HIGHLIGHTS FROM
THE
2014 SOUTHERN REGIONAL MEETING
Southern Society for Clinical Investigation 2014 Founders’ Medal Acceptance: An Academic Career—It Takes a Village Jesse Roman, MD
M
r. President, Councilors, Colleagues and Friends.
Thank you for this honor; I am truly grateful. I am also humble for this recognition and excited to be part of this great tradition that began in the 1970s. While considering what to share with you today, I worried that I had too much to say, but too little time. However, I realized that this is one of the few instances in one’s career where it is unlikely that someone will rush to the stage to ask you to cut it short. So please bear with me.
IT TAKES A VILLAGE I was recently reminded of a dinner engagement my wife and I attended some years ago in Atlanta. We sat next to dear friends and chatted about life, work and family. I learned that night that the person sitting on my right was a disciple of Dr. B. F. Skinner, the famous psychologist, behavioralist and social philosopher. This fascinated me. B. F. Skinner was a firm believer of the idea that human free will is an illusion; that behaviors are causal factors that are influenced by consequences —meaning that you are unlikely to repeat an action that previously led to a negative consequence. Skinner felt that both positive and negative reinforcements were important to determine behavior. He once said, “It is a mistake to suppose that the whole issue is how to free man. The issue is to improve the way in which he is controlled.” This is an important concept, but one that is often misunderstood. Simply put, this theory predicts that an individual can be transformed into a valued member of society if they are exposed to the right reinforcements and surrounded by the right mentors. I remember reading about Skinner’s work in college and struggling with his theory. I was 17 years old when I was first exposed to Skinner. At that age, you think you are invincible and, importantly, you are beginning to develop independence to the point of believing that your persona and your future are entirely up to you—free will. Skinner turned this upside down for me; his work suggested that everything I did or became is a consequence of the reinforcements I received. In essence, who I am today is not because I specifically engineered it, but because I received the appropriate reinforcements; I was surrounded by the right people. Hilary Clinton said it differently: “It takes a village.” It’s the same concept: Those who surround you and influence you are very much responsible for who you are. From the Division of Pulmonary, Critical Care, and Sleep Medicine (JR), Department of Medicine and Pharmacology and Toxicology, University of Louisville Health Sciences Center, Louisville, Kentucky; and Department of Medicine, Robley Rex Veterans Affairs Medical Center (JR), Louisville, Kentucky. The authors have no financial or other conflicts of interest to disclose. Correspondence: Jesse Roman, MD, Department of Medicine, Ambulatory Care Building, 3rd Floor Suite 550 St. Jackson Street, Louisville, KY 40202 (E-mail: [email protected]).
8
If you believe this as I do, then you have to accept that this Founders’ Medal is a reflection of my village. It is a reflection of those who provided me the right reinforcements, the right mentorship. Allow me to tell you about my village and what I learned from these wonderful people.
TEACHINGS THAT DRIVE BEHAVIOR The beginnings of my career stem from the Caribbean: a small town off the southwest coast of Puerto Rico called Cabo Rojo where my parents were born. I owe everything to them. From them, I learned several important concepts that have stayed with me throughout my life. I learned that anything worthwhile requires patience, perseverance and sacrifice, and that I should be driven by the pursuit of excellence in everything I do. I distinctly remember my mother continuously encouraging me to deliver more than what my teachers asked for. I also remember standing next to the kitchen table in front of my parents reciting a presentation due in class the next day because they wanted to ensure I presented my best work. I cannot thank them enough for their sacrifice, counsel, encouragement and love. I already told you about Skinner who I met in college, but the most important person I met in college was Millie, my wife of 31 years who taught me how to be a husband and a father and has grown with me although I am the one aging while she gets younger. She too has sacrificed significantly for my career, and this Founders’ Medal is hers as much as it is mine. This medal is also for my daughters, Victoria and Veronica who have brought so much joy to our lives. Millie and I are at a stage when we have begun to learn from our kids. The roles are beginning to reverse and I often find myself asking for their advice. In Medical School, I met Julio Benabe, Laura Lespier, Roman Franco and many other great educators and clinicians. I also met Dr. Manuel Martinez-Maldonado, Chief of Medicine at the San Juan VA, member of the Southern Society for Clinical Investigation (SSCI), past editor of The American Journal of the Medical Sciences (AJMS) and a prior recipient of the Founders’ Medal. Dr. Martinez brought me to my first SSCI meeting. I remember being lost; I could not even understand the booklet; several societies in the regional meeting and many presentations delivered at the same time. Little did I know then that I would become a member of this talented group of people; that its leadership would embrace me and nurture my career. Many thanks to the SSCI leadership and Joan Kemp, Executive Director, for taking me as one of their own. Dr. Martinez, more than anyone else, showed me what academia is about and ignited my passion for academic medicine; a passion that I cannot break away from even to this day. Martinez harnessed the energy and drive for excellence that I learned from my parents and channeled them into academic medicine; his mentorship and friendship have been invaluable.
