Rising Above the Health Toll of Racism

Updated on Jun 30, 2022 | Diversity and Inclusion, Featured, Your Health


Racism—both on a personal level and in overall society—negatively affects the mental and physical health of millions of people, according to the Centers for Disease Control and Prevention. These health issues, and some ways to rise above them, are addressed in this Q&A with Lynne D. Richardson, MD, Co-Director of the Institute for Health Equity Research at Mount Sinai, and Professor of Emergency Medicine, and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai.

“Racism is a public health crisis that is damaging to all of us, regardless of race or ethnicity,” Dr. Richardson says. “We need to use all of the tools at our disposal to fight it, and to improve our own individual and our collective emotional and physical well-being.”

Lynne D. Richardson, MD

How does racism affect mental health?

That is a big question. The impacts of racism happen at various levels because, of course, racism happens at various levels. There is the experience of being personally discriminated against, whether that’s racial slurs or hate crimes or the experience of being followed in a store because you’re under suspicion that you’re going to steal because of the way you look. All of those sorts of macro and microaggressions really undermine your sense of self-confidence, your sense of self-esteem, and your sense of safety. It’s like having repeated traumas on your mental and emotional well-being.

There is a lot of evidence that racism of various kinds has a destructive impact on mental health, and there is a growing awareness of the importance of structural racism in that picture—this includes limited access to societal resources, like housing, food, job security, and health care. The persistent inequities in the way that those resources are distributed across our society have an impact on our mental health and well-being. It’s those persistent negative messages that you are not valued, that you are not protected. This is why we see huge disparities in conditions like depression. African Americans are much more likely to have more severe symptoms. They have a longer course of illness, and they experience greater levels of disability from depression compared to white patients. This is also why rates of youth suicide are exploding in the black community, with something like a 73 percent increase over the last decade of suicide attempts among young people of color. In terms of suicide death rates, the fastest growing segment are black children between the ages of five and 12. We are seeing the impact of racism and the harmful effects that it has on mental health reflected in this epidemic of suicide among black youth.

How does racism affect physical health?

Racism affects physical health in direct ways. Due to structural racism, you may be more likely to live in housing that is substandard, housing that has environmental toxins or irritants that directly impact your health. You are more likely to live in a neighborhood where there are higher levels of air pollution, where there are higher levels of violent crime. You are more likely to not get the health care that you need, and so you may have a higher burden of disease and more avoidable complications of illnesses like hypertension, diabetes, heart failure, or asthma. These effects are cumulative, and they directly impact the physical health of communities that are experiencing the effects of structural racism.

There is also a connection between mental health and physical health. We know that the assault on your mental health also affects your body. It affects your immune system and makes you more susceptible to disease. It affects your hormonal system and results in problems with your adrenal regulation. So the more we understand about how complex health disparities are and about all the things that create these differences in health between blacks and other groups, the more we understand how racism is often a root cause of many of these effects.

What are some ways to feel better?

I think it is important to not only talk about the negative ways in which racism impacts black people, but also to remember all of the strengths that have helped us to get to where we are today. I think that we have to pay attention, to take care of ourselves and take care of each other, especially given the recent impact of the COVID-19 pandemic. I think it is even more important that we lean on our strong social supports of families and friends. For many people, spirituality is a source of strength and comfort.

In addition, I think we have to try to directly address the inequities that are leading to these negative impacts on our mental and physical health. I have a colleague who talks about spreading hope, as a strategy to deal with what we are facing as we combat the effects of racism—and I love that image.

What are some ways to help?

I think all of us have an obligation to advocate for anti-racist policies, and that happens at every level. There are societal issues. There are policies and processes in every institution that we belong to. There are things that we can do, in every place we are, to try to understand how the structural inequities are embedded in our society, and to start to dismantle them. We need to do that where we work, where we go to school, where we worship. In every context, we all need to be doing this anti-racism work if we really want to make a difference and we really want to end these long-lasting, persistent effects of racism on communities of color.

What else should people know about racism and health?

There is a lot of discussion now about implicit bias. One of the things that is not widely understood about implicit bias, or unconscious bias, is that while it may happen at a subconscious level on the part of the person who has the bias, it has a very explicit impact on the person who is the recipient of the bias. There is often a sense that because this kind of bias is not intentional it’s not harmful, but it is very harmful, and it results in micro aggressions that do create repeated micro-traumas that erode our physical and mental health.

Therefore, I think everybody has individual work to do on themselves to understand the extent to which they have internalized the biases that are pervasive in our society. At the same time, we should work at a higher level collectively on our organizations and institutions and try to eliminate the structural racism that is persistent and pervasive throughout our institutions.

