Pioneers of Hope
Published on December 16th, 2011 by Diana Duren.
At the Monroe Carell Jr. Children’s Hospital at Vanderbilt, our physicians’ work extends beyond patient exam rooms. They are also scientists – searching for discoveries to offer better treatments, and hopefully, find cures for their pediatric patients. The five doctors profiled here represent only a sampling of the physician-scientists working tirelessly to make Children’s Hospital a place where discovery brings hope.
Fred Lamb, M.D., Ph.D., the new director of the Division of Pediatric Critical Care, shrugs his shoulders and muffles a laugh when he explains how he landed in the specialty.
“My father was a pediatrician,” said Lamb. “In fact, he was a pediatric intensivist. I went into cardiology so I wouldn’t follow in his footsteps.
“Well, fate thrust me into the critical care world anyway,” he said smiling. “It’s ironic, really.”
Lamb couldn’t be happier with the direction his career took. His entire professional life has been spent in the Pediatric Critical Care Unit (PCCU).
Lamb came to Vanderbilt in August from the University of Iowa Children’s Hospital where he was the director of the Division of Pediatric Critical Care for nine years.
He received his undergraduate degrees from the University of Michigan. He then entered the Medical Scientist Training Program (MSTP) at the University of Michigan Medical School followed by his pediatric residency at Mott Children’s Hospital and a cardiology fellowship at the University of Iowa.
Upon completing his graduate training in 1994, he landed his first job in pediatric critical care.
“I started as a faculty member and I had my own lab,” Lamb said of his first academic appointment. “I knew it was the right thing for me. Since then, I have been very happy with how my career has progressed.
“I have always wanted to be a physician scientist, doing research that would have some potential usefulness to people. And with research, you don’t know until you get to the end of the line if it was worthwhile or not. But that is part of the puzzle that I enjoy.”
Lamb’s current research focuses on inflammation and the pathways of inflammatory cytokine signaling. More specifically, he looks at the role of CLC-3, an ion transporter, in reactive oxygen signaling with hopes of determining whether the protein is a target for anti-inflammatory drug therapy.
While the opportunity to do his research was one of the factors that attracted him to Vanderbilt, his No. 1 priority is ensuring that the PCCU is the best possible environment for employees and patients and families.
“There is no way to sugarcoat it – by nature and definition, having a child in the ICU sucks. There is no other way to view it,” paused Lamb. “Most of the kids get better and go home, but some don’t and it’s terribly sad.
“My job is to help families cope with the situation they are in. I try to stay focused on the family’s needs and not the tragedy at hand. It’s all about making it the best it can be,” Lamb said. – by Jessica Pasley
Kecia Carroll, M.D., MPH, always knew she wanted to become a physician. Certain of her profession, she began
applying to medical schools upon graduating from Vassar
College.
What she learned during the year between graduation and the start of medical school would influence the direction of her medical career.
While Carroll was applying to medical school she worked as a research assistant studying respiratory viruses in Pediatric Infectious Diseases at Vanderbilt.
“It was really the first time I was able to see how a doctor could really integrate patient care, research and education. From that exposure, I realized that was really a way you can have an impact on child health that extends beyond working with individual patients and families.”
Once enrolled at Vanderbilt University School of Medicine, Carroll continued on the pediatric route. Her work in the
infectious disease division sparked her desire to become a physician-scientist and to focus her research on asthma and bronchiolitis – viruses play an important role in both diseases.
After graduating from VUSM in 1996, she completed her pediatric internship and residency at the University of California, San Francisco, returning to Vanderbilt for a research fellowship in General Academic Pediatrics and to earn a master’s degree in public health.
Carroll joined Vanderbilt’s faculty in 2005 as an assistant professor of Pediatrics and conducts research with investigators in Vanderbilt’s Center for Asthma and Environmental Sciences Research. As a clinical researcher/epidemiologist she studies risk factors for bronchiolitis during infancy and asthma in early childhood. Both respiratory conditions are very common. Asthma, a leading cause of hospitalizations and missed school days, can affect up to 10 percent of children in the country.
