Alumni Profile: Follow Steven Brozinsky, MD ’72, from Downstate to Chula Vista

The Alumni Office contacted Dr. Brozinsky for an interview, and he shared his written highlights from almost 40 years in medicine.

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Continued, from above:
Dr. Morris Zuckerbrod, an elderly but revered internist was our preceptor. He introduced us to one of his patients and proceeded to percuss out the patient’s heart borders with his short, stubby fingers. We all had to agree on exactly where cardiac dullness ended and pulmonary resonance began. Dr. “Z” then took a sheet of loose leaf paper and traced his patient’s enlarged cardiac contours. The five of us went to the X-ray department where Dr. Z pulled that day’s film and snapped it onto a viewbox. With great fanfare he then whipped out the loose leaf page that he had stuffed in his breast pocket ten minutes earlier, unfolded it, and placed it on the X-ray.  The perfect superimposition of cardiac borders was a thing to behold.  Dr. Zuckerbrod smiled benevolently, “That, gentleman, is how you percuss out a heart.”

So, now it’s 2016 and it seems that the only person who touches a patient’s chest is the tech who performs the echocardiogram. Then a computer-generated report appears, signed by the cardiologist who may not have even examined the patient that day.

All of my education from kindergarten through medical school had been in Brooklyn.  The only exception was in February 1972 when I ventured by bus and subway into Manhattan for an elective rotation in gastroenterology with Dr. Michael J. Lepore at St. Vincent’s Hospital in Greenwich Village. He was a legendary clinician who got to know everything about his patients that might have a bearing on their illness. No wonder the likes of Greta Garbo and Herbert Hoover sought him out as their physician. Upjohn supported his fellowship program at Roosevelt Hospital and then St. Vincent’s, and it was one of the most highly sought after in the east. This was before ultrasound, CT, MRI — diagnoses were crafted from histories obtained by careful questioning and meticulously performed physical examination. No scribe taking notes on an iPad, but rather eye contact, hands on, calm but authoritative voice reassuring countless patients that he was there to help them.

That month was my introduction to the ravages induced by alcohol. From the suburban housewife with cirrhosis to the homeless Korean War veteran with pancreatitis, Lepore treated them all with respect and compassion, qualities sorely missing in many newly minted twenty-first century gastroenterologists whose prowess seems to be measured by adenoma detection and biliary cannulation rates.

I never had the pleasure of working with Henry Janowitz in New York or Joseph Kirsner in Chicago, and only met Yale’s Howard Spiro in the twilight of his career, but dozens of tributes testify to their devotion to their patients. As with Lepore, none of the countless accolades given to these giants speak of their endoscopic dexterity.

Maimonides
From 1972-75 I was a house officer in Internal Medicine at Maimonides. The Chief was David Grob, who was one of the world’s experts on myasthenia gravis. He consulted on Aristotle Onassis’ case. A John’s Hopkins trained clinician, he would frequently wow us on Director’s Rounds by palpating a patient’s radial pulse and then accurately predicting both systolic and diastolic blood pressure.

One night my team admitted a very interesting patient, and instead of having the intern present the case to him at morning report, I asked Dr. Grob if he wouldn’t mind interviewing and examining the patient in an attempt to arrive at what was indeed a rare diagnosis. Dr. Grob thoroughly enjoyed the challenge and we were all amazed at the direction of the questioning and ultimately how carefully he examined her extremities. Now how many patients with Ehlers-Danlos have you ever seen? Grob had the diagnosis in fifteen minutes!

VA Medical Center in Brooklyn
I served my fellowship in gastroenterology at the VA Medical Center in Brooklyn, and remained there as a clinical instructor and assistant professor. In 1975 when I started there, the affiliation with SUNY Downstate was rather weak. In an attempt to strengthen that affiliation and attract American graduates to the joint program with Kings County Hospital, the powers that be recruited Victor Herbert, MD, JD to the position of Chief of Medicine.

