healthier living easier.
the courses are not offered in North the opportunity to advance within
Page 9
Carolina, or if the employee’s primary see TUITION, p.10
8 Benefits
Stretching your dollars during a recession
D iane Gifford does her best to
manage money wisely. She creates
a monthly budget, uses online banking
to pay bills on time and regularly sets
aside money in a savings account. But
it’s the unexpected – vehicle repairs,
brokenh appliances or medical bills –
that drain her savings.
“I put the money into the savings
account with the best intentions of
keeping it there, but you know how
things go,” said Gifford, a clinical trial
coordinator with Duke Clinical Research
Institute.
Gifford attended a recent Duke University
Federal Credit Union workshop on “Building a
Better Budget,” an important topic during the
economic recession, which, financial advisors
suggest, is a good time to revisit a personal
monthly budget.
“If you’re paying attention to the news and
volatile market, it’s a scary time for everyone
right now,” said Scottie Dowdy, a financial
counselor with Duke Credit Union. “The key is to
manage your money as best as possible.”
Managing money starts with preparing an
accurate and balanced budget based on net
The letters on the front of the jersey
B efore an audience of several
hundred faculty and staff, Mike
Krzyzewski boiled down his coaching
philosophy to one mantra:
Whether playing for Duke, or for
the USA Basketball team, “You play
for the [team] letters on the front of
the jersey,” he said, brushing his hand
proudly across his chest, “not the name
on the back.
“You don’t just get 12 people
together and call it a team,” he said,
“just like a school is not a school just
because you have people occupying
jobs. How do you get people to work
together?”
The answer, he told employees
during the Primetime forum in January,
is taking time to develop the culture of
teamwork.
Krzyzewski recalled his first
meeting with the USA national team,
long before he coached them in the
Olympic gold-medal game last
year. “[The meeting] was not
about offense or defense,”
he said. “It was about the
standards we were going
to live by.”
income with these suggested budget guideline
allocations: 35 percent for housing (mortgage,
rent, utilities, insurance); 25 percent for other
expenses (food, clothing, entertainment); 15
percent for transportation (car payment, fuel,
maintenance); 15 percent to pay debt (credit
cards, student loans); and 10 percent for savings.
“When creating your budget, you should only
list sources of income that you actually receive
on a regular basis, not overtime or bonuses,”
Dowdy said.
In addition to budgeting, Dowdy suggested
creating a chart with goals for longer-term needs
such as a house or new car, and to earmark
Duke men’s basketball coach Mike Krzyzewski speaks with women’s basketball coach Joanne
McCallie. Coach K talked about teamwork during the Primetime employee forum in January.
Later, Krzyzewski cultivated the
standard of service by introducing the
national team to veterans such
as Scotty Smiley, an MBA
student at the Fuqua School
of Business. Smiley was
blinded in Iraq while trying
to protect his squadron from
savings toward those goals.
Developing a priority list for paying
down credit cards with high interest
rates is also key.
People of all income levels
are “feeling the crunch,” Dowdy said.
“It’s not what you make; it’s how you
use what you earn,” she said. A “nest
egg” for unexpected expenses and
emergencies guards against dipping
into savings, she added.
“If you put money into your
savings and then take it out to pay
bills or unexpected expenses, then that
is not a savings account,” Dowdy said. “If you
know you’re going to need new tires or a new
car in the next year, start saving for it now.”
Gifford, the Duke Clinical Research Institute
trial coordinator, has a new goal after attending
the seminar: leave the savings undisturbed by
creating an accurate budget with an allocation
for unexpected expenses.
“I’m determined to get on track and have
money set aside for unexpected expenses,”
she said. “That’s my financial goal for 2009.” n
By Missy Baxter, Senior Writer,
Office of Communication Services
a car bomber. “I wanted the guys to
understand what selfless service was
about,” Krzyzewski said. “Not only
had these guys served, they wanted to
serve again. After the veterans spoke,
the team – Wade, LeBron and all – were
crying. I thought, ‘we have a chance.
These guys have a heart.’ ”
March 2009
Duke Credit Union
Seminars
Ten Steps to Financial Success
March 17, 12:30 p.m. at the Duke
Credit Union, 2200 W. Main St.
Homebuying
March 24, 12:30 p.m. at the
Searle Center
Go Online:
To register for a seminar, visit
http://www.dukefcu.org and select
“seminar sign-up” under Quick Links;
send e-mail to scottie.dowdy@duke.
edu or call (919) 660-9745.
Video
See a video about budgeting at
http://www.hr.duke.edu/finance
Coach K’s style at Duke is not
much different. “Beyond the basketball
court, we talk to our guys a lot about
character, about being humble and using
the platform they have to help others,”
he said. In answer to questions from the
Primetime audience about developing
teams, he stressed the importance of
being honest with each other, and
developing communication skills and
trust “so that the first time you talk
[tough] isn’t the first time you talk.”
Krzyzewski, who has coached more
than 950 basketball games at Duke,
reminded the audience that the Duke
name garners respect in the world, even
outside of basketball, and that the Duke
name elevates all of us.
“We are lucky to be part of
something bigger than us,” he said.
“But always remember that Duke is
great because of its people. Anything
any one of us does is important. An idea
you have has the chance of being the
idea that makes Duke better. That’s why
we should always act as a team to make
good things happen.” n
By Marsha Green
Writer, Office of Communication Services
March 2009
Grab and go at the gardens
Mobile farmers market makes healthy eating easier
J oyce Newton’s office is a
stone’s throw from the summer
Duke Farmers Market. But as a
staff specialist with the Pediatric
Neonatology Department, she
doesn’t always have time for
market shopping.
