Digging for clues

Archaeologists unearthed a few historic artifacts atop the grassy knoll across the street from the CC's front door during a dig last year in preparation for Clinical Research Center construction. The smattering of arrowheads warranted a second reconnaissance, which concluded recently. It turned up a small cache of glass, china, and nails from the mid-1800s--nothing significant enough to alter or delay construction. The Historical Preservation Act requires that construction projects built with federal funds begin with the assessment of cultural impact. On this dig were Marty Bowen (left) and Molly Stephens.

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 Help make breathing easier at the Clinical Center. Smoking is prohitbited on the Sun Deck, within 100 feet of all entrances and posted no-smoking areas, and in the parking garage and stairwells.

Don't make us kick your butts. Dispose of them properly.

Smoking and related litter targeted

It's been official since July 1995. Smoking's not allowed inside the Clinical Center or within 100 feet of any entrance or posted no-smoking area. It's also banned in the parking garage and in stairwells.

Now, piles of discarded cigarette butts mark nearby retreats popular with smokers ducking out for a quick one and CC officials want the littering to stop.

"The 100-foot rule was necessary because of the stench and the litter that resulted from smoking just outside building doors," explained Dr. John Gallin, CC director. The building's negative pressure pulled smoke inside when smokers did not move away from building entrances.

While the odor problem may have abated as smokers have complied with the 100-foot rule, smoking-related littering has gotten worse.

Don't drop cigarette butts on the ground, officials urge. Thoroughly extinguished cigarettes belong in ash receptacles, which are located along the perimeter of the building.

Also, avoid smoking near the building's air-intake vents.

"The Clinical Center is a house of health," says Dr. Gallin. "The current smoking policy was put into place because our patients and staff deserve a smoke-free environment. They also deserve an environment that is litter-free. Patients and staff should not have to walk through trails of cigarette butts as they enter our building."

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Chaplain interns named

Chaplain interns are working throughout the Clinical Center this summer through a full-time, intensive education program offered by the CC Spiritual Ministry Department. It's designed to help students preparing for the ministry or interested in chaplaincy develop and refine the skills needed for working with patients and families in crisis. With program participants are Karen Morrow (standing left), department chaplain, and Dr. Ray Fitzgerald (seated center), department chief. In front are Greg Jones, General Theological Seminary, New York, and Jim Lucas, pastor of the Grace-Bosley United Methodist Church in Reisterstown, Md. In back are Damian Kabot, Divine Word Theologate, Chicago; Sunny Lee, Wesley Seminary, Washington, D.C.; Doug Burns, DeSales School of Theology, Washington. D.C.; Jane-Ann Lowery, a member of St. Bartholomew Parish in Bethesda; and Patrick Winslow, Catholic University. Two groups of students train here each year. index

Clin path chief accepts Louisville position

The only constant at the Clinical Center is change. That and Masur Auditorium. Take it from one who has participated in an ocean of change.

Dr. Ron Elin, who will become vice chairman of pathology and director of laboratories at the University of Louisville next month, has been chief of the Clinical Pathology Department here since 1975. Planning for a new lab, which opened in 1981 as part of the ACRF, topped the agenda during those early years.

"It was a lot fun, a thrill for all of us to plan the lab and see it built," he said.

"Originally, routine hematology was on the first floor next to a very rudimentary outpatient clinic. Chemistry and microbiology were on the fourth floor. Coagulation and my office were on the fifth. We went from a highly modular laboratory to an open lab, and we're about to begin the first major renovation in the next few months, the first in 16 years, so the design has worked well."

Built into the new lab was a phlebotomy service. "When I became chief, there wasn't one. Adding it was one of the first changes I made." Until the advent of a phlebotomy service, blood draws were done by house staff and nurses, Dr. Elin explained. "The team adds a real quality to laboratory medicine because we can depend on the specimen being obtained properly and delivered to the lab promptly."

An immunology service came a few years later. "Dr. Tom Fleisher [who will serve as acting department chief] has done a superb job over the years updating and expanding that service," Dr. Elin said.

"Now, we're about to add molecular diagnostics. Genes have been identified for a number of diseases and as laboratory medicine evolves, there's going to be more of a need to find out if patients have the defective gene for a specific disease."

Dr. Elin began his NIH career in 1970 as a staff associate in NIAID. He'd already accepted a clinical pathology residency in 1973 at his alma mater, the University of Minnesota, when he hitched a ride home from a medical meeting with the former chief of clinical pathology, Dr. James McLowry. McLowry's plans for the lab sparked Dr. Elin's interest, so he stayed here for a clinical pathology residency instead. "I was able to keep my lab in NIAID and Dr. McLowry encouraged my research interest in magnesium." He joined the Clinical Pathology Department staff the following year.

In his new position at the University of Louisville with its medical school and teaching hospital, Dr. Elin will continue to be involved in the same triad of patient care, teaching, and research that's offered here, but the balance is different. "I won't have as much time for research, but will spend more time teaching, which I've always enjoyed. What's a plus is that there is a residency program. Residents are very curious people and certainly keep you on your toes."

Dr. Elin pauses to look out his second-floor window past the bustle of the CC's front door through the trees lining West Drive, a vantage soon to be obscured by construction. "The plans for the new hospital look great, but these windows won't have the same wonderful view that I've enjoyed."

