Road to Resilience Episode 15: The Comedian and the Brain Tumor

Jeannie Gaffigan, left, and, at right, Ms. Gaffigan with her family.

Five kids. Four Grammy nominations. One pear-shaped brain tumor. When a life-threatening diagnosis turns comedy writer, producer and director Jeannie Gaffigan’s life upside-down, she and her husband, comedian Jim Gaffigan, turn to faith, family, and of course—humor.

Ms. Gaffigan was successfully treated for a large and rare brain tumor by Joshua Bederson, MD, Chair of the Department of Neurosurgery at the Mount Sinai Health System. In the operating room, Dr. Bederson used virtual reality technology that he pioneered to help surgeons operate more safely and precisely.

Ms. Gaffigan talks about her terrifying health crisis and how it’s served as a source of renewed purpose for both her and her family. Her new memoir, “When Life Gives You Pears,” will be published October 1.

Road to Resilience brings you stories and insights to help you thrive in a challenging world. From fighting burnout and trauma to building resilient families and communities, the podcast explores what’s possible when science meets the human spirit. To listen, visit Apple Podcasts, Spotify, Stitcher, Google Play, or the Road to Resilience website.

Closing the Chasm: Collaborating across Community Organizations and Health Systems

Participants at one of several community workshops sponsored by the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai

There is wide acknowledgement that health care and social services need to be better integrated to achieve community health, especially for the most vulnerable. The best way to do this is not always clear. Health systems and community-based organizations need to better understand how to create these successful, sustainable partnerships.

The Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai has taken up this challenge.

The Institute recently convened representatives from community organizations and Mount Sinai Health System, along with philanthropic donors and thought leaders.

During a panel on August 1 at the New York Academy of Medicine, participants discussed the benefits of participating in a year-long initiative led by the Arnhold Institute for Global Health and ideas on how multi-organization collaborations can be improved to better serve community members. The participants included Maxine Golub, Senior Vice President, Planning and Development at the Institute for Family Health; Stephanie Wang, MD, Assistant Professor, Medicine (General Internal Medicine) and a primary care physician at Mount Sinai Saint Luke’s; Shoshanah Brown, Chief Executive Officer at AIRnyc; and Judy Secon, Senior Director of Programs and Operations at New York Common Pantry. The panel was moderated by Principal Investigator Natalie Privett, PhD, Assistant Professor, Global Health, Medicine (General Internal Medicine).

Panelists highlighted that building relationships and having candid conversations with people from other organizations is a critical initial step. Ms. Golub emphasized the importance of making a long-term commitment to working in a community to truly effect change. Participants felt strongly that as the work progresses, it is vital to incorporate members of the community into the process. An important aspect of this will be looking at how care can be better coordinated across health care systems and community-based organizations.

Laurie Zephyrin, MD, MPH, MBA, left, Vice President, Delivery System Reform, the Commonwealth Fund, and Rachel Vreeman, MD, MS, Interim Director of the Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai, Vice Chair of Research for the Department of Health System Design and Global Health, and Director of the Global Sites Network. Photo credit: Andrea Archer

In 2018, the Institute received support from the Commonwealth Fund to develop and implement a participatory process to bring together community health stakeholders to identify and brainstorm how to collectively improve a community health issue in Central Harlem. The Institute facilitated several workshops that included leaders from Central Harlem-based community organizations and health systems.

Stakeholders included AIRnyc, New York Common Pantry, City Health Works, the Institute for Family Health, Mount Sinai St. Luke’s, and the Mount Sinai Performing Provider System (MSPPS), a population-health focused, integrated delivery system in Manhattan, Brooklyn, and Queens. Through design and facilitation techniques, stakeholders identified potential challenges, opportunities, and shared value. Stakeholders began strategizing about potential implementation steps.

Lessons from the initiative workshops were captured and generalized in a guide that is now available for implementers to support community health transformation efforts.

