Mayo Alumni Magazine 2011 Fall - MC4409-0811 - Mayo Clinic

Mayo Alumni
mayo.edu/alumni | Fall 2011
HAITI

Mayo Alumni
Fall 2011
Features
2 Helping Haiti
Mayo Clinic, working with a proven partner, has provided additional resources
to assist with ongoing recovery efforts at a medical center in Port-au-Prince,
Haiti. Mayo physician team members share their experiences.
8 An American doctor in Fukushima
Mayo Clinic alumnus Kenneth Nollet, M.D., Ph.D., provides a bird’s-eye
view of Japan in the aftermath of the March disaster.
14 Government relations update
Patricia Simmons, M.D., medical director of Government Relations,
discusses her new role, and Mayo Clinic outlines this division’s priorities
for relations with the federal government.
About the Cover
Second-year Mayo Clinic resident
Casandra Rosenberg, M.D. [inset photo,
cover], who hails from St. Catharines,
Ontario, Canada, was a first-time
volunteer participating in Mayo’s efforts
in Port-au-Prince, Haiti. She is pictured
with an interpreter at St. Damien’s
Hospital who hopes to continue his
education and become a nurse.
Dr. Rosenberg was humbled by the
dedication of the Haitian staff and the
conditions in which many staff and
patients live. “We returned to a guesthouse
each night after working, but some
of the local hospital staff went home to
tent cities,” she says. “Many patients
also live in tent cities, without running
water and electricity.” According to
published reports, hundreds of thousands
of Haitians live in thousands of tent
cities near Port-au-Prince alone.
Dr. Rosenberg kept a blog,
www.handsoninhaiti2011.blogspot.com.
“I want to share my story to help other
first-time volunteers in underserved health
care to feel more comfortable with the
process,” she says.
18 Learning from the ancient Greeks
Mayo alumni and staff who attended the International CME Conference
reflect on their visit to the ancient healing community of Epidaurus in Greece.
Mayo Update
20 New Arizona CEO, named professors, obituaries
Recognize the exceptional
It’s time to nominate fellow alumni with exceptional contributions
to the field of medicine for the Distinguished Alumni Award.
Information about the award is available at:
http://www.mayo.edu/alumni/awards-distinguished.html
An alumnus or alumna can nominate one candidate each year.
Who do you think deserves this recognition?
Nominations are due April 6, 2012.

A Letter from the Secretary-Treasurer
I
participated in the Mayo Clinic Alumni Association biennial international
meeting in Greece in May. These meetings continue to surprise me in the
high-quality presentations and enthusiastic, engaged attendees. The international
meetings are among the few where a diverse group of Mayo staff provides a
CME program in a setting with the opportunity to develop new relationships
with colleagues and reconnect with alumni. Connecting and reconnecting in
an unpressured environment is especially important to me, in the context of a
fast-paced life in a busy academic medical center.
As I connect with others who trained at Mayo or were or are on the Mayo
staff, I am continually reminded of the organization’s unique values — respect,
compassion, integrity, healing, teamwork, excellence, innovation and stewardship.
Alumni refer to these values in anecdotes about their past and in accounts about
how they mirror these values in the institutions and practices they represent today.
It’s heartwarming to learn how well regarded and enduring our founding values are.
Two stories in this issue are representative of the Mayo Clinic values. Mayo’s
recent efforts in Haiti (page 2) epitomize compassion, teamwork and healing.
And Dr. Ken Nollet’s report of activities at Fukushima Medical University after
the earthquake and tsunami (page 8 ) reflects the compassion, respect, integrity
and healing honed, at least in part, during his 13 years at Mayo Clinic.
As you read these stories, I hope you will take an opportunity to reflect on
how these values may be applied in your work.
Eric Edell, M.D.
Secretary-Treasurer
Mayo Clinic Alumni Association
Be part of Innovation Into Action
The Mayo Clinic Alumni Association biennial meeting, Sept. 21–24 in Ponte Vedra Beach, Fla.,
has a program packed with exciting and dynamic presentations on how innovation is
changing the way we deliver health care. Speakers and panels will address issues such as
research advances, health care delivery systems, accountable care organizations, knowledge
management, social media and regenerative medicine.
The Alumni Association will be reporting throughout the event on our interactive
Alumni Blog: http://alumniblog.mayo.edu/.
Visit the blog for overviews of the presentations, video interviews with speakers and
participants, and a special sneak peek of the brand-new digital version of Mayo Alumni.
Check out what’s happening at the meeting and join the conversation.

