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.

Spiritual Health Symposium Is Centered on Compassion

Roshi Joan Halifax, right, with Deborah Marin, MD, Director, Center for Spirituality and Health, Icahn School of Medicine at Mount Sinai; and the Reverend David Fleenor, STM, BCC, Director of Education, Center for Spirituality and Health.

Show compassion for patients, for co-workers, and most important, for yourself. That was the central message of the recent Spiritual Health Symposium, sponsored by the Mount Sinai Center for Spirituality and Health and the Department of Nursing. About 125 faculty, staff, and students attended the event in Goldwurm Auditorium, receiving a detailed road map to cultivating compassion in the practice of health care.

A keynote speaker of the event was Roshi Joan Halifax, PhD, founder of the Upaya Institute and Zen Center in Santa Fe, New Mexico. Roshi Halifax— whose title means she is the spiritual leader of a community of Buddhist monks—consults with health systems around the world on compassionate care, but she began her life as a “good Christian girl” in Savannah, Georgia. Her grandmother was a trusted figure in the community who cared for sick neighbors and helped prepare the dead for burial. Roshi Halifax said that listening to her grandmother’s stories taught her three things: that death is normal, that death is a mystery, and that caring for people who are profoundly ill “is sacred work.”

Instructing Medical Students on the Spiritual Side of Patient Care

Many patients would like physicians to ask about their religious and spiritual beliefs, but most physicians do not feel comfortable doing that. To address this gap, the Icahn School of Medicine at Mount Sinai has developed an innovative curriculum described in a recent paper, “Teaching Third-Year Medical Students to Address Patients’ Spiritual Needs in the Surgery/Anesthesiology Clerkship,” in MedEdPortal, The Journal of Teaching and Learning Resources.

“We want physicians, who are the leads of most teams in health care, to pay attention to patients’ religious and spiritual needs in the context of their larger cultural needs,“ says the Reverend David Fleenor, STM, BCC, an author of the paper and Director of Education, Center for Spirituality and Health. Most medical schools provide some spiritual education, but the Icahn School of Medicine is unique in tying it to the clerkship in surgery. Rev. Fleenor teaches the session with a transplant surgeon, Susan Lerner, MD, Associate Professor of Surgery, and Medical Education.

Third-year students participate in a one hour session, learning how to describe the role of a chaplain, how and when to contact one, and how to take a patient’s spiritual history along with the general medical history. Of the 165 students who participated in 2017, 120 provided feedback, which was reported in the study published in December 2018. In short-term responses, 82 percent rated the session above average or excellent, and 72 percent said it was very relevant to patient care. The goal is to prepare physicians to handle spiritual and religious challenges, such as a patient who insists on wearing a special amulet during surgery, or resists a procedure on religious grounds, or is questioning their life’s purpose. “This is the right thing to do,” Rev. Fleenor says, “and it can make things a lot easier in the long run for the hospital and for the patient.”

Compassion is essential in health care, Roshi Halifax said, and instead of leading to “compassion fatigue,” it generally gives providers a sense of well-being and purpose. But still, they are at risk of falling into the “shadow” side of altruism and empathy—neglecting to take care of themselves, or empathizing so strongly that they become distressed and ineffective. To help strike a balance in compassion, Roshi Halifax has developed a process called GRACE to use in challenging situations, or in day-to-day patient care. She explained: The “G” of grace is gathering your attention, pausing for a moment. The “R” is recalling your intention, generally to alleviate suffering. The “A” of grace is attuning to yourself, assessing your physical and emotional state and how it may be affecting your interaction with the patient. The “C” is considering what will serve the patient best, and trying to do it. And the “E” is ending the process, perhaps with a thank you or an expression of appreciation.

The other keynote speaker was Shane Sinclair, PhD, Director of the Compassion Research Lab, University of Calgary in Canada, who is a  leader in the study of compassion in health care. “Compassion is like empathy on steroids,” Dr. Sinclair said. “It not only requires action but it extends beyond individuals we can relate to, or we feel are worthy of our care. It targets those we may not easily relate to: the disenfranchised, the homeless, the vulnerable, our enemies, and even to the proverbial ‘difficult patient.’”

Panelists included members of the departments of Nursing, Psychiatry, and Spiritual Care and Education, and leaders of initiatives to improve well-being, such as the Employee Assistance Program, Mount Sinai Fit, and Mount Sinai Calm. “The single most important thing that we can do is listen to the people in our lives and in our work space,” said panelist Jane Maksoud, RN, MPA, Chief Human Resources Officer and Senior Vice President of Human Resources and Labor Relations, Mount Sinai Health System. “If you are ready to listen, without ego, to what the other person has to say, you will make tremendous strides in personal and professional growth and interpersonal connection.”

