Jerry Bell got one concussion when he was playing college football and another playing for the Tampa Bay Buccaneers.

     That was 20 years ago, but now Bell wonders if those injuries could have had long-term effects.

     That question brought him to the USF Health Byrd Alzheimer’s Institute Tuesday for the institute’s annual Memory Screening Day. About 100 people came to get free screening, a process that can show whether they should receive further testing for cognitive problems.

     Bell was among them. He sat down with Dr. Amanda Smith, medical director of the Byrd Institute, who asked him a series of questions.

     What’s the date? What city are we in? What county? What building are you in? What floor of the building are we on?

Former Tampa Bay Buccaneers tight end Jerry Bell answers questions on a memory screening quiz given by Dr. Amanda Smith, medical director of the USF Health Byrd Alzheimer's Institute.

     Bell, 50, answered the questions with ease. But he plans to return each year, to make sure his cognitive abilities show no signs of decline. Bell knows early diagnosis can slow progress of Alzheimer’s symptoms.

     “There’s no cure – but I might get to see my grandkids for five years more,” he said.

     Bell is thinking far ahead. His two children are in college, and he has no grandchildren yet.

     But his presence at Tuesday’s event had a larger purpose as well. Bell wants to bring more attention to the increased risk of Alzheimer’s for former NFL players. The potential long-term damage of head injuries to football players has been the subject of national debate recently, with a Congressional hearing held to discuss the risks and whether players are adequately safeguarded and treated.

     “The thing is, let’s find out what the risk is,” Bell said. “Nobody’s saying, ‘Stop playing football,’ because the guys won’t do it. But put some things in place to make it safer.”

     Working to design better helmets, strictly enforcing game rules to help avoid head injuries and treating head injuries with vigilance are among the steps that football coaches and physicians need to take, Bell said.
Both times Bell was concussed, nobody worried much, he said.

     “I played the rest of the game,” he said. “That’s how it was done.”

     Still, he figures he was lucky.  Now a senior account manager for a company that sells computer equipment, Bell played tight end. His linebacker teammates got hit harder and more often.

     “I had about half the amount of contact that some people did,” he said.

     On Tuesday, he fielded Dr. Smith’s questions correctly as they became more complex.

     I’m going to say three words: apple, book, cat. How do you spell “world” backwards? Please count backwards from 100, by 7s. How many words can you say that start with the letter “f?” What were the three words I said earlier?

     The range of questions is meant to test different aspects of how the brain works, Dr. Smith told Bell.

     “People tend to think of Alzheimer’s as just memory and forgetting,” she said. “But some people show up first with language problems. They can’t find words for things. They hold up a pen and call it ‘that thing you write with.’ “

Former NFL players Jerry Bell, left, and E.G. Green, right, stand outside the USF Health Byrd Alzheimer's Institute with Dr. Amanda Smith.

Getting that early screening will become even more important as medications now in development make it easier to prevent the symptoms of Alzheimer’s, said Dave Morgan, PhD, chief scientific officer of the Byrd Institute.

     “The analogy that I like is that it’s better to take your statins before you have a heart attack, rather than after,” he said.

    Bell wasn’t the only NFL player answering such questions at the Byrd Institute Tuesday. Former Colts player E.G. Green, 34, got a screening test as well. Green may seem young to take such a test, but he said it’s important to show that it’s okay for football players to take steps to protect their health.

    “We grew up in a culture where you try to mask all injuries,” he said. “You have to be able to make it. You have to ‘tough it out.’ Once the game is over, it’s hard to think you’re not Superman anymore.”

      Players, their families and their doctors and coaches need to be aware of that mindset, he said, so that former players get appropriate care.

     “You transform from a gladiator to a citizen,” he said. “You need to be able to take care of yourself after football.”

     - Story by Lisa Greene, USF Health Communications; photos by Eric Younghans, USF Health Communications

L to R: Dr. William Dalton, Dr. Richard Roetzheim, Maria Pinzon, Dr. Leslene Gordon, Dr. B. Lee Green and Dr. Ralph Wilcox.

The USF-Moffitt Center of Excellence for Cancer Health Disparities was formally introduced to the community Nov. 12 at a reception attended by community leaders, elected officials and university and Moffitt Cancer Center faculty and staff.

The center’s new name -- Center for Equal Health: Community Partnerships in Research, Education and Training – was unveiled for the audience by community directors Leslene Gordon, PhD, of the Hillsborough County Health Department and Maria Pinzon of the Hispanic Services Council.

The center will focus on reducing cancer-related disparities among Florida’s minority and underserved populations. Researchers will address such questions as why African-American men are much more likely to develop and die from prostate cancer than white men. This summer, USF and Moffitt were awarded a highly competitive $6-million, five-year program grant from the National Center on Minority Health and Health Disparities, National Institutes of Health, to establish the center --- one of three in Florida.

Desiree Rivers, PhD, center director, was emcee for the reception.

