Public Health: Katrina puts disaster response to test

Mental Health: The healing work of play

Students: Displaced students find a home at Hopkins

Arts: Task force finds arts "orphans at Homewood"

Political Science: The Supremes: Joel Grossman on the Court, handicapping, and cronyism

Public Health: Connections key to success of military kids

Education: No time like now for college

Books: A novel approach to free verse

Medicine: Virtual Rx for sick children

Technology: Clues to ancestral appetites

Public Health: Katrina puts disaster response to test

On the evening of August 30, as the country began to comprehend how much havoc Hurricane Katrina had wreaked on New Orleans and the Gulf Coast, the Johns Hopkins Office of Critical Event Preparedness and Response (CEPAR) swung into action. CEPAR had been created after the September 11 terrorist attacks for just this purpose: to plan and coordinate an institutional response to major disasters. The huge Gulf Coast hurricane provided its first test.

Within days of the storm, Thomas Kirtsch, an assistant professor of emergency medicine and CEPAR's deputy director, flew to Baton Rouge to assess the Red Cross' need for doctors, nurses, and additional medical personnel. W. Courtland Robinson, assistant professor of international health at the Bloomberg School, went to Montgomery, Alabama, to help with assessments on the Mississippi Gulf Coast. A few days later, Bloomberg Dean Michael J. Klag flew to Houston to conduct public health assessments at emergency shelters in Texas and to assist the Red Cross in aiding the thousands of people displaced by the storm.

On Saturday morning, September 3, Kelen received a call from the Maryland Department of Health and Mental Hygiene. The staff of the West Jefferson Medical Center, a community hospital in Marrero, Louisiana, was overwhelmed and exhausted. Could Hopkins send relief? By the afternoon of September 5, CEPAR had dispatched a 12-person team — drawn from Hopkins Hospital, Bayview, Howard County General Hospital, and the Hopkins Home Care Group — to assist the beleaguered West Jefferson staff. Two weeks later, a second Hopkins medical team ventured south to replace them.

CEPAR's biggest coordination effort was in response to plans by the National Institutes of Health to create 40 temporary hospitals in Mississippi and Louisiana. NIH director Elias Zerhouni (former executive vice dean at Hopkins' School of Medicine) called Kelen on September 3 to ask if Hopkins could staff one of the hospitals. Kelen recalls, "I said, 'How long do we have?' And Zerhouni said, 'Well, you've got until tomorrow morning.' We all just came in and starting working our butts off." CEPAR's staff began working through long call-lists of volunteers. "It looked like the Jerry Lewis Telethon," Kelen says. "It was a bit of a zoo, but like emergency medicine, it was controlled chaos." By September 5, CEPAR had assembled a 109-person group of doctors, nurses, pharmacists, technicians, and other staff to fly out of Baltimore the next morning.

Late on September 5, however, NIH notified CEPAR that it was putting a 24-hour hold on its plans for Mississippi. After three more delays, NIH concluded that it had overestimated the need for so many temporary hospitals.

According to Kelen, though the biggest team never deployed, CEPAR learned from its first experience at coordinating Hopkins' disaster response. For example, some difficulty in finding CEPAR team members over the Labor Day weekend revealed communications glitches. Kelen says, "We need a more organized and better supported infrastructure. We were wondering, would we have the energy to do again what we'd just gone through? I don't know if we would." Observing events in Louisiana and Mississippi convinced Kelen that Hopkins needs to be better prepared for a major disaster in its own region. He says, "We learned that when you prepare a system for a disaster, you should assume there won't be appropriate help for up to 72 hours. It takes about that long for people to figure out what's going on. We have to figure out a way to be self-sufficient." —Dale Keiger

Mental Health: The healing work of play

South Louisiana native Eric Green, a brand new addition to the counseling faculty at Hopkins' School of Professional Studies in Business and Education, had been in Maryland only a couple of months when Hurricane Katrina struck. Together with SPSBE counseling colleague Alan Green (no relation), he made a beeline back to the now-ravaged Gulf Coast region, intent on establishing a mental health crisis response for the hurricane's youngest victims.

During the two weeks Eric Green remained in Opelousas, he witnessed positive changes in some children who participated in play therapy. "Some were less excitable; some parents explained to me that their children developed better sleeping patterns and were more eager to go to school. I noticed a decrease in certain clingy behaviors," he says.

