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Bottom Line

Hospitals nationwide have seen malpractice premiums soar, and Johns Hopkins Medical Institutions (JHMI) is no exception. While the number of malpractice cases has remained fairly constant, according to Rick Kidwell of JHMI's Professional Liability Claims Office, the amount sought in malpractice suits has tripled since the late '90s.

54: Millions, in dollars, paid for malpractice insurance in 2004.

36: Percent increase in JHMI's malpractice insurance premiums in 2004.

2,536: Number of doctors insured by JHMI, in full-time equivalents.

125: Medical malpractice suits brought against Hopkins Health System in an average year.

70: Claims settled with payment in an average year. — Kay Downer


No matter how eclectic your music preferences, you can probably find something to suit your tastes on WJHU. Hopkins radio — which started out as a small student venture in the early 1950s and eventually grew into a professional station in the mid-'80s — has returned to its student-run roots. Broadcast out of the basement of McCoy Hall, WJHU was recently reincarnated as an Internet radio station. Now, with a variety of students hosting shows like Shy Radio (experimental) and Red Beans and Rice (hip-hop) the station is a low-key mix of genres ranging from heavy metal to alternative. So find yourself a fast Internet connection and tune in. — KD

Here and Abroad

A new report has found that bilingual education programs produce higher levels of student achievement in reading than English-only approaches. Johns Hopkins' Robert Slavin and the Success For All Foundation's Alan Cheung analyzed three decades of research and found that paired bilingual programs, which offer ongoing instruction in English and a native language at different times of the day, produced the most dramatic results. About 20 percent of students in the United States come from homes in which English is not the primary language, and of those, most are Hispanic.

In January, Sayonara Barbosa became the first nurse from Brazil to come to Hopkins as part of the Fulbright Visiting Scholars Program. The grant will fund Barbosa for six months at the School of Nursing, where she is studying nursing informatics and developing a Web-based simulation in critical care nursing. When she returns to Brazil, where she is an assistant professor of critical care nursing at Federal University of Santa Catarina and a doctoral student at Federal University of Sao Paola, she will evaluate the simulation program as a complementary teaching tool in her undergraduate nursing course.

The Bologna Center's annual Austrian Ball takes place this year on April 24 at Palazzo de Rossi (near Sasso Marconi). The ball, which has been a spring highlight during most of the Bologna Center's 50 years of existence, is organized by the current Austrian students, who for months before the affair teach everyone else how to waltz. Students, faculty, and staff attend, as do friends in the community, Austrian diplomats posted in Italy, and a large contingent of Austrian alumni who return every year for the evening's festivities.


Some 3,500 Hopkins Medical Institutions students, faculty, and staff belong to the Denton A. Cooley Athletic Center in East Baltimore, according to Cooley Center director Darryl Waldon. But only about 5 percent of this group ever avails itself of personal training services at the gym, where a session with one of the center's four personal trainers can run from $24 to $45. Some terms overheard at the trainers' water cooler:

Ripped: Someone with such good muscle tone and with such low body fat that his or her rippling muscles are visible under their skin. Similar to "buff."

Deconditioned: Maybe you were a star football player in high school or a marathon runner way back when, but if your body hasn't seen the inside of a gym for a long time, you're deconditioned, out of shape, the polar opposite of "ripped."

The Breakfast Club: The group of 15 to 20 dedicated regulars at the Cooley Center who arrive to work out on weekdays at 6 a.m. — a full 30 minutes before the center's posted opening time. The gym made up T-shirts for the group.

Gastrocnemius: Not a stomach flu. The gastrocnemius is the calf muscle that is important to strengthen for athletes who jump, like basketball and volleyball players.

Step: Group exercise classes come and go. Sliding is out. Pilates is in. And the Ralph S. O'Connor Recreation Center at Homewood is offering a class this semester called "Strippercize." At the Cooley Center, step aerobics, a two-decade-old brand of aerobics in which participants step on and off a platform, is still hot. "Many gyms have cut their step classes back to one a week," Waldon says. "We have four."