“I’ve spent my entire career documenting the toll of health disparities, so it’s very exciting that we have the chance to do something to develop effective solutions,” said Center Co-Director Richard Roetzheim, MD, MPH, professor and director of research for the USF Department of Family Medicine. “It will be challenging, but we’ve assembled a tremendous team of talented people from USF, Moffitt and the community.”

“The community must be a vital and active participant in our Center,” said Center Co-Director B. Lee Green, PhD, professor and vice president of Moffitt Diversity. “The Center is not intended to be about statistics, but about addressing the needs of real people – some of whom unfortunately suffer disproportionately from serious diseases and disabilities.”

USF Provost Ralph Wilcox, PhD, said the legal, socioeconomic, structural and other barriers that lead to inequities in care and poorer health outcomes for minority and disadvantaged populations are daunting, but not insurmountable.

“The Center is exactly the type of partnership model that allows Moffitt and USF to unleash their complementary strengths,” Wilcox said. “I remain hopeful that this collaboration will help us better understand the scope and root causes of disparities and, most importantly, generate solutions to close the gaps of these disparities.”

Florida ranks second in the United States in the number of deaths from cancer, said Moffitt CEO William Dalton, PhD, MD. He noted that USF and Moffitt had a one in 10 chance of securing the highly competitive NCMHD Center of Excellence award. “Competing with the best and brightest in the nation to win this grant speaks volumes about this community and the partnership between USF and Moffitt,” he said.

USF Provost Ralph Wilcox, PhD, with the College of Public Health's Deanna Wathington, MPH, co-leader for the center's Community Engagement Core.

- Story by Anne DeLotto Baier, USF Health Communications
- Photos by Eric Younghans, USF Health Communications

RELATED STORY:
USF-Moffitt Center of Excellence Targets disparities in cancer care and outcomes

     Cindy Schofield was scared as she approached the starting line.

     She had five kilometers to run and she wasn’t sure she could do it.

     Once, it would have been easy.

     Schofield could always count on her body to perform. She grew up in Lakeland playing soccer. She could run fast, kick strong.

     Her athletic ability won her a scholarship and made her a soccer star at Florida State University. It helped her set college scoring records that remain unbroken. It guided her decision to move to Tampa to coach soccer for Tampa Preparatory School and competitive youth soccer teams.

     But all that was before.

     Now, 28-year-old Schofield was scared.

                                                                     ***

          It began on a Sunday afternoon in January 2008. Schofield had been at the soccer fields all weekend, coaching and leading personal training sessions. She started to feel dizzy and confused. 

     “My head was out to here,” she said. “I felt like I had been hit by a bus.”

     She called her mom in Lakeland, who told her she would drive over and take her to a doctor.

     But Schofield decided the pain was too bad. Her head felt like it was going to explode. She drove herself to a walk-in clinic, went in, waited, saw the doctor.

Cindy Schofield didn't know whether she would ever walk again after a sudden illness nearly killed her.

     Her mom met her in the parking lot and asked her what the doctor had said.

     “I don’t remember,” Schofield told her.

     Her mom drove her to a local hospital. Her father and her brother soon joined her. Doctors took her to get an MRI. Later, she wouldn’t remember any of that, either.

     Nor would she remember the MRI results. A doctor came out and delivered the news to her parents.

     “She has a cancerous brain tumor,” he told them. “She’ll be dead in two years.”

                                                                 ***

     Her parents, devastated, began making phone calls. They were determined to get their daughter the best treatment possible. They took her to H. Lee Moffitt Cancer Center & Research Institute.

     There, Schofield underwent surgery. Doctors were prepared to do a biopsy and to remove whatever part of the tumor they could.

     They didn’t find what they expected.

     This part, Schofield does remember: she was with her father when his cell phone rang with the biopsy results.

     He started to cry. It wasn’t cancer.

     Amidst his tears of relief, her father didn’t realize it was something just as deadly.

                                                           ***

     Schofield kept getting worse. Her vision kept blurring. The pain in her head was horrible. She could no longer move the left side of her body. She couldn’t even walk.

     Moffitt doctors believed her problem was related to multiple sclerosis. They suggested that Schofield see Dr. Stanley Krolczyk, USF assistant professor of neurology and director of the USF Multiple Sclerosis Center. Schofield was impressed when he came in to see her on his day off.

     But Dr. Krolczyk wasn’t happy with what he saw. On a disability scale of 1 to 10, Schofield scored an 8.5 – and 10 was dead.

     “She was going downhill very rapidly,” he said. “There was active inflammation in her whole brain, white blood cells attacking the brain, denuding the neurons of myelin and destroying the brain tissue.”

     Myelin is the protective sheath that covers nerve fibers, like insulation around a wire. When the body’s immune system attacks myelin, it can strip nerves bare, creating scar tissue and leaving neurons unable to communicate.

     Schofield had been attacked by an extremely rare form of multiple sclerosis, called tumefactive MS. While the severity and course of MS is different for every patient, most of them become more disabled gradually, sometimes following a pattern of remission and relapse. In contrast, tumefactive MS can hit somebody like a thunderbolt out of a blue sky.