Yes, that Victor Herbert, who was named for his distant cousin, the composer. Dr. Herbert was an antiquackery activist who tolerated fools poorly and when he arrived at the Brooklyn VA he certainly encountered many old time physicians who fit that description.  Unfortunately his impolitic nature overshadowed his clinical brilliance and despite being given the VA’s Middleton Award “for outstanding achievement in medical research for his work on developing scientific tools to diagnose nutritional deficiencies,” he soon found himself at loggerheads with the Chief of Staff, a psychiatrist. VACO (VA Central Office) in their not-so-infinite wisdom banished both of them, the psychiatrist to Murfreesboro, Tennessee, and Herbert back to the Bronx.

Mission accomplished, however. By the time Herbert left Brooklyn, the old guard at the VA had been replaced by younger, more cutting-edge doctors and the training program in medicine, now more intimately integrated with Kings County Hospital and Downstate’s University Hospital, became one of the most competitive in New York City.

Dr. Herbert got along quite well with me and my GI section chief, Saul Grosberg, perhaps because he sensed that we kept up with the literature and applied this knowledge to the care of our patients. This was when endoscopy was starting to really take off, but Herbert appreciated and made it known that bedside clinical skills would always trump marginally indicated procedures.

No discussion of the Brooklyn VA of the 1970s would be complete without mentioning Harry LeVeen, the brilliant Chief of Surgery. He had some oddball ideas about intraoperative heating of pancreatic malignancies, some of which are being resurrected forty years later. He invented the LeVeen shunt for treating diuretic resistant cirrhotic ascites. In fact, my job as a senior GI fellow was to pick a piece of paper out of a hat to randomize a patient to shunt vs. further intensifying medical therapy. The shunt did work, but unfortunately early on, surgeons did not drain all the ascitic fluid before placing the shunt; hence the inevitable variceal rupture when all that extracellular fluid was returned to the intravascular space. I still recall one bona fide case of hepatorenal syndrome which was successfully treated with the shunt and published in the New York State Journal of Medicine.

University of California, San Diego
In June 1980 I left the borough of my birth to join the faculty at UCSD in the Division of Gastroenterology. This was a very heavily research-oriented group, mostly with Ivy League resumes, and they were looking for young clinicians.

While at UCSD from 1980-1986 I helped to train two dozen fellows, most of whom went into private practice, but several who did well in academia including Loren Laine, Christine Cartright, Salam Zakko and Susan Cummings. I did clinical research with the late Jon Isenberg on acid secretion and worked with the scientists at Hoffmann La Roche, SKF, Glaxo among others. I administered ranitidine (or placebo) to known duodenal ulcer patients and our lab technician extraordinaire Dan Hogan measured their gastric acid secretion.

The drug had not yet been marketed as Zantac. When it was (1983), Tagamet bit the dust.  And then, a few years later (1984) Australian physician Barry Marshall ingested a campylobacter-like organism that was subsequently named the Helicobacter pylori.  Although initially ridiculed for suggesting that this bacteria caused chronic gastritis and peptic ulceration, he had the last laugh, receiving the Nobel Prize in 2005.

I was one of a small group at UCSD who got along quite well with both Marshall Orloff and Abdool Rahim (Babs) Moossa, the Chiefs of Surgery while I was there. Orloff, at age 37, was the youngest Chief of Surgery in the nation when he was appointed as the school opened in 1968 and held that position for fifteen years. He later became world famous for his unbelievable results with emergency portacaval shunts on variceal bleeders. What was unbelievable was not the 30 day mortality which other centers came close to matching, but the recidivism rate among the alcoholic survivors, which Orloff claimed his personal and team’s intervention kept in the single digits!  Alas, hardly anyone is trained to do that procedure in 2016 as we have Interventional Radiology ready, willing and able to perform a TIPS. Orloff’s residents very much appreciated that he never castigated them in public.