Helping after
has faded from the headlines
2 Mayo Alumni

The January 2010 earthquake in Haiti triggered a financial
response from Mayo Clinic through its Disaster Relief
Committee and an outpouring of support from physicians,
faculty and staff members, including volunteerism and
requests for leadership to do even more. When the disaster
faded from the headlines, Mayo Clinic committed additional
resources to assist with ongoing recovery.
From February through May 2011, almost 100 staff
members representing all three Mayo Clinic sites and
Mayo Clinic Health System provided patient care in Haiti.
This project has been a combined effort by the Mayo
Clinic Disaster Relief Steering Committee, Emergency
Preparedness Subcommittee, and Department of Medicine
Program in Underserved Global Health (PUGH).
“Mayo Clinic’s Disaster Relief Committee is focused on
responding appropriately to disasters around the world and
working with nongovernmental organizations to provide
assistance for efforts that are sustainable,” says J. Christopher
Farmer, M.D., chair of the Mayo Clinic Emergency Preparedness
Subcommittee and a consultant in the Division of Pulmonary
and Critical Care Medicine in Rochester. “We evaluate the
nature of our response based on severity and location of the
situation, fit with Mayo’s competencies and our ability to
respond. Global health issues and disaster relief are a basic
societal responsibility of health care organizations and,
increasingly, we are engaged in these types of local, regional,
national and international activities.”
PUGH provides a coordinated and longitudinal program
to address clinical and academic disparities in underserved
health care — both when disasters have occurred and when
they have not.
“PUGH focuses on enhancing the quality and sustainability
of health care delivery through on-site provider
training, local community education and increasing health
care availability in select locations lacking providers,” says
John Wilson, M.D., PUGH chair and a consultant in the
Division of Infectious Diseases at Mayo Clinic in Rochester.
LEFT: Robin Georgeff, a registered nurse in Clinical
Informatics Support at Mayo Clinic in Arizona, bonded with
Haitian youngsters while volunteering in Port-au-Prince.
ABOVE RIGHT: Many patients and hospital employees live in
tent cities, such as this one near Port-au-Prince. These areas
lack running water and refrigeration.
“
In our response to Hurricane Katrina, Mayo learned
the importance of partnering with other organizations
in disaster relief. We’re using that lesson in our
Haiti and future responses.”
J. Christopher Farmer, M.D., chair, Mayo Clinic
Emergency Preparedness Subcommittee
After making initial financial contributions, Mayo Clinic
took time to calculate planning, partnerships, logistics, team
composition and specialty services for its Haiti involvement.
“We very much believe that it’s critical to have relationships
and to team with organizations in the areas affected by
complex humanitarian emergencies,” says Robert Joyce,
operations administrator and incident commander for the
Haiti efforts. “We didn’t want to send in teams without being
able to ensure their safety and efficacy. By choosing the right
organization to partner with, we enabled our teams to focus
on patient care and provider education, without having to
worry about where to eat and sleep and other logistics.”
In May and September 2010, individuals from Mayo
Clinic traveled to Haiti to assess the situation on the ground
and advise about the organization’s response.
The assessors recommended collaborating with Operation
Blessing International, a nonprofit humanitarian organization,
at St. Damien’s Hospital Center in Port-au-Prince. PUGH
Fall 2011 3

ABOVE: David Rushlow, M.D. (left), Mayo Clinic Health System,
Franciscan Healthcare (La Crosse), treats a patient.
AT LEFT: David Claypool, M.D. (right), Emergency Medicine,
Rochester, treats a patient as Haitian providers assist.
has worked with Operation Blessing on joint projects in
El Salvador and Honduras.
St. Damien’s leadership requested a rotation of small
medical/surgical teams to assist with patient care. The
St. Damien’s Hospital Center includes three hospitals —
St. Damien’s Hospital, a 120-bed pediatric hospital providing
care in pediatrics, maternal health and obstetrics; St. Luc’s
Adult Field Hospital, a 40-bed facility providing medical
care; and St. Philomena Rehydration Center, which provides
“
We would like to generate protocols and models of care
appropriate to the resources, customs and diseases in
Haiti, and to develop systems for virtual consultations,
nursing training, skill set curricula development and
health education material provision.”
John Wilson, M.D., PUGH chair, Division of
Infectious Diseases, Mayo Clinic
care for patients with cholera and has an emergency trauma
and acute care center.
Eight Mayo teams, comprised of 10 to 13 members, rotated
for a week at a time, every other week, for four months. They
provided general emergency medicine, acute medicine and
trauma care, and bedside training and educational lectures
for Haitian providers. The groups had a tag-team approach,
in which each returning team shared its insights and experiences
with the team on deck to go. This helped to ensure that
teams were as prepared as possible for a dynamic situation.
“The St. Luc’s facility was very busy and understaffed,”
says Walter Franz III, M.D., a member of the Mayo Clinic
Disaster Relief Committee and PUGH, and a consultant in
the Department of Family Medicine in Rochester. “I believe
we helped to augment the level of care and the number of
patients who could be seen. Our Haitian colleagues had been
doing an outstanding job before we arrived and will continue
to do so after our mission is complete. They were very
appreciative of our assistance and information sharing, and
we were eager to learn from them.”
Dr. Franz and other team members were housed at a
guesthouse run by Operation Blessing in Port-au-Prince.
Mayo Clinic supported teams by paying for air and ground
transportation, lodging and food. Team members donated
their trip and vacation time.
4 Mayo Alumni

Drs. Wilson and Franz hope the efforts in Haiti
will continue with institutionally supported training
and education. “We envision a continued close working
relationship with St. Damien’s Hospital Center to enhance
health care education and training, and provide a secure
forum for ongoing staff volunteerism,” says Dr. Wilson.
“The relationships we’ve developed with administrators,
providers and nongovernmental organizations can
facilitate ongoing efforts to most effectively use the vast
clinical experiences and medical knowledge at Mayo Clinic
to continue to provide a supporting role for St. Damien’s,
even from a long distance.”
Dr. Farmer, an assessor in 2010 and a care provider team
member in March 2011, says the scope and magnitude of
poverty and suffering in Haiti in particular and in underdeveloped
countries in general means fixing the problems is an
insurmountable endeavor. “Helping people is not the same as
solving problems,” he says. “We can go and do our best to touch
and help some people,” he says. “We do what we can. Mother
Teresa said, ‘If you can’t feed 100 people, then just feed one.’”
‘They’ve made remarkable progress’
Like his physician colleagues, Walter Franz III, M.D., a member
of the Mayo Clinic Disaster Relief Committee and PUGH,
and a consultant in the Department of Family Medicine at
Mayo Clinic in Rochester, brings much-needed clinical skills
to less-developed parts of the world, including Haiti. He also
brings significant organizational skills. He has 20 years of
Army experience, including four overseas deployments
— three to Iraq. He has served as commander of a forward
trauma team; chief of staff of a field hospital; and civil affairs
officer, going into Iraqi medical facilities to redevelop
and reconstruct medical systems.
“I use my military and civilian [nongovernmental organization]
experiences and help to organize initiatives such as this
one so they are as productive as possible, with systems and
safety in order in a short period of time,” says Dr. Franz. “Haiti
was in rough shape before the earthquake and is even more so
now. The scope of needs is tremendous. There’s a unique oppor-
tunity to reinitiate things for the betterment of the country, and
to help with reconstruction and establishment of protocols to
“
help our Haitian colleagues improve their health care system
using their tremendous clinical experience and energy.”
Dr. Franz visited Haiti in early May. He’d been with the
first Mayo team deployed in February, and had volunteered
with Mayo colleagues three other times in the last 15 years.
On his most recent trip, he reviewed progress at
St. Damien’s Hospital. “They have hired additional physicians
they astutely diagnose patients at the bedside.
and developed a nursing cadre, and are expanding services
These experiences are priceless.”
to address changing patient care needs,” says Dr. Franz.
“They’ve made remarkable progress since February.”
Walter Franz III, M.D., Mayo Clinic Disaster Relief Committee and PUGH
It strikes me how much clinicians in other parts of the
world do without the resources we are accustomed to.
In the absence of sophisticated equipment and testing,
Fall 2011 5