     “There’s no way to predict which individuals develop this,” Dr. Krolczyk said. “It looks like an aggressive brain tumor on an MRI.”

     Nor is the prognosis any better. Most patients die within a few months.

Dr. Stanley Krolczyk, USF assistant professor of neurology and director of the USF Multiple Sclerosis Center, said the inflammation in Schofield's brain was so bad it could be mistaken on an MRI for a brain tumor.

      Schofield’s situation seemed bleak. About 460,000 people in the U.S. now have MS. But Dr. Krolczyk has found only a few dozen published cases that seem as severe as hers.

     With such a rare condition, there were no guidelines – no protocol to guide Dr. Krolczyk on the best way to save Schofield. He had to design his own treatment.

     Schofield’s best chance, Dr. Krolczyk decided, was aggressive action to try to reduce the swelling and inflammation in her brain before it created any more damage. He decided on a combination of three drugs to attack the inflammation in every way possible.

     Schofield received steroids to reduce the inflammation in her brain. Plasma exchange to remove antibodies and inflammatory mediators from her blood. And a special chemotherapy drug to suppress the T-cells that could attack her brain again.

     Schofield was hospitalized for weeks, but she would remember little of her time there. Only one decision stayed with her: sometime in her hospital bed, unable to walk, she vowed this would not be her future.

Schofield wound up in the hospital, unable to move the left side of her body.

      She would recover, she promised herself. She would walk again. And then she would run. Still in the hospital, she decided she would run a 5K.

                                                                  ***

     It was that vow to herself that Schofield thought of as she approached the starting line of her 5K – the Susan G. Komen Race for the Cure, held in St. Petersburg in October.

     She was still scared. Her balance wasn’t good. What if she stumbled? A stubbed toe might send her sprawling.

     But she stepped over the starting line and began to run.

                                                                 ***

     When she left the hospital, Schofield came home to a different world. Her parents left Lakeland and moved in with her. They rented a hospital bed for the living room. The once strong athlete was in a wheelchair. Not only could she not walk, she couldn’t even lift her left arm.

     Her life seemed to have turned into a shuttle between doctor’s visits and physical therapy sessions. At first, there were days when Schofield didn’t even want to get out of bed.

     And then she would tell herself: No. She was not going back to the hospital. She forced herself to do more.

     Her parents and Dr. Krolczyk encouraged her as well. He and Lise Casady, a USF nurse practitioner who works with Dr. Krolczyk, were in constant contact.

     “They pushed me when I needed to be pushed,” Schofield said.

     She set small goals. She had to work just to gain enough hand strength to squish a stress ball. To be able to lift her arm long enough to put her hair in a ponytail.

Schofield was determined to run again.

     She still felt mentally fuzzy as well. She had to work to remember daily routines, dates and even the trauma that had struck her life. She joked about the movie “50 First Dates,” in which Drew Barrymore suffers a brain injury and can’t remember anything for longer than a day. She tried to write things down to help her memory.

     Schofield had been through hard times before. In her sophomore year of college, her fiancé was killed in a skydiving accident. Shattered, Schofield nearly left FSU. It was her close ties to the members of her soccer team that pulled her through.

     “That was my family,” she said. “I don’t know what I would have done without them.”

     Now, she was relying on athletics to help her again.

                                                                ***

     As she ran, her mind began to slip backwards. Everything started to replay through her mind. Her brush with death, her fall into disability, and all she had been through just trying to walk.

     She struggled not to cry. She didn’t even think about the ground that she was covering, or the speed she was traveling. She just relived the struggle, stride after stride.

                                                               ***

      Schofield moved from a wheelchair to a walker, then to a heavy cane. Next to a lighter one.

      She gradually began reclaiming her life. She returned to her passion, coaching soccer, limping along the sidelines with her cane.

      One tournament weekend, she got tired of the cane. It was in the way. She decided on the spot that she could balance without it. So she put it down.

      The next day, she walked into her physical therapist’s office on her own.

      “I told her I graduated,” Schofield laughed.

      Still, Schofield wasn’t sure she could balance well enough to run. In the spring, she began to run on a treadmill – slowly, about 4.5 mph – so that she could hold on to the arm rails.

     Gradually she increased her speed and distance. Dr. Krolczyk was impressed with her determination.

     “She’s a very hard worker,” he said. “It’s great to have patients like that.”

     Schofield was learning as well about taking care of herself, being careful not to get overheated and giving herself more time to rest after exercise or long spells of coaching in the Florida heat. She also remained on a medicine to modify her immune system.

     Although MS patients are known for going through periods of relapse, Schofield and Dr. Krolczyk are cautiously optimistic.

     “So far she only appears to get better,” Dr. Krolczyk said. “We hope this was one unbelieveably bad case that will not recur.”

     Despite her progress, Schofield was still scared to run outside. Her balance remained a little shaky; she couldn’t balance while standing only on her left foot. She was still afraid of falling.

     Four days before the race, she went to the Upper Tampa Bay Trail with something to prove. She turned right, where the trees shade the path and the trail runs true north, and began to run.

