UAB Magazine Weekly - Features on Health Care
New UAB Treatment Dispels Depression with Magnetism
By Bob Shepard
UAB is the first medical provider in Alabama to offer repetitive Transcranial Magnetic Stimulation treatments to patients suffering from depression. To learn more about this new form of therapy, click here.
Julia Rogers has battled depression for two decades. It has caused serious issues in her life, both personally and professionally. She tried medications—lots of them—with no real effect. Most days, she had to struggle just to function at all.
Depression is a difficult illness to treat because no single therapy works every time in every patient. Psychiatrists now have very good medications to offer, but many patients still find little relief. Psychotherapy and electroconvulsive therapy (ECT) are also successful for some patients, but they do little for others.
That’s why UAB psychiatrist Bates Redwine, M.D., is so excited about the university’s new repetitive Transcranial Magnetic Stimulation, or rTMS, device. This non-invasive treatment delivers a series of highly focused, MRI-strength magnetic pulses to a particular area of the brain linked to depression—the left dorsolateral prefrontal cortex. The Food and Drug Administration approved rTMS therapy within the past two years, and UAB’s device is the only one in Alabama.
“The left dorsolateral prefrontal cortex is known to have decreased activity in depressed patients,” says Redwine. “rTMS seems to ‘wake up’ the neurons, stimulating them to fire and become more active.”
UAB Travel Medicine Expert Joins Global Health Panel
By Troy Goodman
David Freedman is a new member of the Roster of Experts for the World Health Organization International Health Regulations.
Disease knows no boundaries, and neither does David O. Freedman, M.D. At any time, the director of UAB’s Travelers’ Health Clinic could get a phone call summoning him to Europe to help stop a global epidemic.
Freedman isn’t a superhero. He’s an expert in travel medicine—and a new member of the Roster of Experts for the World Health Organization (WHO) International Health Regulations (IHR). A comprehensive set of rules and procedures endorsed by the 193 WHO member states, the IHR is designed to limit the worldwide spread of diseases and other public-health threats while minimizing disruption to travel, trade, and economies. “The emergence of H1N1 influenza in 2009 and SARS in 2003 demonstrates how interconnected the world has become and how rapidly a new disease can spread,” Freedman says.
UAB Medical Students Mix Haircuts with Health Care
By Susannah Felts
Barbershops provide a relaxed atmosphere for SNMA screenings. Assistant dean Anjanetta Foster (middle) and chapter president Whitney McNeil (right) attend to a patient in downtown Birmingham.
During her second week at the UAB School of Medicine, Whitney McNeil was performing a blood sugar check when she got a shock: Instead of providing a numeric value, the glucose meter simply read “high.” She alerted her supervisor, who told the patient to go straight to the emergency room. “I was worried that he might not make it,” McNeil recalls.
The procedure was unusual for another reason: It didn’t take place in a medical facility. Instead, McNeil is more likely to find her patients in Birmingham barbershops.
Her screenings are part of a volunteer effort organized by UAB’s chapter of the Student National Medical Association (SNMA), an organization founded in 1964 at Meharry and Howard University medical schools to advocate for minorities in medicine.
Most minority students at the School of Medicine join SNMA’s ranks, says Anjanetta Foster, M.D., assistant dean for diversity and multicultural affairs. The group holds community health screenings several times a year, checking for warning signs of hypertension and diabetes and counseling the public about preventing and finding help for these common but sometimes avoidable conditions.
White Coats Mark Rite of Passage
By Caperton Gillett
Even with the latest advances in medical technology and pharmaceutical development at their fingertips, many health-care practitioners say their most powerful tool may be a simple clean white coat. “Patients have expectations when someone walks into the room wearing a white coat,” says Stephen Smith, Ph.D., director of student success programs in the School of Medicine at UAB. “There’s a high honor and a high privilege. Patients will allow a physician into parts of their lives where they wouldn’t consider allowing anyone else.”
UAB freshmen optometry students (top) and medical students (above) receive their white coats as the centerpiece of welcoming ceremonies each year
A traditional symbol of compassion and training, the white coat is the centerpiece of ceremonies to welcome the freshman classes at the UAB schools of Medicine, Dentistry, and Optometry. During the annual events, the schools present students with their own white coats, marking their entrance into their chosen profession and emphasizing the ethics and responsibilities required of physicians and dentists.
The white coat ceremonies involve much more than a walk across a stage, however. The medical school starts each class with Patient, Doctor, Society (PDS), a course focusing on medical professionalism and ethics, in which students learn the expectations laid on them as both medical students and practicing physicians. Two weeks later, the new students walk into the Alys Robinson Stephens Performing Arts Center, where each signs the honor code and student code of conduct and recites an oath of dedication that the class composes in the PDS course. Then Senior Vice President and Dean Robert Rich, M.D., presents each student with his or her own white coat.
A similar ceremony and curriculum heralds the beginning of professional education for students in the UAB School of Dentistry. A tradition since 2001, the dental White Coat Ceremony follows a month of ethics education. “From day one, they’re learning the importance of professionalism and ethics,” says Steve Filler, D.D.S., associate dean of student, alumni, and external affairs in the School of Dentistry. “The white coat emphasizes the role and responsibilities of the dentist in the life of the patient.”
For every student who accepts a white coat, the ceremonies hold a unique significance:
Sam Strachan, medical student: Strachan has wanted to be a scientist since age five; his mother’s lifesaving open-heart surgery when he was 13 convinced him to become a doctor. A native of Nassau, Bahamas, Strachan completed his undergraduate education at Benedict College in Columbia, South Carolina, where his professors recommended UAB for medical school. The PDS course reaffirmed his choice, he says. “It was nice to see that the medical school had ethics on their agenda and not just the hard sciences and getting good scores,” Strachan says.