The American Journal of the Medical Sciences
Volume 348, Number 1, July 2014
Academic Career
Because of Dr. Martinez’s counsel (and I am sure several phone calls), I accepted an offer for a fellowship position at Washington University where I met yet another great group of people: Bob Senior, Albert Trulock, and importantly, John A. McDonald, a physician-scientist and head of the Division of Respiratory and Critical Care Medicine at that institution. After my clinical training, I joined Dr. McDonald’s laboratory somewhat reluctantly. I did not choose John as my mentor; he chose me and this was the best thing that happened to me. Over the next 4 years, I learned how to become a scientist and how to keep that sense of wonder alive. John taught me how to incorporate scientific inquiry into my career as a physician-scientist. In 1991, John left to Mayo Clinic in Scottsdale, and I joined the Division of Pulmonary and Critical Care Medicine at Emory University in Atlanta as a young Assistant Professor. Martinez and Dr. Juha Kokko, another member of the SSCI, Past President and previous recipient of the Founders’ Medal, recruited me to this position. There, I learned about taking advantage of opportunity. I had been told by Martinez and others that when opportunity knocks, you answer. At Emory, many great people knocked on my door to collaborate in projects and to develop new clinical programs. Roland Ingram was division chief at that time and later became a mentor and confidant. Roland is no longer with us, but he provided counsel and helped me focus on what really mattered. In 2002, I was asked to serve as division director at Emory and I began to learn about administration and leadership. Dr. Wayne Alexander, Department Chair and SSCI member, gave me that opportunity; something that I will always cherish. I learned from him a style of leadership that I put into practice every day. What unfolded next was something I had never experienced. I saw the manifestation and implementation of the great concepts I had learned years before, patience, perseverance, sacrifice, the acceptance of new challenges and the pursuit of excellence. A wonderful and talented faculty was displaying these concepts on a daily basis. The division experienced unprecedented growth by doubling in size, expanding its training programs and establishing a strong research infrastructure. It was truly magic. That experience will be with me forever and has taught me that much can be accomplished independent of the resources available. It taught me that resources define the strategy, but not the vision. It taught me that all you have to do is hire people that are smarter than you and give them the space to work; support them and great things will unveil before your very eyes. I want to emphasize that the Emory division did not do well because of Jesse Roman; it takes a village. It did well because it had people like Mike Hart, Ralph and Tammy Perez, Sam Aguayo, David Schulman, Gerald Staton, Kenneth Leeper, Dean Jones, Kimberly Jones, Linda Howell and many others who supported me, bought into the vision and carried it forward. Special thanks go to my good friend David Guidot who served as my “wing man,” who was willing to sacrifice for the sake of progress and who rekindled by interest in the Southern Regional Meetings in the mid 1990s. Guidot’s advice, support and friendship will stay with me forever and his family is my family. He has since taken the division to new heights and I am proud. Thank you my friend (Figure 1). In 2009, I was asked to serve as Chair of the Department of Medicine at Louisville. In Louisville, I have had the privilege of meeting yet another wonderful group of people; people who are loyal to their organization, who care about their community and who have embraced me as their own since the day 1 arrived. In the past 5 years, this group has Ó 2014 Lippincott Williams & Wilkins
FIGURE 1. The 2014 Founders’ Medal Award recipient, Dr. Jesse Roman (right) with award presenter, Dr. David Guidot (left).
rallied to grow the department, established programs of excellence, sustained a vibrant research enterprise and created an academic environment that is second to none in our region. Lightning struck twice! Again, there are many people to thank: Edward Halperin; my Division Chiefs and Vice Chairs; Barbara Casper and the Residency Training Program Team; Sherry Hertel, Christy Haden and my Administrative Staff; Ralph and Tammy Perez and the ILD Team, Research Collaborators and many others.
