TRIUMPHS m RESTORING THE body RENEWING THE Spirit N E W Y O R K - P R E S B Y T E R A N HOSPITAL I 1999-2000 Report CONTENTS Triumphs in Medicine 1 Cancer: Creating a Sphere ofCare 2 Heart Disease: Beating the Odds 6 Neuroscience: Making the Connections 10 Pediatrics: Beginning with the Best 14 Mental Health: Achieving New Perspectives 18 The Allen Pavilion: Reaching Out 21 Leadership Report 22 Development Report 24 Hospital Highlights 26 Facts and Financials 29 Important Telephone Numbers INSIDE BACK COVER Meeting medicalchallenges onepatientata time: Front Cover (left to right) : Gerald Allen, Deanna Kadan, Kcmy Dion Blanco and Peter Pivko Back ( over (left to right): Justine Kttppler, Gary Martin, Barbara Tindale, and LuisValdez and Yuderka Beltre with newbornAdrean , Healing and humanity. These are thefunda- mentals ofthe health professions. Tljese are the principles thatguide our every action whether ... in surgery at the bedside in the emergency , , room infamily waiting rooms and even in the , , hallways. At NewTork-Presbyterian Hospital these are the principles wefollow to restore the body and renew the spirit. S /7 mf<Mo / „ „ /? // Cancer: ^4 diagnosis ofcancer starts a complicated web of decision-making and a cascade ofemotional reac- tions that can leave a patient reeling. At NewYork- Presbyterian Hospital agifted team ofoncology , specialists addresses not only the medical urgency ofa cancer diagnosis, but thepsychological urgency as well. And it means all the difference in the world to thepatients who come herefor care. Dr. John Daly, Surgeon-in-Chief NewTork Weill Deanna Kadan speaks for the nearly 185,000 women who will be diag- Cornell, and Dr. Karen Antman, Directorofthe HerbertIrvingComprehensive CancerCenterof nosed with breast cancer in the United States this year. Gerald Allen Columbia Presbyterian, launchthe new Columbia speaks for the same number ofmen who will learn they have prostate WeillCornellCancerCenters. cancer. At NewYork-Presbyterian Hospital, Ms. Kadan and Mr. Allen found the expertise that would save their lives, the resources that would help them recover, and the understanding that would guide them through it all. A Strategic Approach to Breast Cancer When Deanna Kadan was diagnosed with advanced disease by her physicians in upstate New York, she chose Columbia Presbyterian for care. Her physician, Amy Tiersten, M.D., went after die disease with a vengeance and with success. “It’s been a year and a half and here I am,” says Ms. Kadan. Linda Vahdat, M.D., and Dr. Tiersten, medical oncologists with the Herbert Irving Comprehensive Cancer Center, ensure their patients get not only the best chance at survival, but at quality oflife as — well. At their fingertips are the newest therapeutic agents available many ofwhich they have studied as principal investigators for the nation’s most pivotal clinical trials for breast cancer. “The development oftargeted therapies, new drugs, and new combination therapies have 2 really expanded our options for patients,” notes Dr. Tiersten. “We now Cancer have less toxic drugs to treat advanced breast cancer, where quality of football player with the Washington Redskins, Gerald Allen was in and in the prime ot his life professionally and personally when he was diagnosed with prostate cancer. Cancer life is ofparamountimportance.” During his 22 years as a specialist in surgical oncology, John M. Daly, M.D., Surgeon-in-Chief, NewYork Weill Cornell, has seen — tremendous changes in the surgical options available many pio- neered at NewYork-Presbyterian. Breast surgeons here were the first in New York City to perform skin-sparing mastectomy, helping to improve the aesthetic success ofreconstructive surgery. The Hospital was one ofa handful in the metropolitan area to initiate sentinel node biopsy, which limits the number oflymph nodes that need to be removed to determine ifa tumor has spread. And its surgeons are among the few worldwide who perform a bone marrow examination at the time ofsurgery to rule out micro-metastatic disease. AdvancedbreastcancerbroughtDeanna Kadan to Columbia Presbyterianforcare. “When a woman learns ofa breast lump or abnormal mammo- gram, it is a terrifying experience,” says Alexander Swistel, M.D., Dr. AlexanderSwistelremovesa