Moossa was the go-to surgeon if you had pancreatic cancer. Patients from all over the world sought him out and were generally quite happy with his excellent results. He always asked me how my wife and young children were and more importantly, listened intently as I told him.

The inaugural Chief of Medicine at UCSD was Eugene Braunwald, a cardiologist from the NIH who had fled Vienna in 1939, and while a medical student at NYU in the 1950s was mentored by Ludwig Eichna (my Chair at Downstate 1960-1974). Braunwald came to UCSD with his thoracic surgeon wife Nina Starr but she and Orloff reportedly didn’t get along, and the Braunwalds returned to Harvard in 1972.

Henry Wheeler, another founding member of UCSD Medical School’s faculty, was instrumental in then recruiting his friend from Columbia, Helen Ranney to become the Chief of Medicine in San Diego. It was at Columbia that she conducted world-famous research on sickle cell disease. She was Chair at UCSD from 1973-1986.

Private practice
After UCSD, I joined Ed Singer in Chula Vista and we’ve been together now for thirty years. Ed grew up in Houston. He and I are the same age, have similar philosophies about patient care, and perform endoscopic procedures only when results stand a good chance of altering diagnosis or changing treatment.

A final word or two about UCSD. UCSD got it right when they made Tom Savides, a 1987 graduate who trained at UCLA and Indiana University, the head of interventional endoscopy. Tom is able, affable and available and it has been a pleasure to send my toughest cases to him – we have each others cell phone numbers and he has earned a well-deserved national reputation as the guru in EUS and double balloon enteroscopy.

Dr. David Brenner is currently Dean of the UCSD School of Medicine and Vice Chancellor for the Health Sciences. In 1986 he was one of my fellows and then went on to academic careers at North Carolina and Columbia. He lived near us in University City. We jogged together thirty years ago. Our daughters played together. He is primarily responsible for convincing Bill Sandborn to leave the Mayo Clinic and establish an IBD Center of Excellence here in San Diego. Kudos to Tom, Dave and Bill – what an incredibly valuable resource these physicians have been for the entire San Diego medical community. The “town-gown” problems which were rife here in the 70s and early 80s are finally starting to fade away.

The eleven consecutive semesters of French I studied in Brooklyn are not much help in Chula Vista. One of the ER admissions my first year in practice was a “mule” from Nigeria whom the border patrol agents at San Ysidro thought was acting suspiciously and sure enough an X-ray revealed two dozen drug-filled condoms scattered about his gut. When I started interviewing him in French, the guards at his bedside were not too amused and insisted I knock it off pronto, or else.

Unlike the hidden agendas in University politics, I came to appreciate that private practice politics were a more up front. Ancestral homeland and building loyalty more than hospital affiliation influenced referrals for office consultations, unless, of course, the patient were a family member, in which case Ed Singer or I had the honor and privilege of seeing them.

Richard Snyder, MD, a really good guy and a beloved and skilled practitioner was one of the gastroenterologists who spoke at a Sharp-sponsored symposium in 2015. He began his remarks by scanning the audience of physicians and nurses and stating that we all must have been good people in previous lives because we were now being rewarded with the privilege of practicing medicine; allowing us to not only make a comfortable living, but to care for our fellow man and use our education, training and skills to help our sick patients get better.

I was an academic for nine years and really loved teaching students, interns, residents, nurses and fellows. But these past thirty years in private practice have been the most enjoyable of my professional career.

The advances in medicine have enabled me to take so much better care of my patients. We can now cure hepatitis C. If banding bleeding esophageal varices doesn’t stop the hemorrhaging my interventional radiology specialists are available 24/7 to perform TIPS.  Can you believe that 32 years ago I attended a symposium at the Cleveland Clinic on variceal sclerosis – cutting edge then, but extinct now?

Laparoscopy was in its infancy in 1986. How many of you remember 9″ long cholecystectomy scars and the four week “off work” testimonials?