“One thing we know about asthma – we can control the symptoms with proper medications,” said Carroll. “So it is
important that we are properly diagnosing children and providing them with appropriate treatments and monitoring so they can live lives that are not limited by asthma.
“Our research focuses on better understanding potential risk factors involved in the development of asthma, so if possible we can minimize their exposure in hopes of preventing or lessening the severity of asthma.”
Improving the health of current and future generations is what drives Carroll’s research efforts.
“I think there are so many ways to make a contribution to society,” said Carroll. “Whether I am involved in a research project, working with patients or teaching residents, I am able to impact the life of a child. I love what I am doing. It is the ideal combination for me.” – by Jessica Pasley
When Sabina Gesell graduated from college, she had no steadfast plans for what to do next.
Armed with a bachelor’s degree in psychology from Vassar College, she spent the subsequent year living and working in a migrant shelter in Juarez, Mexico.
It was a turning point in her life.
“I was exposed to poverty and atrocious health care,” recalled Gesell. “I was so frustrated by my inability to make a difference. It is what led me to want to make large-scale and sustainable changes to improving children’s health. Research seemed to be the most logical approach to me.”
Gesell returned to school to earn her master’s and doctorate in psychology from the University of Notre Dame. She later joined a national think tank, Press Ganey Associates, focusing on the measurement and improvement of health care quality.
Her combined graduate school and industry research experience brought her to Vanderbilt to pursue an academic career in patient-oriented research in 2006. Her focus – pediatric obesity prevention and how to use social networks to change behaviors that will lead to improved health outcomes in children.
“Obesity is probably the biggest threat to the public’s health,” said Gesell, Ph.D., research assistant professor in
the Department of Pediatrics. “There have been hundreds of interventions across the nation and the vast majority of them have failed. I am intrigued by this puzzle. We can’t seem to crack the code.
“We need an alternative approach to dealing with obesity, and social network analysis is a very promising way to tackle this issue. We know that relationships influence our health. The question is – how do we intervene on social networks to effect positive changes in health?”
Traditionally, peer pressure has held negative connotations. But Gesell is working to change that by showing that peer pressure from social networks, a grouping of persons with similar interests, information or experiences, can promote healthy lifestyle habits too.
The theory of networks is not new, said Gesell, but how to utilize them to understand and change behaviors around health is novel.
“Social networks are an innovative approach to public health interventions,” said Gesell. “We know that our social networks exert measurable influence on our health. But we are only on the cusp of understanding how. Although we don’t have all the answers, yet, there is sufficient evidence to suggest there is an enormous potential for deliberate social network interventions to improve child and adult health – systematically and efficiently. “
Two of her most recent research projects focus on how to use the social networks of school-aged children (ages 5-12) to increase their activity levels and how to use social networks of women to prevent postpartum obesity.
She recently received a five-year award from the National Institutes of Health which will allow her to investigate how
to use social networks of pregnant women to change health behaviors and decrease the susceptibility of their unborn
children to obesity. – by Jessica Pasley
Derek Williams, M.D., MPH, is not daunted by the challenge that his research brings. As a matter of fact, it’s the fuel that feeds his fire.
Williams, instructor in Pediatric Hospital Medicine, is tackling one of the oldest diseases on the planet and one of the top causes of death in children under the age of 5 – pneumonia.
Despite the various treatments and prevention efforts for the lower respiratory illness, it continues to be the most common reason for pediatric hospitalizations in the United States. Williams wants to change that.
“Pneumonia is not going anywhere anytime soon,” said Williams. “This is my career – figuring out what is causing pneumonia, what makes some children sicker than others, and finally, how to most effectively treat and prevent it.
“It’s a huge burden of disease that impacts the extremes of age, especially both young and old. The disease is always changing. So as it evolves, we have to adapt if we want to provide the very best care for our patients today and in the future.”