tumorwhile mini- Director ofthe NewYork Weill Cornell Breast Center. “By knowing mizingdisruption tosurroundingbreasttissue. these fears, our staffrespond accordingly when someone calls for an appointment. This call initiates a chain ofevents that can affect the rest ofher life. That is why it is critical that the multiple aspects ofcare — from confirming a diagnosis, to surgical intervention, to follow-up — treatments be meticulously orchestrated and carefully explained.” The breast cancer programs ofColumbia Presbyterian and — NewYork Weill Cornell now linked under the Columbia Weill — Cornell Cancer Centers do just that. Here women find comprehen- sive services and a multidisciplinary team ofgreat consequence 4 inclusive ofradiologists and pathologists trained to interpret findings Cancer that arc rare or routine, breast surgeons who have a depth ofexperi- ence performing both simple and complex procedures, radiation and medical oncologists who advise on and offer the most advanced thera- pies, nurses who talk with patients about any aspect ofcare, social workers who offer support and access to resources, and genetic coun- selors who are concerned with questions ofrisk. Through the collec- tive and coordinated efforts ofthese skilled individuals, women get answers and they get them quickly. Prostate Cancer: Maximizing Results A routine company physical for Gerald Allen turned up an abnormal PSA (prostate-specific antigen) level and ultimately a diagnosis of prostate cancer. This started Mr. Allen on a search for information and treatment that would save his life and preserve his lifestyle. Choosing radiation therapy first, Mr. Allen did well for three years. When his PSA level began to rise rapidly, he was referred to E. Darracott Vaughan, Jr., M.D., Urologist-in-Chiefat NewYork Weill Cornell and an expert in the treatment ofprostate cancer. Dr. Vaughan performed surgery, and nearly five years later, Mr. Allen is doing great. Dr. Vaughan and his colleagues are at the vanguard ofnew treat- ment approaches lor prostate cancer, often defining the methods and Radiation oncologists,physicists andradiation therapists, under the protocols that are adopted nationwide. They have developed safer thedirection ofDr. PeterSchiff, surgical procedures, which help to spare the nerves that control sexual callonsophisticated technology to improvethelivesofpeople and bladder function, and are currentlyworking on a number ofexcit- withcancer. ing protocols, including treatments for patients who are not candidates for surgery, a vitamin A treatment that may slow the spread ofcancer, and a hormone implant for advanced disease. They also were the first to develop a method for predicting a patient’s response to radiation treatment by analyzing genetic markers. Daniel P. Petrylak, M.D., Director ofthe Genitourinary Oncology Program at Columbia Presbyterian, recently completed a major study evaluating a combination ofchemotherapeutic agents, estramustine and Taxotere®, he developed for treating an advanced type ofprostate cancer. Results were so encouraging that now a nationwide trial ofthe combination therapy is under way by' the Southwest Oncology Group. Dr. E. Darracott Vaughan,Jr., leadsa team ofdis- Peter B. Schiff, M.D., Ph.D., Chairman ofRadiation Oncology, and his tinguishedphysiciansin thefightagainstprostate colleagues are developing new approaches to increase the effectiveness cancerand urologicaldisorders, including (from left) Dr. ErnestSosa, Dr. NeilH. Bander, ofradiation treatment and decrease the risk ofcomplications. They are Dr. BeatriceS. Knudson, Dr. DavidM. Nanus, now using new advanced 3-D technology to direct external beam radi- Dr. Vaughan, Dr. PeterN. Schlegel, Dr. George PH. YoungandDr. Alexis Te. ation more precisely to those tissues that bear the tumorwhile limiting the effect on adjacent normal tissues. When Gerald Allen found out his biopsy was positive, he immedi- ately called his two brothers. But he offers the same advice to all men: 5 “Go for the test. It’s painless. Then go to the best for care.” Cancer Heart Disease: At NewTork-Presbyterian Hospital technology, tech- , nique and talent combine toform thefoundation of one ofthe world’s best cardiac care programs. It is a team effort like no other