TRAINEES AND PATIENTS—THE VERY REASON WE DO WHAT WE DO Throughout these years, my most fulfilling experiences have related to my interactions with trainees. I learn as much from students, residents and fellows as they learn from me. They are what drives academicians to work every day; they enrich our programs, programs often established because of them instead of for them. It is most gratifying when a trainee follows in your footsteps and becomes an academician. I thank Cherry Wontrakool, Viranuj Sueblinvong, Allan Ramirez and many other students, residents and postdoctoral fellows who have allowed me to be part of their education. Many of these trainees have been in my laboratory. However, they would have never been there without the people in my laboratory who make things happen. They include William Schuyler who joined my laboratory when it was limited to a 100 square foot office in the Atlanta VA in 1991; my friend Jeffrey Ritzenthaler who has run my laboratory for over 15 years, Edilson Torres, Susan Roser and many others. Finally, I cannot end without thanking those who are the very reason of why we are here, my patients, Meredith, Donald, Swati, David, Dawn and so many others. I do not know anyone who goes into medicine to be a chair or to receive a Founders’ Medal. We go into medicine to serve. Patients give us that
9
Roman
privilege; they open their hearts to us and put their lives in our hands simply because we have an MD next to our names. I have worked all my life to be deserving of that trust. In the end, I work to give to trainees and patients at least a piece of what they have given me—purpose.
SKINNER’S EXPERIMENT WORKED I have had a fulfilling career; one that has allowed me to reach my potential while helping others. I want them to learn that I am the very example of what academic medicine can do. I ask you at this time to look around you. There are people in the SSCI
10
that have defined medicine in one way or another and continue to drive it. These people will agree that you do not have to be extraordinary to have a wonderful career as long as you have a village. I am proud to be one of them. In the end, however, this is not about success. Einstein once said: “Try not to become a man of success, but rather try to become a man of value.” I strive for this daily, but only because of the people around me. They have become the mirror upon which I look at myself every day. My village, my family, colleagues, trainees, patients and friends; I cannot thank them enough for what they have given me—joy.
Volume 348, Number 1, July 2014
THE
2014 SOUTHERN REGIONAL MEETING
Southern Society for Clinical Investigation 2014 Founders’ Medal Acceptance: An Academic Career—It Takes a Village Jesse Roman, MD
M
r. President, Councilors, Colleagues and Friends.
Thank you for this honor; I am truly grateful. I am also humble for this recognition and excited to be part of this great tradition that began in the 1970s. While considering what to share with you today, I worried that I had too much to say, but too little time. However, I realized that this is one of the few instances in one’s career where it is unlikely that someone will rush to the stage to ask you to cut it short. So please bear with me.
IT TAKES A VILLAGE I was recently reminded of a dinner engagement my wife and I attended some years ago in Atlanta. We sat next to dear friends and chatted about life, work and family. I learned that night that the person sitting on my right was a disciple of Dr. B. F. Skinner, the famous psychologist, behavioralist and social philosopher. This fascinated me. B. F. Skinner was a firm believer of the idea that human free will is an illusion; that behaviors are causal factors that are influenced by consequences —meaning that you are unlikely to repeat an action that previously led to a negative consequence. Skinner felt that both positive and negative reinforcements were important to determine behavior. He once said, “It is a mistake to suppose that the whole issue is how to free man. The issue is to improve the way in which he is controlled.” This is an important concept, but one that is often misunderstood. Simply put, this theory predicts that an individual can be transformed into a valued member of society if they are exposed to the right reinforcements and surrounded by the right mentors. I remember reading about Skinner’s work in college and struggling with his theory. I was 17 years old when I was first exposed to Skinner. At that age, you think you are invincible and, importantly, you are beginning to develop independence to the point of believing that your persona and your future are entirely up to you—free will. Skinner turned this upside down for me; his work suggested that everything I did or became is a consequence of the reinforcements I received. In essence, who I am today is not because I specifically engineered it, but because I received the appropriate reinforcements; I was surrounded by the right people. Hilary Clinton said it differently: “It takes a village.” It’s the same concept: Those who surround you and influence you are very much responsible for who you are. From the Division of Pulmonary, Critical Care, and Sleep Medicine (JR), Department of Medicine and Pharmacology and Toxicology, University of Louisville Health Sciences Center, Louisville, Kentucky; and Department of Medicine, Robley Rex Veterans Affairs Medical Center (JR), Louisville, Kentucky. The authors have no financial or other conflicts of interest to disclose. Correspondence: Jesse Roman, MD, Department of Medicine, Ambulatory Care Building, 3rd Floor Suite 550 St. Jackson Street, Louisville, KY 40202 (E-mail: [email protected]).