‘I’m optimistic it’s the start of something really good’
Ritu Banerjee, M.D., Ph.D., was part of a team of 11 Mayo
physicians, physician assistants and nurses who served in
Haiti for a week in late April 2011. Dr. Banerjee, a consultant
in the Division of Pediatric Infectious Diseases, joined the
staff at Mayo Clinic in Rochester in 2009 and is interested in
international health. “I’ve had a lot of privilege and education
in the United States and wanted to take this opportunity to
share my clinical skills to help people in need,” she says.
Dr. Banerjee and her colleagues worked eight-hour shifts
in the emergency room at St. Luc’s Hospital. Patients had
conditions such as hypertension, stroke, trauma, diabetes,
rheumatic heart disease, tuberculosis, HIV, cholera, malaria,
asthma and sexually transmitted diseases.
“It was sobering to see such severe manifestations
of chronic disease — young people with terrible cerebral
hemorrhages due to hypertension, very young women with
advanced heart failure, diseases such as rheumatic fever
that we no longer see in the United States, and a cholera
epidemic,” says Dr. Banerjee. “The pathology and poverty
is overwhelming.”
The Mayo team treated patients and instructed Haitian
providers at the bedside and in formal teaching sessions.
“They seemed very receptive to our teaching and
suggestions,” says Dr. Banerjee. “We talked to the physicians
there about managing diabetes, managing pain and isolating
patients with tuberculosis. In turn, they taught us about
treating malaria.
“The clinical needs in Haiti are huge. Little by little,
we can make a difference. This partnership is in its
infancy, but it has great potential to be a long-standing,
sustainable relationship. I’m optimistic it’s the start of
something really good.”
ABOVE: Among the Mayo team members volunteering in Haiti in
late April were (from left) Ritu Banerjee, M.D., Ph.D., Pediatric
Infectious Diseases, Rochester; Lester Kiemele, certified physician
assistant, Gonda Vascular Center, Rochester; and Robin Georgeff,
registered nurse, Clinical Informatics Support, Arizona.
“
On our last day, we attended a church service that
honored two patients who had died. In broken English
and despite his grief, a man spoke about his father and
thanked us for coming to his country to provide care.
It was a powerful moment and put the care we
provided in a more personal context.”
Ritu Banerjee, M.D., Ph.D., Division of Pediatric
Infectious Diseases, Mayo Clinic Rochester
6 Mayo Alumni

‘Winging it was challenging
but exhilarating’
While the conditions at St. Damien’s Hospital were far
different from those at Mayo Clinic, second-year resident
Casandra Rosenberg, M.D., found similarities among patients.
“We saw all types of patient personalities and family dynamics
just like we see at Mayo,” she says. “Because staff members’
time is stretched so thin, involvement of family members in
patients’ care is important. They provide food and water, do
laundry and even alert staff about changes in a patient’s status.
Everyone pitches in to help everyone else in the hospital.”
Dr. Rosenberg, who is from St. Catharines, Ontario,
Canada, speaks French, which assisted in communication
with some patients. But many patients speak Creole, and
many are illiterate. “Communication was a challenge in
those cases,” she says. “I had a patient who we suspected
had mitral stenosis. We treated her dyspnea and abdominal
discomfort, and I wanted to explain to her what we’d
done and how she should manage the condition at home.
I drew a picture and described the path of blood past
several ‘doors,’ or valves. If one door was hard to open, the
rooms behind it would get full — like her lungs and belly.
To describe stenosis, I grabbed two drinking straws and
blew air through one to demonstrate the normal heart. To
show stenosis, I squeezed the other in the middle, making
it hard to puff air through. This experience reinforced
how important communication with patients is, even if
it is a hand gesture or a caring smile. This has definitely
carried over into my practice back home.”
Dr. Rosenberg is specializing in physical medicine and
rehabilitation and was able to put her training to use. Patients
use donated prosthetic limbs, which do not fit properly. “I
worked with the Haitian nurses and the resources they had,
such as wrap elastic bandages, to make the prostheses fit
better,” says Dr. Rosenberg. “We brainstormed about how to
prevent pressure sores in stroke patients. The hospital doesn’t
have padding like we use. They fill hospital gloves with water
and position them beneath patients to alleviate pressure. It
was valuable to learn to think in different ways when we did
not have every tool at our disposal.
“It’s impressive how much Haitians are doing to improve
their health care system. During the week I was there, a new
building went up on the St. Damien’s campus. Vision translated
to reality very quickly, with everything done by hand.
“
Nurses at the hospital worked 12-hour shifts, then
some returned home to tents, without running water
or electricity. Their strength and resourcefulness is
truly courageous and humbling.”
Casandra Rosenberg, M.D., resident, Mayo Clinic Rochester
Patients’ family members brought buckets of water to the
construction workers. The progress was amazing to see.”
Initially, Dr. Rosenberg says she was nervous about
having limited medical resources. “We had a patient with a
rapid heart rate whose blood pressure was dropping, with
signs of poor perfusion,” she says. “We needed to slow the
heart rate, but we didn’t have an EKG or echocardiogram
to diagnose the type of heart failure. We gave the patient a
beta-blocker and observed with a pulse monitor and blood
pressure cuff. The patient did well and the perfusion slowed.
At Mayo, I’d have requested a cardiology consultation, the
patient would have been monitored by nurses around the
clock and we’d have had the luxury of various medications.
Winging it was challenging, but it was exhilarating to learn
to work with the available knowledge and resources.”
Fall 2011 7