Williams came to Vanderbilt in 2008 for a fellowship in General Pediatrics and also received his Master of Public Health degree. He obtained his medical degree from the Medical College of Georgia in 2005, followed by a pediatric residency at the University of Virginia. He joined the Vanderbilt faculty in 2010.
His current research focus is a Centers for Disease Control and Prevention-sponsored study exploring the incidence and etiology of pneumonia hospitalizations in the U.S.
“We are finding that there is often a co-mingling of viruses and bacteria that lead to pneumonia,” said Williams. “There is also evidence that those patients who have both the virus and the bacteria have more severe disease. It points to the need to properly diagnose the bug or bugs causing the pneumonia so that the most effective treatments can be applied.”
And that will take some time. Thankfully for Williams, he is OK with delayed gratification.
“As investigators we have the natural desire to dig deeper and really try to figure things out. I know I won’t have all the answers. That’s the reward, sometimes you get a hit and you know you are on to something – one that can actually impact care and help improve the lives of a lot of children.”
When Williams is not studying the epidemiology of pneumonia, he is busy with his family – wife, Elizabeth Williams, M.D., and two sons, Benjamin, 4, and Harrison, 2; rooting for the Georgia Bulldogs and the Atlanta Braves and trying new recipes in the kitchen.
“I love to cook,” smiled Williams. “I really like the process of experimenting.”– by Jessica Pasley
Ask Nathalie Maitre, M.D., Ph.D., how she landed in neurodevelopmental research and you will get a one-word
answer – Leo.
Born with a brain bleed at 27 weeks gestation, Leo, spent three months in the Neonatal Intensive Care Unit at Duke
Children’s Hospital where his mother, Maitre, was a resident.
“I knew I was going into intensive care, but until I had my son and went through the NICU experience and I still wanted to do it afterwards – I knew it was a sign,” recalled Maitre. “I started being interested in ways to study what children actually perceive, how their brains are working and what kind of intervention we can develop to help them recover from injury.”
It’s a perfect fit for Maitre, who characterized herself as the “annoying kid” with all the questions. Her insatiable curiosity drew her into research while her desire to impact the lives of children led her to Pediatrics. It was her personal journey that influenced her focus on neonatal-perinatal medicine.
“While a parent in the NICU, I realized that’s just one instance in your life and that of your child,” said Maitre. “The objective from here on out is to try to make the rest of your child’s life better. My goal is to figure out how to make that happen for a parent and child.”
The first year of a child’s development is intrinsically linked to perception, said Maitre. The only way to decipher how a baby perceives touch, sound and visual input is to look into the brain.
“In the past, a baby’s perception has been subjective,” said Maitre, assistant professor of Pediatrics at Vanderbilt. “People seemed to think they knew what a baby felt, heard or saw. But now, using various techniques, we are actually able to measure how a baby’s brain perceives the world. We no longer have to conjecture.”
Maitre came to Vanderbilt in 2008 after completing her Neonatology Fellowship at the University of North Carolina at Chapel Hill. Currently, she is director of the Developmental Follow-Up Clinic at Vanderbilt’s One Hundred Oaks campus.
She received both her graduate degrees from the Medical University of South Carolina. She graduated from Boston
University in 1991 with dual degrees in biotechnology.
“What is important about my work is that we have found that how a baby’s brain works in the NICU is going to predict how they are going to think, talk and develop movement. We are developing interventions in the NICU that are going to make a difference to these children throughout their infancy and childhood. Our goal is to take advantage of the fact that young brains are plastic and can change.
“Every day I know I am trying to make a difference,” Maitre said smiling. “There is always one more thing you can do to make your child’s life better. I believe that because I see it every day in my patients’ lives and in my own life. It’s what I live.”
When Maitre is not at Vanderbilt, she is busy with her sons, Leo, now 7, and Lucas, 4. A black belt in Taekwondo, Maitre and the boys take classes together. They also love the outdoors and travel. – by Jessica Pasley