That’s why she’s a fan of the
Duke Mobile Farmers Market. She
signs up for both the summer and
winter mobile market to get fresh,
local vegetables nearly all year
round.
“It is so convenient,” she said.
“I just drive to Duke Gardens after
work on Tuesdays, and a box of veg-
gies is waiting. I really miss the few
weeks between growing seasons.”
With the mobile market, faculty
and staff pre-pay for produce and
pick up their share of the harvest
once a week. This year, seven local
“The farmers introduce us to vegetables we might
farmers/vendors will provide fruit,
vegetables and flowers, with deliver-
ies starting April 7 at Duke Gardens That was different!”
(with one farmer delivering
to Durham Regional
Hospital). The produce,
price, size of share and
number of delivery weeks
vary among farmers.
“My husband and I
are local potters, so we
recognize the importance
of supporting community
businesses,” Newton
said. “And the farmers
introduce us to vegetables
we might otherwise
never see — like purple
cauliflower from Vollmer
farms. That was different!”
More than 300 employees
participated in the 2008 mobile
market, organized by LIVE FOR
Learn more and enroll in the mobile farmers market at
http://www.hr.duke.edu/mobilemarket or contact
Jason Horay at (919) 681-0504 or Jason.Horay@duke.edu
Benefits
Fresh food is to be had at the Duke Mobile Farmers Market.
otherwise never see — like purple cauliflower.
Joyce Newton, staff specialist with the Pediatric Neonatology Department
Meals to go at
mobile market
Rosie’s Plate offers fresh entrees,
side dishes, salads, soups, snacks
and desserts for take-out.
Each week, employees can order
food from Rosie’s Plate up to one
day in advance of Duke’s Mobile
Market. View the menu and order
online at RosiesPlate.com or call
(919) 833-0505.
LIFE, Duke’s employee wellness
program. Based on employee
feedback, LIVE FOR LIFE made the Writer, Office of Communication Services
following enhancements this year:
• Most farmers offer payment plans
to reduce the up-front cash layout.
• Britt Farms will begin pickup at 3
p.m. to make it more convenient
for employees who work an early
shift. Other farmers will offer
pickup from 4 p.m. to 6 p.m.
• Rosie’s Plate, a restaurant special-
izing in gluten-free, shellfish-free
and peanut-free food, will offer
fresh, local, organic meals-to-go.
Farmers accept customers on
a first-come basis until they reach
capacity. n
By Marsha A. Green
9
opportunities
Learn latest technology
through Lynda.com
A new online training resource offered through
Duke’s Office of Information Technology (OIT) is
enabling faculty, staff and students to learn the
latest technological tools with video tutorials
available anytime, anywhere. For Richard Lucic,
associate chair of the Computer Science
Department, the pilot program through Lynda.com
offers a convenient way for him and his students
to stay up-to-date on emerging Web and
multimedia technologies.
“These technologies change rapidly – just keeping
up as new versions come along can be a real time
sink,” said Lucic, who includes the videos as part
of a class he teaches in the Information Science
and Information Studies (ISIS) program.
Lucic is among more than 200 Duke faculty,
staff and students who have participated in
OIT’s Lynda.com pilot since it was launched in
October. Lynda.com offers more than 30,000
online training courses on topics ranging from
Microsoft Word and Excel to Web design and
computer programming.
OIT is providing a limited number of individual
accounts for Duke users during the yearlong
pilot. Staff and faculty can review the training
tutorials online (from Duke or at home) or can
use designated workstations at the ACT
Warehouse lab, Multimedia Project Studios, the
Center for Instructional Technology and the Link
in Perkins Library. Tutorials in PHP, Dreamweaver,
Microsoft Excel and PowerPoint have been among
the most popular with Duke staff, who comprise
about 75 percent of program participants to date,
said Christine Vucinich, OIT’s training coordinator.
As more jobs throughout the university and health
system demand technology skills, online training
can help users at all levels, Vucinich said.
“Online training provides an opportunity to get
quick questions answered and for staff at any
location to get the training they need when they
need it, not weeks or months later,” she said.
The training helped Terry Banfich get up to speed
during a recent Microsoft Word upgrade in Duke
Law School’s Alumni & Development Office. It also
proved useful as she transitioned into a new job as
a trainer in Central Development’s IT department.
“Everything and anything is there, and it’s there at
any time, even if you’ve just got five minutes to
spend,” Banfich said. “It’s a great tool for giving
folks the essential training and tips that can help
make our work lives more effective and efficient.”
OIT will gather user feedback this spring to
evaluate whether the program will be imple-
mented on an ongoing basis next fall.
By Cara Bonnett
Go Online: More information about OIT’s on-
line technology training program is at http://
www.oit.duke.edu/help/training/online/
10
TUITION, cont.
Duke as they expand their skills,”
she said.
Results show the program is
meeting Duke’s goals of getting a
diverse group of employees to utilize
higher education opportunities and
encouraging managers to help staff
develop career goals.
In a recent survey of staff and
faculty who participated in Duke’s
employee tuition assistance program,
87 percent said knowledge gained by
using the benefit will help them better
perform in their jobs; in a similar
survey of Duke managers, 85 percent
agreed that the benefit helped improve
employee performance.
The benefit program evolved
from the 2003 recommendations of
the Women’s Initiative, which called
for greater opportunities for profes-
sional development. It was designed to
provide more employees with oppor-
tunity for professional development by
offering reimbursement for classes not
offered at Duke or access to courses
at local community and state colleges
with lower tuition.
Before the program was intro-
duced, only courses at Duke were
covered. Today, the program offers
employees more options, including
evening classes at community colleges.
Durham Tech, University of North
Carolina at Chapel Hill and North
Carolina Central University are now
among the most utilized schools.
