Medicine: Rapid relief for sickle cell pain

Homewood: The "hidden" memorial

Honors: Provost wins Fritz Medal

Engineering: Z rings yield their secrets

Education: Certifying summer learning

Books: A poet of the everyday

APL: Oceans under Titan's surface

Arts & Sciences: The film that became a class

University: New money for diversity

Commencement: One student's banner day

Sports: A spring for the record books

Rapid relief for sickle cell pain

When the pain got too bad, LaShanta Whisenton would do what's done by tens of thousands of people who suffer from sickle cell anemia. She would gather her medical cards and drive to her local emergency room. But before leaving her home in suburban Washington, D.C., she always did one more thing. She worked through debilitating pain to put on a fresh skirt, jacket, and pair of heels for the trip. Though she would face an excruciating six or seven hours of waiting before receiving narcotics to numb the pain that sickle cell anemia patients regularly endure, she wanted to appear "professional," she says.

"I knew I'd have to look serious and not like I was just out for drugs when I got there," says Whisenton, a 29-year-old software technical analyst and mother of three. "Otherwise, I wouldn't get the treatment I need."

"Many of our patients in the adult clinic talked of long waits just to get their blood drawn, and of then being told they're not in crisis, even though there's no objective measure of whether they are having [a crisis] or not," says Sophie Lanzkron, director of the new center and assistant professor of medicine and oncology at the School of Medicine. "Too often, they were viewed as drug addicts, or denied treatment because the medical staff thought they didn't look like they were in enough pain."

Sickle cell patients are in pain as much as 95 percent of the time, Lanzkron adds. The new infusion center allows 300 patients with a history of treatment at Hopkins to find more rapid relief. If a patient arrives in especially severe pain, one of the center's six staff members immediately will administer a pain-killing shot. Then, the patient typically will receive Dilaudid, morphine, or oxycodone intravenously within 15 minutes of taking a seat in one of the center's four heated chairs. (Cold exacerbates the pain of a sickle cell crisis.) Televisions outfitted with DVD players help distract patients from their discomfort. An on-staff psychiatrist counsels them about problems associated with their disease, which often is so debilitating they cannot work. The center also offers facilities and materials for a support group.

Sickle cell is expensive to treat, with the typical patient in Maryland costing insurers $40,000 per year. The need to reduce outlays associated with patients contributed to a decision by the hospital's leadership to aggressively seek and make deals with insurers and managed-care companies to finance the bulk of the center's $500,000 annual budget.

"If you make treatment available and deliver it promptly and effectively, and with a positive attitude, you reduce the costs of care and the percentage of patients who have prolonged crises," says Myron L. Weisfeldt, chair of the Department of Medicine at the hospital, who negotiated several of the deals. The goal now is to persuade state health officials and insurers to provide more money so the center, currently open only weekdays, can remain open on nights and weekends, he adds.

Whisenton is already grateful that she has someplace to go when the most crushing pains begin. "I'm really so glad that I stumbled upon Dr. Lanzkron a few years ago," she says. "Right now, I don't want to think about what I'd do without the center." — Michael Anft

New hope for a cure?

The new Sickle Cell Infusion Center isn't the only inroad Johns Hopkins physicians are making toward understanding and treating this dreaded disease. A new, experimental bone marrow transplant procedure performed by a team of doctors that included Robert Brodsky, associate professor of hematology at the School of Medicine, has given these patients hope of a cure. Using a bone-graft procedure that has been used to treat leukemia patients, Brodsky and a team of doctors at Hopkins took 1 percent of bone marrow stem cells and one liter of blood from the mother of Pamela Newton, a 35-year-old who suffers from sickle cell anemia, then intravenously funneled those cells into Newton's bloodstream.

Newton had been in constant pain her entire life. By the time of her procedure, she could not walk and had been given a prognosis that measured her remaining life in months. Now, almost a year and a half after her procedure, she appears free of the disease. She plays basketball and goes to movies with friends.