Before returning to Hopkins, Eric and Alan Green — with Jennifer Baggerly of the University of Southern Florida — led a mental health training session involving more than 150 school leaders from St. Landry's Parish and left behind resource materials for area teachers. The goal, says Eric Green: to equip teachers and counselors to set up "warm, supportive" environments for the region's displaced children "so that they may begin to reconnect with a sense of belonging." —Sue De Pasquale

Students: Displaced students find a home at Hopkins

If everything had gone as planned, Sarah Mariner would be at Tulane University right now, deep into her first semester. Due to Hurricane Katrina, the 28-year-old never left Baltimore. Prompted by her adviser's suggestion, Mariner contacted Johns Hopkins. Within a few days, she was enrolled at Homewood and taking three classes toward her master's in Latin American Studies. "It's been an incredible experience," says Mariner. "I never expected to be welcomed so warmly."

She is just one of the dozens of students from New Orleans- area schools who enrolled at Hopkins in September after being displaced by Hurricane Katrina. The Bloomberg School of Public Health and the Nitze School of Advanced International Studies both welcomed Tulane students. The Krieger School enrolled students from Tulane and the University of New Orleans. The majority are staying with relatives and attending Hopkins tuition-free for the fall semester.

Undergraduate admissions director John Latting says the mission was to help not just students but fellow universities. "It's just normal to want to lend a hand," he says.

Mary O'Rourke, admissions director for the School of Nursing, says her school is now accepting applications for next fall from students affected by Hurricane Katrina. "We're just trying to be as flexible as we can," she says. "If they apply now, at least I can give them a decision immediately, and that way they can start planning their lives." — Maria Blackburn

Arts: Task force finds arts "orphans at Homewood"

In his sophomore year at Homewood, Christopher Kovalchick cut 60 hours of classes.

He wasn't a slacker. Just the opposite, actually. Now a senior, Kovalchick is pursuing dual degrees in mechanical engineering in the Whiting School of Engineering and violin performance at the Peabody Institute, and he had to skip those classes at Homewood to attend mandatory rehearsals and classes at Peabody.

Kovalchick says his professors at Homewood were understanding but not forgiving, and he doesn't think he did as well in those classes as he might have otherwise, especially in the one class he had to miss twice a week during that spring semester.

"Logistically, it's tough, and it's tiring," Kovalchick says of the demands of his dual-degree life. When he started at Hopkins, he was one of about 15 freshmen pursuing dual degrees at Homewood and Peabody, he says, adding, "I think there are six or seven of us left, and only two of us are graduating in four years."

The difficulties of pursuing dual degrees at Homewood and Peabody were among the many issues Kovalchick and a group of other students, faculty, administrators, and community members took up together last year as a task force studying the arts at Homewood. The 18-member group, headed by Dean of University Libraries Winston Tabb, issued its final report and recommendations in May, assessing the state of the arts on campus and what's needed to improve it.

The Homewood Arts Task Force report said generally that the campus has numerous vibrant, diverse, and lively visual and performing arts offerings, both academic and extracurricular, but that they suffer from a lack of coordination, promotion, and integration into the intellectual and cultural life of Hopkins. In a nutshell, the report concluded, "The arts are orphans at Homewood."

The task force recommended 48 separate actions for improving upon the arts at Homewood and marked 10 of them as priority recommendations, saying they should be accomplished no later than 2010. At the top of the list is the proposal to create a senior leadership position — a vice provost for the arts — to promote and coordinate the arts, raise awareness and money, plan for necessary infrastructure improvements, and more.

At least in the short term, because of budget constraints, the task force recommended that the arts responsibilities be added to an existing administrator's duties, so that someone at a high level in the administration would be charged with "paying attention to the arts," says Pamela Cranston, associate provost for academic affairs and chief author of the task force report. "The initial focus of the new position ... would be on doing bigger, better, smarter with what we've got," Cranston says, with an eye toward longer-term enhancements and additions to the arts.

For now, Tabb is the de facto champion of the arts, seeing to it that progress is made immediately on a number of the task force's recommendations.