Learn more about the Mount Sinai's Institute for Health Equity Research

Crystal Party Virtual Tribute Spotlights Four Patients Saved by Mount Sinai’s Innovative Care

Updated on Jun 30, 2022 | Featured

Raghav Murthy, MD, shows a small plaque he got from the family of his patient who got a heart transplant when he was 7 months old. The plaque, which sits on his desk, reads “Thank you for saving my life with your compassion and extraordinary dedication to getting me my heart.” Says Dr. Murthy: “I smile at it every morning….It reminds me of what a difficult journey they had. But what a beautiful ending.”

For the 37th time, Mount Sinai’s annual Crystal Party proved to be more than just a fundraiser. Held as a virtual event for the second time since the onset of the COVID-19 pandemic, the event brought hundreds of viewers to a special video that debuted on Thursday, May 5. By celebrating the extraordinary achievements of the Mount Sinai Health System through a series of patient stories, the 30-minute short film showed the wide-ranging capabilities of Mount Sinai, demonstrating that no matter what the issue, “we find a way.”

“I want to start by thanking our staff for all they’ve done over the past two years,”  Kenneth L. Davis, MD, Chief Executive Officer of the Mount Sinai Health System, said in opening the event. “I know your work has been exhausting. As we continue to make progress with vaccines and treatments, I’m hopeful that we’re seeing the light at the end of the tunnel. The time you have given of yourselves is what has gotten us through the many challenging days we have endured as a community and a city.”

Dr. Davis noted that the help of donors was essential to Mount Sinai’s many accomplishments. “Thanks to your contributions, we’ve made extraordinary progress on several groundbreaking diagnostic tests and therapies that will be life-changing for patients. Over the past year alone,” Dr. Davis continued, “we’ve formed seven new companies, were granted 115 new patents, and filed another 357, an incredible number.” Moreover, “Our leading immunology group is testing a COVID-19 vaccine that will be able to adapt to new variants as they emerge.”

Dr. Davis also highlighted breakthroughs “in cancer, diabetes, and conditions that affect the brain and the heart,” pointing out discoveries such as uncovering blood biomarkers for early diagnosis of certain cancers, revealing how particular cells and genes affect Alzheimer’s disease, and developing an artificial pancreas to help diabetes patients manage their insulin intake.

Click here to watch the full video of the Crystal Party, including all of the patient stories.

Margaret Pastuszko, MBA, President and Chief Operating Officer of the Mount Sinai Health System, remarked on the world-class health care services provided by Mount Sinai—some of which can only be found here. “Our skilled physicians apply their deep knowledge and extensive training to solve the most complex health problems, bringing cutting-edge treatments into daily application,” said Ms. Pastuszko, “They are determined to find answers for their patients and their families and do so in a compassionate way. They have an unrelenting drive to find a way to heal all of our patients.”

Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai, and President for Academic Affairs, Mount Sinai Health System, continued on that theme, pointing out that outstanding outcomes for patients are achieved through the deep collaboration between Mount Sinai’s scientists and clinicians, calling them “the best and the brightest who are dedicated to solving the mysteries of disease, healing patients, and educating the next generation.”

David Miramontes and his doctor, Mark S. Courey, MD

Four patient stories vividly illustrated these opening remarks, starting with David Miramontes of San Antonio, Texas. Six months after marrying Christina, he went to see the doctor with what he thought was bronchitis. He soon learned that he had cancer between his vocal cords and his trachea. “And that’s when our jaws dropped, our hearts broke in half, and we started our journey,” he said. That journey soon led to Mount Sinai, the one place that offered to try to both remove the cancer and save his voice. As the Medical Director for the San Antonio Fire Department, he could not imagine life without a voice. “I couldn’t teach, I couldn’t see patients. It would literally kill me,” he said.

Mark S. Courey, MD, Professor of Otolaryngology-Head and Neck Surgery, Director of the Grabscheid Voice and Swallowing Center, Division Chief of Laryngology, and Vice Chair of Quality for the Department of Otolaryngology-Head and Neck Surgery at the Mount Sinai Health System, was not going to let that happen. There were no guarantees, however, as Dr. Courey knew from experience that it was complicated surgery.

The solution Dr. Courey arrived at was innovative and far beyond the standard of care. “ To reconstruct the bottom part of David’s voice box, we took a rib for its solid structure. But the rib is so large that if I put it into the voice box without a blood supply, it would die,” he explained in the video. “So, to prevent that, we take some vascularized tissue of the fascia from David’s thigh. In this particular area, the fascia has its own blood supply, and we can use the blood supply from the fascia to support the rib. I had been thinking about doing this for about 15 years.”