The procedure-developed by Ephraim J. Fuchs, an associate professor at the Johns Hopkins Oncology Center, and Leo Luznik, an assistant professor there-is unusual because it doesn't require a direct match (marrow from a sibling). But it carries a lot of risk: One in six leukemia patients who've undergone the procedure have died from it. Sickle cell anemia patients who undergo various types of transplants have imminent mortality rates of 10 percent to 40 percent, depending on their age at the time of the procedure.

A clinical trial of the new procedure, with 25 patients, is in the works.

"We're guardedly optimistic that we're on to something," Brodsky says. — MA

The "hidden" memorial

Flanking Gilman Hall's front steps for 91 years, they may be the least noticed memorials on the Johns Hopkins Homewood campus. Two slim, white poles, each about six feet high, bear plaques saying they were given by the university and the Class of 1918 to honor the "courage and devotion" of Robert Tong Layfield, "injured October 31, 1914, died March 2, 1915." They were not always so nondescript. Once they supported two-story-high flagpoles from which the Stars and Stripes and (occasionally) the Maryland state flag fluttered. Sometime between 1937 and 1938, however, the flagstaffs were lopped off — for reasons lost to history — leaving only their bases.

William Baer, founder of orthopedic surgery at Johns Hopkins Hospital, took personal control of Layfield's case. William Halsted, the legendary surgeon-in-chief at Hopkins, consulted. Despite being encased in a full body cast, young Layfield remained upbeat and optimistic throughout his ordeal, ensuring his physicians that he would fool them and get better. Learning that the football team planned to cancel its season if he died, he insisted that they continue playing no matter what. In turn, the university's athletic association awarded Layfield a varsity "H" sweater — which he proudly kept in constant view on his bedstead.

On January 13, 1915, Baer led a four-member team of Hopkins surgeons in a last-ditch operation on Layfield to reduce pressure on what the surgeon called a "mashed" spinal cord. Although Layfield improved enough to return home, his condition soon deteriorated and he died there on March 2. His funeral was held two days later, with Hopkins President Frank Goodnow and 40 undergraduates (most members of Layfield's class) traveling to Wilmington to attend.

After Layfield's death, the press reported that his classmates vowed to put up a memorial. In March 1917, with the United States edging ever closer to entering the First World War, engineering students erected the two commemorative flagpoles. On April 3, 1917 — the day after President Woodrow Wilson, A&S 1886 (PhD), asked Congress to declare war against Germany — Hopkins' ROTC unit (the first of its kind in the country) dedicated the flagpoles, then marched in review before Goodnow and a crowd of somber spectators.

Photographs of Gilman Hall in the Hullabaloo yearbooks from 1917 to 1936 show the flagpoles. By 1938's Hullabaloo, however, only the bases remain. Asked about the Layfield Memorial, students, faculty, and administrators who have been on campus for decades draw a blank. The white poles are like the purloined letter in Edgar Allan Poe's famous story: They're hidden in plain view. For 70 years, they've stood without their flags, serving as silent sentinels in memory of the only Hopkins athlete ever to die from injuries sustained in competition. — Neil A. Grauer, A&S '69

Provost wins Fritz Medal

In its announcement of the medal, AAES said it was conferring it on Johnson for "her internationally acknowledged expertise in optics, optoelectronic switching, and display technology." The holder of 40 patents, Johnson has applied much of that expertise to smart pixel arrays, which are used for, among other things, pattern recognition and the high-resolution sensors in digital cameras.

Scan the list of past winners and you will find one woman — Johnson. "I am so pleased that the Fritz Medal happened while [I was] at Johns Hopkins," Johnson says, "and I'm doubly pleased to be the first woman. In fact, with the medal, this might be the first time that I really appreciated what it personally means to be first."