                                                                     ***

      Step by step, the distance fell away. Thirty-two minutes after she began to run, Cindy Schofield, a woman left battered by multiple sclerosis, crossed the finish line.

Schofield runs along a sunny section of the Upper Tampa Bay Trail.

     Her mother cheered as she saw her daughter cross the line and then she began to spread the news. She got out the cell phone, calling everyone: Cindy did it. She finished. She really did it.

      But Schofield saw the clock coming over the finish line.

     “That’s it?” she asked herself.

     She had been so scared. She hadn’t run for speed – just to finish. Now, she thought, she could have run faster if she had pushed harder.

     She felt a rush of her old competitive spirit. In November, she decided, she would do another 5K. Then a half-marathon, maybe in the spring. And this time, she’d run faster.

     Then she knew.

     She was back.

Runner 3443, Cindy Schofield

                                                                ***

-- Story by Lisa Greene, USF Health Communications; Trail photos by Eric Younghans, USF Health Communications; Other photos courtesy of Cindy Schofield

The uncommon, high-risk delivery involved more than 20 physicians and other health practitioners

Read St. Petersburg Times story...

Tampa, FL (Nov. 12, 2009) -- A multidisciplinary team of USF Health and Tampa General Hospital physicians recently performed the first Ex Utero Intrapartum Treatment (EXIT) at TGH -- successfully securing an airway for a baby girl with a large benign tumor wrapped around her neck before fully delivering the 7 pound, 11 ounce infant by Cesarean section.

EXIT is an innovative procedure developed to deliver infants with severe congenital abnormalities that may make breathing after delivery difficult or impossible. During EXIT, the newborn is partially delivered in a manner similar to a C-section, but the umbilical cord supplying oxygen from mother to baby is not immediately cut. Instead, the baby is intubated -- a breathing tube is inserted through the mouth or nose into the windpipe – and delivery of the infant is completed and cord cut only after a clear airway has been established.

“The biggest challenge in this type of procedure is establishing an airway for the fetus while maintaining a steady supply of oxygen so that no neurological damage occurs,” said Valerie Whiteman, MD, lead USF obstetrician for the EXIT delivery on Oct. 1. “If you can’t successfully intubate on the first attempt, surgical intervention is required and that potentially increases the risk for both the fetus and mother.”

Dr. Valerie Whiteman, interim director of Maternal-Fetal Medicine at USF Health, led the EXIT delivery.

This challenging, uncommon procedure (only about 100 cases have been documented in the United States) required extensive, seamless coordination by the USF-TGH team of 20-plus physicians, nurses and other health professionals assembled inside and just outside the operating room.

The following were the key physicians on the EXIT delivery team:

• Maternal-Fetal Medicine -- Dr. Valerie Whiteman, USF assistant professor of obstetrics and gynecology and interim director of Maternal-Fetal Medicine, assisted by Dr. Aaron Deutsch, senior maternal fetal medicine fellow

• Anesthesia – Dr. Devanand Mangar, anesthesiologist with Gulf-to-Bay Anesthesiology and chief of staff at Tampa General Hospital, and Dr. Amrat Anand, Gulf-to-Bay anesthesiologist

• Neonatalogy - Dr. Terri Ashmeade and Dr. Laura Haubner, both USF assistant professors of pediatrics, and Dr. Lewis Rubin, professor and chief of neonatology at USF

• Pediatric Surgery - Dr. Charles Paidas, director of USF Division of Pediatric Surgery

Patty Bornick, RN, MSN, perinatal navigator for the USF Health Fetal Care Center of Tampa Bay, coordinated care for the high-risk obstetric patient, a 31-year-old woman who lives in Tampa with her husband and two other children.

Anesthesiologists delivered anesthesia to the mother and a medication to prevent contractions during intubation. Obstetricians performed the high-risk surgical delivery using a special autosuturing device to minimize maternal bleeding. Neonatologists intubated once the infant’s head and shoulders were delivered and assessed the baby after birth. The pediatric surgeon was on standby in case intubation proved difficult, so that some of the tumor could be cut away or a hole could be made in the windpipe. The infant’s heart rate was continually monitored by ultrasound for any signs of oxygen loss.

The USF-TGH team established protocols and contingency plans for the surgery and practiced with two dry runs in the operating room in August and September. During the actual EXIT procedure, intubation was successful on the first attempt.

“We were all familiar with our roles, our equipment and what steps needed to be taken when. We prepared for the best and worst case scenarios. It took teamwork, teamwork and more teamwork,” Dr. Whiteman said. “This EXIT procedure required tremendous collaboration, and the successful outcome speaks well of the partnership between TGH and USF and our extensive resources.”

“Preparing for the procedure with Dr. Laura Haubner, director of the Department of Pediatrics Center for Team Education and Multidisciplinary Simulation was vital,” said Dr. Ashmeade, the neonatologist who placed the breathing tube. “She is an expert in critical resource management and patient safety. I knew that she was aware of the entire situation in the operating room, which allowed me to concentrate solely on securing the baby’s airway.”