In the months since the report's release, architects have submitted proposals for a programming study of the all- purpose Shriver Hall auditorium, which the task force said needs a basic renovation now. While the group stopped short of recommending a new performing arts center, it said Shriver isn't likely to become "the kind of performing arts center appropriate for a university with the stature and mission of Johns Hopkins."

On the curricular front, Adam Falk, interim dean of the Krieger School of Arts and Sciences, has given the go-ahead to develop a minor in museum studies. It will capitalize on the school's already strong ties with the Baltimore Museum of Art and the Walters Art Museum.

A faculty committee is studying how to synchronize Homewood and Peabody class schedules — an idea raised in 2003 by the Commission on Undergraduate Education (CUE), in which Cranston also played a significant role.

Cranston says the CUE report was "absolutely the model" the arts task force followed, particularly given the success the university has had in implementing CUE's proposals. Much of that success can be attributed to the accomplishment of one of CUE's principal recommendations — the creation of a senior leadership position, now called dean of undergraduate education and held by Paula Burger, charged with executing CUE's recommendations.

On other fronts, Hopkins has discussed with the Maryland Institute College of Art the possibility of closer ties and collaborations, and the university recently moved management of its two historic houses (Homewood House and Evergreen) to Tabb in the libraries. The goal is to better integrate the houses' collections into the university and to coordinate their promotion, fundraising, and exhibitions. Tabb sees as a primary goal the development of a university-wide collections management policy to govern, among other things, acquisitions, preservation, storage, and exhibitions.

Eric Beatty, director of Homewood Arts Programs, is working on building a one-stop Web site for the arts and on connecting alumni with the Homewood campus's various student arts groups, which now number more than 30. In September, Beatty started a file in his Mattin Center office for the newest addition to the arts scene: a Bollywood hip-hop co-ed fusion dance troupe called Masti.

Indeed, Burger says, "There's much to celebrate already," and a good deal of the problem with arts at Homewood is one of visibility. The arts "don't really impact the overall culture here, I think, as they should," Burger says.

That's one reason Tabb and Cranston talk about the university doing more with what it already has before looking for big money for new projects. "I don't think people had any idea how successful the Mattin Center would be, and how much more interest it would generate," Tabb says of the student arts center, which opened in 2001. "It's a good problem to have, if we can now step up and do something about it.... I don't want to raise expectations we can't fulfill. To have done all of this just to stick [the report] on a shelf would be such a disaster."

Tabb remembers Kovalchick telling him he wasn't looking for special treatment as a dual-degree student. He just wanted to pursue his musical interests without sacrificing his engineering ones. "We are making it too hard for students," Tabb says.

Kovalchick agrees, and says he's hopeful that the task force's recommendations will bring about more coordination and collaboration among arts-related entities that will ultimately increase student involvement in all aspects of the arts.

"I think everybody should be exposed to the arts, especially in a city like this, at a university like this, with all these resources," Kovalchick says. "It should be easy." — Angela Paik Schaeffer

Priority Recommendations of the Homewood Arts Task Force

1. Create a senior leadership position to promote and coordinate the arts

2. Create a university-wide arts coordinating council

3. Develop a funding strategy to achieve the report's recommendations

4. Create an "arts innovation fund" to support creative programming in the arts

5. Renovate Shriver Hall's auditorium and undertake a programming study to determine long-range needs and options for a dedicated performing arts complex

6. Expand arts-related curricular offerings at Homewood

7. Synchronize the class schedules of Peabody and Homewood

8. Develop a user-friendly, comprehensive Web site to support the arts

9. Develop and implement a university-wide collections management policy

10. Identify and implement strategies to promote and increase the visibility of the arts

Political Science: The Supremes: Joel Grossman on the Court, handicapping, and cronyism

Has so much always been made of the importance of Supreme Court nominees?

There's clearly been a change on the playing field. I would date it to the mid-1960s and the [Earl] Warren court. As the court has come to be more prominent in American political life, the value of appointments to the court has gone up. Supreme Court appointments are important in their own right because the court is important. A president has an interest in what kind of decision the court makes. Is the court going to overrule Roe v. Wade? Is the court going to go one way or another on campaign finance? But his interest is also linked to his own political fortunes. Why did George H. W. Bush appoint Clarence Thomas to replace Thurgood Marshall? He wanted to replace Marshall with an African-American for political reasons. It's a way of telling one part of your constituency that you favor or respect them.