In the 1920s, Johnson's grandfather, Charles, was an engineer for George Westinghouse, the 1906 winner. When Charles noted the lack of women and minorities in engineering, he co-founded schools in Pittsburgh to train women and African Americans for higher-paying technical jobs. One imagines he would be proud of his granddaughter. — DK

Z rings yield their secrets

For decades, scientists have known about Z rings, protein bands that rod-shaped bacteria like E. coli need to reproduce. Z rings encircle the middle of bacterial rods and constrict until each bacterium splits into two. But knowing what Z rings do did not explain them. What are they made of? How are they positioned invariably in the middle of the rods, where they can neatly squeeze bacteria in half? How do they muster enough force to cut through the cells? After three years of research, investigators at the Whiting School of Engineering have unlocked those secrets, and their findings may enable development of a new generation of infection-fighting drugs. The discovery comes at an important time: A growing number of bacterial infections are becoming more resistant to long-standing antibiotic treatments.

Using imaging, light microscopy, in vitro testing, and an advanced form of computational modeling, Denis Wirtz, professor of chemical and biomolecular engineering, along with Sean X. Sun, an assistant professor of mechanical engineering, and Alex Dajkovic, a post-doctoral fellow, have discovered that several proteins take part in the formation and placement of Z rings around cells. What's more, though bacteria lack muscle cells, they have the ability to use several proteins at once to fulfill muscle function essential to their reproduction.

The Z ring "is made and spurred into action not from one protein but from a wash of proteins," says Wirtz. "We were able to confirm in the lab that there is direct interaction among the proteins. Bacteria are much more organized than people had thought."

Key among the lab team's findings are the actions of two bacterial proteins. One of them, named FtsZ, polymerizes into filaments that coalesce to form gel bundles; these bundles form a sort of scaffolding and recruit other proteins to create Z rings. While observing purified proteins in a test tube, Dajkovic noted that a second protein, called MinC, counters this bundling by liquefying the filaments, which prevents them from coalescing. Why doesn't the presence of MinC prevent Z rings from forming? The researchers found that a third protein induces MinC to oscillate, so that its concentration varies along the length of bacterial rods, highest near their poles and lowest in the middle. This explains why Z rings always form around the rods' midsections. If MinC were distributed along the cell's entire length, the rings could not form at all.

Because MinC inhibits filament bundles from forming — and because the molecules that govern cell division are similar in almost all rod-shaped bacteria — Wirtz and his team hope that their findings might spur pharmaceutical companies to develop a new class of antibiotics against a whole category of pathogens. A new drug that mimics the action of MinC and is powerful enough to break through a bacterial cell wall would prevent disease-causing bacteria from reproducing, thus halting an infection.

In the meantime, Wirtz's lab will continue to work on Z rings and other protein-made structures. "Sean and I are convinced there are mammalian homologs or equivalents of this — ways that the body uses waves of proteins to create cells and place parts of them within cells," Wirtz says. "It wouldn't surprise us at all to find these amazing processes in much larger creatures." — MA

Certifying summer learning

Mathew Boulay, A&S '93 (BA/MA), '98 (MA), was a senior at Johns Hopkins University when he founded Teach Baltimore, a summer learning program for city high school students. "I was 22, but I knew there were city schools that were struggling and I was trying to find a way to do something," he recalls. That first program proved to be the seed for the Hopkins School of Education's Center for Summer Learning, which has since helped create more than 1,000 summer-school programs throughout the United States. The center each year trains 2,000 educators to serve more than 2 million students in 30 states nationwide. Last year, it generated $14 million in public funding for support of summer programs.

The center's newest initiative is a graduate-level program to certify teachers in after-school and summer education, what it calls "out-of-school time" or OST learning. The purpose is to equip educators with the expertise to create and run local programs. Most of the work for the new 15-credit certificate can be done online; the program also requires three face-to-face meetings in Baltimore and attendance at the center's national conference in April. Educators can combine OST certification with any other School of Education graduate certificate to earn a master's degree.

