Pioneers of Hope

Published on June 20th, 2011 by Christina Echegaray.

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.”

Amy Woodward, M.D., M.P.H. Pediatric Rheumatology. Photo by Daniel Dubois.

Amy Woodward, M.D., M.P.H., loves a good mystery.

Outside the hospital, that means watching old Alfred Hitchcock movies. Inside the hospital, she specializes in Rheumatology.

“Rheumatology is a bit of a puzzle and you have to put all the pieces together,” Woodward said. “Each patient is a different challenge. It’s how to make that specific child feel better, not one size fits all. Sometimes it’s straightforward and other times there are a lot of steps to get the right answer.”

Rheumatology is the treatment of autoimmune disease, or when a person’s immune system attacks its own body. Unfortunately, there is a shortage of pediatric rheumatologists – only about 200 are practicing in the United States.
With this shortage in mind, Woodward is creating an interactive website to educate community providers about
Pediatric Rheumatology.

“I’m from Nebraska and there is one person in the whole state practicing Pediatric Rheumatology. Families either end up driving extensive distances to get to an academic medical center, or other providers end up giving care, either adult rheumatologists or general practitioners.”

The project, funded by a grant from the Katherine Dodd Faculty Scholars Program and the American College of Rheumatology, seeks to diagnose children more quickly and to collaborate with their primary care providers for treatment.

Though the website is still in early development, Woodward is excited about its potential to address the expected shortage.

“Even though there is a big push from the American College of Rheumatology to increase the number of pediatric rheumatologists, they know that the need is going to outpace the gains in providers over the next several years. We’re trying to think creatively of how we can fill that gap and help the people that are actually seeing these kids and get them the care and attention they deserve.”

After medical school at Vanderbilt, Woodward did her residency at Children’s Hospital of Philadelphia and a fellowship in Pediatric Allergy, Immunology and Rheumatology at Children’s Hospital Boston. After joining the faculty in Boston and then Indiana University, Woodward came to the Monroe Carell Jr. Children’s Hospital at Vanderbilt last July.

“Some things are familiar, but so much is new. The freestanding Children’s Hospital didn’t exist when I was here,” she said. “It’s been a circuitous route, but I was very excited to come back to Vanderbilt.”  – by Leslie Hill

Eric Austin, M.D., M.S.C.I. Pediatric Pulmonary Medicine. Photo by Susan Urmy.

Although he is very dedicated to his research and spends a lot of time in the lab, Eric Austin, M.D., M.S.C.I., breaks into a wide grin when he talks about seeing his patients in the clinic.

“I love the opportunity to interact and have fun with the children but then also make an impact on their families by talking about their challenges and how to attack them together,” said Austin, assistant professor of Pediatric Pulmonary Medicine.

Practicing pulmonary medicine has let Austin form especially tight bonds with his patients and develop close relationships that he relishes.

“One of the many things that’s fun about pulmonary medicine is the opportunity to be a subspecialist who deals with patients and families over a long period of time – we get to have an almost primary care-like relationship with them in the setting of a complex series of health challenges,” he said.

Growing up in Atlanta with a father and grandfather who were physicians, Austin always knew that he would go into medicine, even though there was no pressure to follow in their footsteps.

“Medicine is in my family, but for me it was always about people. I always wanted to do something that relates to people, and I always particularly liked children.”

Austin’s positive energy and sense of caring is palpable, and it’s easy to see why he gravitated to being a physician. But he is also very dedicated to research and making discoveries that can benefit all children, not just the patients he sees.

Austin’s research focuses on the genetics of hereditary pulmonary arterial hypertension (PAH), a disease that constricts and destroys the smallest blood vessels in the lungs, disrupting normal blood flow and making the heart work harder. About 80 percent of those with PAH have a known genetic mutation, but why the other 20 percent develop PAH has baffled researchers.

Austin and colleagues performed a study to look for other genes associated with PAH, and found a new lead with one called Caveolin-1. Although a mutation in this gene is only found in a small part of the population, it brings many new possibilities for treatment.

“Mutations in Caveolin-1 had never before been described in humans,” Austin said. “This opens up a whole new avenue of potential research and thinking about this disease.”

Austin attended medical school at Emory University and did residency training at the University of Colorado Health Sciences Center. He came to Vanderbilt for a fellowship in Pediatric Pulmonary Medicine and joined the faculty in 2008. – by Leslie Hill

Jill Simmons, M.D. Pediatric Endocrinology. Photo by Daniel Dubois.

Jill Simmons, M.D., loves people as well as a good challenge.

Simmons, a Knoxville native, once thought she was destined to be a stockbroker, but quickly abandoned that path after one economics class, she says lightheartedly.

Medicine fulfilled her passion for people and her desire for intellectual tests, she learned while volunteering at a children’s hospital as a college undergraduate.

In her second year of medical school, she was drawn to endocrinology, which deals with the secretion of hormones from endocrine glands. These hormones are responsible for regulating body functions, such as metabolism, growth and pubertal development.