NOTES (natural orifice transluminal endoscopic surgery) is the new rage although I’m not sure it’ll catch on in the US, but if you go to China you can have your gall bladder stones removed via the rectum!  I kid you not. I just read a case report in the American Journal of Gastroenterology and the patient did fine – no visible scars at all – I suspect a little bit meshugi, but no scars!

I’ll probably hang up my shingle before I fully submit to the chazari of the EHR. Sure it’s nice to easily access the lab studies and X-ray reports on my patients – but my God – those ridiculous templates that are being shoved down our throats – they’re for the coders’ benefit and not our patients’.

And now that some patients are complaining about their practitioner (see – no longer their doctors) making eye contact with a tablet or pad instead of them a few practices are hiring scribes, that’s right, scribes to take notes. I’m sure we’d all love to have some total stranger record our symptoms, our history, our fears.

What I’ve cherished the most is the one on one when I meet a new patient for the first time. My favorite ice-breaking question is, “Where are you from way back when?” I know enough US geography to continue that line of questioning and, oh boy, if the patient is from New York I can really put them at ease.

My Spanish-speaking patients very much appreciate that I’m making the effort to converse with them. On occasion they’ll even compliment me on my accent. My bilingual MA Belinda has no equal.

What a pleasure to be able to make a diagnosis that might actually benefit a patient – celiac disease or Whipple Disease and not IBS. Microscopic colitis with instantaneous and dramatic response to budesonide. I have two young ladies in their twenties with Crohn’s who are symptom-free on the new biologic agents. Even the more mundane GI diagnoses GERD, IBS, dyspepsia, fatty liver have new therapies that did not exist a decade ago.

My colleagues in surgery, radiology and pathology are first class. The nurses at Sharp Chula Vista are a cheerful, talented and dedicated bunch. I am proud and honored to have served on the Board of Directors there from 2005-2014. Dr. Snyder is right. I am a lucky man.


If you’d like to share your experience in an alumni profile, let us know at alumni@downstate.edu!


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Great Brooklyn Turnout for SUNY Downstate Autism Fair

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More than 300 people and nearly 30 local organizations providing services to people with developmental disabilities, including autism spectrum disorder, met at the Grove at SUNY Downstate Sept. 25 for food, fun, information and community.

The FDNY and its mascots distributed fire safety information and giveaways for kids, and provided a firetruck for the children to explore, said Ben Schindel, MD/MPH. Children also got to interact with therapy dogs. A performer specializing in children with special needs entertained everyone for several hours.

Councilman Mathieu Eugene also spoke, along with Dr. Harris Huberman from the SUNY Downstate Child Development Clinic, and two mothers from the community. An ice cream truck closed off the event. There were arts and crafts, a sensory playground by the Downstate OT program, and lots of games and toys.

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SUNY Downstate Student Profile: Demitri Dedousis

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Demitri Dedousis, a third-year SUNY Downstate medical student, presented his preliminary findings, “The Effect of Formative Usage on Summative Grades for Preclinical Medical Students,” Sept. 3 at the Pediatric Medical Student Research Forum at the University of Florida. His travel was funded partially by an Alumni Association travel conference grant, provided by alumni giving.

The project goal was to evaluate whether the use of weekly formative exams by first- and second-year SUNY Downstate medical students has a positive result on student outcomes as measured by unit summative scores. He and classmate Christina Sorrento will work to continue further analysis.

How was this experience valuable?

Attending the Future of Pediatric Practice conference was valuable in many ways. It gave me a chance to present my research and receive critical feedback and suggestions for future directions. I also had the opportunity to network with physicians from all over the country and received career and residency application advice.  Finally it was refreshing to mix with medical students from all over the country who share similar interests.

Did you get any feedback?

Yes. Several physicians and faculty members who looked at my presentation board gave me suggestions for improvement and future directions. They pointed me to papers to read and educational strategies to research. One was kind enough to say “I can see that you will make a great medical educator someday, you are really looking at the foundation of medical education.”