Besides providing support for individual programs, the Hopkins center has assisted school systems in Illinois, Indiana, and California as they have developed comprehensive new summer programs. "Our role now is not only to improve the quality of summer learning opportunities but to increase the number of people who understand its value as a unique learning experience, and get public support for that endeavor," says Fairchild. "The real promise of these summer programs is that the students get authentically engaged. So, summer is actually an opportunity to do a different sort of learning — not just catch up, but learn in new ways." — Jim Paterson, Ed '04 (MS)

A poet of the everyday

A spell of insomnia at a friend's beach house. The sight of a young couple and their baby meandering down a train platform. A postcard discovered in the brittle yellow pages of an old paperback.

In the poem "Goodbye Train," she begins, "I'm stepping off the train behind a pair/of thirtysomethings with their baby daughter" and concludes, "That's how I follow, twenty years ahead/of the parents, as I lug my bags behind them,/vowing to keep a stranger's proper distance — /as I did from those two lovesick teenagers/clinging in tears some stations back, when he/prepared himself to be left there on the platform/by a girl who swore it wasn't possible, and both were stunned to discover that it was./I think what luck it is, to be one who says/goodbye to trains instead of other people."

"Mary Jo is a poet of enormous intelligence and luminous phrasing," says Dave Smith, chairman of the Writing Seminars and a fellow poet. "She understands that language needs to be as subtle and complete as life experiences always are, and she has a unique power of translating those complexities to readers."

Salter's sixth book collects older work from volumes now out of print, in addition to new poems. "My motivation for including selected poems was purely practical — to resuscitate dead poems, poems that you couldn't get unless you went to the used bookstore," she says.

Salter says that ideas often come to her while she's reading, or just before she's about to drift off to sleep. "I'm not an organized person," she says. "I don't always have a notebook with me. I often write scribbles on the inside flaps of books. So I have to look back at these inside flaps to find out what it is I thought I wanted to write."

Sometimes the writing comes easily, sometimes it doesn't. "The thing that's gotten easier with time is that I'm more confident that if I keep writing, I'll come up with a decent solution," says Salter. "It may not be the best poem I've written. It may not be the poem I wanted to write. But it's not likely to just vanish. When I was younger I had so much less confidence that I could figure it out."

That sense of confidence comes through in the new poems, which contain less conventional forms than her earlier work. The poems also express longing for the past. In "Wake Up Call," Salter writes about how even though she may talk about going back to Venice or to the beginnings of a romance, she never will. "The longer you live there's more not to go back to/and what you demand in your gratitude and greed/is more life in which to get so attached to something,/someone or someplace, you're sure you'll die right then/when you can't have it back."

"I think that wistfulness is called middle age," says Salter, 53. "Part of life is not only having experiences, it's looking back on them with wisdom and gratitude or, as I say in that poem, with 'gratitude and greed.' I feel very much middle, middle, middle. And yet I am young enough to be looking ahead to all sorts of things I'd like to see and do." — MB

Oceans under Titan's surface

Titan, the largest of Saturn's 60 known moons, has intrigued and baffled scientists since Dutch astronomer Christian Huygens first spotted it with a telescope in 1655. Bathed in an impenetrable orange haze 845 million miles from Earth, Titan has revealed its mysteries rarely and reluctantly.

Now a team that includes a planetary scientist at Johns Hopkins' Applied Physics Laboratory Planetary Exploration Group has "unearthed" one of those secrets: an underground ocean of water and ammonia. In a recent paper published in Science, lead author and APL investigator Ralph Lorenz, along with other members of the international Cassini-Huygens space mission, outlined how data collected during the spacecraft's 19 passes over Titan from October 2005 to May 2007 confirmed the existence of an internal ocean 62 miles beneath the ice and rock of the moon's surface.