As a result of the expanded
program, participation and diversity
of enrollment have increased – from
320 staff and faculty with an average
salary of $66,172 in 2006, to 549
employees with an average salary of
$53,060 in 2008. Minority enrollment
increased from 19 percent in 2006 to
40 percent in 2008.
“Since we expanded the program
to include other schools, there’s been a
lot more participation among non-
exempt employees, skilled labor staff
and minorities, which is wonderful
because we want all Duke employees
to have the opportunity to develop
professionally,” Green said.
Adding community colleges makes
it easier for healthcare workers and
non-exempt employees with non-
traditional schedules to tap into the
tuition benefit, Green said.
Take Jones, the utility worker with
Duke’s Housekeeping Operations.
He’s a father of four who works the
third-shift at Duke from 11:30 p.m.
Benefits
“When I’m done, I want to
be a wealth of knowledge
for Duke to use.”
Patricia Agbai, health unit coordinator,
Heart and Lung Transplant Unit
to 8 a.m. and attends evening classes
several times a week at Durham Tech.
Going back to school is challenging,
he said, but the rewards of career
development are priceless. When he
graduates in about two years, he will
be the first person in his immediate
family to receive a college degree.
“It’s a lot of hard work to be back
in school with a full-time job and
family, but I’m learning a lot of skills,”
said Jones, who joined Duke in 2004.
Patricia Agbai, a health unit coor-
dinator in Duke University Hospital’s
Heart and Lung Transplant Unit, is
also tapping into the tuition benefit to
learn new skills that will expand her
responsibilities at Duke.
She’s pursuing a bachelor’s degree
in social work at Shaw University, her
first degree. She’s on track to graduate
later this year.
“In working with patients in the
Transplant Unit, the social work skills
I’m learning will allow me to help
families who are coping with major
medical challenges even more,” Agbai
said. “When I’m done, I want to be a
wealth of knowledge for Duke to use.”
Although most Duke employees
use the tuition benefit at local colleges,
there is growing demand for the tuition
program in satellite offices. To address
this, Duke expanded the program this
year to allow employees to apply for a
waiver to attend accredited out-of-state
schools in specific circumstances.
“That’s especially helpful for
employees in highly-specialized fields
who might not be able to find the
courses they need in North Carolina,”
Tuition Assistance
by the numbers
2008 Participation
$1,036,673 Tuition paid by Duke
549 Staff and faculty enrolled
88 Participants at Durham Tech
75 Percent of female participants
$53,060 Average salary of participants
38 Average age of participants
9.45 Average years of service
Video
See a video about the tuition benefit
with “Ask The Expert” at http://www.
hr.duke.edu/tuition
Green said.
“And with the way Duke is
growing globally, this will also help the
increasing number of Duke staff and
faculty based outside the state.”
Convenience is a big factor
for Daniel Rudd, a clinical staff
assistant at The Preston Robert Tisch
Brain Tumor Center at Duke. He’s
taking evening classes at Alamance
Community College, near his home in
Prospect Hill in Caswell County.
“When I’m done, I’ll have an
associate’s degree and be a registered
nurse without having a lot of loans to
pay off,” Rudd said.
In addition to using the Employee
Tuition Assistance Program, Rudd
is hoping to eventually enroll in
Duke’s new Registered Nurse Tuition
Assistance Program to continue
developing his skills.
“It’s great that Duke assists
employees who want to advance their
careers,” Rudd said. “I love helping
the patients at Duke. By using the
tuition assistance program to get my
degree, I will be able to do even more
to help others.”
This semester, Jones, the utility
employee in housekeeping, is taking
two courses in English and math at
Durham Tech.
“Nowadays, almost every machine
or appliance has electronic components
and circuit boards,” he said. “When
I get my degree, I’ll be able to
work on those.” n
By Missy Baxter, Senior Writer, Office of
Communication Services
March 2009
Tips for Tuition
Reimbursement
• Read program details at http://www.
hr.duke.edu/tuition
• Discuss professional development with
your supervisor to determine courses
related to your current job or
continued career growth at Duke.
• Download the Employee Tuition
Assistance Program application at
http://www. hr.duke.edu/forms
and complete it with your supervisor.
• Complete and return the application
by mail or fax before the first day of
each class to request reimbursement.
• If approved, Duke Benefits will send an
e-mail with your eligibility confirmation
and reimbursement request form.
• Within 60 days of completing each
class, submit to Duke Benefits a copy
of the e-mail confirmation, proof of a
“C” or better in coursework and a
reimbursement request form com-
pleted by the school attended.
Fast Facts:
The cost of books is not covered. And
if you voluntarily terminate employment
within two years of receiving more than
$2,500 in tuition reimbursement, you
must repay 50 percent of the amount
over $2,500.
Benefits
Benefits is published quarterly by
Duke’s Office of Communication
Services as a supplement to Inside
Duke Medicine. Benefits invites
your feedback and suggestions
for future story topics. Please call
(919) 681-4533 or send e-mail to
working@duke.edu
Editor: Leanora Minai
(919) 681-4533
leanora.minai@duke.edu
Assistant Vice President:
Paul S. Grantham
(919) 681-4534
paul.grantham@duke.edu

news
HIV-1 budding from cultured lymphocyte.
Multiple round bumps on cell surface
represent sites of assembly and budding of
virions. photo courtesy wikipedia commons
Antibody for
HIV discovered
By Michelle Gailiun
Duke researchers have for the first time
isolated an important antibody in human
serum that could potentially play a key role in
the design of an AIDS vaccine.
The research appears as a highlighted feature
online in the Journal of Virology.