8 Mayo Alumni

An American Doctor in Fukushima
A bird’s-eye view of
JApAn’s disAster AftermAth
T
he world rocked, tumbled and shook while
Kenneth Nollet, M.D., Ph.D. (MMS ’93, BIOC
’93, PATH ’97, TRMED ’98), and a colleague
struggled to remain standing. The two moved from
offices on the top floor of a research facility at
Fukushima Medical University (FMU) in Fukushima
City, Japan, to a hallway when the magnitude 9.0
earthquake hit at 2:46 p.m. on March 11.
FMU gave priority to severely injured patients
and those directly affected by the earthquake
and its aftermath. Patients arrived from inside
and outside Fukushima Prefecture in buses,
ambulances and medical evacuation helicopters.
The medical center saw 28 life-threatening injuries,
86 minor injuries and one fatality.
Regularly scheduled bedside learning rotations
and lectures for medical students were disbanded
so that student volunteers and their faculty
mentors could devote themselves to emergency
care. Students not directly involved in FMU’s
efforts attended to family and community needs.
Within 48 hours of the disaster, Dr. Nollet
started a blog, “An American Doctor in Fukushima”
(http://cbbstoday.org/nollet_fukushima.php), to
spur thinking about “this kind of event happening
in your own backyard and redoubling institutional
and personal preparedness initiatives.” The blog
was published on the website of the California
Blood Bank Society with which Dr. Nollet was
involved as co-chair of its Emergency Planning
Committee in 2003.
“Helen Keller said, ‘Character cannot be developed
in ease and quiet. Only through experience
of trial and suffering can the soul be strengthened,
ambition inspired and success achieved,’” says
Dr. Nollet. “ We are all stronger as a result of this
trial, but not as individuals. Strength in Japan is a
collective attribute. The gossamer threads of interpersonal
relationships, woven at FMU and in the
community, held fast. Threads tested become
threads trusted.”
Dr. Nollet, a transfusion medicine specialist,
is a specially appointed professor at FMU in the
Division of Blood Transfusion and Transplantation
Immunology. He joined Fukushima Medical
University in 2008 and hopes to stay in Japan,
noting that 13 years of practicing teamwork at
Mayo Clinic helped to prepare him for life and
work in Japan. “I would like to earn the right
of permanent residency by mastering Japanese
and making meaningful contributions to society,”
he says. “Japan feels like home.”
Fall 2011 9

Mayo Alumni shares excerpts from Dr. Nollet’s blog throughout
the days and weeks after the disaster.
March 13
Friday afternoon, March 11, buildings at Fukushima Medical
University shook long and hard, and aftershocks continue.
Fukushima City is not close to the eponymous nuclear plant,
and we are inland from Sendai. No tsunami here, but no
running water either. Electricity is OK, and I queued to fill
some jugs from a water truck that came to the neighborhood.
That took more than an hour, but this is Japan and people
passed the time in friendly, quiet conversation. The medical
center itself normally uses around 150 tons of water per day.
Reserves fell below 500 tons over the weekend. A water
rationing protocol started; laboratory procedures are being
modified as much as possible, and employees have been
asked to use chemical toilets in the parking lot instead of
our usual indoor plumbing.
People continue to exercise the good manners and
cooperation that make living here worthwhile. As one person,
I can’t do much, but as part of a team, I’m trying to be useful.
March 14
Being a specialist with an interest in disaster response is not
quite the same as being a disaster specialist. Maybe my biggest
contribution to the effort on Sunday was tracking down some
bakery rolls, and then catching up with a surgeon who had
been on overnight duty and still hadn’t eaten by mid-afternoon.
Being human, he promptly inhaled two rolls. Being a surgeon,
he washed them down with some strong coffee. Being Japanese,
he put the rest in a freezer for others and went back to work.
March 15
We are still outside the radiation evacuation area, but some
incoming patients are being wanded with a Geiger counter,
in much the same way as some people are wanded with a
Kenneth Nollet, M.D., Ph.D., has been at
FMU since 2008 and hopes to stay in the
country. “Japan feels like home,” he says.
10 Mayo Alumni

Patients arrived at Fukushima Medical Center by helicopter,
ambulance and bus.
Fukushima Medical Center saw 28 life-threatening injuries,
86 minor injuries and one fatality.
magnatometer at airport security. Perhaps the most important
place to measure radiation is the Neonatal Intensive Care Unit.
March 26-27
At a Japanese medical university, there is generally one full
professor in each department, who serves as its chair, often
until retirement. The system has been likened to a pyramid.
But what is it like to be at the top?
Professor Yasuhiro Hashimoto directs leading-edge
glycomics research aimed at diagnosing serious neurological
disorders. A weekend at the university would normally be
for academic activities. But this Saturday and Sunday, he is
also a radiation technologist [measuring radiation levels at
the hospital with a portable gamma-ray detector].
Scholars from around the world know Professor Hitoshi
Ohto for research in transfusion-associated graft-versus host
disease and other topics. To patients in Fukushima, however,
he is a kindly physician who attends to therapeutic apheresis
and personally draws blood from autologous donors.
Power and service seem to be related here.
April 2
International media attention and domestic anxiety seem
to focus on nuclear plant issues and possible long-term
effects of stray radioactivity. Caregivers have to consider
an even bigger picture. Our hospital is once again receiving
non-urgent patients, but FMU teams continue to travel
around the prefecture, attending to refugees.
April 11
Today marks one month since an earthquake changed
everything. Or did it?
Hourai East Primary School, a block from where I live,
resumed classes today. Last night, there were students in the
gymnasium, rather than refugees. Tens of thousands are still
displaced and will be for some time. While new accommodations
are being built, young doctors unaccustomed to making
house calls are calling on the homeless. Earthquakes and
tsunamis put every structure to the test, but social order has
not collapsed.
At 2:26 p.m. today, FMU observed a minute of silence for
those removed from their homes, especially those removed
from this world. I observed this silence from the vantage
One month after the disaster, a decontamination tent remained
outside of Fukushima Medical Center although Fukushima City has
only slightly elevated radiation levels. “Worthy of surveillance but
not worth worrying about, despite what people exposed only to mass
media might believe,” says Kenneth Nollet, M.D., Ph.D.
Fall 2011 11