Max out: To lift the most weight possible in one repetition. Not a smart thing to do if you're deconditioned. — Maria Blackburn


New Clues to Spiral Galaxy Formation

A team of astronomers that includes Johns Hopkins' David A. Thilker has found important evidence in support of an existing theory on the formation of large spiral galaxies. The team recently detected a swarm of 20 hydrogen gas clouds orbiting Andromeda. Astronomers believe that giant galaxies like the Milky Way and neighboring Andromeda form by repeated mergers with smaller galaxies, augmented by the accretion of immense clouds of gas that orbit the galaxies and over time are drawn into them by gravity. The theory predicts that this process continues today, but scientists had never detected conclusively the required orbiting gas. They had found hydrogen near the Milky Way in what they call high-velocity clouds, but they could not be certain if these HVCs were galactic building blocks or merely trace gases left over from phenomena like supernovae. Scientists turned to Andromeda because it was large and close by. "In some sense, the rich get richer, even in space," says Thilker. "All else being equal, one would expect to find more primordial clouds in the vicinity of a large spiral galaxy than near a small dwarf galaxy, for instance. This makes Andromeda a good place to look, especially considering its relative proximity-a mere 2.5 million light-years from Earth." Detection of the hydrogen gas clouds orbiting Andromeda strengthens the case for the accretion theory.

Indoor Pollution: Worse Than We Thought?

The Environmental Protection Agency estimates ambient concentrations of air pollutants by a computer model it calls ASPEN (Assessment System for Population Exposure Nationwide). These estimates are used to assess aggregate cancer risks from ambient air pollution including volatile organic compounds such as benzene, chloroform, and carbon tetrachloride. Now, researchers from the Johns Hopkins Bloomberg School of Public Health have found that ASPEN significantly underestimates the actual risk. Timothy J. Buckley, Devon C. Payne-Sturges, and three Bloomberg School colleagues were the first to compare ASPEN models to actual measured indoor and outdoor personal exposure. They supplied 33 research participants with passive air-sampling badges and found that ASPEN was reasonably accurate for outdoor exposure to toxins such as those from automobile emissions. But it had far underestimated exposure for pollutants of indoor origin such as cigarette smoke and fumes from cleaning solvents. The Bloomberg study, published in the April issue of Environmental Health Perspectives, showed that the ASPEN ambient-based estimate underestimated the actual risk by a factor of three due to the contributions of indoor sources. "The public health implications of our findings loom large," says Buckley. "ASPEN has already shown that for many U.S. census tracts, risk from ambient air toxins exceeds acceptable levels. Now our data indicates that because of significant indoor source contributions, these risks are much worse." — Dale Keiger


Course: The Story of Ireland

Instructor: Carmel McCaffrey, an instructor in the School of Professional Studies in Business and Education (SPSBE), is author of the book In Search of Ancient Ireland and chief historical consultant and script adviser of the PBS television series of the same name.

Course Description: Offered through SPSBE's non-credit Odyssey Program, this 10-week course explores Ireland's rich and complex history, which dates back thousands of years. Topics include Ireland's earliest settlers, the evolution of a new Anglo-Irish culture in the 18th century, the Great Famine of the 1840s and subsequent waves of emigration, and the rise of modern Ireland and its division into two states. In addition to books and films, McCaffrey lectures using her own extensive collection of slides, which cover Irish history from the Neolithic period to the present day.

Reading List:

In Search of Ancient Ireland, Carmel McCaffrey and Leo Eaton (2002).

The Course of Irish History, T.W. Moody and F.X. Martin, eds. (2002).

Film List:

In Search of Ancient Ireland (2000).

The Story of English, Program 8, "The Loaded Weapon" (1986).

When Ireland Starved: The Great Famine (1992).

Michael Collins (1996).

Bloody Sunday (2002).

Up & Comer

Name: Amit Peled
Age: 30

Position: Peabody Conservatory faculty member and rising-star cellist.

Credentials: Undergraduate study at New England Conservatory of Music; graduate study at Hochshule für Musik "Hanns Eisler" in Berlin. Student of renowned cellists Bernard Greenhouse, Laurence Lesser, and Boris Pergamenschikow.

Scouting Report: Greenhouse, former cellist with the Beaux Arts Trio, says, "He has a natural ability to make music, and make it in a very classical manner. He's turned out to be a great delight to me. I'm very proud of his work."

Tools of the Trade: There are in the world 14 cellos made by Andrea Guarnieri. Peled plays one of them, crafted in 1689.

How It All Began: Grandfather played violin, mother played piano. But ... "I grew up in a very small kibbutz in Israel. In the fourth grade, we all started an instrument. I was in love with a girl who played the cello. I was 10, she was 14. This was the only way to get close to her."

First Mentor: He had a full scholarship at Yale, but left after one year. "My dream was to study with Bernard Greenhouse. He was 81 then, and lived in Cape Cod. I just drove there one day and played for him and said, 'I want to study with you.' He said, 'If you're willing to leave Yale, you can come live here and study with me.' So I did it. I was crazy."