“The 2F5-like antibody is one of the gold
standards for what an HIV vaccine needs to
induce, but no one had ever found it before
circulating in the blood of infected patients,”
says Georgia Tomaras, PhD, associate
professor of surgery, immunology and
molecular genetics and microbiology in the
Duke Human Vaccine Institute and the senior
author of the study.
The 2F5 antibody is especially valuable
because previous research has shown it can
successfully neutralize 80 percent of transmit-
ted HIV viruses.
Now that researchers have found the antibody
in circulating blood, Tomaras says they might
be able to find ways to duplicate or enhance it,
thereby boosting the body’s defense system.
2F5-like antibodies belong to a class of
immune cells called broadly neutralizing
antibodies, one of the body’s most powerful
responses to infection. Only a small fraction of
patients with HIV make these antibodies and
they typically appear many months after initial
transmission of the virus — at a point when
scientists feel it is too late to do much good.
Tomaras, working closely with lead author
Xiaoying Shen, led a team of researchers who
examined the antibodies present in 300
patients infected with HIV-1. They found only
one patient who had developed 2F5-like
antibodies, supporting the notion that they
are, indeed, very rare.
Researchers discovered that the 2F5-like
antibody was potent enough to block multiple
strains of HIV in the laboratory, but research-
see HIV, p.12
The Science & Research Supplement to Inside Duke Medicine
VOLUME 18 NO. 3
F EATURE
The Duke Center for Hyperbaric Medicine and Environmental Physiology research runs the gamut from the effects of various pressures
on the human body to the influence of oxygen and carbon dioxide on cellular organelles. photoS courtesy HYPERBARIC MEDICINE
More than just ‘the bends’
By Kelly Malcom
C
lad in swim trunks and neoprene
slippers, Jason, a medical student,
climbed out of the chamber, drip-
ping wet. Careful not to disturb the
catheters put into his arms to measure
his blood pressure and pulmonary
arterial pressures, he walked into an
adjacent room to recuperate from his
underwater exercise.
Jason had answered the call for fit
volunteers to assist in a clinical study
to understand immersion pulmonary
edema, a condition that causes some
divers’ lungs to suddenly fill with fluid.
“The condition is life-threatening
and has caused some swimmers and
divers to die,” said principle investigator
Richard Moon, M.D., professor of an-
esthesiology and medical director of the
Duke Center for Hyperbaric Medicine
and Environmental Physiology. “We’re
still unclear as to what causes pulmo-
nary edema but it could be related to
high pressures in the pulmonary artery
or deficiencies in the way some people
clear their lungs of fluid.”
This Navy-funded study is just
one example of the ongoing basic
and translational research projects
at the Center.
The facility, located in Duke
South, contains an impressive series of
chambers, the largest of which can hold
up to 12 patients plus staff, as well as
water tanks for physiological studies.
In an area resembling the control
room of a submarine, physicians and
technicians constantly monitor oxygen
n inside.dukemedicine.org n March 2009
levels, pressure, and patient conditionlargest civilian facility in the world.
in each chamber. Hyperbaric oxygen is “Duke’s facility is not just
administered for a variety of medical another hyperbaric chamber,” said
conditions, including most famously, John Freiberger, M.D., MPH, assistant
decompression illness, colloquially professor of anesthesiology. It is a
known as “the bends.” unique facility where investigators can
Scuba divers and people who work readily research the effects of extreme
in pressurized environments who return environmental conditions on human
to normal atmospheric pressure and physiology. Current projects deal with
aviators and astronauts who rapidly topics ranging from molecular biology
transition to low pressure environmentsto the ill patient’s bedside and all strive
can develop bubbles of nitrogen gas for an in-depth understanding of the
in their tissues. Symptoms can include biology of oxygen and other metabolic
gases and their clinical applications.
skin rashes, joint pain, and more serious
symptoms such as blurred vision and Freiberger is currently investigating
the use of hyperbaric oxygen
“Our studies run the gamut from for the treatment of jaw
analyzing the effects of pressurized necrosis in patients who have
received certain drugs for
suits on NASA astronauts to using
chemotherapy that inhibit
oxygen to help cancer patients.“ bone cell growth.
John Freiberger, M.D., MPH In addition, he has a pilot
assistant professor of anesthesiology
study to diagnose chronic
disorientation. Sever decompression carbon monoxide (CO) exposure and
sickness can be life threatening. examine possible prevention efforts in
Treatment requires the admin- medically underserved populations.
istration of 100 percent oxygen in Hyperbaric oxygen is often
a pressurized hyperbaric chamber, prescribed for victims of house fires
usually for one or more periods of or suicide attempts who are acutely
4-6 hours. Duke University Medical exposed to elevated CO, because
Center is also where the Divers Alert in addition to its known immediate
Network (DAN), a network that toxic effects, CO can have devastating
provides educational and emergency long-term neurological consequences
information for recreational divers if not treated immediately. This has
internationally, got its start. Duke important public health implications
physicians routinely consult for DAN because even low levels of chronic
and Duke’s hyperbaric facility is open CO intoxication may lead to subtle
for emergencies 24 hours a day, seven but significant changes in neurological
days a week. Duke’s chamber is the see HYPERBARIC, p.12
12
HYPERBARIC, cont.
function if exposure persists over time. metabolism and may have important
Epidemiologic research has shown
Duke’s hyperbaric facility is open
for emergencies 24 hours a day,
seven days a week.
that certain populations, especially
recent Hispanic immigrants, may be
more likely than other ethnic groups to B. Suliman, Ph.D., assistant professor
be exposed to chronic, low-level CO
exposure through the use of generators
or cooking grills indoors. This study
seeks to document CO exposure and
develop strategies for prevention in all
populations vulnerable to this disease. cardiac cell death. Suliman and her
A new direction for immune response
A n immune system response that
is critical to the first stages of
fighting off viruses and harmful
bacteria comes from an entirely
different direction than most scientists
had thought, according to a finding
by researchers at the Duke University
Medical Center.