On March 24, a scaled back graduation ceremony was held for degree candidates from the School of Medicine, Graduate School of Medicine,
School of Nursing and Graduate School of Nursing. In recent years, FMU introduced simulation technologies that allow students to learn medical
procedures without putting themselves or patients in harm’s way. Students, in harm’s way themselves, learned from a disaster too big to simulate.
point of a hallway window overlooking the courtyard. A small
plaque in the courtyard commemorates the life and the oath
of Hippocrates. It is a dull, overcast day and the courtyard
trees are still bare. But this will change in the next week.
Nature has the power to destroy; human artifice adds insult
to injury, but nature also manifests creation and re-creation.
May 8
The entrance ceremony for new students was held May 6.
Like other recent events, this one began with a minute of
silence. Perhaps for anyone entering a caregiving profession,
this ritual should be the norm rather than the exception. Near
or far, there will always be people in need.
Hana-mi-yama, or flower-viewing mountain, is a popular tourist
destination in Fukushima City. Despite the disaster, residents and
visitors made time to take in the cherry blossoms.
12 Mayo Alumni

with Kenneth Nollet, M.D., Ph.D.,
an American Doctor in Fukushima
Why did you observe a moment of silence near a plaque
commemorating the life and oath of Hippocrates?
In the course of teaching medical English presentation
skills, I convene students around this plaque. They compare
and contrast the classic oath and modern variations. In common,
every respectable oath is a promise of service to others.
This comes naturally in times of disaster, but I also wanted to
reflect on Hippocrates’ injunction to guide the next generation.
Before the earthquake,
we expected 100 medical
students to matriculate
in April. Circumstances
forced Fukushima
Medical University
(FMU) to postpone the
new academic year by one
month, and for various
reasons 11 students
withdrew. The remaining
students have made an
extraordinary commitment.
Those of us
privileged to teach the art
should do the same.
Fukushima Medical
University’s model
of care translates to:
“To show compassion, possess knowledge,
apply skill, foster harmony, and build community.”
How does it compare to the Mayo Model of Care?
FMU’s model of patient care and education resembles
what is practiced at Mayo. Of course, FMU cannot claim
to be an international health care destination. On the other
hand, I’ve never forgotten that farmers from southeastern
Minnesota were as welcome at Mayo as princes and kings
from around the world. Like southeastern Minnesota,
much of Fukushima’s economy is agricultural, but not as
mechanized. Farmers here work much harder for my meals
than I do. Many of them come into old age and into hospital
bent over from years of diligent crop tending. They deserve
our best efforts.
To what degree is daily life at FMU back to normal?
FMU has resumed routine patient care. Radiation
surveillance is a normal activity at any medical university
but was scaled up when problems began at the nuclear plant.
I walk past one radiation checkpoint every day, where log
sheets are kept in plain view next to a Geiger counter. Between
official measurements, I am at liberty to check myself or
anything I might be wearing or carrying for radioactivity.
My day-to-day
life was never really
disrupted. A doctor
always has something
to do. People in the
community who
wanted me to focus
on my job made sure
that other things
were taken care of.
Among those in the community who helped to take care of things so Kenneth Nollet,
M.D., Ph.D., could focus on his job were the owners of a family-owned lunch
counter. “The business could not operate when running water and gasoline were
not available, but they kept their doors open for me,” says Dr. Nollet. At left, an
FMU medical student joins Dr. Nollet (center) and members of the owner family.
What would you
like Mayo Clinic
alumni to know about
disaster relief?
Mayo alumni
know firsthand
what charitable giving
can accomplish. Just
as we are taught to practice evidence-based medicine, it
behooves us to practice evidence-based benevolence.
A compelling narrative suggests that Rochester’s
F5 tornado in 1883 inspired an institution now known and
respected around the world. We, as heirs to this legacy,
should redouble our efforts to expect the unexpected and
be of service in difficult times.
visit dr. nollet’s ongoing blog
for more information,
http://cbbstoday.org/nollet_fukushima.php.
Fall 2011 13

... we face serious issues wiTh how healTh care
is funded and insured, and how care
is delivered To be high qualiTy, accessible and affordable.
14 Mayo Alumni

pAtients Are
‘GlAd mAyo is
speAkinG up’
Patricia simmons, M.d.
new medical director of government relations
patricia Simmons, M.D., is the medical director for Mayo
Clinic’s new Division of Government Relations. In this
role, she is the physician leader for Mayo Clinic’s
interactions with federal and state governments and other
organizations. The new division encompasses the work of
state legislative activity in Arizona, Florida, Minnesota and
Wisconsin, and the work of the Health Policy Center and
other federal government relations.
Dr. Simmons came to Mayo Clinic in Rochester in 1977
for her residency and fellowship and has remained ever since.
She is chair of Pediatric and Adolescent Gynecology, a
consultant in the Department of Pediatric and Adolescent
Medicine and the Department of Obstetrics and Gynecology,
and a professor of pediatric and adolescent medicine.
Mayo Alumni interviewed Dr. Simmons about this new
leadership position.
why did you want to serve in this role?
I’ve been privileged to be in leadership positions at Mayo
Clinic as well as on the “front lines,” and I have a passion for
our values and model of care. Mayo is a wonderful place for
people to receive health care, be educated and do research.
I want to play a role in preserving the extraordinary thing
that Mayo Clinic is. Serving at the decision-making table has
given me insights and knowledge. I know to whom to go
when I don’t have the answers I need. I want to use those
resources and experiences in the broader environment.
I also have had leadership positions outside of Mayo,
such as serving on the Board of Regents of the University
of Minnesota since 2003, including chair of the Board. The
process involved in becoming a public servant and that
engagement helped to stimulate my interest and provide
experiences and relationships for my new role in Mayo’s
government relations.
Of course, I will protect my patient care responsibilities.
One reason I took on this new role was because I care so
much about patients. I don’t want to shortchange my primary
reason for being at Mayo Clinic.
Patricia Simmons, M.D., medical director of Government Relations,
says she is grateful to Drs. Denis Cortese and John Noseworthy for
making Mayo Clinic engagement in government relations a priority.
Fall 2011 15

