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An alumnus describes his 40-year odyssey in medicine to students beginning theirs

Yale Medicine Magazine, 2010 - Autumn

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The career of Lewis Landsberg, M.D. ’64, HS ’70, took him from Yale to the NIH, back to Yale, then to the banks of the Charles River in Boston, and finally to Chicago’s Northwestern University. Landsberg, who retired as dean of Northwestern’s Feinberg School of Medicine in 2007, returned to Yale on May 11 to deliver the Farr Lecture on Student Research Day.

After describing what he called his 40-year odyssey in academic medicine—he is an expert on hypertension, metabolic syndrome, and obesity—Landsberg had some advice for medical students in the auditorium of The Anlyan Center.

“In scientific inquiry, let curiosity be your guide,” he said. “The most interesting and important discoveries are frequently counter to your original hypothesis. You should never ignore seemingly discordant results.”

Few scientists have not had a grant application rejected, he said, urging students to be persistent. “Don’t get discouraged,” he said. “Good ideas win out in the long run.”

And noting his own good fortune in having had several strong mentors, including Paul B. Beeson, M.D., chief of internal medicine at Yale in the 1960s, he told students that mentors do more than help shape a career. “They embody an aspiration to be better,” he said. “They provide a role model that inspires us.”

Earlier in the day 71 students, including six from the School of Public Health and 11 in the M.D./Ph.D. program, presented posters of their original research in the atrium of The Anlyan Center. Topics ranged from genetic risk factors for asthma to the use of cell phones in South Africa as a means of improving postnatal care to studies of protein signaling in squamous cell carcinoma.

Five medical students—David Gimbel, Elizabeth Kvach, Yasha Modi, Katherine Mullen, and Palioura Sotiria—gave oral presentations of their award-winning theses.

Among those presenting posters in the atrium was Sachin J. Shah, who’s taking a fifth year to complete his medical studies. His research looked at the impact of financial stress on recovery after myocardial infarction. Although he found no causal relationship, he said, such stress correlates with worse outcomes. “High financial stress modifies outcomes after heart attacks such that patients are in worse physical health, they are in worse mental health, and they are more likely to have worse quality of life.”

Rocksheng Zhong, a second-year medical student, used a survey to study how pediatric resuscitation decisions are made. He asked participants to decide whether to resuscitate pediatric patients in three scenarios of acute distress. One patient was a premature infant and another was a full-term infant. Both patients had a 50 percent chance of being disabled after resuscitation. The third patient was a seven-year-old who already had disabilities. “Participants in the study,” Zhong said, “were much less likely to say that they would resuscitate the infant compared to the seven-year-old. We found that the effect was driven not by age but by disability status. There appears to be a sense of being responsible for creating a loss. You have a disabled kid where before you had a healthy kid. … This has ethical implications.”

Health care providers, Zhong said, should be aware of biases affecting their decisions, question their motives when deciding on resuscitation, and be alert to inconsistencies in their practice.

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