“Endocrinology allows you to use your brain, while building good, long-term relationships with children and their families,” said Simmons, an endocrinologist with the Ian M. Burr Division of Endocrinology. “It’s also like a puzzle. If you can figure out what’s missing, generally you can replace it.”

She graduated from the University of Tennessee – College of Medicine, and completed her pediatric residency and fellowship in Pediatric Endocrinology and Diabetes at the University of Colorado Children’s Hospital and Barbara Davis Center for Childhood Diabetes.

Simmons joined Monroe Carell Jr. Children’s Hospital at Vanderbilt in 2006.

In a current research project, funded by the Katherine Dodd Scholars Program, she studies the bone health and vitamin D abnormalities that occur in pediatric cancer patients from early treatment through long-term survivorship.
She also focuses on endocrine late effects faced by pediatric cancer survivors, and studies the endocrine system’s sensitivity to chemotherapy and radiation therapies.  She tries to identify patients at risk for diabetes, insulin resistance and the metabolic syndrome.

“If we can figure out who these children are, we can intervene early,” said Simmons, assistant professor of Pediatrics.
Along the way, she works with families to explain what’s happening with their child, listening to every question and concern.

“The most important thing that we do every day is educate families,” she said. – by Christina Echegaray

Stacy Tanaka, M.D. Pediatric Urology. Photo by Susan Urmy.

Stacy Tanaka, M.D., used to have her head in the clouds – but now with feet firmly planted, she is very happy where she landed.

Tanaka, an assistant professor of Urologic Surgery and Pediatrics, wasn’t always interested in medicine. Her first choice of careers was Astrophysics.

“It wasn’t until I was in graduate school that I realized that it might not be something I wanted to do for the rest of my life,” said Tanaka.

“While in graduate school, I noticed a lot of my friends were either going to medical school or were starting their residencies. I saw that they were doing things with research that could make an impact. And I wanted that too.”
Armed with Bachelor and Master of Science degrees in Physics from Princeton and the University of California-
Berkeley, Tanaka enrolled at the University of California-Davis School of Medicine. Initially, she was interested in General Surgery, but found her niche in Urology.

Tanaka came to Vanderbilt University in 2007 as a fellow, later joining the staff in 2009.

“When I come to work my days are never the same,” she said. “That is what is so awesome about my job. I do surgery one day, hold clinic on another and do research the rest of the week. I am able to balance my love for research and my interest in surgery.”

Her research focus is on the bladder. Specifically, she looks at what causes scarring that can eventually lead to kidney damage. The bladder, which fills up much like a balloon as it stores urine, is a muscle that contracts when it is time to release its contents. But in some cases, the bladder is overworked and becomes overdeveloped, which can lead to scarring. Over time, this creates increased pressure within the organ that can be transmitted to the kidney, causing damage.

“My main concern is kidney damage and how to prevent that,” said Tanaka. “I have done some preliminary work with stem cells in mice. We found that when we block the bladder of mice and give them the stem cells derived from bone marrow, some of the bladder characteristics improve.”

She is studying why there is an improvement and if the findings could be translated to humans.
Tanaka is motivated to make a difference.

“I am inspired daily because I truly like what I am doing,” she said. “I have great satisfaction with my work. Where I am feels good. It feels right. I am really happy I made that switch to medicine.” – by Jessica Pasley

Thomas Morgan, M.D. Pediatric Genetics. Photo by Daniel Dubois.

Thomas Morgan, M.D., always searches for the story behind the story.

As a clinical geneticist, Morgan’s job is to explore human disease at the smallest level – inside the genes, units of hereditary information that define each person and that can cause disease.

He seeks to identify genes and genetic mutations that may be responsible for different diseases. The human body contains tens of thousands of genes, and the search can be arduous.

But the challenge of genetics is what attracted him to the profession.

Morgan knew as a teenager growing up in Rhode Island that he wanted to be a doctor.

He had an intense curiosity, even contemplating the meaning of life in his youth.

“I always knew I wanted to be a doctor. It was the deep, idealistic thoughts of youth that led me to the medical profession,” said Morgan, assistant professor of Pediatrics in the Division of Medical Genetics and Genomic Medicine. “I saw medicine as a noble quest for truth and an opportunity to rebel against the existential absurdity of disease.”

Morgan did his undergraduate and graduate work at Boston University School of Medicine. He completed his residency in family medicine at Dartmouth-Hitchcock Medical Center in New Hampshire, which was followed by fellowships at Yale University in the Robert Wood Johnson Clinical Scholar Program as well as in Clinical Genetics. He arrived at the Monroe Carell Jr. Children’s Hospital at Vanderbilt in 2008.

He has several current research projects in his quest to understand genes that cause different diseases. In one study, he employs new DNA sequencing technology to search for genetic mutations that can cause heart attacks in young women.

In 2010, he was awarded the Turner-Hazinski Award, an annual grant given to help foster the research activities of a faculty member in the Department of Pediatrics. He is working to identify possible genetic links between premature birth and adult diseases.

“Many of the pathways involved in adult disease are also very important in the process of pregnancy and birth,” said Morgan.

“It is very exciting to gain new knowledge that will allow for the successful treatment of children and infants so they can go home with their parents.”– by Christina Echegaray