bringing together the \ diverse expertise ofcardiologists, heart surgeons, car- diac nurses and many others to address all stages of heart disease. Here, medical and surgical triumphs translate into the personal victories ofpatients. Dr. O. WayneIsom, CardiothoracicSurgeon-in-Chief The cardiac programs ofColumbia Presbyterian and NewYorkWeill NewTork WeillCornell, creditsaphenomenalteam, complete withthebestnursesanywhere,forthe Cornell are exceptional in their own right. By bringing them together Hospital’s well-earned reputation in thetreatmentof under the umbrella ofthe Columbia Weill Cornell Heart Institute, heartdisease. NewYork-Presbyterian Hospital has created a catalyst for comprehen- sive care and treatment innovations for heart disease like no other. The Miracle of Heart Transplant At 4 pm on Friday, June 19, 1999, a call came in to Mary Donovan, Cardiac Transplant Nurse Practitioner at Columbia Presbyterian Medical Center, alerting her ofan available heart. Over the next five days, Ms. Donovan would receive six more calls and the Medical Center’s heart transplant team would orchestrate and perform a record number oftransplant surgeries. To the outside world, the numberoflives saved that week by the heart transplant team would seem extraordinary ... and it was. To the heart transplant team, it was business as usual ... times seven. To the — — recipients four men, two women and one teenage girl the calls they received were the most important oftheir lives. Ms. Donovan and Senior Transplant Coordinator Helen HaufT become involved with potential transplant patients at the beginning of — their ordeal. They are with them throughout the waiting period Heart Disease - Gary Martin was dying slowly from a rare heart condition until Dr. Allan Schwartz pinpointed the diagnosis of constricted pericarditis and Dr. Craig Smith operated to save his life. HeartDisease which could be days or months. They help them understand the entire process, discuss their expectations and address their anxieties. They provide the link between hospital and home, and they celebrate in their triumphs. “Transplant medicine is extremely rewarding as it allows you to be on the cutting edge ofmedicine while still being deeply involved with the patients and their families,” says Donna Mancini, M.D., Medical Director, Cardiac Transplantation. Columbia Presbyterian is the largest heart transplant program in the country, having performed more than 1,200 heart transplants to date. It is also a leader in the development ofnew therapies for heart failure and transplant patients, such as die left — ventricular assist device (LVAD) a machine that is used as a bridge for patients awaiting a transplant, and new immunosuppressive drugs. PeterPivko wasonly52yearsold when hesuffereda massiveheartattack. Quadruplebypasssurgerypro- videdno improvement, leavinghim withaheart transplantastheonlyoptionforsurvival. Hewas transferredto Columbia Presbyterian, where Dr. Toshi Naka implantedan LVADtosustainhim untilthetransplant. Within monthsofthe trans- plant, Mr. Pivko wasback in the race. Dr. BruceLerman’s expertiseisin thediag- nosisandtreatmentof complexcardiacarrhyth- miasusingcatheter- basedtechniques. Heis alsoa distinguished researcher. “Theonlyway you can maintainyour cuttingedgeposition clinicallyistohaveit supportedbyyour researchprogram.” Teamwork isthesecretofthehearttransplantteam!rsuccess. “Because ofour depth ofexperience, we are able to take patients with unusual medical problems who cannot be treated elsewhere,” says Niloo Edwards, M.D., Director, Cardiac Transplantation. “Today, our — survival rates one year following surgery are at 90 percent all the more impressive when you consider how sick our patients are when they first come to us.” As for the “magnificent seven”... they’re doing just fine: Michael Enthosven, age 49, is a banker and art historian; Michael Tosch, age 52, exercises three times a week; Fauzi Kanhan, age 56, works in inter- national trade; Rev. Leonis Quinlan, age 63, is a ministerwho likes to fish, play golfand swim; Corliss Hubay, age 45, is a secretary in corpo- rate sales; Sherriese Belle, age 29, is the mother offour; and 15-year- old Kayla Trolle baby-sits, loves animals and is a budding entrepreneur. Heart Disease