Alternate Career: Leading player in the National Basketball Association. "Until I was 15, cello was a secondary thing. I was really into basketball. Then I moved to Tel Aviv [to begin serious study of music]. My teacher, Mr. Uri Vardi, said, 'I will accept you, but you have to decide between basketball and cello.' I was not tall enough then, so I picked the cello. Then I grew up. Now I'm six-foot-five — too late to make anything of it. I'm probably one of the best basketball player-musicians in the world."

Forever Altered

Mentor, hero, inspiration: Hopkins teachers who have left their mark

"In the spring of my freshman year, I was an engineering major not doing very well in chemistry or calculus, and I was considering changing majors or even transferring to another school. At the urging of my English comp instructor, I met with the chairman of the Writing Seminars, Elliott Coleman, who is now deceased.

"I found him in his office, dressed in a dark gray suit, with a wool muffler around his shoulders. He was tall and distinguished-looking, with delicate hands and fine white hair combed straight back. We chatted for a long time, then he leaned forward and asked me what writing experience I had. 'Absolutely none,' I replied, fully expecting him to show me the door. Instead, he laughed, slapped his knee, and said, 'Good! We can start fresh!'

"Within two weeks, I had written my first short story, and Elliott decided I should enter the graduate-level Writing Seminars the following fall. He also reshaped my curriculum for the coming year: Keats with Earl Wasserman, art history with Phoebe Stanton, and an independent study with Elliott Coleman.

"What a gift he gave me. By November I had read all of Hemingway; by January, all of Fitzgerald. I was writing a short story nearly every week, and each time I sat down to the typewriter I could feel Elliott at my shoulder.

"Today, nearly 40 years later, I have traveled the world as a journalist and foreign correspondent. But I get my deepest satisfactions from teaching writing, because I want to do for others what Elliott Coleman did for me. Bless you, Elliott; let's keep the fire burning."

Paul Chutkow '69 (BA), '71 (MA), is the author of Harvests of Joy: How the Good Life Became Great Business, with Robert Mondavi, and Depardieu: A Biography.

Vital Signs

Another Reason to Take Your Vitamins

Use of antioxidant vitamin supplements, particularly vitamins E and C, may reduce some of the effects of Alzheimer's disease, according to a recent study by researchers at Johns Hopkins' Bloomberg School of Public Health and other institutions. Researchers examined data from the Cache County Study, a large population-based investigation of the prevalence and incidence of Alzheimer's disease and other dementias. "Our study suggests that the regular use of vitamin E in nutritional supplement doses, especially in combination with vitamin C, may reduce the risk of developing Alzheimer's disease," though further study is needed, says lead investigator Peter P. Zandi '01 (PhD), an assistant professor in the school's Department of Mental Health. The study was published in the January issue of the Archives of Neurology.

Picturing the Future of Breast Cancer Detection

Scientists have long known that cancers contain elevated levels of choline, a product of membrane synthesis. Now, a new Hopkins study may be the first to identify its value in accurately diagnosing breast cancer. Hopkins radiologists used proton magnetic resonance spectroscopic imaging (MRSI) to produce pictures of choline within breast tumors. In the study, which was published in the December-January issue of the Journal of Magnetic Resonance Imaging, the researchers demonstrated that choline signals analyzed by MRI were significantly elevated in malignant tumors of 15 out of the 18 patients studied. The three remaining cases could not be included because of technical failures. "These data are proof of principle, and strongly suggest that MRSI can serve as an important adjunct to the routine MRI scan," says lead researcher Michael A. Jacobs. "We can envision a time when this procedure may even replace the need for biopsy in some cases."

Plenty of Doctors in the House

Many physician groups, government agencies, and medical schools foresee a physician shortage in the United States. However, new research from the School of Public Health suggests that the current U.S. physician supply is large enough to meet the needs of patients. The study, featured in the February 4 online issue of the journal Health Affairs, compared the current supply of U.S. physicians with the staffing at several large medical group practices, known as prepaid group practices, or PGPs, that treat health maintenance organization patients. The study found that HMOs had about one physician for every 650 patients, compared with the current U.S. practicing physician supply of one per 400. Says Jonathan Weiner, the study's author and a professor in the school's Department of Health Policy and Management, "All told, the physician-to-population ratios at the three PGPs studied were about 25 percent lower for primary care physicians and 32 percent lower for specialists. This evidence does not lend support to the premise that the current national supply is inadequate." — MB


At the Johns Hopkins School of Nursing, a male patient with pneumonia lies on a bed wheezing severely. Students Paul Schwartz and Marguerite Baty have applied an oxygen mask to his nose and mouth and are using a nebulizer to administer medicine to open up his airway. They watch the patient's monitor intently. Finally, the wheezing stops, and the patient's vital signs return to normal.