The guide is designed for anyone who wants to improve community health through collaboration across health systems and community-based organizations. It will help people build meaningful partnerships, achieve consensus, and scope out a strategy for community health issues. It is meant to be instructive in thoughtfully convening community-based organizations and health care systems to work towards a collaborative goal while building trust. The guide offers exercises, instructions, and tips to help others create a successful collaboration. It is rooted in the Institute’s experiences developing the collaboration and incorporates lessons learned from leading the collaborative. It was developed with support from the Commonwealth Fund.

Experts agree it is clear that systematic change is needed to improve collaboration. It is complicated and will require dedicated involvement from community organizations, health systems, health information technology experts, policy makers, and payers.

As Arthur Gianelli, President of Mount Sinai Saint Luke’s, noted, “The only way to make change is to change policy at the top and piece-by-piece make improvements at the bottom. We look forward to deepening collaborations across health systems and community organizations.”    

Two Mount Sinai Doctors Featured in New Netflix Series “Diagnosis” Treating a Young Girl with a Rare and Devastating Neurological Disease

Saadi Ghatan, MD, and Sadie Gonzalez before her surgery.

Episode 2 of a new Netflix docu-series titled “Diagnosis” focuses on seven-year-old Sadie Gonzalez from Queens, who suddenly began suffering seizures. Doctors at one New York hospital give her the devastating diagnosis of Rasmussen’s encephalitis and tell her parents the only option is a damaging and irreversible brain surgery that would leave her paralyzed over half her body.

When her parents seek a second opinion  at The Mount Sinai Hospital with Saadi Ghatan, MD, director of the Pediatric Neurosurgery Program for the Mount Sinai Health System, and Lara Marcuse, MD, co-director of the Mount Sinai Epilepsy Program and Associate Professor of Neurology at the Icahn School of Medicine at Mount Sinai, they learn there is another option.

Dr. Ghatan, who is also Associate Professor of Neurosurgery and Pediatrics at the Icahn School of Medicine, suggests that a less-invasive surgery is possible—a responsive neurostimulator (RNS) system, a small, implantable neurostimulator connected to tiny wires that are placed in specific seizure onset areas of the brain to deliver electrical stimulation that normalizes the disturbed brain circuitry causing the seizures. He explains that similar to a pacemaker that monitors and responds to heart rhythms, the RNS system will monitor and “learn” her seizure patterns, then deliver electrical stimulation to stop them in their tracks.

Lara Marcuse, MD

The episode follows Sadie’s and her family’s journey through the decision-making process and successful surgery at Mount Sinai.

Although Rasmussen’s encephalitis is an incurable condition and it may be six months to a year before physicians know if the device is successfully helping her, early results look promising.

The seven-part Netflix series is based on the long-running New York Times Magazine column titled “Diagnosis.”Watch the trailer and learn more about the series here. Read more about the series in an article in USA Today.

Cerebrovascular Stroke Center Opens in Queens

At the Mount Sinai Queens Cerebrovascular Stroke Center opening, from left: Argero “Roula” Siklas, Program Officer, Stavros Niarchos Foundation; Michael E. Minikes, Vice Chair, Mount Sinai Health System Boards of Trustees; J Mocco, MD, MS, Vice Chair, Neurosurgery, Mount Sinai Health System; Caryn A. Schwab, Executive Director, Mount Sinai Queens; David L. Reich, MD, President, The Mount Sinai Hospital and Mount Sinai Queens; Howard A. Zucker, MD, JD, New York State Commissioner of Health; and Costa Constantinides, New York City Council member, 22nd District.

The New York State Commissioner of Health, Howard A. Zucker, MD, JD, and New York City Council member Costa Constantinides were among the esteemed guests at a special celebration as Mount Sinai Queens unveiled its world-class Cerebrovascular Stroke Center, officially establishing a new model of stroke care in the nation.