USF pediatric surgeon Dr. Charles Paidas has already performed one surgery to begin removing the benign tumor wrapped around the baby's neck.

The baby was discharged home from Tampa General’s neonatal intensive care unit on Oct. 12. The benign tumor, a cystic hygroma, will be resected in two stages because it is attached from the base of her skull to her tongue, and surrounds her heart, windpipe and great vessels. She underwent a first operation Oct. 30 to remove the neck portion of the hygroma. In two to three months, a second operation will remove the remainder of the tumor in her right chest.

“This was not simply a team, but a team that practiced all aspects of the planned procedure and practice makes perfect,” Dr. Paidas said.

- USF Health –
USF Health is dedicated to creating a model of health care based on understanding the full spectrum of health. It includes the University of South Florida’s colleges of medicine, nursing, and public health; the schools of biomedical sciences as well as physical therapy & rehabilitation sciences; and the USF Physicians Group. With more than $380.3 million in research grants and contracts last year, USF is one of the nation’s top 63 public research universities and one of 39 community-engaged, four-year public universities designated by the Carnegie Foundation for the Advancement of Teaching. For more information, visit www.health.usf.edu

- Tampa General Hospital -
Tampa General is a 988-bed acute care hospital on the west coast of Florida that serves as the region’s only center for level I trauma care, comprehensive burn care and adult solid organ transplants. It is the primary teaching hospital for the University of South Florida College of Medicine. TGH is also one of only 16 comprehensive stroke centers in Florida and is a state-certified spinal cord and head injury rehabilitation center.

- News release by Anne DeLotto Baier, USF Health Communications

Dr. Alexander Rosemurgy was recognized for his dedication to pancreatic cancer research and patient advocacy.

USF -TGH surgeon Alexander Rosemurgy, MD, was recently honored for his leading expertise and research contributions in the field of pancreatic cancer by the patient-based advocacy organization Pancreatic Cancer Action Network of Tampa Bay.

Dr. Rosemurgy was recognized for his years of dedication to helping patients and families understand and fight the devastating disease Nov. 5 at the local PCAN’s 3rd Annual Auction for Action at the Columbia Restaurant in Ybor City.

Dr. Rosemurgy, professor of surgery and medicine and surgical director of the Digestive Disorders Center at Tampa General Hospital, holds the Vivian Clark Reeves/Joy McCann Culverhouse Endowed Chair for Digestive Diseases and Pancreatic Cancer at USF.

He is world renowned for his expertise in resecting pancreatic cancers and has extended the lives of many patients through surgery. Dr. Rosemurgy and colleagues at USF-TGH continue to conduct innovative research in the field of pancreatic research and have published numerous high-impact papers about how to best operate on patients with pancreatic cancer.

Pancreatic cancer is among the top four cancer killers in the United States. Most of the more than 30,000 Americans diagnosed with pancreatic cancer die of it because the symptoms are often so subtle that the disease is far advanced before it is diagnosed.

The Pancreatic Cancer Action Network is a nationwide network of people dedicated to working together to advance research, support patients and create hope for those affected by pancreatic cancer. The organization raises money for direct private funding of research -- and advocates for more aggressive federal research funding of medical breakthroughs in prevention, diagnosis and treatment of pancreatic cancer.

- Photo by Ellen Fiss, Tampa General Hospital

Students at Essrig Elementary School in Tampa now have a covered play court that will provide year-round protection from the sun’s harmful rays, thanks in part to USF Health’s Neil Fenske, MD.

Dr. Fenske helped secure the seed money from the American Academy of Dermatology for the fundraising effort to build the school’s Proud Panther Pavilion, which provides students and staff with year-round shade protection and reduced sun exposure while participating in activities on the school’s existing outdoor courts.

Dr. Neil Fenske stands under the Proud Panther Pavilion with Jamie Dietrich, parent of an Essrig Elementary student.

A ribbon-cutting ceremony officially opening the pavilion was held Oct. 30 at Essrig Elementary to thank all of the supporters and donors who made the pavilion possible. Dr. Fenske presented information to the students about the importance of sun protection and acknowledged the AAD grant award and the school’s efforts to protect the students.

In addition to the AAD grant, provided in June 2008 and called the 2008 Shade Structure Program Grant, funding for the pavilion came from events and activities supported by the school, the students and their families, the PTA, and the School Advisory Council. Additional grants and donations came from St. Lucy’s Vision, SAMS Club Giving Program, Dr. Nalin Patel, and Library Interior Signage. The Hillsborough County Public School System provided matching funds, as well.

Story by Sarah A. Worth, USF Health Communications

The plane began its descent suddenly, dropping thousands of feet and turning in a corkscrew pattern so tight that some passengers were sick.

The move was deliberate – a way for the military C-17 to evade ground fire as it landed in Bagram, Afghanistan.

It was just one more sign of the dangers that soldiers face every day – signs that USF's Nicole Johnson saw firsthand a few weeks ago, as she went to visit the troops with a group of five other former Miss Americas.