Was it a good conference? How were the other presentations?

The other posters and presentations were of high quality. I was greatly surprised at what many of my peers were able to accomplish while in medical school or residency. There was also great diversity of topics covered, from molecular biology to social science.

Had you presented at a conference before?

I had not, this was a novel experience.

How valuable was the travel funding to you? We know you’re a med student, and probably trying to keep expenses to a minimum.

It was very valuable I would not have been able to attend this conference without Alumni Association support.

Are you a Downstate medical student who has been accepted to present at a conference? Check out the criteria to apply for an alumni travel grant!

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Join Downstate at the Crohn’s & Colitis 2016 Walk, Brooklyn

Take Steps for Crohn’s & Colitis 2016 Walk, October 9

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Join SUNY Downstate’s GI Division team, and to raise money for crucial, cutting-edge research, and to support the local patients and families in our area. Help us reach our team fundraising goal of $5,000!

On Sunday, Oct. 9, the Crohn’s & Colitis Foundation of America (CCFA) hosts a morning of music, food, kids’ activities, patient resources, and a celebratory 2-3 mile walk around Prospect Park. It’s a great way for local patients and their families to feel that they are not alone in their IBD struggle, and to feel the community support.

The mission of the non-profit CCFA is to cure Crohn’s disease and ulcerative colitis, and to improve the quality of life of children and adults affected by the diseases. Take Steps is the nation’s largest event dedicated to finding cures for digestive diseases.

If you have questions, or need help registering,  contact Kim Pang at 646-388-9285 or kpang@ccfa.org.


Brooklyn Take Steps Walk Prospect Park Bandshell, Sunday, October 9

10:30 AM Check-in and Festival Opens
11:30 AM Walk Starts

Each step we take together is one step closer to cures for our patients!

Photos: SUNY Downstate Alumni Wine & Cheese Event Sept. 22

Mark the next one, Dec. 15, 2016, on your calendars!

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Student Jonas Kwok talks to alumnus Stephen Danziger, MD ’68.

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Dan Nicoll, MD ’72, catches up with Louis Cregler, MD ’75

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From left to right, foreground, Bandele Omokoku, MD ’75, Vinette Greenland, MD ’79, Dan Nicoll, MD ’72 and Louis Cregler, MD ’75

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Bandele Omokoku, MD ’75 and Louis Cregler, MD ’75, talk in front of Alumni Auditorium

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From left to right, William Urban, Jr. MD, ’89, Joseph Merlino, MD, MPA, and Paul Pipia, MD, ’89

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Robert Iskowitz, MD ’66, Walter Diamond, and M. Monica Sweeney, MD ’75, Alumni Association president, talk over hor d’ oeuvres.

All SUNY Downstate medical alumni are welcome to the next event. For questions or to RSVP, contact alumni@downstate.edu.

Photos by Alumni Association Executive Director Eric T. Shoen-Ukre, CFRE


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Mentoring starts for Downstate Medical Students

carol-ipad-4It’s not too late to get involved

SUNY Downstate medical students met their new mentors, many of them Downstate alumni, this week in small lunch groups based on specialty interest. This year, and potentially throughout their med school career, the first-year students have the chance to ask for career advice one-on-one, or specific questions related to a specialty.

To date, 1,936 students have been served by the Faculty-Alumni Mentoring Program, said Dionne Davis-Lowe, program coordinator. “We have had students graduate and come back as a mentor.”

More than 270 faculty and alumni physicians volunteered in the past decade, she said. The program connects the students and volunteers. As for a time commitment, the current 27 mentors are encouraged to meet with students three or four times a year, or once a quarter.

It’s time well spent, Davis-Lowe said. Many students form a bond with their mentor that lasts well after the mentoring program finishes, and the guidance could influence healthcare infinitely.

For more information, please contact dionne.davis-lowe@downstate.edu.