kathleen harrington
new division chair for
Government relations
Kathleen Harrington has
joined Mayo Clinic as chair for
the Division of Government
Relations. She oversees a team
that develops health policy
recommendations, monitors
congressional and legislative
activity, and seeks to influence
stakeholder groups at state and
national levels.
Prior to joining Mayo Clinic,
Harrington spent 25 years in
Washington, D.C., working on
health policy issues in various
roles, including serving as chief
of staff for Congresswoman
Nancy L. Johnson, vice president
of federal government relations
at Aetna, and director of the
office of external affairs for
the Centers for Medicare and
Medicaid Services. Most recently,
Harrington was director of
government relations and public
affairs for Carol Corp, a strategy
and solutions company that
empowers health systems to
transition to accountable care.
what challenges do health care organizations
face in the government environment?
At the state and federal levels, we face
serious issues with how health care is
funded and insured, and how care is
delivered to be high quality, accessible
and affordable.
Now that the health reform law has
passed, it’s time to work on the interpretation
and what we know will be
substantial revisions in the years ahead.
We have to be prepared for change and
to provide informed, valued input.
who do you look to for support in this role?
I’m helped by my colleagues throughout
Mayo, including those who work in
government relations. I still have a lot
to learn, and I am grateful for their
support. We’re doing this as a team in
true Mayo style.
I rely on fellow leaders at Mayo
Clinic for their ideas, skills and
involvement. I admire Mayo leaders
who have championed taking on a
more public role with issues that are so
important. Drs. [Denis] Cortese [former
president and CEO] and [John]
Noseworthy [president and CEO] have
regarded this activity as important for
Mayo to engage in. That says a lot
about their sense of social responsibility
and commitment to our patients
and mission. Following their lead,
Mayo has done this with dignity and
style. Those of us who have trained
here, work here and who are patients
can be proud.
Other organizations and individuals
who share our values also are
valuable resources. And the public is a
tremendous ally for Mayo Clinic. In our
engagement with national health
policy, we’ve tried very hard to provide
the public with a voice and a forum.
I look forward to a new set of
interactions with Mayo leadership and
external leaders in federal and state
government.
has anything surprised you so far in this role?
I was surprised at how engaged Mayo
Clinic is with government and active in
health policy and how much my
colleagues know. But I shouldn’t have
been. Mayo Clinic has always been
engaged, dating back to the Mayo
brothers. It’s part of our tradition to
share what we know.
It’s gratifying when a patient knows
about Mayo’s or my activities in this area
and expresses thanks. Patients have
said, “I’m so glad you’re trying to do
something — so glad Mayo is speaking
up.” Patients, alumni and people around
the state and country care deeply about
health care in the United States and the
future of Mayo Clinic.
how will you measure success in this role?
We’ll succeed when health care in the
United States grows in value and Mayo
Clinic thrives.
We would like everyone to advocate
for continued federal funding for
research, particularly for National
Institutes of Health (NIH) funding.
We believe that Mayo Clinic is
the best health care model in the
United States, and we have a moral
obligation and responsibility to try to
influence national and state policy.
What’s good for Mayo Clinic is good
for our patients and people everywhere.
It’s wonderful to think you can
improve health care for people and
have the institution you love succeed.
One goal serves the other.
16 Mayo Alumni

division of governMenT relaTions
federal PrioriTies
through its new Division of Government Relations, Mayo
Clinic will work with groups who share similar points
of view to advocate for extending high-value, efficient,
affordable, accessible, patient-centered care for all. The goal
of this activity is to ensure patients have access to Mayo
Clinic and that the Mayo Clinic Model of Care is used to
help guide public policy decisions.
Mayo Clinic is involved in state
government relations activities in
Arizona, Florida, Minnesota and
Wisconsin. At the federal level, Mayo
Clinic has developed this message to
guide its efforts:
As the U.S. Courts examine
the Patient Protection and Affordable
Care Act, Mayo Clinic will continue
to work toward the implementation
of its provision and timelines until
the court system’s judicial review
reaches final resolution. Mayo Clinic
believes that the status quo in health
care is not acceptable because too
many patients lack access to patientcentered,
high-value health care. Mayo
Clinic has consistently said that there must be two key
principles in any successful reform effort:
1 Incentives for physicians and hospitals to offer highquality
care at a reasonable cost because this defines
high-value health care
2 A means to enable all Americans to purchase affordable
health insurance
The Affordable Care Act has begun to address the
coverage aspect of health care, but much more needs to be
done to advance the creation of a high-value health care
system. Now is the time to focus on developing, testing and
implementing concrete policies that will produce highquality,
efficient, affordable, accessible, patient-centered care
for all Americans.
Priority areas for Mayo Clinic in 2011 within the framework
of the Affordable Care Act are:
• Guide the implementation of Accountable Care
Organizations (ACO) that meet the needs of patients.
• Contribute to the Institute of Medicine study on value
so that new payment models effectively reward patientcentered,
high-value health care.
mAyo CliniC hAs AlwAys been enGAGed.
it’s pArt of our trAdition
to shAre whAt we know.
• Work with the CMS Innovation Center on potential
high-value health care projects.
• Help develop workable guidelines for health insurance
exchanges by working closely with states.
• Provide input to CMS about the value modifier so that
patient-centered, high-value health care is rewarded.
• Guide the distribution of comparative effectiveness
research funding through the Patient
Centered Outcomes Research Institute.
Mayo also is committed to advancing
these initiatives, separate from the
Affordable Care Act:
• Advance health information technology
standards and interoperability in health care
systems by focusing on two priorities: unique
patient identification and meaningful
exchange of medication, allergy and
problem lists between organizations.
• Monitor unobligated funds from the
2009 American Reinvestment and Recovery
Act because these funds are at risk of
being reclaimed. This may affect the health
information technology efforts of the Office
of the National Coordinator.
• Determine and build support for a permanent solution
to the sustainable growth rate formula issue within
Medicare.
• Monitor and protect National Institutes of Health and
Graduate Medical Education funding.
Mayo Clinic also is involved in state government relations
activities in Arizona, Florida, Minnesota and Wisconsin.
Mayo clinic’s government relations team
Patricia Simmons, M.D. Medical Director, Government Relations
Kathleen Harrington Division Chair, Government Relations
Jennifer Mallard Director, Federal Government Relations
Layne Smith
Director, Florida Government Relations
Erin Sexton
Director, Minnesota Government Relations
Michael Yardley Division Chair, Public Affairs, Arizona
government relations operations Team
Shelly Plutowski Judy Samson
Nora O Sullivan Randy Schubring
Fall 2011 17