"It changed my life," said Johnson, Miss America 1999 and director of education, communication, and outreach for the USF Diabetes Center. "You see their struggle and what they're giving up. They're 20 years old, and they're dying for us."

USF's Nicole Johnson, Miss America 1999, surrounded by soldiers in Afghanistan with a banner of well-wished from USF Health faculty, staff and students.

The group made the trip to boost morale among the soldiers and thank them for the work they do. Unlike traditional USO shows, the Miss Americas didn't perform for crowds. Instead, their work was more personal. They listened to soldiers' stories of home and families far away. They joked about the irony of beauty queens in flak jackets. And they cried with soldiers as they talked of comrades who had died.

"We'd just hug them, and say, 'We love you, and we are here because we want you to know that,' " Johnson said. "It became that intense and emotional."

The group spent the most time with soldiers who had been under heavy fire, often witnessing the deaths of their battle buddies. With little prompting, soldiers would pour out stories of loss and talk to the women about trying to cope with grief while standing guard in a lonely land.

"We would get back on the helicopters every night, and we'd just cry for about 30 minutes," Johnson said. "It just still hurts, thinking about it – a kid that's 20 or 21, they don't deserve to have their lives cut short. And I don't know how they deal with all the psychological turmoil."

Nicole Johnson, front left, and five other Miss Americas visit with soldiers in Afghanistan.

The trip was physically demanding as well. In an effort to reach as many soldiers as possible, the women were up at 3 a.m. each day, often not returning to their temporary home – a wooden hut – until at least 10 pm. Reminders of danger were constant. They wore helmets and flak jackets, and a bomb shelter loomed just a few dozen feet from the hut. One helicopter crashed the day after Johnson rode in it. A village was bombed the day after the women visited.

But there were lighter moments too.

"I think we shocked the soldiers," Johnson laughed.

Soldiers' jaws would drop as they saw a platoon of beauty queens hit the ground and begin competing against each other to see who could do the most push-ups. The women invented a comic "Miss America formation," starting by standing at attention and segueing into a series of hokey model poses.

The oldest in the group, Miss America 1948, Bebe Shopp, 80, told all the soldiers the same thing:

"You may not know my name – but your grandfathers did."

The group flew first into Ali Al Salem Air Base in Kuwait, and spent nearly two days there. While the soldiers there are physically safer at that base, known as "The Rock," than those on the front lines, Johnson said, it's still difficult.

"It's very safe, but desolate," she said. "It was dirt, dust and more dirt. It was very depressing. There was nothing there to do."

Visitors usually arrive there on their way to Iraq or Afghanistan, so soldiers based in Kuwait rarely interact with them. When Johnson and her companions did, they saw a universal response when they were introduced.

"It was a lot of joy," she said. "Their faces would light up, and then their eyes would get big."

Then she laughed.

"The sobering fact was, I was easily older, at 35, than almost everybody there."

Ericka Dunlap, Miss America 2004, and USF's Nicole Johnson, Miss America 1999, as their Blackhawk helicopter takes off.

As a public health doctoral student, Johnson was pleased to see health messages about hand-washing, flu prevention and dehydration everywhere she went. Soldiers couldn't enter the cafeteria without washing their hands first.

"They really do so much better than we do at motivating people to practice good health and providing access to the right tools," she said.

There were scarier signs too: one warned to be on the lookout for cobras.

In the midst of the bomb shelters and the unfamiliar terrain, reminders of home stood out. There was a Subway and a Pizza Hut. Soldiers had painted concrete construction barriers in bright colors to honor other military units and to memorialize Sept. 11.

When the women visited Bagram Hospital, where Johnson saw a boy injured by a bomb and scrubbed in to witness a surgery to help an Afghan man wounded by insurgents, Johnson took photos of the hospital beds. Each one was ready to receive injured soldiers, covered with a quilt sewn by American hands and marked by at least one letter written by anonymous American well-wishers.

Making the journey wasn't an easy decision for Johnson. It meant a long separation from her 3-year-old daughter, Ava, and, since Johnson has type 1 diabetes, the possibility of health complications in a place with limited care.

Johnson was able to use Skype a few times during the trip to contact her family, but she wound up in a base hospital on the last night of her stay when her insulin pump backed up, sending her blood sugar level to a dangerous high. Because soldiers diagnosed with diabetes usually leave the Army, the base hospital did not have any insulin. Johnson had brought her own store of insulin, and was able to use the hospital's syringes for an injection.

Still, even Johnson's diabetes provided opportunities. She posed for a photo with one soldier holding her insulin pump high in the air. The soldier wanted to show his wife, who has diabetes, that even Miss America uses an insulin pump. Johnson also brought two banners from USF Health, signed by USF faculty, staff and students with messages of support for the soldiers. One banner is now displayed in Bagram Hospital; the other is in the terminal at Bargram Air Field.

Nicole Johnson also brought this USF Health banner to Afghanistan.

Johnson also brought five banners signed by children at her daughter's school. They are now displayed at the various Afghanistan bases the women visited, including some in base churches.