When they compared imaging data compiled from earlier fly-bys to later ones, they found that prominent landmarks recorded by SAR had moved from their expected positions by up to 19 miles. The investigators concluded that Titan rotates at a variable rate, which indicates its crust is not connected to its core — because an ocean is between the two. This "decoupling" makes it easier for the crust to move, changing the landmarks' positions.

The discovery of the ocean is important, says Lorenz, because "organic molecules and liquid water are the two big ingredients for life." Covered with organic dunes, lakes, and mountains, Titan has a dense atmosphere and a varied and active surface like Earth — rare among bodies that orbit the sun. Lorenz and Jacqueline Mitton, co-author of Titan Unveiled (Princeton University Press, 2008), call Titan "a world that offers planetary scientists a richer scientific bounty than any other in the solar system, apart from Earth." Some scientists believe that Titan may resemble aspects of the early Earth and could provide clues about the formation of certain molecules necessary for life.

Lorenz has been working on the Cassini project since 1990, when it was still on the drawing board. He joined APL 18 months ago, and will continue to plan and analyze radar operations for the mission, which NASA recently extended to July 2010. — MA

The film that became a class

Adam Lovett, A&S '08, was walking to class when he first learned of an October 2006 off-campus fraternity party called "Halloween in the Hood." The party, which encouraged students to come dressed as racial stereotypes of African Americans, created a buzz on campus and got students talking about the presence of racism and the lack of diversity at Johns Hopkins University.

Last summer, Lovett secured a $3,000 Provost Undergraduate Research Award and began working with Wexler on the film. Midway through the fall 2007 semester, the project got the attention of Ben Vinson, director of the Hopkins Center for Africana Studies. Vinson, who learned of the film through Lovett's PURA faculty sponsor, visiting faculty member Melanie Shell-Weiss, had been looking for ways to bring students and Baltimore residents together. He realized that turning Lovett and Wexler's film into a class would engage these two groups while allowing a closer study of race.

The class, From Civil Rights to Multiculturalism: Student Movements for Social Change, brought together last semester 14 Hopkins undergraduates and 11 high school students from three city schools to study how student activism can be critical to social change. The class focused on how student movements like Black Power and the push for black student unions and black and Africana studies departments on college campuses were important to gaining racial equality in the United States. The course also looked at issues specific to Hopkins, such as efforts by students in the late '90s to secure a living wage for university employees and the administration's response to the "Halloween in the Hood" party. "A course like this offers patient and cautious reflection and engagement with the core issue of race and representation," Vinson says. "At the same time, we're talking about people's lives and going beyond caricature. We see this as something that's important to the undergraduate educational experience."

"So often race is seen as something that's peripheral in a class," says Michael Henderson, a Hopkins PhD candidate in history who co-taught the course with Mark Carter of Kids on the Hill, a community arts group. "Out of a [typical] 14-week class, race might occupy only one class discussion. Here we've made race central."

Vinson is already looking ahead to next year when he would like to offer the class again. "The beauty of a course like this is that it's going to be a wildly different course from semester to semester. The issue constantly changes as society changes. What we need to do is provide the institutional structure to keep these kinds of conversations alive and current on campus." — MB

New money for diversity

Johns Hopkins University has added 206 more women and 45 more members of underrepresented minorities to its full-time faculty of 3,519 during the last four years. Nevertheless, women make up only 38 percent of full-time faculty members and fewer than 20 percent of full professors. Underrepresented minorities make up just 6 percent of full-time faculty members and less than 4 percent of full professors.

According to Ray Gillian, vice provost for institutional equity, departments can apply for up to $250,000 for each new hire, to be spent over a three-year period on salaries, research support, and laboratory equipment. Between 20 and 30 faculty members could be hired in the next five years as a result of the effort, he says.

"One of the reasons for this funding is that it allows deans and department chairs to extend their departmental funds and look over a different horizon in their recruiting," says Johnson. A department that does not have an open position in its current budget may apply Mosaic funds to secure a promising candidate anyway.