Though he wasn’t originally aware of the White Coat Ceremony tradition, Strachan appreciated its importance. “It is a kind of symbolism, because we wear the white coat when we’re on the wards or visiting people in their homes,” he says. “It distinguishes us as medical students, and it reminds us why we’re studying biochemistry.”
The ceremony also touched Strachan personally. “I was very proud to have my wife there,” he says. “Putting on the coat meant that I was actually in the field of medicine now.”
Timothy Smith, dental student: As president of his dental school class, Smith had a particularly deep involvement in the White Coat Ceremony. “This past year, we were given the opportunity to write our own ethics statement instead of reading a standard statement from the dental school,” he says. “It was special, and our class took it seriously.” During the ceremony, Smith read the statement aloud, and then each student crossed the stage to receive his or her coat from Michael McCracken, D.D.S., assistant professor in the Department of Prosthodontics and Biomaterials. Students then sign the ethics statement and receive a School of Dentistry pin from Dean Huw F. Thomas, Ph.D.
“It’s an honor to receive the white coat, to have the dean present the pin of the dental school, and to wear the seal,” Smith says. “It’s a moment to know that you’re being invested in a faculty’s worth of knowledge—that M.D.s and Ph.D.s and D.M.D.s will be working with you over the next four years. It’s the moment that the school says, ‘Your name doesn’t have “D.M.D.” after it or “Dr.” before it, but that’s what you’re working toward, and we’re working to help you get there.’”
Sean Vanlandingham, medical student: Vanlandingham took a somewhat longer route to medical school than most of his classmates. After 10 years of business consulting and a Stanford M.B.A., he realized that he had missed his calling. “I think it’s the same reason a lot of younger people go into medicine—I want to help people, I have a deep fascination with the health sciences, and I just missed it in college.”
It took Vanlandingham five years of balancing his job and studies at Virginia Commonwealth University to make up his premedical requirements and apply to UAB, near his wife’s family. They’ve been helpful, he says, with his three-year-old daughter and new baby, who was born three weeks after the White Coat Ceremony.
The ceremony was a nice celebration, Vanlandingham says, but merely a symbol of everything to come. “The reality of things set in when I started my coursework,” he says. “Ceremonies are nice, especially when people you care about come to watch. But I think it’s the same as a wedding—it’s a nice ceremony, but it’s not a marriage. It’s just a symbol of the marriage. The reality of it comes from what you do every day.”
Freshman dental students recite the hippocratic oath at their white coat ceremony.
Michael Browning, dental student: Browning understands the challenges Vanlandingham has overcome—he briefly set aside his lifelong dream of a dentistry career to pursue an infantry career in the United States Army. But after seven years, “I realized that I could stay in the Army, which I loved, and be a dentist as well.” His education at UAB is supported by an Army scholarship.
Browning didn’t know much about the ceremony itself until he was actually walking across the stage. “I knew that it was a symbolic transition from preclinical science classes to actual clinical science classes,” he says. “But while I was at the ceremony, I realized that it was much more. It emphasized how important our education was going to be. It was an excellent introduction to the code of ethics and professional conduct that all dental professionals are expected to follow.”
The ceremony held a special significance for Browning as he began a new stage of his career. “For a few of us in our class, that ceremony marked a major transition from what we were doing before,” he says. “It was a definite—but welcome—change of gears. When I walked across the stage and the dean put the white coat over my shoulders, my excitement reached its highest point yet. And if this is how I feel now, imagine how I’m going to feel as I study and learn and graduate and go on to do what I want to do in dentistry.”
Sarah Abroms, medical student: Like Sam Strachan, Sarah Abroms has wanted to be a doctor since a young age. “I love the idea of serving people and gaining knowledge,” she says. In addition, several of her family members suffer from significant medical conditions, elevating the importance of the career she has chosen.
Abroms, who is originally from Birmingham, moved to Philadelphia for undergraduate studies at the University of Pennsylvania; she came back for medical school at UAB to be near her family and to take advantage of the school’s strong reputation. She says the PDS course underlined the responsibilities of a medical career. “In the first two weeks, we definitely got the picture of what professionalism means and what it means to go into medicine,” she says. “When we came here, we were kids—there wasn’t a lot expected of us. But orientation made clear what was expected of us.
“It excited me more than anything,” Abroms adds. “When I was in college, we had convocation, and our whole class came together to graduate. I see this ceremony as a starting point—the clean white coat goes on, and then four years from now, we’re going to be together again. Maybe the coat will be a little dirtier, but we’ll be a lot more experienced and a lot more knowledgeable.”
Examining the Benefits of Animal-Assisted Therapy
By Grant Martin
Mia enjoys a visit to the Bell Center, where she visits each week to work with children suffering from cerebral palsy.
Mia Rowe is a master motivator. Even though she’s only five years old—and her conversation is limited to barks and licks—Mia has a gift for encouragement that transcends age and language. In her presence, physically challenged toddlers forget their pain and start to run, while shy readers learn to speak out and enjoy a good book.
Mia and her sister Stella are Cavalier King Charles spaniels belonging to Jan Rowe, Dr.O.T., an associate professor of occupational therapy in the UAB School of Health Professions. Together, the three volunteer through Hand-in-Paw, a Birmingham affiliate of the Delta Society, which is the leading international resource for animal-assisted therapy and activities.
“Most people are familiar with service animals and the types of assistance that they can provide, but there are many other ways that animals assist in therapy,” Rowe says. “Animals can get through to people when other methods have failed.”
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