Despite the hardships of the trip, Johnson has already volunteered to return.

"War doesn't seem real to us here. I'm thankful to understand a little more about that reality," she said. "We get so wrapped up our world and our lives, and we're all spoiled. We all owe it to do more for the people who are sacrificing their lives – to do more to support them."

-- Story by Lisa Greene, USF Health Communications; Photos by Nicole Johnson, USF Diabetes Center

Dr. Stephen Klasko, CEO for USF Health and dean of the College of Medicine, makes a point while speaking with Jessy Divo de Romero, President (Rectora) of the University of Carabobo, and USF President Judy Genshaft.

The University’s global health initiative got a boost last month when USF President Judy Genshaft met with representatives from three Latin American universities -- the University of Carabobo in Venezuela, the University of Panama College of Medicine, and the Universidad Latina College of Health Sciences -- to sign agreements for collaboration.

During their two-day visit here, Sept. 21-22, top officials of the University of Panama and Universidad Latina also held extensive discussions with USF Health leadership on ways the College of Medicine can partner with their medical schools on education and research.
The guests met with Hispanic medical students and faculty. They toured the Morsani and South Tampa Centers for Advanced Healthcare, several USF Health-directed programs at Tampa General Hospital, USF Health’s new da Vinci Center for Computer Assisted Surgery, the Shimberg Health Sciences Library and the Center for Human Morpho-Informatics.

Stephen Klasko, MD, MBA, CEO for USF Health and dean of the College of Medicine, presented some recent achievements of USF Health and its medical college, including PaperFree Tampa Bay, simulation training, iTunes Health and others.

Leaders of USF Health and the Panama schools discussed institutional and regional needs in medical sciences. John Sinnott, MD, vice dean of International Affairs and director of Infectious Diseases, and Lynette Menezes, PhD, director of International Affairs for the College of Medicine, have facilitated faculty and student exchanges and capacity building to enhance HIV clinical research and infectious diseases education in Panama.

Discussions with Deborah Sutherland, PhD, USF Health associate vice-president for Continuing Professional Development, focused on ways to advance continuing medical education, technological training and leadership. With the support of IT technology, the discussions are continuing long distance to develop Memoranda of Understanding for approval.

“With these efforts the USF College of Medicine and USF Health are moving forward to achieve the global mission of USF,” said Carlos Callegari, MD, PhD, professor of public health and pediatrics and senior advisor for the Ibero-Americas Programs at USF Health, “We’re incorporating our distinguished friends from Panama and Venezuela into a long-lasting partnership committed to improving world health.”

After hours of hard work, the Latin American visitors joined their USF colleagues and members of the Hillsborough County Medical Association for a night of music and medicine at the Dean’s Lecture Series. They were entertained at the Tampa Bay Performing Arts Center by psychiatrist-pianist Dr. Richard Kogan, who played pieces by composer George Gershwin and spoke about the power of music to heal.

L to R: Dr. Stephen Klasko, CEO for USF Health and dean of the College of Medicine; Dr. Ann DeBaldo, associate vice president, International Programs, USF Health; Jessy Divo de Romero, President (Rectora) of the University of Carabobo; USF President Judy Genshaft; Veronica Arce, secretary of Board of Directors, University of Latina; Dr. John Sinnott, director of Infectious Disease and International Medicine at USF; Dr. Julio Rodriguez, dean of the University of Panama College of Medicine; Dr. John Curran, USF Health associate vice president for academic and faculty affairs; and Maria Crummett, dean of International Affairs at USF.

Jessy Divo de Romero, President of the University of Carabobo, Venezuela, and USF President Judy Genshaft sign the collaborative agreement.

Top officials from medical schools at the University of Panama College of Medicine and the Universidad Latina College of Health Sciences met with USF Health leadership to discuss opportunities for educational and research collaboation.

Dr. Donald Hilbelink, director of the Center for Human Morpho-Informatics, which combines the resources of medical and engineering faculty, shows the visitors a 3-D computer reconstruction of human anatomy.

Dr. Carlos Callegari (right), senior advisor for Ibero-Americas Programs at USF Health, shows one of the guests the same reconstructed human anatomy on a personal hand-held device.

Dr. Julio Rodriguez, dean of the University of Panama College of Medicine, tries out the high-fidelity endovascular simulator at the USF Health Simulation Center at Tampa General Hospital.

Veronica Arce, secretary of the Board of Directors of Universidad Latina, checks out a device held by Dr. Lennox Hoyte, medical director of the USF Health daVinci Center for Computer Assisted Surgery.

L to R: Jessy Divo de Romero, President of the University of Carabobo; Dr. John Curran, associate vp for USF Health academic and faculty affairs; and Veronica Arce, secretary of Board of Directors, Universidad Latina.

- Photos by Eric Younghans, USF Health Communications, and Dr. Carlos Callegari, Ibero-Americas Programs at USF Health

Listen to psychiatrist-musician Dr. Richard Kogan play Gershwin

Faculty, staff and students nearly filled the USF Health Auditorium Sept. 22 to hear award-winning concert pianist Richard Kogan, MD, play for the Department of Psychiatry Grand Rounds. As a psychiatrist and a musician, Dr. Kogan provided key insights into how vital music is to medicine.