 

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Anonymous Alumnus Donates 200 iPad Minis to 1st-Year Downstate Med Students

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Downstate’s first-year medical students got a highly anticipated email Tuesday, September 20. The more than 200 iPad minis purchased by an anonymous Downstate alumnus for the entire class were ready to pick up in the Alumni Office.

“It’s easier to pull stuff up for anatomy,” said med student, Vinny Sinatra, waiting to pick up one of the 7.9-inch, 32GB iPads. “You can put it in a Ziploc bag and take it to anatomy with you. It’s small enough to fit in your coat pocket.”

Student Oriana Tascioe plans to download the 3D Essential Anatomy app, and use her new iPad through the course of the day.

“It’s a lifesaver,” she said. “It’s not like I can carry around my laptop during anatomy.”

First-year Clifford Chao was inspired by the philanthropy.

“It’s amazing,” he said. “I didn’t know people did this kind of thing, but now that I know, one day I would consider doing it too.”

 

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Leave Downstate and Go Anywhere: Diversity and a Vision for Urban Health

A conversation with Carla Boutin-Foster, MD ’94, MS
SUNY Downstate Associate Dean for Diversity Education & Research
Carla Boutin-Foster, MD

The SUNY Downstate Office of Diversity Education and Research supports diverse students interested in pursuing medical education. It’s an important initiative for SUNY Downstate, Dr. Boutin-Foster said. The students are increasingly diverse, medicine is increasingly global, and Brooklyn, in particular, provides a singular opportunity to develop standards to impact urban health worldwide.

Support for a diverse community
“The office was formerly known as the Office of Minority Affairs, but we changed the name when I got here. I wanted to be more inclusive of what diversity is. I really wanted to capture differences in perspectives, experiences and abilities, as well as gender identity, sexual orientation and gender. I wanted it to be more comprehensive in our approach and, in doing so, allow more talents to contribute to the diversity that is Downstate.

“The office is really here to allow students who may sometimes feel marginalized, or may have barriers because of the way they look, the way they sound – any attributes that are placed upon them, and any barriers that happen as a result of that. We want to be a place where we talk about it, and where we embrace differences, look at similarities and bring about change. The students are telling me what to do, really. They live this every day.”

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Improving medical care
“Diversity, for me, is about providing patients with the best quality of care possible. SUNY Downstate happens to be in a community that’s largely minority. Our doctors need to understand that when you see a patient, you’re seeing their culture, their family, the stressors placed upon them. You’re sometimes seeing bias inflicted upon them. You’re seeing the total patient.

“And diversity, for me, is a way to address that. I think the more diverse a medical school is, the more likely students are to learn from each other, and to realize, ‘Wow, we’re from different places, and we do the same thing.’ You focus on differences when you don’t know someone. When you get to know someone, you realize we’re the same.

“It’s important for medicine. It’s important for student education, so students can function in an increasingly global society. I mean, Brooklyn is global. You’ll speak with someone who is from Bangladesh, and you’ll go to another patient, and they’re from Haiti or Russia. I want students to be able to ask questions. But it comes with being comfortable. If you’ve never interacted with a minority group and the first person you see is a patient who’s vulnerable, and sick – that will impact the treatment of that patient, inadvertently. So, it’s about providing the best care for our patients, and providing the most enriched medical education for the students who come here, and diversity does that.”

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The Office of Diversity Education and Research hosted its first event in July for diverse residents, fellows and fourth-year students, supported by Joseph Merlino, MD, Faculty Affairs and Professional Development, Kevin Antoine, JD, Diversity and Inclusion, and Stephen Wadowski, MD ’87, Associate Dean for Graduate Medical Education.

In October, the office hosts an event for Latino heritage and health, and in February, focuses on minority men’s health. The theme shifts to women’s health in March, and to LGBT health and wellness in June.

“When I was at (Weill Cornell), there was a strong LGBT support group, and I worked with some amazing faculty and colleagues around that. They’ve done things like have a speaker on transgender health, and faculty from Callen Lorde in the Bronx. I’m looking really to build on that. Or if there’s something already happening with the Pride Club at Downstate, to be supportive.”