It was a stunning success. “My voice is actually better than expected,” Mr. Miramontes said. “I can talk to patients, even through a mask. I can work in the ER, I can work in the field. I actually have some range. I can go up and down and I can talk with pretty good volume.” Dr. Courey was dedicated to not only keeping his patient alive, but giving him his life back. And the one place he could do that is Mount Sinai: “I can do this here at Mount Sinai because I don’t like accepting the status quo. I am allowed the opportunity to think about new solutions to common problems or rare problems.”

Jayceon Serrano is joined by, from left, his mom, Raghav Murthy, MD, and Jaqueline Lamour, MD

Heart transplantation in an infant is also a rare thing, but that’s what Jayceon Serrano, who was born in early 2021 with dilated cardiomyopathy, needed. The disease was hidden for a while, but his heart grew to twice the normal size, and he was soon failing to thrive. He was admitted to the intensive care unit in severe heart failure.  At that point, “the best thing we can do for survival is to get him a new heart,” said Raghav Murthy, MD, DABS, FACS, Director of the Pediatric Heart Transplantation Program at the Mount Sinai Kravis Children’s Heart Center.

More than 100 people were involved in Jayceon’s care, providing more than just medical care for the four months it took for a heart to become available.

“As much as the focus is on the patient,” Samantha Corbin, LCSW, said, “how can I, as a social worker, support the parents to put their best foot forward and be that presence and support for their child?” Ms. Corbin met with Jayceon’s parents every day, helping them advocate for him and being their sounding board. Nurses provided essential support in addition to skilled care, as Janet Jimenez, RN, remembered: “If they needed a hug, we were there to provide that for them. If they needed to talk, we were there to provide that for them. You truly want the best for them as if they were your own family member.”

Mount Sinai is one of 50 to 75 pediatric heart transplantation programs in the country. But Jayceon was in the right place when it came time for his complex surgery. “The heart of newborn baby is the size of a strawberry,” Dr. Murthy noted, making the reconnection of the tiny blood vessels a delicate operation. While the transplant was a success, this will be a lifelong journey for Jayceon—but a hopeful one. As Jacqueline Lamour, MD, the Director of Pediatric Heart Failure and Transplantation in the Mount Sinai Kravis Children’s Heart Center, pointed out, Jayceon has “the potential to live an incredibly long time. As pediatricians, we follow children from birth through young adulthood, and he’s going to know me his whole life.”

Joshua Bederson, MD, and David Reichman

David Reichman was saved by Mount Sinai at a very different stage of life—after a brain abscess failed to resolve with antibiotics. In fact, the abscess began to enlarge, leading to dire situation: “The clock was ticking,” said Leslie Schlachter, PA, Clinical Director and Chief Physician Assistant in the Department of Neurosurgery at the Mount Sinai Health System. “There was a rapid decline, and we needed to get him to the operating room quickly, because every moment that passed was brain activity and brain tissue that we might not get back.”

Immediate brain surgery was necessary, and the outcome was not guaranteed as the abscess was very deep. But as he was rolled into surgery, the patient made his expectations very clear to Joshua B. Bederson, MD, the Leonard I. Malis, MD / Corinne and Joseph Graber Professor of Neurosurgery and Chair for the Department of Neurosurgery, Mount Sinai Health System. “I said, ‘If I can’t come out of this that I can dance with my daughter on my next birthday, I don’t want to come out.’ And I remember him saying, “You’re going to dance.’”

By combining multiple scans of Mr. Reichman’s brain, Dr. Bederson and his team created a 3D virtual reality environment that allowed them to precisely map an opening, a trajectory through the brain, and a pathway into the abscess that was safe. “There are so many ways in which we push boundaries in Mount Sinai in neurosurgery,” Dr. Bederson noted. “We are making strides now that we wouldn’t have thought possible even five to 10 years ago.”

Mr. Reichman was in the right place at the right time by coming to Mount Sinai. “His prognosis is excellent,” said Ms. Schlachter, “There should be no ill effects on the rest of his life, as if it never happened.” And two years later, he went to visit his daughter. “On my birthday, we danced right on the street. It was amazing, just an amazing thing. Tears were coming down my eyes because life was worthwhile.”