“This finding will have important
implications in vaccine science and
autoimmune disease therapy develop-
ment,” said Michael Gunn, M.D.,
an immunologist and cardiologist at
Duke and senior author of the study
published in Nature Immunology.
Type 1 helper (TH1) T cell
immune responses are critical for
the control of viruses and certain
bacteria. Immunologists have gener-
ally believed that TH1 responses are
induced by rare immune cells, called
dendritic cells. When activated by
infection or vaccination, the dendritic
cells were thought to move from
peripheral tissues into lymph nodes
to stimulate T cell responses.
The Duke researchers found,
however, that the dendritic cells that
stimulate TH1 responses didn’t come
from peripheral tissues, but rather
arose from monocytes, a common cell
type in the blood, that moved directly
into lymph nodes after infection.
“The result speaks to the most
basic principles of immune response
to pathogens,” Gunn said. “It may
also explain the poor results we have
seen in attempts to develop effective
dendritic-cell vaccines.”
Gunn previously had identified
a particular protein, known as a
Inquiry
Although CO is a known
toxin, it is also a normal product of
roles in cell signaling. Researchers at
Duke’s hyperbaric center are
utilizing the facility to examine
the effects of carbon monoxide
and oxygen on mitochondria,
the powerhouse of the cell.
“CO at high levels inflicts damage
through oxidative stress,” says Hagir
of anesthesiology. At low doses,
though, CO has an important role in
cell signaling. Certain chemotherapy
drugs, such as doxorubicin, can
cause mitochondrial damage and
Duke researchers have found that the immune response against infection begins
differently than previously thought. file photo
chemokine, that stimulates the
migration of activated dendritic
cells from peripheral tissues to lymph
nodes. The researchers generated
a TH1 response in laboratory mice
that lacked this chemokine with
influenza viruses.
“We really thought the mice
would not be able to generate much
of an immune response at all,” Gunn
said, because they wouldn’t be able
to mobilize dendritic cells. “The
mice, however, had increased TH1
responses. We knew we had to find
what was really causing the response.”
One scientist who knew about
these findings told Gunn the group
would “never figure this out” because
their findings were so unconventional.
To solve the mystery, the Duke
team studied several different types
of mice, which were missing other
chemokines or chemokine receptors.
colleagues have found that exposure
to low levels of CO can promote the
biogenesis of mitochondria, a process
that may be intimately involved with
the underlying mechanisms of wound
healing and aging.
“Duke’s hyperbaric facility is spe-
cial because of its commitment to both
quality clinical care and to high-caliber
research,” said Freiberger. “Our stud-
ies run the gamut from analyzing the
effects of low atmospheric pressure on
NASA astronauts to using hyperbaric
oxygen to help cancer patients heal
chronic wounds. We have the clinical
and scientific depth to figure out how
to make people better in a rational and
reproducible way.” n
They found that mice without the
Ccr2 chemokine receptor that controls
the migration of inflammatory mono-
cytes had much lower accumulation of
monocyte-derived dendritic cells and
TH1 responses.
The scientists concluded that
there is a blood-derived lymph node
dendritic cell type that has a key role
in developing acute T-cell responses.
“For so long, dendritic cells from
tissues were the obvious answer,”
Gunn said. “We found out that that’s
not always the case.”
The team now plans to look at
the blood-derived dendritic cells under
different conditions to see if they may
have other activities. “We observed
the activity of these cells after TH1-
inducing stimuli, like influenza,”
Gunn said. “Next we’d like to study
other types of immune stimuli to see
how the cells respond.” n
March 2009
1st Annual Human
Research Protections
Program Workshop
Improving Research Quality
All those involved in clinical research at
Duke including investigators, coordinators,
and administrators are encouraged to
attend this workshop.
Featured guest speakers will include:
Greg Koski, PhD, MD, CPI, professor of
anesthesiology at the Harvard School of
Medicine, speaking on Investigators’ Role
in a Model HRPP.
Gregg Fromell, MD, executive director of
the Office of Human Research at the
University of Pennsylvania, speaking on
How to Engage Your Investigator in the
HRPP Process.
Gigi McMillan, BA, of the Children’s
Brain Tumor Foundation, speaking on
Investigators’ Interactions with Vulnerable
Populations: Specific Considerations.
When: April 29 12:00 pm-4:30 pm OR
April 30 7:30 am-12:00pm
Where: Searle Center
For more information and to register:
http://crso.som.duke.edu/
HIV, continued
ers say they are not entirely clear if it played
any part in controlling the virus in the
patient who carried it.
The scientists were also struck by another
discovery: The 2F5-like antibodies arose
concurrently with particular autoantibodies
that may be a clue as to why these
antibodies developed in this person and not
in others.
“Tomaras and her team have created the
opportunity for us to isolate and study the
immune cells that enabled the production
of this very rare antibody,” says Barton
Haynes, MD, director of the Duke Human
Vaccine Institute. “Our goal will be to
understand how to trigger these cells to
routinely make these kinds of antibodies
before infection occurs.”
The research was funded by the National
Institutes of Health and the Duke Center for
AIDS Research.
Science Editor: Kelly Malcom
Inquiry features science and research-
related news items from Duke Medicine
News and Communications and other
Duke departments. To submit content,
contact us at editorinside@mc.duke.edu
13
Drug combo may be effective against deadly melanoma
B y targeting and disabling a protein
frequently found in melanoma
tumors, doctors may be able to make
the cancer more vulnerable to chemo-
therapy, according to early results of
a clinical study conducted by research-
ers in the Duke Comprehensive
Cancer Center.