Students, faculty and alumni are invited to contact the office with ideas, Dr. Boutin-Foster said. Two fourth-year students are planning tours for local youth to Brooklyn cultural centers. A male faculty member volunteered as a mentor after witnessing professional inequity in the treatment of women in medical research.

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Professional past, preparation
Born in Haiti, Dr. Boutin-Foster’s family moved to Brooklyn when she was 5. She and her best friend decided in high school to study medicine to make a change in the world. Dr. Boutin-Foster first wanted to specialize in OB/GYN, when her classmates started to get pregnant, but ultimately chose internal medicine.

“It really started out as—I enjoyed science,” she said. “But it was public health, social change, that I wanted to do way back when, and medicine was one way to do it.”

Dr. Boutin-Foster completed her residency in Internal Medicine at New York Presbyterian, and earned a Master’s from the Weill Graduate School of Medical Sciences of Cornell University in Health Services Research and Clinical Epidemiology. She later served as an associate professor of medicine, associate professor of healthcare policy and research, and associate dean for diversity and inclusion at Weill Cornell Medical College.

faculty-diversity-final“After residency, I did a Health Services Research Fellowship, a clinical research fellowship to learn how to ask and answer questions using rigorous research methods. I started doing health disparities research and looking at social factors that impact health. So, I’m looking at diversity as a health behavior. How do you get people from diverse backgrounds to engage in the activity of medical education? I’m always thinking about the research question. What’s the evaluation outcome? Because that’s what we’re trying to do, trying to change behaviors. We’re trying to help people have cultural humility, and to be culturally sensitive and aware.

“I loved my residency, I loved my training at NY-P, you know, but coming back here, and seeing the patients and the students, and the community. And walking on Clarkson Avenue, and just seeing people’s lives, and being in the midst of this daily is something I hadn’t seen in such a long time. It’s been a tremendous blessing to come back and use what I learned, and to build on what’s already happening. There are a lot of folks here doing amazing things.

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Vision for Downstate
Dr. Boutin-Foster said she’d like more interdisciplinary programs between Downstate’s five schools. Each has a unique diversity profile, and all the schools, uniquely concentrated on one campus, could form complete models for urban health.

SUNY Downstate at Brooklyn can be the place “students and faculty come to learn how to train students in a culturally diverse community. How do you increase cultural awareness and sensitivity in this population? We’re the place that can really do it, and set the stage and create models. I’d like Downstate to be the place where faculty and students come to learn about social justice and equity, and with that, violence prevention.”

She wants the Brooklyn community, if asked, “What’s in Brooklyn?” to answer, “Well, we have the Barclays Center, we have Coney Island and we have SUNY Downstate.’”

“Downstate’s doing it,” Dr. Boutin-Foster said. “It’s happening here. Community is here. We want students to leave this place and know they can go anywhere in the world and practice medicine. The problems that we see here are everywhere – from Chicago, to LA, to Wisconsin. I think one of the ways to get students to stay, is letting them know what can be done here. This is what happens when you graduate from Downstate. You can go anywhere.”


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Downstate Student Renee McDonald-Fleming, Public Health, and the Long Way Across the Street

 

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Renee McDonald-Fleming grew up in a gabled brick house on 37th Street in Flatbush, Brooklyn, directly across the street from SUNY Downstate Medical Center. She used to ride her bike under the sycamores that dwarf the streetlights, and watch doctors take their smoke breaks by the ambulance bay from her bedroom window.

Twenty years later, Downstate is her medical school, just like she said.

“I’d say, ‘I’m going to be here. When the time comes, I’m going to be a doctor, and I’m going to come to this school,’” Renee said. “I just worked toward it.”