Robin Varghese, MD, and Benjamin Thomas

For Benjamin Thomas, a pastor, the pandemic proved very challenging. After contracting COVID-19, Mr.  Thomas “went through a very rough time—54 days on the ventilator. Over six weeks in a coma. Lost over 50 pounds. It was a very rough journey.” But no one at Mount Sinai gave up on him, least of all Robin Varghese, MD, Associate Professor of Cardiovascular Surgery, starting with a transfer from another institution. “He was admitted to a hospital in Long Island, and was going in the wrong direction. The family was losing hope, and the hospital was losing hope on his case. And that’s when they were trying to reach out to me to see if I could help in any way. The doctors told me if we don’t take Pastor Thomas this weekend, he’s going to die here. And that was a sign to me that I had to act.”

Dr. Varghese learned of all the good Mr. Thomas did in his church and community. His only child was preparing to graduate. “And I kept telling the team, ‘We got to get him to the graduation.’ We took care of him as best as we could, and he was quite sick for weeks. Even our team members and myself sometimes could not see the light at the end of the tunnel for him.”

One night, Dr. Varghese drove from his home in Connecticut to be at Mr. Thomas’s bed. “Being a man of faith myself, having very little hope left in me, I had just set a prayer and told God that I got to put it into his hands,” Dr. Varghese said, “But at Mount Sinai, we don’t give up. We fight till the end. As I was praying in the room, I just started thinking of his case more and more, and what could I do? I started to really just look at his case and go through the chart over and over again. I came up with a few different ideas, and we started to mobilize those over the next few days.”

Those ideas led to slow improvement, and Mr. Thomas eventually came off the ventilator and recovered further before leaving the hospital to go back to his family, his church, and his community. And he made it to his daughter’s graduation. Looking back, Dr. Varghese said, “We lost a lot of patients during the pandemic, but this is one that we saved, and changed a family.”

The video closed with remarks from the Co-Chairs of the Mount Sinai Boards of Trustees, James Tisch and Richard Friedman. “The three pillars of the Mount Sinai Health System are strong and sturdy,” Mr. Tisch said. “We provide outstanding patient care, we generate brilliant research, and we offer superb education for the next generation of physicians and scientists. But we can’t, and won’t stand still to maintain Mount Sinai’s high quality and sustain its extraordinary work. We need to invest.”

Mr. Friedman expressed pride in the people of Mount Sinai for their dedication, ingenuity, and skill and also thanked patients and their families for putting their faith in the institution. “Mount Sinai is now recognized as one of the nation’s very top academic medical centers,” he said, “As a Mount Sinai supporter, you deserve to have great pride in our achievements, because giving to Mount Sinai means you are helping to save lives. You are helping to drive important advances in science and medicine, your donations make it possible for Mount Sinai to find a way.”

Ms. Pastuszko thanked all the donors who helped the Crystal Party raise more than $2.5 million. “Mount Sinai’s groundbreaking research and outstanding clinical care could not be possible without your philanthropy and continued commitment. Your partnership and ongoing support of our clinical mission is truly inspirational.”

Read more Featured stories about Mount Sinai

Helen Mayberg, MD: Seizing Unexpected Opportunities at Every Turn

Jun 8, 2022 | Featured, Research

Helen Mayberg, MD: Seizing Unexpected Opportunities at Every Turn

Depression has long been considered a serious mental disorder caused by extreme stress or a chemical imbalance that is treated by psychotherapy or medication. That is, until Helen Mayberg, MD, Professor of Neurology, Neurosurgery, Psychiatry, and Neuroscience, and founding Director of the Nash Family Center for Advanced Circuit Therapeutics at Mount Sinai, took a different approach.

“I am a neurologist, and neurologists map signs and symptoms to specific locations in the brain,” she said. She had always seen depression as a circuit disorder and the availability of brain imaging early in her training provided a method and strategy to study a psychiatric disorder as a neurological one. “That was a novel, if not heretical, idea at the time,” Dr. Mayberg said. “Now, it’s commonplace.”

For her body of work integrating imaging techniques to reveal mechanisms of depression, Dr. Mayberg was elected to the National Academy of Sciences (NAS) in May.

Dr. Mayberg considers her career to have taken an unconventional arc. She first trained clinically in neurology at Columbia University, then did a research fellowship in nuclear medicine and functional imaging at Johns Hopkins University. Prior to joining Icahn School of Medicine at Mount Sinai, Dr. Mayberg held a series of cross-disciplinary appointments in neurology, psychiatry, radiology, neurosurgery, and neuroscience at various institutions, including Johns Hopkins, University of Texas, University of Toronto, and Emory University.

Dr. Mayberg was elected to the National Academy of Sciences along with Yasmin Hurd, PhD, Ward-Coleman Chair of Translational Neuroscience and Director of the Addiction Institute of Mount Sinai. Read more about Dr. Hurd’s achievements here.