A panel on well-being initiatives, from left: Dan Hughes, PhD, Director, Employee Assistance Program; Maggie Keough, M.Ed., BCC, Chaplain and Director of Chi Time; Jane Maksoud, RN, MPA, Chief Human Resources Officer and Senior Vice President of Human Resources and Labor Relations; Rajvee Vora, MD, Vice Chair of Psychiatry; Frances Cartwright, PhD, RN-BC, Chief Nursing Officer; Jonathan Ripp, MD, MPH, Senior Associate Dean for Well-Being and Resilience; with a moderator, the Reverend David Fleenor, STM, BCC, Director of Education, Center for Spirituality and Health.

Roshi Joan Halifax, a keynote speaker, is the spiritual leader of the Upaya Institute and Zen Center in Santa Fe, New Mexico.

Panelists on compassion and the patient experience, from left: Lindsay Condrat, RN, MSN, Associate Director of Nursing; Rocky Walker, M.Div, Chaplain, The Mount Sinai Hospital; and MaKaya L. Saulsberry, MPH, Director, Patient Experience, The Mount Sinai Hospital.

Shane Sinclair, PhD, a keynote speaker, is Associate Professor, Faculty of Nursing, and Director, Compassion Research Lab, University of Calgary.

Organ Transplant Team Offers “HOPE” to Patients

Jose Velez, seated, with, from left, transplant team members Sander S. Florman, MD; Shirish S. Huprikar, MD, Chief Medical Offi cer, The Mount Sinai Hospital; Vikram Wadhera, MBBS, Assistant Professor of Surgery (Kidney/Pancreas Transplantation); Brandy Haydel, Clinical Research Program Director; and Meenakshi M. Rana, MD, Assistant Professor of Medicine (Infectious Diseases).

In June, Jose Velez became the 50th person at the Mount Sinai Health System’s Recanati/Miller Transplantation Institute to receive a transplant under the HIV Organ Policy Equity (HOPE) Act, which allows organs from HIV-positive donors to be transplanted into HIV-positive recipients with end-stage disease, thus increasing the organ donor pool. Prior to the HOPE Act, which went into effect in late 2015, all patients—those with and without HIV—were required to use organs from HIV-uninfected donors.

During the nine years that Mr. Velez waited for a kidney transplant, he was notified four times that a kidney might be available only to be told that it had gone to someone else on the waiting list. “I would tell anyone who is eligible to be in the HOPE program that they should do it,” he says.

Before surgery, he was dependent on dialysis several times a week and could not travel freely or participate in activities that conflicted with such a constricted schedule. Now Mr. Velez’s plans include buying season tickets to the opera and traveling to Abu Dhabi, London, and Paris. “It’s a whole new world, a very different life than I was living for nine years,” he says. “I’m open to so many things now.” He credits Mount Sinai for providing a “safe, secure, and caring” environment. “Sometimes they make you feel as though you’re their only patient,” he says.

Mount Sinai was the first hospital in New York State and the second in the nation to perform a HOPE transplant in 2016. Today, Mount Sinai performs more of these transplants than any other U.S. hospital.

“Thanks to tremendous advances in antiviral therapies, patients with HIV now live long lives and may suffer from end-stage liver and kidney diseases that can be treated by transplantation,” says Sander S. Florman, MD, Director of the Recanati/Miller Transplantation Institute at The Mount Sinai Hospital. “Carefully selected people with HIV can have comparable outcomes with transplantation as people without HIV and deserve an equitable opportunity to get a transplant. This has increased the availability of organs for these patients, and has allowed people with HIV to be donors and offer the gift of life to others.”

Mount Sinai Oncologist Cardinale Smith, MD, PhD, Receives Sojourns® Scholar Leadership Program Grant

Cardinale Smith, MD, PhD, Associate Professor, Medicine (Hematology and Medical Oncology); Associate Professor, Geriatrics and Palliative Medicine, received a two-year grant through the Cambia Health Foundation’s Sojourns® Scholar Leadership Program in 2018. The program provides emerging leaders in palliative care with funding for an innovative project in the field. For her project, Dr. Smith is studying the role of implicit bias on the outcomes of minority patients with advanced cancer.

To learn more about Dr. Smith, listen to her Road to Resilience episode on The Art of Self-Care.