The opening of the Stroke Center on Wednesday, June 19, also kicked off festivities marking the 20th anniversary of Mount Sinai Queens becoming a part of The Mount Sinai Hospital. “Even 20 years ago, we had a vision that Mount Sinai Queens would be a great hospital in its own right,” Caryn A. Schwab, Executive Director, Mount Sinai Queens, told the standing-room-only audience. “This is a glorious way to begin our 20th anniversary celebration.” Added Michael E. Minikes, Vice Chair of the Mount Sinai Health System Boards of Trustees: “This is a most exciting time and a stunning achievement. This is a top-of-the-line Stroke Center.”

Mount Sinai Queens intends to vastly improve the speed and efficiency of stroke diagnosis and treatment, including the most devastating form of stroke, emergent large vessel occlusion (ELVO), which occurs when there is a blood clot in a major artery in the brain. Stroke may cause severe symptoms in the patient and, when not diagnosed or treated quickly, may result in severe disabilities or even death.

“Every passing minute that blood flow to the brain is blocked, about 2 million neurons die,” said J Mocco, MD, MS, Professor of Neurosurgery, Icahn School of Medicine at Mount Sinai, Vice Chair of Neurosurgery for the Mount Sinai Health System, and Director of the Health System’s Cerebrovascular Center.

Dr. Mocco led the effort to establish the Mount Sinai Queens Cerebrovascular Stroke Center, which has specially designed equipment that is unique in the United States. It permits the stroke team to rapidly conduct a CT scan, and then an angiogram, to precisely locate the clot, and then perform an endovascular procedure known as a thrombectomy—all in one room, and while the patient remains on the same table.

“The patient doesn’t have to go down multiple halls, or through multiple doors, and they don’t need to be transferred from a stretcher to a bed multiple times before they get their treatment,” said Dr. Mocco.

J Mocco, MD, MS, center, with Icahn School of Medicine at Mount Sinai faculty, from left: Hazem Shoirah, MD, Assistant Professor of Neurosurgery, Neurology, and Radiology, and Director of Thrombectomy Services in Queens; Stanley Tuhrim, MD, Professor and Vice Chair for Clinical Affairs, Department of Neurology, and Director, Comprehensive Stroke Center, The Mount Sinai Hospital; and Reade A. De Leacy, MD, Assistant Professor of Neurosurgery, and Radiology, and Director of Cerebrovascular Services, Mount Sinai Queens; and Danny Hom, RT, Administrative Director, Mount Sinai Queens Cerebrovascular Stroke Center.

Thrombectomy is the gold standard of care for most ELVO strokes. It requires the expertise of a highly specialized neuroendovascular surgeon who guides a catheter through an artery in the groin or wrist to the brain and uses suction and/or a stent to remove the clot and quickly restore blood flow to the patient’s brain, often eliminating or minimizing brain damage. The goal, Dr. Mocco said, is to drastically reduce the time between hospital arrival, diagnosis, and the start of the clot removal.

“This is cutting-edge medicine,” said David L. Reich, MD, President of The Mount Sinai Hospital and Mount Sinai Queens. “Mount Sinai Queens has changed the paradigm of medicine and shown what a community hospital can do.”

Dr. Zucker and Mr. Constantinides, who represents the 22nd District, joined the celebration as a show of support for effective and efficient stroke care. Dr. Zucker acknowledged that New York State is a national leader in stroke care and congratulated Mount Sinai Queens. “This is really about leadership and vision—this is big vision,” he said. Mr. Constantinides helped secure funding from the City Council for the specialized equipment. Mount Sinai Queens also received significant support from the Stavros Niarchos Foundation for the newly named Stavros Niarchos Foundation Advanced Thrombectomy Suite, where stroke diagnosis and treatment take place.

“Only about 10 percent of people who have this kind of stroke ever even get a chance at this therapy because patients don’t have access to treatment where they live,” said Dr. Mocco. “Conservative estimates suggest there are about 600 patients a year in Queens who have one of these emergent large vessel occlusion strokes. Those patients now have access to treatment that will not only save lives but rapidly restore function so they are able to live their best lives.”