Over the last 35 years, she had used neuroimaging techniques to study abnormal brain circuits in depressed patients, explaining not just mood, motivation, cognitive, and motor feature characteristics of depression, but also providing a systematic strategy to understand how different treatments work and how to match a patient with an optimal treatment.

Forging partnerships, breaking frontiers

A milestone in her collaborative work came about when Dr. Mayberg discovered the critical role of Brodmann area 25 of the brain, a region of the prefrontal cortex, in negative mood in healthy individuals as well as how it was targeted when antidepressant treatments were successful for depression. The area is known to play a role in mood, appetite, and sleep, but its role in depression was unknown.

Following work on Brodmann area 25, Dr. Mayberg found that deep-brain stimulation—implanted electrodes that deliver electrical stimulation to precise brain locations to treat Parkinson’s disease and epilepsy—was a potential treatment for patients with treatment-resistant depression. Mapping studies she did in the 1990s led to her testing the new treatment in 2003, in which a majority of treated patients showed long-term recovery.

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Every move to a new institution has been a scientific adventure with opportunity to work in a new environment with new colleagues, Dr. Mayberg said, but a constant has always been unexpected, exciting, and important new insights. “Creative disruption seems to best describe my trajectory,” she said.

Dr. Mayberg considers transdisciplinary collaboration as the philosophical anchor of her work, one that forms the overarching mission of the Nash Family Center for Advanced Circuit Therapeutics, which she founded in 2018. “The opportunity to fully realize this vision was the condition of my move to New York,” she said.

The Center brings neurology, psychiatry, neurosurgery, imaging, physiology, engineering, and behavioral health under the same roof. Researchers are working on circuit disorders, including Parkinson’s disease, depression, and obsessive-compulsive disorder, which can be treated with deep-brain stimulation, albeit in different brain targets.

“We all knew we needed to work together so that a discovery or new method developed for one disease could inform the others,” Dr. Mayberg said, “so we’re not reinventing the wheel each time.”

Continuing progress through collaborations

Technology innovations in the last several years have further advanced the deep-brain stimulation field, providing new opportunities for Dr. Mayberg and the investigators at the Center. With the capability to read electrophysiological signals in real-time via the stimulating electrodes, researchers at the Center are working on improving delivery of deep-brain stimulation, understanding what kind of patients are most appropriate and why the treatment works.

The Center is also interested in answering more basic questions, such as whether deep-brain stimulation repairs brain circuits or promotes brain plasticity. These studies are complemented by parallel work in animal models at The Friedman Brain Institute. “I consider my research ‘bedside to bench.’ I have always taken advantage of the work of basic neuroscientists, even if their methods cannot be fully applied to human patients,” Dr. Mayberg said.

“My work has had the same basic thread over the course of 35 years: what is the neurology of depression and how do we optimally treat it; not just generally, but in individual patients,” Dr. Mayberg said. “Mount Sinai is the ultimate place for this work, with a committed set of clinicians, scientists, and engineers who share this transdisciplinary vision.”

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A closer look at Dr. Mayberg’s work

Dr. Eric Nestler

Eric Nestler, MD, PhD, Nash Family Professor of Neuroscience, Director of The Friedman Brain Institute, Dean for Academic Affairs of the Icahn School of Medicine at Mount Sinai, and Chief Scientific Officer for the Mount Sinai Health System, weighs in on what he found impressive about Dr. Mayberg’s research.

“Dr. Mayberg’s work is all translation since it’s all performed in humans,” said Dr. Nestler, “Even though her research has been tethered in basic neurobiology, thinking about how it intersects with patients is evident.”

Membership of the National Academy of Sciences—considered one of the highest honors for a scientist—comes through election by existing members only. Candidates’ entire bodies of work and contributions to the field are considered as part of the nomination process and their entries are voted on in April each year, with a maximum of 120 U.S. citizens and 30 non-citizens elected annually, according to NAS. There are currently approximately 2,400 U.S. members and 500 international members, of whom 190 have received Nobel prizes. Mount Sinai has six current faculty in the prestigious organization.

Dr. Mayberg had a longstanding track record in using brain imaging to study people with psychiatric disorders, but her breakthrough was using deep-brain stimulation to treat depression.

“What Helen did was extremely novel, especially because this was for a group of patients who had especially severe depression who did not respond to a wide range of existing treatments including electroconvulsive therapy, also known as ’shock’ therapy,” Dr. Nestler said.

The paper on using deep-brain stimulation for depression, published in Neuron in 2005, remains Dr. Mayberg’s most cited work. In her study, six patients with severe depression who had failed at least four different forms of treatment underwent the experimental stimulation procedure. All six saw improvement in clinical scores, with three achieving remission or near-remission that was sustained long term.

