Pioneers of Hope

At Monroe Carell Jr. Children’s Hospital at Vanderbilt our work extends beyond patient exam rooms. We are also searching for discoveries to offer better treatments, and, hopefully, find cures for pediatric patients. The profiles here represent only a sampling of the tireless work performed daily to make Children’s Hospital a place of unwavering hope. In each issue, we also include a profile to highlight our longstanding partnership with our community pediatricians who help ensure all children receive the best care each and every day.

 

Arie L. Nettles lives by the mantra, “Good, better, best. Never let it rest. Until your good is better, then your better is best.”

Nettles, Ph.D., NCSP, HSP, an associate professor of Clinical Pediatrics in the Division of Developmental Medicine and a psychologist for school-age children with developmental disabilities and autism, began reciting this refrain in first grade in Chattanooga, Tennessee. She was part of a group of students that integrated schools through the busing movement, and she strived to be great to break down any biases.

She learned from an early age the importance of serving and helping, teaching others, having a good reputation, always expanding her education and appreciating knowledge.

“I grew up in a family of service to people in the ministry and education,” Nettles said. “My mother was a special education teacher for over 40 years.”

In 1977, after three years of college, Nettles earned her Bachelor of Science in social science from the University of Tennessee-Knoxville. She spent her fourth year completing her Master of Science in Education Administration and Supervision. Following her mother’s footsteps on a path to become a school superintendent, Nettles was a secondary education teacher in Iowa and then a behavior specialist and English teacher for Metro Nashville Public Schools.

“It occurred to me that health impacts children’s behaviors, scholastic performance and family dynamics. How can I put that all together and make it work?” she recalled.

An American Psychological Association Fellowship Minority Scholar award led her to Vanderbilt where she obtained her Ph.D. in psychology from Peabody College of Education and Human Development in 1987. During her studies, she began weaving her interest in clinical and school psychology taking internships at Fort Knox Army Base as the first school psychologist for dependent student services followed by a clinical psychology internship at Howard University Hospital Department of Psychiatry in Washington, D.C.

After a time as a school psychologist in New Jersey, she accepted a faculty position in the College of Education at the University of Tennessee, and subsequently joint faculty posts in education and pediatrics at the University of Michigan.

Nettles and her husband, Michael, whom she describes as “brilliant,” was her college sweetheart and they’ve now been married for 37 years. Their careers moved them across the United States until they settled their “family headquarters” in Nashville when Nettles joined the Vanderbilt faculty in October 2004.

“I thoroughly enjoy the work I do as a psychologist here in developmental pediatrics for school-age children,” she said.

Nettles also leads the Office of Inclusion and Health Equity (OIHE), a joint effort between Children’s Hospital and the Department of Pediatrics to help address the needs of a diverse pediatric population.

Nettles has fought obstacles that tested her strength to be her best. In November 2012, she was diagnosed with cancer and turned to physicians at Vanderbilt. She is now in remission.

“My family and I are most grateful to have extraordinary health services,” she said.

Nettles serves on several boards and organizations dealing with health education, child psychology and intellectual and developmental disabilities.

She is a classically trained pianist who keeps music as an integral part of family life and currently directs a music ministry. Her husband is senior vice president and the Edmund W. Gordon Chair of ETS’s Policy Evaluation & Research Center (PERC) in Princeton, New Jersey. They raise koi fish, collect antiques and have published two books about educational assessment. They have three daughters, Ana, Sabin and Aidan, all Harpeth Hall School alums.

– by Tavia Smith

 

While in college at Yale, Nashville native and associate professor of Plastic Surgery Reuben Bueno Jr., M.D., took the usual pre-med courses, but he also felt pulled to a career in teaching young people.

To explore that possibility, he returned to his alma mater, Montgomery Bell Academy, to teach seventh grade science and coach football. After two years, he went on to medical school at Vanderbilt, an experience that solidified his desire to be involved in the lives of young people.

He carried his passion through his medical training and on to his current role in caring for children and training future physicians and surgeons.