8
If you believe this as I do, then you have to accept that this Founders’ Medal is a reflection of my village. It is a reflection of those who provided me the right reinforcements, the right mentorship. Allow me to tell you about my village and what I learned from these wonderful people.
TEACHINGS THAT DRIVE BEHAVIOR The beginnings of my career stem from the Caribbean: a small town off the southwest coast of Puerto Rico called Cabo Rojo where my parents were born. I owe everything to them. From them, I learned several important concepts that have stayed with me throughout my life. I learned that anything worthwhile requires patience, perseverance and sacrifice, and that I should be driven by the pursuit of excellence in everything I do. I distinctly remember my mother continuously encouraging me to deliver more than what my teachers asked for. I also remember standing next to the kitchen table in front of my parents reciting a presentation due in class the next day because they wanted to ensure I presented my best work. I cannot thank them enough for their sacrifice, counsel, encouragement and love. I already told you about Skinner who I met in college, but the most important person I met in college was Millie, my wife of 31 years who taught me how to be a husband and a father and has grown with me although I am the one aging while she gets younger. She too has sacrificed significantly for my career, and this Founders’ Medal is hers as much as it is mine. This medal is also for my daughters, Victoria and Veronica who have brought so much joy to our lives. Millie and I are at a stage when we have begun to learn from our kids. The roles are beginning to reverse and I often find myself asking for their advice. In Medical School, I met Julio Benabe, Laura Lespier, Roman Franco and many other great educators and clinicians. I also met Dr. Manuel Martinez-Maldonado, Chief of Medicine at the San Juan VA, member of the Southern Society for Clinical Investigation (SSCI), past editor of The American Journal of the Medical Sciences (AJMS) and a prior recipient of the Founders’ Medal. Dr. Martinez brought me to my first SSCI meeting. I remember being lost; I could not even understand the booklet; several societies in the regional meeting and many presentations delivered at the same time. Little did I know then that I would become a member of this talented group of people; that its leadership would embrace me and nurture my career. Many thanks to the SSCI leadership and Joan Kemp, Executive Director, for taking me as one of their own. Dr. Martinez, more than anyone else, showed me what academia is about and ignited my passion for academic medicine; a passion that I cannot break away from even to this day. Martinez harnessed the energy and drive for excellence that I learned from my parents and channeled them into academic medicine; his mentorship and friendship have been invaluable.
The American Journal of the Medical Sciences
Volume 348, Number 1, July 2014
Academic Career
Because of Dr. Martinez’s counsel (and I am sure several phone calls), I accepted an offer for a fellowship position at Washington University where I met yet another great group of people: Bob Senior, Albert Trulock, and importantly, John A. McDonald, a physician-scientist and head of the Division of Respiratory and Critical Care Medicine at that institution. After my clinical training, I joined Dr. McDonald’s laboratory somewhat reluctantly. I did not choose John as my mentor; he chose me and this was the best thing that happened to me. Over the next 4 years, I learned how to become a scientist and how to keep that sense of wonder alive. John taught me how to incorporate scientific inquiry into my career as a physician-scientist. In 1991, John left to Mayo Clinic in Scottsdale, and I joined the Division of Pulmonary and Critical Care Medicine at Emory University in Atlanta as a young Assistant Professor. Martinez and Dr. Juha Kokko, another member of the SSCI, Past President and previous recipient of the Founders’ Medal, recruited me to this position. There, I learned about taking advantage of opportunity. I had been told by Martinez and others that when opportunity knocks, you answer. At Emory, many great people knocked on my door to collaborate in projects and to develop new clinical programs. Roland Ingram was division chief at that time and later became a mentor and confidant. Roland is no longer with us, but he provided counsel and helped me focus on what really mattered. In 2002, I was asked to serve as division director at Emory and I began to learn about administration and leadership. Dr. Wayne Alexander, Department Chair and SSCI member, gave me that opportunity; something that I will always cherish. I learned from him a style of leadership that I put into practice every day. What unfolded next was something I had never experienced. I saw the manifestation and implementation of the great concepts I had learned years before, patience, perseverance, sacrifice, the acceptance