“It was a remarkable and brave study and she has since further developed its key findings and implications,” Dr. Nestler said.

Other notable publications from Dr. Mayberg included discovering areas of the brain that were involved in feelings of sadness, and how they exhibited dysfunction in returning to baseline state in people with depression. Dr. Mayberg considered that paper, published May 1999 in The American Journal of Psychiatry, one of her hardest to get published, but it ultimately led to her work with deep-brain stimulation.

“We recruited Dr. Mayberg because we had a great deal of confidence in her multidisciplinary approach,” Dr. Nestler said. “With the additional resources possible at Mount Sinai, she can take the program to the next level.”

Yasmin Hurd, PhD: Asking the Questions No One Was Asking

Updated on Mar 9, 2023 | Featured, Research

Yasmin Hurd, PhD: Asking the Questions No One Was Asking

A couple of decades ago, most people familiar with cannabis called it marijuana—and had probably never heard of cannabidiol (also known as CBD), one of its components.

Today, many people have heard about CBD and its potential therapeutic uses thanks to the work of Yasmin Hurd, PhD, Ward-Coleman Chair of Translational Neuroscience and Director of the Addiction Institute of Mount Sinai, who pioneered research into the compound, cannabis more generally, and their various interactions with substance-use disorders.

“I believe I had been asking questions that no one was asking at the time,” said Dr. Hurd. Her work helped her get elected to the National Academy of Sciences (NAS) in May. She is also a member of the National Academy of Medicine.

Dr. Hurd’s research focuses on the neurobiology of drug addiction and various psychiatric disorders, spanning both basic science research and translational work in humans. Having evidence in both non-clinical and clinical settings has helped the research be applicable in guiding treatment and health policy, she said.

“Producing research that actually has impact to our society was important to me,” Dr. Hurd said. Through her work in studying molecular impacts of exposure to substances from prenatally to adulthood, including pioneering studies of the human brain, she discovered milestones about the developmental and transgenerational effects of exposure to cannabis, and also its therapeutic potential for treating other forms of addiction, such as with opioids.

“At the time no one knew what cannabidiol was, and today you can even see it being added to coffee in coffee shops,” she said with a laugh.

Dr. Hurd was elected to the National Academy of Sciences along with Helen Mayberg, MD, founding Director of the Nash Family Center for Advanced Circuit Therapeutics at Mount Sinai. Read more about Dr. Mayberg’s achievements here.

The Potential of a Limitless Environment

More than a decade ago, in the field of medicine, marijuana was still seen as having limited evidence for being a treatment for any condition and many thought that it was a benign drug without long-term impact on the brain. “My research into the developmental effects of cannabis as well as potential therapeutic aspects of cannabidiol made people take another look at cannabis and have shaped the questions people are asking today,” she said.

Being able to ask the questions that no one was asking requires the combination of the researcher’s driving instinct and institutional support. “I think Mount Sinai helped me to not only ask, but to answer those questions,” Dr. Hurd said.

“Physicians had always focused on treating the adult patient in front of them, but the thinking about what had brought them there in the first place was unaddressed,” she said. As she studied adults with substance-use disorders, she found many had drug exposures early in life, and sought to understand whether those early exposures were linked to psychiatric illnesses later on as adults.

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Dr. Hurd recalled that when she joined Mount Sinai in 2006, she pitched ideas about advancing her preclinical work into humans to Dennis Charney, MD, Anne and Joel Ehrenkranz Dean of Icahn Mount Sinai and President for Academic Affairs of the Mount Sinai Health System. She had begun to study how cannabidiol worked in animal models but had not yet investigated it in live human beings. “Dean Charney said, ‘You could absolutely do that here,’ and just knowing that was possible enabled me to run clinical trials.”

“Early in my career, I never thought that my research would evolve the way it has,” Dr. Hurd said. “Instead of being theoretical about translation, I actually got to study it in humans.”

“The whole thing about being in an environment where there are no limitations placed on you is that it becomes dependent on your drive, on the questions you want to ask,” Dr. Hurd said. “I remember going away from that meeting feeling happy, thinking, ‘Whoa, there are no limits. What do I really want to do now?’”

Even today, that is a question Dr. Hurd asks herself. A constant in her research is for her work to always reveal something relevant to the human condition. As she advanced her work in addiction, she has come to understand that addiction is more a disorder of epigenetics, in contrast to a disease of genetic inheritance.