“Music is a highly underutilized modality,” Dr. Kogan said. “When science documents exactly what music does for healing, there will be an explosion in its use for treating people.”

From left, Dr. Lois Nixon, Dr. Francisco Fernandez, Dr. Richard Kogan, and first-year medical student Trey Penton.

In the Grand Rounds, Dr. Kogan focused on George Gershwin, noting that the world-renowned composer’s story is probably the most profound example of the healing power of music. Dr. Kogan said the young Gershwin would probably be diagnosed today with Attention Deficit Hyperactive Disorder (ADHD) and that his lack of focus and bad behavior as a child came to an abrupt halt when he first heard a violinist at a school assembly.

“Gershwin was transfixed by the music,” Dr. Kogan said, adding that Gershwin had come from a poor home and that hearing the violinist was probably his first real exposure to music. After that moment, Gershwin’s bad behavior stopped and he pored over learning music, even dropping out of school at the age of 15 to devote himself to it. Gershwin noted himself that “studying piano turned a bad boy into a good boy.”

Dr. Kogan displayed his own musical talent by playing Gershwin’s Rhapsody in Blue (which Gershwin wrote in three weeks) and then Summertime (from the score Gershwin wrote for the play Porgy and Bess).

Although Gershwin’s ADHD may have been eased after finding music, Dr. Kogan said that Gershwin continued with mental illness, entering a boastful period in his 20’s that might have been signs of narcissism, and then serious depression at age 35, with sleeping troubles and crying spells. Interestingly, Dr. Kogan said, it was during these down times that Gershwin wrote mostly peppy love songs, and that writing the bluesy, melancholy tone for Porgy and Bess may have helped him deal with some of his depression.

Signs of the brain tumor that eventually killed Gershwin came next, with dizzy spells, pounding headaches, and the sense that he smelled burning garbage or rubber before blacking out. George Gershwin died July 9, 1937, following surgery trying to remove the tumor.

Dr. Kogan studied piano at the Juilliard School and medicine at Harvard Medical School. He is known for his lecture/recitals that explore music’s role in healing and the influence mental illness has had on the creative output of classical composers. The evening following USF’s Grand Rounds, Dr. Kogan performed for the Second Annual Hillsborough County Medical Association/USF Health Dean’s Lecture, an annual collaborative lecture also supported by Tampa General Hospital.

Story by Sarah A. Worth, USF Health Communications
Photos by Eric Younghans, USF Health Communications

Physicians in the Dominican Republic gained expert knowledge on starting and running epilepsy programs when USF’s Selim Benbadis, MD, and Fernando Vale, MD, visited them last month.

The trip was part of the travel award the USF/Tampa General Hospital Comprehensive Epilepsy Program earned last year from the International League Against Epilepsy (ILAE) to partner with and develop comprehensive epilepsy programs in Latin American.  The USF/TGH program was one of four centers selected nationally for the ILAE award.

Drs. Fernando Vale and Selim Benbadis (center) with a DR health team.

Dr. Benbadis, professor of neurology, directs the USF/TGH program and Dr. Vale, associate professor of neurosurgery, is the surgical director for the program.

While in the Dominican Republic, the two USF physicians visited Hospital Padre Billini, the Hospital Robert Reid Cabral for Children, and the General Hospital Plaza de la Salud, and met with administrators to plan future collaboration opportunities. Drs. Benbadis and Vale also gave medical lectures to hospital physicians, residents and students at the Hospital Padre Billini and attended the annual meeting of the Sociedad Dominicana de Neurologia y Neurocirugia (SDNN). Both lectured at the SDNN meeting, with Dr. Benbadis presenting “What Every Neurologist Should Know About Epilepsy” and Dr. Vale presenting “Temporal Lobe Surgery.”

Drs. Benbadis (center) and Vale (right) presented medical lectures while in DR.

“We met many neurologists, child neurologists, and neurosurgeons who were very enthusiastic about our mission to help develop epilepsy centers in their country,” Dr. Benbadis said.

“We believe we have formed new relationships and solidified existing ones, and we have no doubts that our collaboration will flourish and develop. From Dr. Vale’s and my point of view, we feel that this endeavor adds a new challenge and a new dimension to our successful epilepsy program. We believe that our Dominican colleagues truly have the capability and motivation to successfully develop centers. This could be a bridge to, and a model for, other Latin American countries.”

The ILAE is a worldwide association of physicians and health professionals dedicated to improving the lives of people with epilepsy through education, research and improved access to treatments.  The USF/TGH Epilepsy Program meets and exceeds the guidelines for a fourth (highest) level medical and surgical epilepsy center, based on guidelines established by the National Association of Epilepsy Centers. It is one of only four centers in Florida, and the only one in West Central Florida, with this level of expertise.

Story by Sarah A. Worth, USF Health Communications.