When Schwartz removes the oxygen mask, the patient says, "You saved my life. I have a lot of respect for nurses."

This isn't the first time he's spoken these words, nor is it the last time students will save his life. In the future, he will suffer heart attacks, diabetes, stroke, burns and wounds, and more respiratory distress. But he will always recover.

SimMan, with Diane Aschenbrenner at the controls
Photo by John Dean
He is SimMan(tm) Universal Patient Simulator, a computer-controlled manikin purchased last fall for just over $30,000 as a gift for the school from the classes of 1958, 1963, and 1968. Created by Laerdal, a Norwegian company, SimMan is a vast improvement on the manikins normally used to teach students. The older manikins don't seem nearly as real, and students often work on them one body part at a time.

SimMan is blond, 5'5'' tall, and weighs 75 pounds. He talks, breathes, coughs, moans, and makes vomit noises. "He does everything but stand up and salute you," says Diane Aschenbrenner, an instructor in the School of Nursing.

Attached to a compressor and a PC, SimMan is so complicated that Aschenbrenner had two days of training to learn to use him. He also comes with accessories. You can change his abdominal plate to make it look like a bowel is protruding and alter the skin on his hand to make him a burn victim. You can even change his genitalia.

With SimMan, students can practice clinical skills safely before moving on to humans, and they don't have to wait for a real patient with the necessary condition to practice certain skills. Students can check his blood pressure and pulse, listen to his heart and bowels, insert IVs and chest tubes, and give him injections and urological exams.

Students started using SimMan last fall to learn basic skills such as blood pressure checks, and there are plans to use SimMan for more complicated situations such as heart attacks. The school has also purchased VitalSim, a simpler model for basic teaching only, and is raising the funds for more accessories, an obstetrical model, and SimBaby, due in the coming year.

"This will give us extra ways to challenge students and make it more realistic," says Aschenbrenner. — Kristi Birch

March 6, 2004

The Johns Hopkins Band doesn't just play music. At every football and lacrosse game, the 30 students and alumni cheer the Blue Jays on. Today they are defying an ominous gray sky to support the Jays against Princeton, one of Hopkins' biggest rivals.

Noon Wearing matching blue polo shirts and khakis, the band members meet inside the Mattin Center to unpack their instruments. Drummer Tina Hadlich, wearing blue and white face paint, has brought rice crispy treats for everyone.

12:25 p.m. After some practice, the band heads to the Freshman Quad to wake the sleeping freshmen. "Feel free to play as loud as possible," says clarinetist Kevin Philpy.

12:40 p.m. The band sets up in the Homewood Field stands near the 50-yard line. Some members have brought along garbage bags or jackets to spread over the wet bleachers; the rest suffer damp pants.

12:58 p.m. The team steps onto the field, greeted by cheers from the crowd and the rousing bars of "Johnny Hopkins on to Victory" from the band.

1:20 p.m. The Blue Jays score their first goal, tying the game 1-1. The band members jump to their feet and play "To Win" and then cheer loudly, "One: We want more!"

1:30 p.m. Hopkins scores again. "One, Two: We want more!" The band plays "Cleveland Rocks" as the players regroup.

1:40 p.m. End of the first quarter, Hopkins leads 4-1. During the break the band plays a spirited rendition of the pep band classic "Louie, Louie."

2:10 p.m. Halftime. Kids teams take the field and the band plays when either team scores.

2:56 p.m. Band president Beth Johnson distributes bananas. "Keep them out of sight," she says. The "banana guys" — a small group of Hopkins alumni and self-proclaimed victory prognosticators — have decided that the next goal will be the "banana goal," the point at which a Hopkins victory would be assured. According to legend, the banana guys have never been wrong.

2:57 p.m. Hopkins scores again, increasing the lead to 12-4. Victory assured, the band waves their bananas — "One, Two, Three, Four, Five, Six, Seven, Eight, Nine, Ten, Eleven, Twelve: We want more!" — then eats them.

3:20 p.m. Hopkins wins, 14-5. The crowd departs to "Johnny Hopkins on to Victory," "Washington Post March," "Celebration, Celebration," and "The Impression That I Get." — KD

Return to April 2004 Table of Contents

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