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Staff nurse Lori Guthrie and Amanda Rutz are a team, the kind of team that makes the Clinical Center a special place.

Patient and nurse form special team here

After college, Lori Guthrie came to the CC to add experience to her resume. That was nearly nine years ago-and she has no intention of leaving.

Vicky Rutz didn't want to come at all, but now she's thrilled to bring her daughter Amanda for treatment. Guthrie is a big part of why Rutz travels here twice a year from Kansas, and patients like Amanda are part of the reason Guthrie never left the Clinical Center for a "traditional nursing job."

Working as a 9th floor clinic nurse, Guthrie says she enjoys helping patients and their families make the transition to the Clinical Center. "There's an incredible amount of teaching that goes along with this job," Guthrie says, "I like that."

CC nurses are a strong link between patient care and research. "We provide direct care to patients and manage patient data as part of the research team. We have the ability to become involved with the patient and with their families during their triumphs and sadness."

Rutz, mother of a seven-year-old child with Turner syndrome, credits the CC staff for her decision three years ago to bring her daughter Amanda here for treatment.

"My doctor received a letter from NIH seeking research patients with Turner syndrome. But I didn't like the idea," she says. "I thought about it, and decided I didn't want someone doing research on my daughter."

But when she finally agreed to come and look around, she saw that the giant government research facility wasn't as scary as she thought. And, Amanda's condition, a rare chromosomal disorder of females characterized by short stature, heart defects, and various other malformations, could possibly be helped by the treatment offered.

"It was depressing to know that there was a medication available that we couldn't afford-growth hormone costs approximately $10,000 to $20,000 a year. At NIH Amanda might be given medication that would help her grow to a normal height and receive help with her other Turner syndrome symptoms. We knew there was a chance she would be given the placebo, but we decided if that's the role she would play in this, then we were all for it, but it was a hard decision to make."

And what does Amanda think about traveling from Kansas to Bethesda to visit doctors and nurses? She answers with a typical burst of energy that only a seven-year-old can display: "It's fun! I like to see Lori and wonderful stuff in Washington."

When asked why she came to the CC she crosses her legs and swings around sideways in her chair to explain what she knows so well: "Turner Syndrome is a birth defect that makes me small. They take my blood pressure and measure me ten times to get it right. Then they take blood from this arm because this arm didn't work. And I get shots and they do a bone density. That's where you lie down on a table and be real still for hours and hours and hours." (Real time: 45 minutes.)

Amanda paused from her explanation to relish a chocolate chip cookie offered by a Red Cross volunteer.

"I knew from amniocentesis that I would have a girl with Turner syndrome, but they couldn't tell me how severe. I prayed every day for God not to give me more than I could handle. I guess I can't handle very much, because she's a perfect joy."

Kids in school are giving Amanda a hard time, so Guthrie brought in a social worker to talk about ways to deal with kids who are being mean. "We have a wonderful interdisciplinary team," Guthrie says.

Rutz also feels fortunate for the CC team treating her daughter. "Any questions I have are answered. I can call anytime and know that my phone call will be answered right away. The whole structure of NIH is amazing and I get a sense of pride to be part of it." (by Laura Bradbard)

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New look for the Outpatient Cancer Center 

Outpatient Cancer Center, gives a tour of the unit's new facilities to William "Billy" Washington, nursing assistant on 12 West. The unit averages about 750 outpatient visits a month.

 The Outpatient Cancer Center (OCC) on 13 East has a new look thanks to extensive renovations. As staff and patients celebrated with a ceremony last month, patient Lanny Harrison (left) had ribbon-cutting honors. Joining him were staff nurse Cathy Parker, Dr. John Gallin, CC director, and Laura Chisholm, OCC head nurse. The new unit features two-room suites, a comfortable waiting area for patients and their families, a patient education room, and staff-friendly touches such as in-room computers for nursing notes.

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Neuroscience grads

Certificates were presented recently to members of the ninth class to complete the Neuroscience Nurse Internship Program for registered nurses. Graduates are (seated from left) Colleen Campbell, Jennifer Boyd, Virginia LeBaron, Donna Gaskins, and Jose Leandro. The neuroscience leadership team includes (standing from left) Sandra MacDonald, acting nurse manager, neuroscience program of care, Critical and Acute Care Patient Services, CC Nursing Department; Dr. Mark Hallett, NINDS clinical director; Dr. Audrey Penn, NINDS deputy director; and Beth Price, clinical nurse specialist for patient care and staff education, neuroscience program of care, Critical and Acute Care Patient Services, Nursing Department.

Student workers welcomed

More than 100 high school and college students are working with mentors in labs and offices throughout the Clinical Center this summer. They joined staffers, including Walter Jones (third from right), CC deputy director for management and operations, at Lipsett Amphitheater for an orientation session last month. With Jones are (from left) Earnest Alexander, Pharmacy Department; Laura Green, Outpatient Department; Sarasa Kimata, Transfusion Medicine Department; Ednilson Moreau, Rehabilitation Medicine; Deborah Owolabi, Nursing Department; Jennifer Kim-Ca, Spiritual Ministry Department; and Dee Antonio, Nursing Department.

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