25TH REUNION SYMPOSIUM

The Varieties of Medical Experience

Answering the question, “What do you want to do when you grow up?” has not been as easy or as obvious for Harvard medical students as it might seem, according to members of the Class of ’84 who spoke at the 25th Reunion Symposium.

The June 4 program on the Quad featured a morning of talks from two hospital presidents, two deans, a venture capitalist and an inventor. The afternoon session showcased advances in cardiac physiology, regenerative neuroscience, women’s healthcare, doctor–patient communication and electronic medical records.

Photo by Steve Gilbert

Their medical degrees launched the Class of ‘84 on a variety of non-traditional career paths, according to the morning talks in the 25th Reunion Symposium by (from left) Peter Slavin, Anula Kusum Jayasuriya, Edward Hundert, moderator Robert Kaplan, Cato Laurencin, and Fred St. Goar.

For some people who “always wanted to be a doctor,” the first adult career decision comes at the time of applying for a residency program, said morning speaker Edward Hundert, senior lecturer in medical ethics at HMS and dean of student affairs from 1990 to 1997.

The bright, hard-working, high-achieving HMS students tend to be exquisitely sensitive to detecting and meeting expectations, Hundert said. The personal emotional pull of one specialty can conflict with the field a student feels pushed toward by their perception of expectations from parents or teachers. Sometimes, rarely, a fourth-year student even realizes practicing medicine is not what he wants to do at all, Hundert said.

This realization came a little later to Anula Kusum Jayasuriya, managing director and founder of the Evolvence India Life Science Fund.

Jayasuriya was 11 when her brother, 24, suffered severe brain damage in an auto accident in their native Sri Lanka, motivating her to become a physician. Seven years after graduating with her MD and PhD degrees, she entered Harvard Business School and never looked back. “I found what I loved,” said Jayasuriya, who earns her living as a venture capitalist, but still sees herself first and foremost as a pediatrician.

She was one of five speakers in the morning session by ’84 alums who had chosen paths outside of traditional clinical practice or research.

Another was classmate and fellow MBA-holder Peter Slavin, president of Massachusetts General Hospital and HMS professor of health care policy. Slavin has navigated the business side of medicine to try to improve healthcare.

“The only way to get ideas into the market is to interact with industry,” he said. “We need to do a better job of policing ourselves. We need to maintain our integrity and get the costs down.”

To the south, Cato Laurencin, dean of the University of Connecticut School of Medicine, is less than one year into his 12-point plan to lead the integrated medical and dental schools, research and medical practices into a top tier medical center. “The most important thing I learned at Harvard was to be an agent for change,” Laurencin said.

Meanwhile, Fred St. Goar, director of interventional cardiology at a private clinic in California’s Silicon Valley, has spent the last 10 years inventing and developing an endovascular device that can repair a mitral valve without open-heart surgery. The implantable clip is approved in Europe, but the clinical study data review is still pending at the U.S. Food and Drug Administration.

The afternoon session was devoted to selected classmates who conducted original research or blazed new trails in medical practice.

Anthony Muslin, director of the Center for Cardiovascular Research at the Washington University School of Medicine, has found that a signaling pathway involving well-known AKT enzymes underlies the exercise-induced growth of the heart in athletes and may convert pathological processes into beneficial physiological ones with drugs now being tested in clinical trials.

Paula Johnson, chief of the Division of Women’s Health at Brigham and Women’s Hospital and an HMS professor of medicine, explained how a better understanding of sex differences in health and disease and a more comprehensive approach to women’s health can improve the value of healthcare and improve the health of the overall population.

An HMS professor of surgery and of neurology at MGH, Jeffrey Macklis reviewed the dramatic advances in developmental and regenerative neuroscience during the last 25 years. He described mouse studies in his lab showing how a specific sequence of molecular signals from early development can direct the cellular repair of targeted neural progenitor cells. In adult mice, newly recruited corticospinal neurons grow all the way down the spinal cord and connect. “We’re not there yet in humans,” he said.

Perhaps prompted by his Silicon Valley upbringing and or the teasing of his tech-savvy siblings, pediatric cardiovascular surgeon Redmond Burke developed a secure web-based electronic medical record system by imbedding an informational technology genius into his congenital heart surgery team based at Miami Children’s Hospital. The system, called I-Rounds, integrates patient data, provides crib-side real-time viewing, and even connects families with patients and other families.

Speaker Ronald Epstein, professor of family medicine at the University of Rochester School of Medicine and Dentistry, has found in his research on patient-centered care that doctors who are truly responsive to patient concerns (as revealed in audio recordings and transcripts) are more likely to prescribe appropriate medications and be less reactive to patients’ requests for medications they have seen in advertisements.

“Everyone involved in the [symposium] planning was overwhelmed both by the remarkable diversity of career paths and by the incredible achievements of our classmates,” said Hundert, a co-organizer. “If none of the 10 who spoke had been available, we could easily have had 10 other members of the Class of ’84 who would have given equally amazing talks.”

—Carol Cruzan Morton

top