of new challenges and the pursuit of excellence. A wonderful and talented faculty was displaying these concepts on a daily basis. The division experienced unprecedented growth by doubling in size, expanding its training programs and establishing a strong research infrastructure. It was truly magic. That experience will be with me forever and has taught me that much can be accomplished independent of the resources available. It taught me that resources define the strategy, but not the vision. It taught me that all you have to do is hire people that are smarter than you and give them the space to work; support them and great things will unveil before your very eyes. I want to emphasize that the Emory division did not do well because of Jesse Roman; it takes a village. It did well because it had people like Mike Hart, Ralph and Tammy Perez, Sam Aguayo, David Schulman, Gerald Staton, Kenneth Leeper, Dean Jones, Kimberly Jones, Linda Howell and many others who supported me, bought into the vision and carried it forward. Special thanks go to my good friend David Guidot who served as my “wing man,” who was willing to sacrifice for the sake of progress and who rekindled by interest in the Southern Regional Meetings in the mid 1990s. Guidot’s advice, support and friendship will stay with me forever and his family is my family. He has since taken the division to new heights and I am proud. Thank you my friend (Figure 1). In 2009, I was asked to serve as Chair of the Department of Medicine at Louisville. In Louisville, I have had the privilege of meeting yet another wonderful group of people; people who are loyal to their organization, who care about their community and who have embraced me as their own since the day 1 arrived. In the past 5 years, this group has Ó 2014 Lippincott Williams & Wilkins
FIGURE 1. The 2014 Founders’ Medal Award recipient, Dr. Jesse Roman (right) with award presenter, Dr. David Guidot (left).
rallied to grow the department, established programs of excellence, sustained a vibrant research enterprise and created an academic environment that is second to none in our region. Lightning struck twice! Again, there are many people to thank: Edward Halperin; my Division Chiefs and Vice Chairs; Barbara Casper and the Residency Training Program Team; Sherry Hertel, Christy Haden and my Administrative Staff; Ralph and Tammy Perez and the ILD Team, Research Collaborators and many others.
TRAINEES AND PATIENTS—THE VERY REASON WE DO WHAT WE DO Throughout these years, my most fulfilling experiences have related to my interactions with trainees. I learn as much from students, residents and fellows as they learn from me. They are what drives academicians to work every day; they enrich our programs, programs often established because of them instead of for them. It is most gratifying when a trainee follows in your footsteps and becomes an academician. I thank Cherry Wontrakool, Viranuj Sueblinvong, Allan Ramirez and many other students, residents and postdoctoral fellows who have allowed me to be part of their education. Many of these trainees have been in my laboratory. However, they would have never been there without the people in my laboratory who make things happen. They include William Schuyler who joined my laboratory when it was limited to a 100 square foot office in the Atlanta VA in 1991; my friend Jeffrey Ritzenthaler who has run my laboratory for over 15 years, Edilson Torres, Susan Roser and many others. Finally, I cannot end without thanking those who are the very reason of why we are here, my patients, Meredith, Donald, Swati, David, Dawn and so many others. I do not know anyone who goes into medicine to be a chair or to receive a Founders’ Medal. We go into medicine to serve. Patients give us that
9
Roman
privilege; they open their hearts to us and put their lives in our hands simply because we have an MD next to our names. I have worked all my life to be deserving of that trust. In the end, I work to give to trainees and patients at least a piece of what they have given me—purpose.
SKINNER’S EXPERIMENT WORKED I have had a fulfilling career; one that has allowed me to reach my potential while helping others. I want them to learn that I am the very example of what academic medicine can do. I ask you at this time to look around you. There are people in the SSCI
10
that have defined medicine in one way or another and continue to drive it. These people will agree that you do not have to be extraordinary to have a wonderful career as long as you have a village. I am proud to be one of them. In the end, however, this is not about success. Einstein once said: “Try not to become a man of success, but rather try to become a man of value.” I strive for this daily, but only because of the people around me. They have become the mirror upon which I look at myself every day. My village, my family, colleagues, trainees, patients and friends; I cannot thank them enough for what they have given me—joy.
Volume 348, Number 1, July 2014