“Our next phase, especially in medication development, is to see if we can leverage the knowledge about epigenetic dysregulation to develop targeted interventions to reverse addiction,” Dr. Hurd said.

Addressing the Future of Addiction Research

Epigenetic changes are reversible, and this gives rise to hope that addiction ultimately can be, too. “When I started in this field, there was the pervasive stigma of the common phrase ‘Once an addict, always an addict,’” she said. “After studying this for such a long time, I know it’s not true. The effects may be long-lasting, but they are not locked for perpetuity.”

The road ahead will be challenging. Some challenges are merely logistical, such as space issues for animal and clinical research. Others are more systemic. “Those problems I face today remain the same I had at the start of my career,” Dr. Hurd said. “Getting grant money is still challenging, especially for high-risk projects. Stigma still surrounds addiction, even within science.”

Addressing the stigma will help with securing funding. They’re linked, Dr. Hurd said. “But with good support, I believe I’ll get there.”

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A closer look at Dr. Hurd’s work

Dr. Eric Nestler

Eric Nestler, MD, PhD, Nash Family Professor of Neuroscience, Director of The Friedman Brain Institute, Dean for Academic Affairs of Icahn Mount Sinai, and Chief Scientific Officer for the Mount Sinai Health System, discusses how Dr. Hurd’s work, which comes from asking basic questions, can translate into helping patients.

“Yasmin has always put a premium on mining the results of her work in rats to devise a new understanding for how substances affect humans and also to develop new treatments,” Dr. Nestler said.

Membership of the National Academy of Sciences—considered one of the highest honors for a scientist—comes through election by existing members only. Candidates’ entire bodies of work and contributions to the field are considered as part of the nomination process and their entries are voted on in April each year, with a maximum of 120 U.S. citizens and 30 non-citizens elected annually, according to NAS. There are currently approximately 2,400 U.S. members and 500 international members, of whom 190 have received Nobel prizes. Mount Sinai has six current faculty in the prestigious organization.

Her recent work on epigenetic changes that marijuana causes in the brain and that can be passed across subsequent generations has considerable importance to society, Dr. Nestler said. That paper on epigenetic changes, published in 2021 in the Proceedings of the National Academy of Science, discussed how children from mothers who used cannabis during pregnancy showed higher anxiety, aggression, hyperactivity, and levels of the stress hormone cortisol, compared to children of non-cannabis users.

“As marijuana is increasingly legalized, many people think of marijuana as being extremely safe,” Dr. Nestler said. “Yasmin has shown clearly that it may not be so safe, especially in pregnant women.”

Dr. Hurd’s research on the intersection of cannabinoids and addiction has significant impact too, Dr. Nestler said. Notable publications include her paper, published 2017 in Trends in Neurosciences, that laid out animal model evidence of cannabidiol, a non-high-producing compound derived from cannabis, as a treatment for opioid addiction because it lowers the reward for opioid use.

“That led her to launch a clinical trial that is funded by the National Institute on Drug Abuse,” Dr. Nestler said, referring to the agency that’s part of the National Institutes of Health. “This is a major milestone for Dr. Hurd’s research program and for the field at large.”

Staying Informed on Mpox

Jun 6, 2022 | Featured, Global Health, Infectious Diseases, Your Health

Mpox—a rare disease caused by the monkeypox virus that results in fever and a blistery rash—has been in the news lately. Normally found in parts of Africa, an increasing number of mpox cases have been confirmed in Europe and the United States. In this Q&A, Bernard Camins, MD, Medical Director for Infection Prevention at the Mount Sinai Health System, says most people shouldn’t be too worried about mpox, but calls for a bit of vigilance by physicians and the public. “It’s good to just inform people, even though the likelihood of the average person living in New York being exposed to someone with mpox is low,” Dr. Camins says.

What is mpox?

The monkeypox virus is a virus that is in the same family as smallpox and cowpox. As you probably know, smallpox was eradicated years ago. But we do have to worry about mpox every now and then.

Should I be concerned about mpox?

Most of us should not really worry about getting exposed to or getting mpox. The current situation is that some people who have traveled to countries in Europe or Africa have been exposed to people with mpox, and potentially they could be at risk for also having mpox. These returning travelers have exposed other people within their social circles, so there are reports of people contracting mpox who have not left the United States.  You should only worry about mpox if you know someone who has symptoms of mpox or who has been diagnosed with mpox.

Click here to read the latest travel advisory on mpox from the CDC

What are the symptoms of mpox?

The hallmark of mpox is a rash, but before the rash appears, people can have a fever and a feeling of malaise or tiredness. Another hallmark is “diffuse lymphadenopathy” or enlarged lymph nodes. So if you do have fever and enlarged lymph nodes, and you were exposed to someone suspected of having mpox or someone who has been diagnosed with mpox, then you need to seek medical care.