Were you surprised, at the start of John Roberts' confirmation hearing, when Republican members of the Senate Judiciary Committee advised him to not really answer their questions?

It's a little mind-boggling, but it's not unusual. The hearings are something less than an investigatory proceeding. They're basically a political charade. These people [on the committee] don't really think they're going to get information from the nominee. They're making a statement that's going to play in their local newspaper.

What did you make of Roberts' repeated assurances that he would not be guided by politics, but would seek only to "uphold the law"?

Without my appearing to be unduly cynical, to say that you "uphold the law" is meaningless. [If you're on the Supreme Court] the law is what you say it is when a case comes up. For example, Roberts said that Roe v. Wade was entitled to respect for precedent. What does that mean? Well, it doesn't mean anything. It merely means that if he wants to overturn Roe v. Wade, he's going to do it respectfully, with appropriate language telling people how much he's agonized over it.

Critics of President Bush's nomination of Harriet Miers have labeled it cronyism. Is the nominating of cronies an old story?

That's right, but it's been relatively on the wane. Eisenhower, after Warren, really wanted to appoint people whom he basically didn't know. Kennedy appointed people he knew professionally, not personally. Lyndon Johnson, of course, hit the jackpot with Fortas; nobody gets more crony than Abe Fortas and LBJ. But since then, there have been very few appointments that looked like cronyism. Reagan made it clear he didn't want to know these people.

Political advocacy groups have invested a lot in the idea that they can forecast how someone will rule once he or she has been placed on the court. How well does this sort of handicapping work?

The answer is "mixed." The fact is, when justices join the court, it's a new life, and they're in a position to rethink their basic philosophy. We've had a number of appointments of generally moderate conservatives who have moved to the center and even to the left — Earl Warren, certainly, and David Souter. Harry Blackmun was the most liberal justice on the court when he retired in 1994, and he'd started right of center. Being on the court can liberate people to think about issues in ways they couldn't in their former lives.

Harriet Miers has no previous experience as a judge. Should that be considered a liability?

I think somebody once did a count, and more than a third of all Supreme Court justices had no judicial experience. That would include some of the greatest names, starting with John Marshall and Roger B. Taney. The court has to decide issues that require it to know not just the law, in a technical sense, but to have had varied experiences in life. Thurgood Marshall, for example, was a marvelous addition to the court in many ways, but one that's not often spoken about is that he was the only justice who had any idea about life on the street. There's nobody on the court now who has that kind of experience. [Chief Justice John] Roberts has lived well above the average person all his life and has had all the advantages. There's no evidence that he's had any experience, other than maybe taking his kids to a softball game, that would say, "I know how people live."

Public Health: Connections key to success of military kids

Even in times of peace, things can be pretty tough for military kids. At an age when friendship and stability are vastly important, they're often shuttled from school to school as their parents transfer to bases throughout the country. In times of war a parent may be absent, or in harm's way.

This summer, the Defense Department awarded Johns Hopkins Bloomberg School of Public Health a $4.5 million grant to establish the Military Child Initiative, which will address the special needs of military children.

But for that to work, schools have to offer a welcoming atmosphere. Over the next year, the Military Child Initiative — a collaboration between the Bloomberg School and Hopkins' Center on School, Family, and Community Partnerships — will conduct focus groups to understand how parents, teachers, administrators, and students perceive the school environment. They will create a database of best practices in engaging students and increasing their sense of inclusion. They will design a Web-based course for teachers and administrators. And they will help schools with a large number of military kids develop programs that foster relationships between schools and families.

Particularly important when dealing with a mobile group of students is to find ways to help them integrate quickly into a new environment, Blum says. For example, some schools designate a group of students to show new arrivals the ropes. Other schools have incoming students create a video resume. "Even if he comes after the football season begins or she comes after the gymnastics season begins, they can be integrated onto the team, and the coach knows them before they walk in the door," Blum says.