What can Mayo Clinic learn
from the ancient Greeks?
Alumni, Mayo staff reflect on visit to ancient healing community of Epidaurus
Attendees of the Mayo Clinic Alumni Association International CME Conference,
Living Long, Living Well, , visited the small community of Epidaurus, which dates
back to the fourth century B.C.
The asclepieion at Epidaurus was a healing center, where ill people went in
the hope of being cured. The asclepieion featured a 160-person guest house,
gymnasium, stadium, theatre and healing springs.
Mayo Clinic staff and alumni marveled at the many parallels between Epidaurus
and Mayo Clinic, and lessons we can learn from the ancient community. They
share their reflections with Mayo Alumni, with photos by Eddie Greene, M.D.
A museum on the Epidaurus grounds displays artifacts, including medical instruments
that closely resemble those used today.
Epidaurus at the time of its popularity
embodied many of the concepts
that we espouse as being important for
health: Exercise, mind-body connection,
and an environment that promoted
health of the body and health of the
spirit. However, even though this is
regarded as important even in the age
of more esoteric and scientifically based
treatment of illness, this particular site
is currently a ruin, and has been so
for thousands of years. This begs the
question: How did this site, which held
the attention of healers and the sick for
many years, with ideals and practices
that we regard even today as being
important to health and well-being, lose
its connection for the community which
18 Mayo Alumni

it served? What lessons can we as Mayo
Clinic learn and apply from this ancient
“destination medical center?”
The context of health, illness and
healing is the context of the society
in which the practices reside. Society
and societies are not static organisms,
but living organisms within which
the accepted practices, ideals, mores
and ethics may be in flux. The role of
science and “best practices” may be
more real or relevant to the practitioner
than they are to the patient, and those
practices and patient expectations can
change over time. For example, within
our own lifetimes the role of the physician
and caregiver as an authoritarian
and paternalistic figure has given
way to a care partnership between
the patient and the physician, with
shared decision making on diagnostic
testing and treatment the expectation.
Providers that do not share and
practice within the context of this new
perception and expectation of medical
care are likely to be marginalized and
serve an increasingly small proportion
of the population that continues to hold
this view of the paternalistic provider
and the compliant patient.
It can be plausibly inferred from
Epidaurus that the type of medicine and
healing practiced at this site, though
some of the practices performed there
have withheld the test of time, somehow
lost its relevance in Greek society.
The basis for this loss of relevance is
unknown. Could other cult followings
of healing displaced it? Could political
processes such as war, political fractionation
of society or other rules imposed
by society impeded its success through
restricted access? Or did disease, famine
or other natural disaster render its
brand of healing as ineffective, unaffordable,
or perhaps dangerous?
The process that led to the demise
of Epidaurus will likely never be
known, yet the lessons from that early
“destination medical center” should not
be lost or discounted. The healing arts
and sciences must remain relevant to
the societies they serve. Practitioners
must be vigilant and responsive to the
societies they serve, holding the science
and compassionate care as unyielding.
They also must be nimble and flexible
to meet patients on their terms and
engage them in a partnership. As we
strive to meet the guiding principle
“The needs of the patient come first,”
let’s make sure we are constantly and
consistently asking our patients about
their needs, listening carefully to their
responses and crafting the delivery
of our care to meet those needs. This
process and practice will help us
continue and improve our relevance to
our patients, and prevent Mayo Clinic
from becoming the next Epidaurus.
Terence Cascino, M.D. (’80 NEURo)
James Garrity, M.D. (’85 oPh)
Eddie Greene, M.D (NEPh)
David herman, M.D. (’83 oPh)
Fall 2011 19