“In this pilot study, we gave
patients with advanced extremity
melanoma a compound that had been
shown in pre-clinical studies to weaken
melanoma tumors by targeting a
protein expressed on the surface of the
cancer cells. When chemotherapy was
then given by infusion, it was much
more effective compared to chemo-
therapy given alone,” said Douglas
Tyler, M.D., a surgeon at Duke and
the Durham Veterans Affairs Medical
Center, and senior investigator on this
study. “Not only was the treatment
well tolerated but a surprising number
of this small group of patients had their
Genetic link between anger and health problems
M en with a common genetic vari-
ant produce more than twice as
much of a hormone known to increase
blood pressure and blood sugar when
they are angry, according to researchers
from Duke University Medical Center.
The findings, presented March 6 at
the American Psychosomatic Society’s
annual scientific meeting, shed more
light on the notion that stress can
trigger physiological changes that result
in the development of cardiovascular
disease and type 2 diabetes.
“We know that emotional stress
can lead to negative health outcomes
but our goal with this study was to
obtain a better understanding of the
biological mechanisms behind this
phenomenon,” says Redford Williams,
M.D., director of Duke’s Behavioral
Medicine Research Center and study
co-author.
Researchers analyzed variants of
serotonin receptor genes, which regu-
late effects of the neurotransmitter
serotonin on emotions and physical
functions, including levels of the stress
hormone cortisol.
“We looked at specific points
along a cascade of events,” says
Inquiry
tumors completely disappear.”
The researchers discussed their
findings in an oral presentation on
March 6 at the Society of Surgical
Oncology annual meeting, and results
of the study have been accepted for
publication in the journal Cancer.
The study was funded by Adherex
Technologies, the company developing
the compound that was tested in
combination with chemotherapy, the
United States Department of Veterans
Affairs, the Duke Institute for Genome
Sciences & Policy, and the Duke
Comprehensive Cancer Center
Data from 16 patients treated
at Duke and the University of Texas
MD Anderson Cancer Center were
examined for this study. Half of them
experienced a complete response — or
an obliteration of cancer — as a result
of treatment, Tyler said. The compound
— called ADH-1 — was delivered
intravenously and the chemotherapy
Stephen Boyle, Ph.D., study co-author.
“Serotonin is processed in the brain
and controls the release of cortisol by
the adrenal grand. Cortisol is known
to stimulate the production of glucose
and makes the influence of adrenaline
more pronounced.”
Researchers measured cortisol
in two blood samples taken from 41
“Not only was the treatment
well tolerated but a
surprising number of this
small group of patients
had their tumors completely
disappear.”
Douglas Tyler, M.D., surgeon and senior
investigator on the study
given under surgical conditions, through
the artery and vein in the affected limbs.
Melanoma often affects people on
their extremities, with a common sce-
nario being a mole that appears on the
foot and then spreads up the leg. Up to
ten percent of patients with extremity
melanoma develop multiple recurrences
in the extremity that cannot be treated
with surgery alone.
“These early results are very excit-
ing because metastatic melanoma is
men. One sample was collected during
a five-minute resting period and the
other during five-minutes when they
described a recent event in their lives
that made them angry.
Men with common variants of
one of the serotonin receptor genes
(5HTR2C) had increased cortisol
production when recalling a situation
March 2009
one of the most deadly cancers and one
which is typically very unresponsive to
therapy,” said Georgia Beasley, M.D.,
a surgical resident at Duke and lead
author on this study. “The next step
will be to continue testing the efficacy
of this treatment in more patients, here
and at other centers.”
A larger phase II trial involving
46 patients with advanced extremity
melanoma, using the same combination
of drugs, was designed to try and better
define the response rate in this popula-
tion, Tyler said. This trial has recently
completed recruiting patients and data
will be forthcoming, he said.
The incidence of malignant mela-
noma is increasing at a rate faster than
any other cancer, with 60,000 new
cases expected to be diagnosed this
year in the United States. Melanoma
that has spread beyond the primary
site is rarely curable, and treatment
options are limited. n
that made them angry. One of those
variants was associated with an average
increase in cortisol that was more than
twice as large (70 pg/ml vs. 30 pg/ml)
when compared with men possessing
the other variant of the same gene.
“Interestingly, one of the genetic
variants associated with a prominent
affect on cortisol production is also
known to alter the amount of receptor
protein the gene makes,” says Williams.
“This tells us that this variant is a
strong candidate to be responsible for
the findings we observed.”
“This work may provide a clearer
understanding of the genetic and envi-
ronmental factors that combine to put
some men at greater risk for developing
increased belly fat, type 2 diabetes and
cardiovascular disease,” adds Boyle.
The next phase of research will
study large samples of people to
determine if men with the genetic
variant associated with larger cortisol
responses to anger seen in this study are
more likely to develop type 2 diabetes
or cardiovascular disease.
The research was supported by a
grant from the National Heart, Lung
and Blood Institute. n
14
ESSAY
Lawmakers need a crash course in science
By Susanne B. Haga, IGSP
T he more than 50 rookie
congressional members who
headed to Washington in January
face a steep learning curve on
complex and, probably, unfamiliar
subjects, from foreign policy to
the budget appropriations process.
Many of these topics will involve
science in one form or another
— from scientific evidence under-
pinning a specific policy to decisions
influencing the direction, investment
and advancements in our country’s
scientific enterprise.
Consider that more than $38
billion was spent by the federal
government in 2007 for health-
related research and more than
$2 billion for energy research and
technologies. That’s not as high
as the numbers attached to the
stimulus package but large enough
to get our attention when it comes
to educated decision-making.