For academic departments that have faculty openings, the funds help make Hopkins more competitive in salaries and laboratory start-up costs, Johnson says. "The market is very hot. Because the pool is small in some of these departments, female and minority candidates are very sought after. This [new funding] allows us to be very competitive."

Making sure there are enough women and minorities choosing academic careers is also part of the initiative, Gillian says. Departments can use resources from the Mosaic Initiative to offer lectures by visiting minority and female junior faculty members and to coordinate visits to Hopkins for female and minority graduate students who are close to finishing their PhDs. "We want to start building relationships very early," he says.

Response to the Mosaic Initiative has been "overwhelming," says Johnson. Within three weeks of the announcement, departments had filed eight applications for the upcoming academic year, and one full-time faculty member had been hired. "This is just a start," Johnson says. The university hopes to raise more money to increase the initiative's scope.

"This is an important symbolic step for the university," says Adam Falk, dean of the Krieger School of Arts and Sciences, who has already applied for Mosaic funding. "It raises the visibility of the issue, gives us help for something we already do, and allows us to be competitive for the people that we want to attract." — MB

One student's banner day

Three years ago, at age 30, Nciweni was taking classes at Howard Community College in Maryland, working full time at Hopkins' Comprehensive Transplant Center, and wondering if she had a shot at attending Hopkins. Encouraged by co-workers and her high school mentor, she applied to what was then the Hopkins School of Professional Studies in Business and Education. Soon she learned that not only had she been accepted, she was a candidate for the Baltimore Scholars Program. Now in its fourth year, Baltimore Scholars offers full-tuition scholarships to Baltimore City public school students. Most recipients enter Hopkins straight from high school, but Nciweni qualified for one of three annual slots reserved for part-time evening students.

She turned out to be much more than that. She transferred credits from the community college and took on more than a full-time course load to complete a bachelor's degree in only three years. With the goal of becoming a human rights activist, Nciweni will begin work in September on a master's in law and justice from the Krieger School of Arts and Sciences' Washington, D.C., program. Further plans include a master of public health, then a PhD. That's a lot of school, but Nciweni doesn't seem fazed. "Degrees don't define you as a person," she says. "But you can never learn too much." — SP

A spring for the record books

Six Johns Hopkins sports teams contended for championships in a spring that must rank as one of the most successful in Blue Jays athletics. The biggest story at press time was men's swimming. Sophomore John Thomas claimed his second straight national crown when he won the 200-meter backstroke at the NCAA Div. III championships in March in Oxford, Ohio. Overall, the men's team finished second in the nation, and head coach George Kennedy was named Div. III national coach of the year for the sixth time.

Hopkins men's lacrosse rebounded from a mid-season five-game losing streak, the worst in team history, to win seven in a row and secure a place in the NCAA national championship Final Four for the sixth time in the last seven years. At press time, they were set to play top-seeded Duke in the national semifinals.

On March 29, the Jays baseball team defeated Swarthmore, 12-1, and tallied head coach Bob Babb's 800th career victory. In May, the Jays rallied from an opening-round loss to win the NCAA south regional tournament and qualify for the College World Series for only the second time in team history.

Men's crew captured the novice eight title at the Mid-Atlantic Collegiate Crew Championships in May. The previous week, varsity crew coach Joel Carlin was named coach of the year at the Mid-Atlantic Div. III regional championship.

Women's tennis rolled through its conference schedule with a perfect 20-0 record and advanced to the Sweet Sixteen at the NCAA national championships before losing to Mary Washington College; sophomore Anita Bhamidipati qualified for the NCAA national championships in singles. Men's tennis won its second consecutive Centennial Conference championship and made it to the second round of the NCAA tournament before losing to the College of New Jersey. Sophomore David Maldow broke the single-season record for singles victories when he notched his 19th. He finished the year 24-6 after advancing to the second round of the NCAA singles championships. — DK

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