Mayo Update
New Arizona CEO
Board of Trustees honors new named professors
The Mayo Clinic Board of Trustees has honored two new Mayo Clinic named professors.
Wyatt Decker, M.D.
Robert Spinner, M.D.
Department of Neurologic Surgery
Department of orthopedic Surgery
Mayo Clinic Rochester
Burton M. Onofrio, M.D.,
Professor of Neurosurgery
Michael Ackerman, M.D., Ph.D.
Divisions of Cardiovascular Diseases
and Pediatric Cardiology
Department of Molecular Pharmacology
and Experimental Therapeutics
Mayo Clinic Rochester
Windland Smith Rice Cardiovascular
Genomics Research Professor
At its quarterly meeting in May, the
Mayo Clinic Board of Trustees appointed
Wyatt Decker, M.D. (MMS ’90, I ’93,
EM ’97) as the new vice president
and chief executive officer in Arizona.
Dr. Decker succeeds Victor Trastek, M.D.
Dr. Decker has been with Mayo
Clinic for more than 16 years as a
consultant and professor of emergency
medicine. His leadership roles have
included chair of Emergency Medicine,
with responsibilities for the emergency
departments at Mayo Clinic in
Rochester and Jacksonville. Currently,
he is chair of the Mayo Clinic Personnel
Committee in Rochester and leads the
Rochester Destination Medical
Community initiative.
Robert Spinner, M.D. (NS ’00) (left), and Michael Ackerman, M.D. (MMS ’95, PhAR ’95,
PD ’98, PDC ’00) (right), are presented with named professorship certificates from Michael
Camilleri, M.D. (center), a member of the Mayo Clinic Named Professorship Committee.
For more information about these named professors, visit mayo.edu/alumni.
Obituaries
Hermance Legait, M.D. (N ’50),
died May 15, 2011.
Alexander Lucas, M.D. (CAP ’71),
died March 31, 2011.
James McPherson, M.D. (I ’59),
died April 23, 2011.
20 Mayo Alumni
Douglas Pritchard, M.D. (OR ’72),
died May 19, 2011.
Troy Rollins, M.D. (DERM ’58),
died March 30, 2011.
Kevin Shaw, M.D. (CRANI ’87, PLS ’87),
died Jan. 17, 2011.
Robert Sigler, M.D. (S ’66),
died Jan. 27, 2011.
Gabriel Toro, M.D. (I ’48),
died Jan. 2, 2011.
Complete obituaries and the Update section,
with alumni and staff news, are available on
the Mayo Clinic Alumni Association website,
mayo.edu/alumni.

Mayo Clinic Alumni
Association Officers
S. Mark Laney, M.D., St. Joseph, Mo.
President
Eric J. Grigsby, M.D., Napa, Calif.
President-Elect
Juan M. Sarmiento, M.D., Atlanta
Vice President
Eric S. Edell, M.D., Rochester, Minn.
Secretary-Treasurer
David K. Teegarden, M.D., Tyler, Texas
Past President
Karen D. Herman, Rochester, Minn.
Director
Executive Committee
Peter C. Amadio, M.D., Rochester, Minn.
Sarah Y. Boostrom, M.D., Rochester, Minn.
(MSGME Representative)
Terrence L. Cascino, M.D., Rochester, Minn.
(Department of Education Representative)
Maria L. Collazo-Clavell, M.D.,
Rochester, Minn.
Diane F. Jelinek, Ph.D., Rochester, Minn.
Margaret M. Johnson, M.D.,
Jacksonville, Fla.
Clive P. Nyauncho, Rochester, Minn.
(MMS Representative)
Justin P. Peters, Rochester, Minn.
(MGS Representative)
Daniel L. Roberts, M.D., Scottsdale, Ariz.
Carl W. Soderstrom, M.D., Peoria, Ill.
Board of Directors 2009–2011
Carl L. Backer, M.D., Winnetka, Ill.
Susheela Bala, M.D., San Bernardino, Calif.
Wendelyn Bosch, M.D., Jacksonville, Fla.
(MCF-MSGME Representative)
Kenneth H. Brookler, M.D., New York
Nancy L. Elwess, M.D., Plattsburg, N.Y.
Juan Gallegos, M.D., Scottsdale, Ariz.
(MCA-MSGME Representative)
Robert P. Kazan, M.D., Chicago
Peter H. Layer, M.D., Hamburg, Germany
Kevin G. Madden, M.D., Scranton, Penn.
Gregory K. Mayer, M.D., Phoenix
M. Mark Melin, M.D., St. Louis Park, Minn.
Nicole W. Pelly, M.D., Seattle
David W. Romness, M.D., Arlington, Va.
Scott R. Ross, D.O., Colorado Springs, Colo.
Guillermo Ruiz-Arguelles, M.D.,
Puebla, Mexico
Marcia J. Sparling, M.D., Vancouver, Wash.
Mack H. Sullivan, M.D.,
West Bloomfield, Mich.
Pamela B. Sylvestre, M.D., Memphis, Tenn.
Karl F. Tamussino, M.D., Austria
Robert L. Van Dervoort Jr., M.D.,
Nashville, Tenn.
Executive Editor — Karen Trewin
Editorial Assistant — Emily DeBoom
Advisory Board — Steven Altchuler, M.D., Ph.D., Brigitte Barrette, M.D., Matthew
Bernard, M.D., Charles Burger, M.D., Eric Edell, M.D., chair, Michael Farnell, M.D.,
Robert Giere, Colum Gorman, M.B.B.Ch., Ph.D., Nancy Henry, M.D., Ph.D., Karen
Herman, Richard Hurt, M.D., Andrew Landstrom, Nicholas LaRusso, M.D., Paul
Mueller, M.D., Lonzetta Neal, M.D., Robert Safford, M.D., Ph.D., Patricia Odean,
Karen Trewin, Dietland Wahner-Roedler, M.D., Alexandra Wolanskyj, M.D.
Alumni Center
507-284-2317
Karen Herman, director
507-538-0162
Email: mayoalumni@mayo.edu
Website: http://www.mayo.edu
Physician Referral
Arizona 800-446-2279 (toll-free)
Florida 800-634-1417 (toll-free)
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mayoclinic.org/medprofs
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800-237-6822 (toll-free)
mayomedicaltransport.com
For information
about alumni meetings
and receptions,
visit
mayo.edu/alumni
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Contact: Robert W. Giere
Director for Alumni Philanthropy
800-297-1185
tdms@mayo.edu
Mayo Alumni magazine is published quarterly and mailed free of charge to
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Permit No. 135
In May, the Mayo Clinic Alumni
Association hosted an International
CME Conference in Greece. Many
attendees visited Epidaurus, a former
healing center dating back to the fourth
century B.C. Numerous parallels exist
between Epidaurus and Mayo Clinic,
including an emphasis on health of body
and spirit. One cannot help but wonder
what led to the ruination of this ancient
destination medical center. Did it cease
to be relevant or ineffective?
Several Mayo physicians provide their
perspective about lessons Mayo Clinic
can learn from the ancient Greeks and
Epidaurus in the story on page 18.
Greece photos, Eddie Greene, M.D.