What should doctors do if they see a patient with mpox symptoms?

If a doctor suspects a patient has mpox, even before the rash appears, we instruct them to isolate the person in a private room. The medical team will then wear personal protective equipment that includes an N95 respirator, gowns, and gloves, and then they will do an extensive interview. We need to know the details of the patient’s interactions with people who may have mpox. One of the key things that decides if someone needs to be tested is whether they have an epidemiological link to someone with mpox—meaning that either they traveled abroad and were exposed to someone with mpox or that they are at high risk for having mpox. While mpox is not usually considered a sexually transmitted infection, the latest outbreak has been observed among sexual partners.

Why are we talking about mpox now?

While mpox is a viral infection that is rare, a large outbreak has occurred in the United States before, in 2003. Mpox is endemic in Africa, meaning it is normally found there, but because we have a lot of people traveling around the world, it is spreading in countries where it is not endemic.

You can get more information about mpox and the latest updates from the New York City Department of Health and Mental Hygiene and the Centers for Disease Control and Prevention.

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New Center for Engineering and Precision Medicine Paves the Way for Two Fields to Work More Closely Together

Updated on Jun 30, 2022 | Featured, Research, School

Shirley Ann Jackson, PhD, President of Rensselaer Polytechnic Institute, Eric Nestler, MD, PhD, Director of The Friedman Brain Institute, and Andrew Kimball, president of the New York City Economic Development Corporation, sign a ceremonial agreement at the launch of the Center for Engineering and Precision Medicine.

The Icahn School of Medicine at Mount Sinai and the Rensselaer Polytechnic Institute on May 12 announced the opening of the Center for Engineering and Precision Medicine (CEPM), forming a new venture to bridge engineering and biomedical science expertise between the two organizations.

The center, located at 619 West 54th Street in Manhattan, focuses on three research areas—neuroengineering, immunoengineering, and regenerative and reparative medicine. Its footprint includes spaces for wet and dry laboratories, as well as offices for faculty and researchers.

In addition to research, CEPM will develop a joint PhD in engineering and precision medicine, and ultimately master’s degrees and certificate programs. Enrollment could occur as early as the fall of 2023, said Jonathan Dordick, PhD, Institute Professor of Chemical and Biological Engineering at Rensselaer and Co-Director of the Center.

The Center is the latest development borne from a partnership between Mount Sinai and Rensselaer—dating to 2013—that has secured more than $70 million in shared research funding. Milestone achievements have included an artificial pancreas system developed by the two institutions and a number of advances in improving treatment and health infrastructure during the COVID-19 pandemic.

“We identified that there was a need in New York City and the state for such a collaboration to be the foundation of a new path of innovation between engineering and precision medicine,” said Priti Balchandani, PhD, Professor of Diagnostic, Molecular and Interventional Radiology, Neuroscience, and Psychiatry at Icahn Mount Sinai and Co-Director of the Center.

FAST FACTS

  • Project planned since: 2018
  • Footprint: 14,000 usable square feet
  • Faculty size: Mount Sinai and Rensselaer jointly hope to recruit 20 faculty members within five years for the center
  • Planned academic programs: PhD in Engineering and Precision Medicine jointly awarded by Mount Sinai and Rensselaer, master’s programs, and certificate programs in entrepreneurship and other areas relevant to advanced education at the interface of medicine and engineering.

The creation of the Center sets the stage for engineers to consider the needs of biomedical researchers to develop tools, systems, and infrastructure needed to address unanswered questions, Dr. Dordick said. “As a field, we’ve been asking how engineering can play a closer role at each stage of development in biomedical science from bench to bedside.”

Read a Q&A from the leaders of the new Center on how bridging engineering and precision medicine can benefit patients

The Center will also serve as a hub for industry partners and collaborators. Its “Development Labs” will be working with Mount Sinai Innovation Partners, the team focused on commercializing innovations from Mount Sinai Health System, on technology transfers with industry partners, as well as fostering the creation of startups, Dr. Balchandani said.

“This partnership with Rensselaer is truly a first where not only are two organizations coming together for research and academic excellence,” she noted, “it is also creating a partnership that will augment translational work in the city.”

Mount Sinai is also growing its presence in the area by building laboratory spaces in a facility on 11th Avenue, adjacent to the Center, for the Mount Sinai West campus.

“Ultimately, the goal is to develop new innovations that will benefit patients,” Dr. Dordick said. “The work at the Center cannot start soon enough.”

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