Blum points out that while military kids are the most mobile group of students, they are far from alone. The children of business people, diplomats, or migrant workers; foster children; children whose families are poor or whose parents are in prison — all move more frequently than average. The hope: that the lessons learned can be applied to all kinds of kids, so that they all reap the benefits of a protective, caring school environment. —Catherine Pierre

Education: No time like now for college

Taking a year off between high school and college has increasingly gained acceptance as a valuable way for young adults to travel, work, or experience the real world before continuing on as full-time students.

"What was surprising was that even socioeconomically advantaged, high-performing kids, even those who started at four-year schools, will be at a disadvantage in terms of completing their degree if they delay," says lead author Stefanie DeLuca, assistant professor of sociology at Hopkins. The study, done with then Hopkins graduate student Robert Bozick, A&S '05 (PhD), was published in the September 9 edition of the journal Social Forces. It drew from the National Education Longitudinal Study of 1988, a national survey of 24,599 eighth graders that was followed up in 1990, 1992, 1994, and 2000, when the students were eight years out of high school.

The study reports that 16 percent of high school graduates postpone enrollment by seven months or more after completing high school. Delayers tended to be from less- advantaged backgrounds, were generally low-performing in school, had kids or had gotten married before college, and started at a two-year college first.

At Hopkins, delaying enrollment by one or two years is a "growing phenomenon," according to John Latting, director of undergraduate admissions. Of the group of students who applied for 2005 entry to Hopkins, 52 are delaying their enrollment. Only 18 incoming freshmen delayed their Hopkins enrollment in 2002.

DeLuca, who studies education trends, became interested in the topic of students delaying college when she started noticing that high school students were increasingly bombarded with information about all kinds of college options such as distance learning and evening and weekend colleges. "The messages of all of these programs seemed to be, 'You can go back to college at any time and there's no penalty for putting it off,'" she says.

However DeLuca knows from past research that "most irregular timing patterns don't bode well for long-term educational attainment." She comments that everything from losing connection with one's high school advisers, to family and work commitments, to simply being older than the rest of one's college class all complicate delayers' re- entry into full-time schooling. — MB

Books: A novel approach to free verse

If the thought of a narrative poem more than 4,500 lines long isn't daunting to you, read on.

If it is, read on anyway, because this poem is the latest from John Bricuth — aka the Writing Seminars' John T. Irwin, the Decker Professor in the Humanities — and it's a roller coaster of a narrative that is by turns hilarious, raunchy, slapstick, heartbreaking, tender, and sweet.

Set in a reconciliation hearing between a couple grief- stricken over the suicide of their only child, As Long As It's Big (published this fall by Johns Hopkins University Press) explores meaning-of-life questions similar to those posed in Irwin's previous narrative poem, Just Let Me Say This About That, using characters of the same names. This poem's authority figure is a somewhat old-fashioned judge who insists on a reconciliation hearing for the couple before he'll consider a trial date in divorce court:

Sit-downs such as these can serve a purpose,
Giving both the parties, as they say on TV
When a jet explodes or gunfire

Rakes the schoolyard, 'closure.' After all,
If two people call it quits, having
Spent the better part of life locked

In holy headlocks, baggage needs to be
Unpacked, because, you know, your married couples
Grow so much alike in time, sharing

Tastes, swapping habits, starting next
To look alike, then like their pets — that if
They break up hating one another's guts,

Chances are they'll go through life regretting,
If not loathing, something deep inside
Themselves, but more than that, there's the problem,

Once they split, how to deal with, what
To feel about, some twenty, thirty years
Compacted, sacked, and thrown out with a spouse.

When Irwin began As Long As It's Big, he stuck to his previously successful strategy of writing poetry and prose simultaneously, authoring a book of literary scholarship and criticism at the same time. (Called Unless the Threat of Death is Behind Them: Hard-Boiled Fiction and Film Noir, it is due out from Hopkins Press in fall 2006.) "When I got tired of one, I turned to the other," he says.

His latest narrative poem is a tragicomedy — like life, he says. "Everybody has had terrible things happen, but if you can't laugh ... you're not going to make it through."

Irwin says he admires Shakespeare for understanding that "you could put the most terrible things and the funniest things cheek by jowl" in the same story. "When you do, it makes the most terrible more terrible, and the funniest funnier."

Why write such a long poem?