Renee is a third-year Downstate medical student, considering a specialty in OB/GYN, Gastroenterology or Pulmonology. She took the long way across the street, though, so to speak, working two years first in basic science and immunology at the National Institute of Health in Bethesda, Maryland, and then as an NIH Health Disparity Fellow. Research led Renee to start contraception education classes at three women’s shelters in southeast Washington DC. Her interest in health led her to medical school.

“During my time at the NIH, I was thinking about how my passion for research fit with my desire to do medicine,” she said. She set up a meeting with Dr. Jeffrey Weiss, Downstate Chair of Urology, before she matriculated.

“I said, ‘I’m going to be a student, and I want to kind of do some public health research,’” Renee said. “That’s how it began. Halfway through the year, I found that the Alumni Association had a program where they funded research, and I applied.”

The summer 2015 research grant, funded by Downstate medical alumni, enabled Renee to work with the Downstate Department of Urology, with Dr. Weiss as advisor. She also collaborated with Dr. Michael Joseph of the School of Public Health, with assistance from the Department of Epidemiology and Biostatistics.

Renee used data from the Brooklyn VA and the National Health Interview Survey database to determine how the diagnoses of cancer in minority men had changed following a 2012 USPSTF recommendation against the use of PSA for prostate cancer screening. With a majority population of minority students, Downstate had a prime population for the study, she said.

“(Dr. Weiss) let me act like I was the principle investigator,” she said. “Being a part of a team and following suit is important, but being a leader and thinking from the ground up, figuring out how to troubleshoot it, to make it work, from beginning to finish, is a good skill set.”

Public health, with its shifting social influences, requires constant investigation.
“You have to think of innovative things, where you can have an impact,” she said. “This is population-based.”

As an NIH fellow, Renee got an idea while listening to the ads for female contraception on her Pandora radio station, targeting her geographic location. “They know the situation,” she said. She researched, contacted the DC government for free female condoms, and spent her afternoons answering questions in shelters.

“I decided I wanted to give the power of contraception to homeless women,” Renee said. “It was my first exposure to health disparities. Then I was like, this is how I can make an impact. This is what put the seed in my heart. In terms of being a physician, this is what I can do.”

Renee had her first vision, for medicine, as a second grader, hearing her friend’s doctor dad talk at a school career day. She had a second vision for her career while working with databases, interpreting the health data of a population. The summer research project offered practical hope that she could combine medicine and public health into one career.
“This was the start,” Renee said. “I feel like this was something I’d always wanted to do and now I have the opportunity to do it. That’s how I see myself being of value as a physician, doing more in a public-health aspect to directly impact my patients.”


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Brooklyn Free Clinic Thanks Downstate Alumni Volunteers

bfcThe Brooklyn Free Clinic is completely run by students from Downstate’s five schools.

In August, the Brooklyn Free Clinic recognized Downstate alumni volunteers for “dedication to student medical education and community service,” said Cleopatra McGovern, Chief Operating Officer. “We are so grateful to them for working with us.”

The list of clinic volunteers includes former and current (and future) attendings at the BFC who are also Downstate alumni, as well as Douglas Lazarro, MD ’90, who offers patients free ophthalmology appointments at Downstate.

James Ferguson

Ernest Garnier

Amanda Harris

Michelle Haughton

David Marcus

Michael O’Brien

Lorenzo Paladino

Richard Sadovsky

Sarah Yu

The Anne Kastor Brooklyn Free Clinic is a free clinic for the uninsured that was founded by SUNY Downstate students in 2006. It is staffed and operated by Downstate students from the College of Medicine, the College of Nursing, and the College of Health Related Professions. In addition to student volunteers, the clinic operates under the supervision of volunteer attending physicians, many of whom are SUNY Downstate alumni. Read our 2015 profile, here. And click, here, to learn how to become a volunteer.

The Alumni Association contributes financially to the Brooklyn Free Clinic annually. All gifts, including $6,000 for the 2016-17 academic year, come from alumni and return to students and the Brooklyn community. Students screen hundreds of patients annually at 840 Lefferts Avenue.


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