President Barack Obama has
stated that he aims to promote
scientific research and incorporate
scientific evidence into policy de-
bates. This re-emergence of science
as a national policy priority requires
a level of informed engagement that
hasn’t been seen in Washington in
some time.
From medicine and health care
to food safety, energy, space and
the environment, science will play a
key role in many of the policies our
legislators will propose and debate.
Members of Congress possess a
range of backgrounds, including
ministers, sheriffs, farmers and
accountants. More than 40 percent
hold law degrees, but only 8 percent
LE C TURE
Chancellor’s Lecture
Clay Christensen, Harvard
professor and author of The
Innovator’s Dilemma, speaks on
“The Innovator’s Prescription:
The Future of Academic Medicine
and Health Care.” March 11 at
10:30 a.m. Geneen Auditorium at
Duke’s Fuqua School of Business.
Inquiry
With a better base of scientific knowledge, members of Congress and
other politicians will be better equipped to make informed decisions on
science-related policy. ILLUSTRATION BY VANESSA DEJONGH
hold a medical or doctorate degree fundamental understanding of
with formal training in science and how research is conducted and
the scientific process. the strengths and weaknesses
With the exception of a small
group of doctors and scientists, “The re-emergence of science as a national
most members of Congress lack policy priority requires a level of informed
the background to understand the
process of science and the subtle engagement that hasn’t been seen
nuances that justify investments in Washington in a long time.“
science and engineering or changes
in existing priorities. inherent in any scientific dataset.
What to do? We should take The Conservative Party in Great
a lesson from the British and Britain recently announced that
encourage all freshman members it will include classes on scientific
of Congress to take a crash course methodology and basic concepts
in science to equip them with a in the orientation activities for
EVENT
Research Career Day
The first research Career Day
will be held on Wed, May 6. To
register, visit https://research
careerday.wufoo.com/forms/
duke-medicine-research-career-
day-registration/. Registration
will be open until April 15.
March 2009
all new Conservative members of
Parliament after the next elections,
specifically to address politicians’
lack of scientific expertise.
Shadow Science Minister Adam
Afriyie, the architect behind these
new courses, says, “By building a
base of scientific knowledge among
politicians and officials, we aim to
strengthen the role of science in
policy making.”
Although the official orienta-
tion for our new congressmen has
already taken place, it isn’t too late
to impart some knowledge about
subjects they almost certainly will
be voting on. A good starting point
would be with the scientific groups
that already visit Capitol Hill to
present workshops and seminars.
The need for education works
in both directions: the scientist-
politicians, for instance, should be
brushing up on Economics 101.
Although public policy is
rarely based on scientific evidence
alone, it no doubt could benefit
from improved dialogue between
experts and policymakers. Even
seemingly unrelated policies on
immigration and defense will have
implications for
the scientific re-
search enterprise.
Let us be
in sure that our
policymakers are
making informed
decisions, for these decisions may
well impact generations to come.
Susanne B. Haga is a senior policy analyst
and an assistant research professor in the
Institute for Genomics Science & Policy at
Duke University. n
ONLINE
Duke Articles
A list of the most recent articles
by Duke authors added to the
PubMed (MEDLINE) database is
updated every Sunday and can
be found at http://www.mcli-
brary.duke.edu/pubsupport/
dukeauthors
March 2009
C ALEN D AR
March
Attend a seminar on “Race, Genetics and Health,” on March 18. This is the sixth in a monthly series that discusses the role of “racial”
differences in explaining health disparities. Details below. illustration by vanessa dejongh
do
March 9 5:30-6:30 p.m.
LIVE FOR LIFE’s Run/Walk Club starts its 12-
week session with a new breathing techniques ses-
sion at 5 p.m. each Wednesday and strength training
class at 5 p.m. each Monday and Wednesday. Staff
and faculty in the club meet 5:30-6:30 p.m. every
Monday and Wednesday. Beginners meet at the East
Campus track, across from Whole Foods on Broad
Street. Advanced runners and walkers gather in front
of Wallace Wade Stadium on West Campus. Details:
hr.duke.edu/runwalk
March 12 4-6 p.m.
Duke University Physician Assistant Program
Open House in celebration of the new facility on
800 S. Duke St. in Durham. Guided tours and light
refreshments. RSVP: Mildred.Woody@duke.edu
or 681-3159
March 22 12-4 p.m.
Free Family Day at the Nasher Museum of Art
Inside Duke Medicine
Your insider's guide to what's
happening at Duke Medicine
Celebrate “Escultura Social: A New Generation of Art
from Mexico City” with live entertainment, hands-on
projects and gallery hunts. Limited tickets available
at the door only. Details: 684-3314
March 24 5:30- 6:30 p.m.
Duke Run/Walk Club Workshop – Prepping for
Races Whether you are planning on participating
in a 5K run/walk race, competing in a triathlon or
running a marathon, preparation is a must. Meg
Pomerantz, director of the Duke Faculty Club, will
discuss the trials and tribulations from her own
experience of training as well as teaching the group
what works best for your race of choice. Wallace
Wade Stadium, Alumni Box
learn
March 18 12 p.m.
DUSON Research Conference Series with Shar-
ron Docherty, Ph.D. and Debra Brandon, Ph.D. A se-
ries designed to stimulate discussions and showcase
emerging issues in nursing and research. Open to
nursing school faculty and students, Duke Investiga-
tors, and DUHS nurses interested or engaged in
research. Clipp Research Building, Room 1017
March 18 5:30-7:30 p.m.