“I have been inspired by great teachers, coaches and mentors and always knew that I would have a career in teaching,” said Bueno. “I am fortunate that I have the opportunity to teach medical students and residents what I love to do—taking care of kids. I hope to challenge them and question how they would manage a clinical problem, not just as a plastic surgeon but also as a parent.”

After completing an integrated plastic surgery residency at Southern Illinois University (SIU), a hand fellowship at the Hospital for Special Surgery in New York City, and a pediatric plastic surgery fellowship at the Hospital for Sick Children in Toronto, Bueno returned to SIU in 2006 where he served as director of Pediatric Plastic Surgery and Residency Program director. He returned to Nashville in 2014 to his medical school alma mater to serve as chief of Pediatric Plastic Surgery and Plastic Surgery Residency Program director, to which he also has strong family ties.

Bueno’s father, Reuben Bueno Sr., was Vanderbilt’s first Plastic Surgery Residency graduate and had a private practice for 27 years in Nashville.

Bueno Jr.’s clinical focus is reconstructive plastic surgery, including hand surgery, cleft lip and palate surgery and burn surgery. Since joining the faculty, he performed two surgeries at Monroe Carell Jr. Children’s Hospital at Vanderbilt never done before at the hospital—free muscle transfer for facial reanimation, using a nerve that is normally used for biting to allow a patient to smile, and targeted muscle reinnervation (TMR), surgery after traumatic amputation at the forearm level.

For upper extremity amputees, TMR surgery allows for a prosthetic that is controlled by the patient’s thoughts. This innovative procedure, also referred to as “bionic arm” surgery, reroutes severed nerves that previously went to the amputated limb to nerves on the chest wall or the residual limb. The reinnervated muscles serve to amplify nerve signals from the brain, and a custom-built prosthetic can then sense these signals, allowing restoration of elbow and hand function. The thought-controlled prosthetic is more intuitive and less cumbersome to use than the traditional body-powered prosthetic.

In his educator role at Vanderbilt, Bueno has been involved in the development of an assessment tool to teach microsurgical skill using surgical simulation. “It is a way for surgeons in training to develop skill and confidence in a lower stakes environment than in a real live patient and allows teachers to provide meaningful feedback to learners.”

Outside the hospital, Bueno spends as much time as possible with his wife, Dana, and their two sons, Jude, 9, and Roc, 8. His stepdaughter, Audra, started her first year of college in the fall. At home, he enjoys grilling on his Big Green Egg grill and playing ping pong, air hockey and classic 80s arcade games with his family. Along with his boys, he is also learning to play tennis. “I am just a beginner, but I have to show them that I am willing to learn new sports too.”

– by Christina Echegaray

 

Brent Graham, M.D., watched firsthand as his father, now a retired pediatric cardiologist at Vanderbilt, healed the children of Nashville.

Graham, director of the Division of Pediatric Rheumatology at Monroe Carell Jr. Children’s Hospital at Vanderbilt, was just 5 years old when his father, Thomas Graham, M.D., moved their family to Nashville in 1971 to start the first Pediatric Cardiology program at the Children’s Hospital.

He spent a lot of time watching his father in a hospital setting, and as he grew, a passion for medicine became ingrained in him.

“I spent a lot of time around the hospital growing up,” Graham said. “My father’s legacy at Vanderbilt is significant. I am mindful of that, but am more mindful of all the simple but profound lessons he has taught me and continues to teach me by his example.”

Upon graduating from Vanderbilt University School of Medicine, the younger Graham was drawn to pediatric rheumatology.

“I became interested in pediatric rheumatology when I observed a pediatric rheumatologist making the diagnosis of Lyme disease,” Graham said. “I began spending time at his clinic and enjoyed the diagnostic challenges as well as the multisystem nature of the diseases and the long-term follow-up of patients.”

After medical school, he spent 16 years away working in hospitals in Philadelphia and Cincinnati before returning home to Vanderbilt.

When his wife was looking at schools to pursue her Master of Divinity degree, Vanderbilt was a leading choice.

Simultaneously, Graham was approached about taking a position in pediatric rheumatology.

The timing was perfect for the family and they soon settled their roots back in Music City.

Much had changed on the campus when Graham returned.