 

New Martha Stewart Center for Living at Mount Sinai-Union Square

Martha Stewart in her new white coat, with R. Sean Morrison, MD, the Ellen and Howard C. Katz Chair of the Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai.

With a significant gift from the lifestyle mogul Martha Stewart, the Mount Sinai Health System has expanded its successful model of care for older adults by opening the Martha Stewart Center for Living at Mount Sinai-Union Square. The Center, at 10 Union Square, joins the Martha Stewart Center for Living at The Mount Sinai Hospital, which opened in 2007. The goal of both centers is to ensure the best quality of life for adults aged 65 and older, who by 2030 will outnumber people under age 18 in the United States.

At the ribbon-cutting for the facility on Wednesday, June 26, Ms. Stewart received a monogrammed white coat and was named an honorary faculty member of the Icahn School of Medicine at Mount Sinai, and she jokingly volunteered to teach nutrition and yoga. “Through our partnership, Mount Sinai has established a pioneering model of comprehensive care for older adults and their loved ones,” Ms. Stewart said at the event, which was also attended by New York City and State lawmakers, and leaders of the Mount Sinai Health System.

“With the opening of this new Center, that level of optimal care is available for even more New Yorkers.” Americans can expect to live an average 20 years after age 65, said R. Sean Morrison, MD, the Ellen and Howard C. Katz Chair of the Brookdale Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai. “We need models of health care delivery to better meet the needs of our aging population,” he said.

With the goal of comprehensive, one-stop care, the new Center offers patients access to specialists from more than 20 disciplines, including cardiology, gastroenterology, cancer, dermatology, orthopedics, and rheumatology, as well as radiology, pharmacy, and physical therapy services. In addition, the Center will provide free services, including tai chi and yoga classes, music therapy, nutrition planning, and fall prevention programs.

At the Martha Stewart Center for Living at The Mount Sinai Hospital, this model of holistic care has led to patients experiencing half as many emergency room visits as other older adults, shorter hospital stays when admitted, and 50 percent fewer readmissions after hospitalization. “We are so very grateful to Ms. Stewart,” Dr. Morrison said. “Her personal philanthropy, her willingness to engage in our shared mission to improve care for older adults, and her advice and expertise in healthy living have been instrumental in creating centers that see and treat the needs of the whole person—the medical, psychological, social, and spiritual needs—and are serving as a training center for the next generation of health care professionals.”

Ms. Stewart said her own role model was her mother, known to all as “Big Martha,” who remained active for most of her 93 years, with a wide circle of friends and a lifelong sense of curiosity and joy. “I wrote a book called Living the Good Long Life, and that outlines very clearly how I have negotiated getting older,” said Ms. Stewart, age 78. “I am lucky that I have a full-time job—more than full-time. I live on a farm and commute to New York City, I ride horses, I raise all kinds of vegetables and fruits, I travel as much as I can, learning about all kinds of things.”

Support for the Centers for Living runs deep in Ms. Stewart’s family. The first Center was inspired by Ms. Stewart’s daughter, Alexis Stewart, who was impressed with Mount Sinai’s geriatric practice, and it was dedicated to Ms. Stewart’s mother. The new Martha Stewart Center for Living at Mount Sinai-Union Square is dedicated to Ms. Stewart’s grandchildren, Jude and Truman.

Ms. Stewart said that people often ask when she wants to retire, but she has no plans to. “I don’t ever want to think of the aging process as getting old, I just want to think of it as living as well as I can, as long as I possibly can,” she said. “And that is the goal of the Centers for Living, too.”