Race, Genetics and Health Seminar Series The
sixth seminar in the monthly series under the theme
of Race, Genetics and Health will be presented by
Fatimah Jackson and will focus on her method of
group classification. These seminars are a forum for
the systematic examination of the role of “racial”
differences in explaining health disparities. Dinner
provided. RSVP, by March 11: donna.sullivan-
khouri@duke.edu
March 18 6:30- 8:00 p.m.
Duke Integrative Medicine Free Information
Session We invite you to a free information session
to explore Duke Integrative Medicine. In our state-of-
the-art healing environment, our expert physicians
and therapeutic staff will share information about our
unique approach to healthcare--and how it can make
an enduring difference in your life. Light refreshments
will be served. Center for Living, Integrative Medicine
Building, Room AB. Details: 681-2958
15
April 1 8:30 a.m. - 4:30 p.m.
Duke HomeCare and Hospice presents a grief
conference with nationally renowned speaker and
grief counselor Alan Wolfelt for both professionals
and lay people. Sarah B. Duke Gardens Pavilion.
There is a $100 fee to register. Six nursing contact
hours or 0.6 CEUs will be awarded. Register:
http://dhch.duhs.duke.edu/wysiwyg/down-
loads/Brochure_wilderness_of_grief.pdf
give
March 14 10 a.m.
“Scope Us Out” 5K Run/Walk Join Duke
Gastroenterology to raise money and support
the fight against colon cancer. Registration is
$15 and forms are due by March 6. Registration
includes t-shirt, goodie bag, and box lunch. Duke
Forest Al Buehler Cross Country Trail in Durham.
Register: http://www.dukehealth.org/
events/20090128164313538
March 28 10 a.m.
2009 Second Annual Triangle Kidney Walk
Duke Medicine is helping fight chronic kidney
disease as a premier sponsor of the Triangle Kidney
Walk. The 5K non-competitive walk will raise money
and awareness about kidney disease. Research
Triangle Park Headquarters. Details: 388-1602 or
http://www.trianglekidneywalk.org
March 29 9 a.m. - 12 p.m.
Build Blue and True 5K Come run a 5K in support
of Habitat for Humanity and your favorite rival Duke
or UNC. Cost is $20. All proceeds will go toward
Habitat for Humanity of Durham and Chapel Hill. Lo-
cation: UNC Ranson-Hamrick Cross Country course
in Chapel Hill. Details: 668-5700
How to submit:
Send calendar listings to
editorinside@mc.duke.edu
Want more info?
Visit us online at http://inside.
dukemedicine.org
The Calendar is a monthly selection
of events that feature the best of
happenings at Duke and Duke Medicine.
16 Inside Duke Medicine March 2009

on the web

Just a few of your colleagues who’ve

received High Fives:
Steven Adair, Duke Raleigh Security, A patient tells why Shelley McNair,
make sure patients, visitors and staff clinical nurse IV at Duke University
are safe: Hospital, is a true asset to Duke:

“Long after most employees have gone
home and into the evening while others
are working, this officer is checking
doors (377 of them each night),
reminding employees to lock up and go
home and giving assistance to custom-
ers who find their way to Duke Raleigh
in the wee hours of the morning. For
five years, he has been making sure that
the campus is safe and secure so that
those sharing the shift can do their
“Shelly hustles nonstop to help me get
through these difficult days. She takes
the time to bathe me and does so with
much care and compassion — like I am
her mother. She is a true asset to Duke!”
Monette Mabolo, of Duke Raleigh
Nursing, was praised for bring her

5
work free from worry.” unit closer together:

ve a
“Monette Mabolo pays attention to

Gi
what we say and to what matters
most to us. She continues to come in
early to interact with the night shift

h
Arista Stewart, mammography

ig
technologist at Duke University and provide them with leadership and

H
Hospital, helped a patient feel at ease: support as well. To foster camaraderie
between the nurses and nursing
“Arista was so kind and sensitive. She assistants, she has them give report to
made me feel at ease. I have been each other at the beginning of the shift
going to her for the past three years. or whenever there are abnormal vital
She is wonderful and awesome.” signs that the nursing assistants note.
way
s id e O n line’s daily uke As a result, our unit has become more
In D
igh Fives is g the good work of
closely knit as a team.”

H of reco
Medicine
g n iz in
.
employees on of the well-dese
rved
t a selecti st few A patient thanked the entire CCU
Here’s jus olleagues over the la staff at Durham Regional Hospital,
en to c
praise giv h Five especially Mark Branch, M.D.:
months. e s a t le a st one Hig ine. Jolly John, clinical nurse II on 5300
line giv kemedic at DUH, made a lasting impression
Inside On h tt p :/ /inside.du
Our “family … would like to personally
. Che c k THANK YOU for the excellent, profes- on a patient’s mother:
every day igh
fo r m o re. w h o d e s erves a H sional care you gave our father from Sept.
“Jolly has been a blessing to my daughter
or g n
w a perso side
. Go to In t the
24th - Oct. 7th. The Lord truly blessed us,
If you kno e n t fo r m and myself while in the hospital. She was
ct” link a
and our father, during this time with ‘our
ur comm
Five, use o lick on the “Conta
very attentive and showed so much care
angels of care’ he provided. Your heartfelt
dc ge. and concern. My daughter remembered
Online an e O n li n e home pa concerns for our father (your patient) …
her name out of all nurses that took care
Insid
top of the could be seen and felt by the family. Our
of her. We love you, Jolly!”
hearts and prayers go out to the CCU
family. Thank you! Thank you! Thank
you! May God bless you as you care for
other families the way you cared for ours
and in your everyday life!”

Feedback Online any time Next issue

Tell us what you think at http://inside. You can download a pdf of this issue, The next print edition will appear
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