“Vanderbilt is much larger than when I was here as a medical student,” he said. “Nevertheless, it has maintained its collegiality. This leads to a positive work environment and improved care for patients.”

In September 2008, Graham left his position as clinical director of the Division of Pediatric Rheumatology at Cincinnati Children’s Hospital Medical to take his current director’s role at Children’s Hospital.

“Vanderbilt was in the perfect position to grow a program in pediatric rheumatology. The need for pediatric rheumatologists nationally and within the state is significant,” Graham said. “I enjoy pediatric rheumatology because of the diverse patient population that includes diseases which affect all organs. We still have a lot to learn, but our ability to treat patients with chronic diseases and improve their quality of life has improved dramatically since I started in this field. We are starting to recruit more people to our team to help us in this challenge. I am especially grateful for all of the support staff, nurses, therapists, nurse practitioners and physicians in our group.”

Graham and his wife, Evelyn, have been married for 26 years. She graduated from Vanderbilt Divinity School in 2015. They have three children: Caroline, 21, David, 19, and Will, 15. Graham has enjoyed playing and coaching sports with his children for several years, and the family enjoys boating on the weekends.

– by Tavia Smith

Rufus Clifford, M.D., spent a lot of time on his grandparents’ farm in Maury County, Tennessee. His many hours of tending to the animals stirred his desire to become a veterinarian. But something happened along the way—a mentor convinced him to attend medical school instead.

“During my last two years of high school, I worked with a veterinarian,” recalled Clifford. “He told me that he always regretted that his patients couldn’t talk to him.

“I took his advice, became a pediatrician and still most of my patients can’t talk to me,” he chuckled. “There’s just something about taking care of children—it’s a real joy, and I love watching them develop and grow up.”

Clifford, a general pediatrician, has been practicing pediatrics for a little more than 50 years. After being away for college and work, he returned to Tennessee in 1964, settling in Columbia to join an established clinic. Ten years later, he convinced his sister, Patricia Clifford Davis, M.D., a developmental pediatrician, to join, and the pair formed Columbia Pediatric Clinic.

What started out as a sibling operation in 1974 has grown into a 12-person practice serving upwards of 300 patients a day in two locations—the main office in Columbia and a secondary site in Spring Hill, which offers night and weekend hours.

“My sister decided to go into medicine against my advice,” said Clifford. “So after she had been in practice a few years in Arkansas, I coerced her to move here. For several years it was just the two of us, but our practice just grew and grew.

“My work here has been so rewarding,” he said. “I can go into a room these days and I have taken care of three generations. It’s truly amazing.”

Columbia Pediatric Clinic serves a nine-county area reaching the edge of Alabama, he said. With a good percentage of their patient base coming from outside of Maury County,

Clifford said developing a strong relationship with Monroe Carell Jr. Children’s Hospital at Vanderbilt has been important.

“We are really dependent on that relationship,” he said. “It’s been a great affiliation. Vanderbilt sends specialists to our Spring Hill location and they put a NICU at Maury Regional Hospital.

“The Cumberland Pediatric Foundation has been good at bringing pediatricians from Middle Tennessee and Vanderbilt together—we all want to put our best foot forward to take care of our patients.”

A native Tennessean, Clifford attended Lipscomb University, graduated from the University of Tennessee Knoxville in 1955 and earned his medical degree from the University of Tennessee-College of Medicine in Memphis in 1959. He went on to complete his pediatric internship at the University of Tennessee Memorial Research Center/Hospital in Knoxville in 1960 before joining the United States Air Force as a flight surgeon for two years. In 1962, he returned to the University of Tennessee Memorial Research Center/Hospital to complete his residency in Pediatrics.

“I’ve been practicing here for a very, very long time,”

Clifford said pausing. “What is nice about that is—I see something new almost every day. And when one of my younger colleagues comes across something they have never seen before, they come get me.”

Davis followed the same education path as her brother, earning her bachelor’s degree from University of Tennessee-Knoxville in 1959, and then her medical degree from University of Tennessee College of Medicine in Memphis in 1965.

She did her pediatric internship and residency at University of Tennessee and City of Memphis Hospitals.

– by Jessica Pasley