Martha Stewart cutting the ribbon at the Center with, from left, State Assembly Member Harvey Epstein; State Senator Brad Hoylman; R. Sean Morrison, MD, the Ellen and Howard C. Katz Chair of the Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai; State Assembly Member Richard N. Gottfried; William Abramson, Co-Chair of the Union Square Partnership; Taylor Abbruzzese, aide to Congresswoman Carolyn B. Maloney; and Katherine Madden, Associate Director of Communications, Brookdale Department of Geriatrics and Palliative Medicine.

Scholar-Athletes Learn About Health Care Careers at Inaugural NYC-SWAG Summit


Scholar-athletes learned about careers in health care, medicine, and science—and learned that they might have exactly the right attributes to succeed—at the inaugural NYC-SWAG (Scholar-Athletes With Academic Goals) Summit. About 120 participants attended the event, held in June in Davis Auditorium, including students from middle school to college, parents, teachers, coaches, and medical professionals who were once student-athletes themselves.

From left: Reginald W. Miller, DVM, DACALM, Dean for Research Operations and Infrastructure, Icahn School of Medicine at Mount Sinai; Hannah Valantine, MD, Chief Officer for Scientific Workforce Diversity, National Institutes of Health; Brian Hainline, MD, Chief Medical Officer, National Collegiate Athletic Association; Norma Poll-Hunter, PhD, Senior Director, Human Capital Initiatives, Association of American Medical Colleges; and Gary C. Butts, MD, Dean for Diversity Programs, Policy and Community Affairs, Icahn School of Medicine at Mount Sinai.

In planning the Summit, “the conversation started around the severe lack of African American and Latino males in science and medicine, and expanded into a conversation around the larger student body of athletes,” said Reginald W. Miller, DVM, DACLAM, Dean for Research Operations and Infrastructure, Icahn School of Medicine at Mount Sinai. The event was hosted by the School of Medicine’s Diversity in Biomedical Research Council in partnership with the National Institutes of Health, the Association of American Medical Colleges, and the National Collegiate Athletic Association.

Young people who participate in athletics are developing important habits of mind, said the keynote speaker, Hannah Valantine, MD, Chief Officer for Scientific Workforce Diversity, National Institutes of Health. “Confidence, self-discipline, time management: these are all things that are critically important to be successful as a researcher and a scientist, and you already have it,” she told the attendees.

Speakers also included Brian Hainline, MD, Chief Medical Officer, National Collegiate Athletic Association; and Norma Poll- Hunter, PhD, Senior Director, Human Capital Initiatives, Association of American Medical Colleges. A panel of premed and medical students who had competed in swimming, rowing, football, and basketball shared practical tips: don’t neglect your studies; network; schedule time for plenty of sleep; and seek an internship in medicine or research. They said medical school might actually be easier than juggling school and sports.

The panel was led by Valerie Parkas, MD, Senior Associate Dean for Recruitment and Admissions, Icahn School of Medicine at Mount Sinai. Dr. Parkas said that she herself competed as a gymnast in college and that athletes often have attributes that allow them to be successful professionals in all spheres, but particularly in STEM careers and in medicine. “We are looking for young people who are hardworking, who are motivated, who have grit, who are team players, who are leaders,” Dr. Parkas said. “And those are young people who have been athletes their whole lives.”

Alvin Alonso, a student at Dr. Richard Izquierdo Health and Science Charter School in the Bronx, said the Summit gave him a lot of motivation. “It brought my hopes up,” he said. “It told me that anything is possible if you just put your mind to it.”

 

Valerie Parkas, MD, Senior Associate Dean for Recruitment and Admissions, Icahn School of Medicine at Mount Sinai, led a panel of medical and premed students who are former athletes, from left: Femi Oyewole and David Octeau, Icahn School of Medicine at Mount Sinai; Showly Nicholson, Harvard Medical School; and Enna Selmanovic, University of Cincinnati.

Showly Nicholoson, a Harvard medical school student who played basketball at Phillips Exeter Academy, enjoyed lunch with young scholar-athletes.

About 120 people, including scholar-athletes from middle school to college, attended the NYC-SWAG Summit at Davis Auditorium.