Irwin says when he turned 40, he considered what it meant to have a career as a poet. A collection every five to seven years would amount to maybe 500 poems over the course of his career, he figured. "Then I asked myself the hard question, 'Are there 500 things I know enough about and care enough about to write about?'" The answer was no, the number likelier is in the range of two dozen. So, he says, "I knew I was going to have to write longer poems." — APS

Medicine: Virtual Rx for sick children

What do you get when you pair up a 300-pound purple she-hulk; a flaxen-haired superhero in tights; a government spy; and a crime-fighting, afro-topped Brooklynite named "Disco Sanchez"? Believe it or not, you get a dream team of Johns Hopkins physicians, researchers, and IT experts who came together to interject some fun into the lives of chronically ill children.

The Hospital-based Online Pediatric Environment (HOPE) is a new Hopkins-based research initiative that uses video games to help relieve young patients' suffering. The super-hero characters are the Web site aliases of the "co-conspirators" who are making the program happen.

Disco Sanchez and UltraViolet, the online alter egos of HOPE principal investigators Arun Mathews and Susan Furth.

He brought his idea to Hopkins, where he was a research fellow in the School of Medicine's Division of Health Sciences Informatics. (He is now a hospitalist for the Apogee Medical Group in New Mexico.) In May, he launched HOPE, a pilot research project led by faculty in the Johns Hopkins Children's Center.

Mathews and his co-conspirators this past spring outfitted the hospital's hemodialysis unit, which is owned by Gambro Healthcare, with access to an online network that will ultimately allow Hopkins patients to play games with children at other hemodialysis units. The intent is to give chronically ill children the opportunity to escape the stresses inherent in their conditions. Abstracts of the study results have been accepted by the Journal of the American Medical Informatics Association and the American Society of Nephrology.

The children in the Hopkins unit where the study is being conducted are those with end-stage kidney disease who receive dialysis three times a week — each session lasting for three hours — for several years, or until they receive a transplant. Susan Furth, HOPE's principal investigator and an associate professor in pediatrics and epidemiology at the School of Medicine, says that it's not uncommon for these patients to miss sessions or want to finish early because they either don't feel well or become bored.

"My hope is that this project will give these kids an opportunity to do something fun and distract them while on dialysis, and also allow them to interact with other children," says Furth.

In addition to Mathews and Furth, the project's principals are Harold Lehman, an associate professor in the Division of Health Sciences Informatics, and Alicia Neu, an associate professor in the Department of Pediatrics and the clinical director of pediatric dialysis. —Greg Rienzi

Technology: Clues to ancestral appetites

For years, scientists trying to learn what early humans ate have pored over electron microscope images of fossil teeth, teasing meaning from scratches and pits. But such analysis has always been tedious and subjective. Johns Hopkins professor Mark F. Teaford, in collaboration with colleagues at four other institutions, has devised a faster, more objective way to examine teeth. The technique already has demonstrated that two extinct species of hominins ate more varied foods than previously suspected.

As he displays on a computer monitor an older electron micrograph of a tooth, Teaford explains all that was wrong with the old method of analyzing images of dental microwear by hand, so to speak. A scientist would have to painstakingly go over the image mark by mark, and subjectively determine the boundaries of each scratch and pit. "You get a surface like this," he says, pointing to the micrograph. "It's got a lot of long, skinny scratches. It's got round things that are sort of pits. What do you do with that?" He points to another vertical feature on the tooth. "It's got this big thing coming right up the middle here. What the heck is that?" Despite the high resolution of the images, two observers could examine the same picture, Teaford says, and arrive at much different conclusions. "We wanted something where you put the tooth in and the numbers come out, and anybody who puts the tooth in will get the same numbers."

When Teaford and colleagues at the University of Arkansas, Worcester Polytechnic Institute, Stony Brook University, and Penn State applied the technique to detailed casts of hominin teeth selected by Teaford, they found that, as expected, A. africanus seemed to subsist mostly on tough, chewy foods like leaves and grasses, while P. robustus tended toward more hard, brittle foods. But features found on teeth from both species suggest more overlap in dietary habits than previously suspected, and indicate the hominins could modify their usual diets to survive.

Did they brush and floss? Teaford laughs at the question, but says, "Most of these diets were just abrasive enough to be sort of like dog biscuits. They kept the teeth relatively clean. We don't see a lot of problems with caries [decay] and stuff like that." — DK

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