The Importance of Clinical Research

This month, I decided to write about the power of clinical research because it has the potential to change patients’ lives. I recently experienced this in a powerful way myself.

In November, I received an invitation from Drs. Christine Holland and Jennifer Rai to attend Internal Medicine Morning Report and participate in a discussion of a patient who had anaphylaxis (severe allergic reactions) to her own progesterone production. The literature review for this case turned up an article published 28 years ago in the New England Journal of Medicine, in which the authors detailed the first reported case of progesterone induced anaphylaxis and its treatment with a new class of drugs called long-acting GnRH analogs. I was one of the authors on that first case report. Since then, numerous other cases have been reported, and I learned that the patient that was being treated here at Michigan was the beneficiary of research that was started so very long ago.

A few weeks later, on Dec. 18, I received a touching note from my daughter, Naomi. Naomi is a television news reporter in Minneapolis, which is where I completed my pediatrics residency and held my first faculty position. She received the note from a viewer. It said:

Naomi,

For several months we have been watching and admiring your reporting. … But, it was not until just recently that we satisfied our curiosity and investigated the possibility of your relationship to Ora.

Twenty-five years ago when our daughter was just four, she entered a precocious puberty experimental drug trial that your mother conducted at the University of Minnesota.  [We saw your mother] for 7 to 8 years, and were always impressed with the understanding and care she expressed.  But, outside of a couple of follow-up calls, we have lost touch.  Today, our daughter is pastor for a congregation in Iowa. We are so thankful that we found your mother and that she was able to help us.

[We] will always be thankful for the impact that your mother’s care had on our family.  

I remember this patient and her family very well. The patient was a 4-year old girl with precocious puberty who was enrolled in a clinical trial for which I was the principal investigator. Were it not for this clinical research and the new drug that this little girl was able to access as a result of this trial, she would not have gone on to live a normal adult life. Even now, 25 years later, her family remains indebted to biomedical innovation and clinical research.

This is why clinical research is so incredibly important – because it is how we test, improve and advance new drugs, devices and methods of treatment that save and improve lives. It is how we help to build healthier and more productive communities. And it is how we create the future of health care through discovery.

This type of research and discovery is happening every day across our Health System. Currently, 800 active clinical trials are in progress at UMHS, and we have more than 12,000 people on our clinical research volunteer registry. Additionally, medical school researchers begin 90 new industry-sponsored clinical trials each year, and the results of the work are impressive! For example:

  • Dr. Charles Burant, professor of Metabolism and Internal Medicine, and his colleagues conducted phase 2 clinical trials which found that a new treatment for type 2 diabetes improves blood sugar control without increasing the risk of a dangerous drop in blood sugar (hypoglycemia). More on this study
  • Researchers from UMHS and the Veterans Administration Ann Arbor Healthcare, led by Drs. Fernando Martinez and Jeffrey Curtis, both professors of Internal Medicine, participated in a large-scale national clinical trial that found adding a common antibiotic to the usual treatment regimen for chronic obstructive pulmonary disease (COPD) can reduce acute symptoms and improve quality of life. COPD impacts more than 12 million Americans and is a leading cause of death in the United States. More on this study
  • Research conducted by the U-M Department of Aerospace Engineering and supported by MICHR showed that the beating heart may generate enough electricity to power a heart-regulating pacemaker, thus negating the need for battery-replacement surgeries. More on this study

I was thrilled to be directly involved in clinical research myself, and I am so very proud now to be part of an institution that is on the cutting-edge of some of the most exciting clinical discoveries today. And yet, this work is threatened by sequestration which presents significant reductions in research funding. As our government grapples with the federal budget, we must commit ourselves more than ever to advocate for increased research funding, and we must find new and creative ways to support discovery. Because when research is compromised, society bears the burden of a decrease in new therapies and treatments that improve and save lives. Medical research means hope, and America needs to invest more, not less, in medical research.

VIDEOS: Demonstrating our Values; Achieving our Goals

STRATEGIC GOALS IN ACTION: PROMOTING DIVERSITY, CULTURAL COMPETENCY AND SATISFACTION & IPCE
Jane Miller conveys the importance of Interpreter Services in helping people get the right care, in the right way:

PATIENT- & FAMILY-CENTERED CARE
Laura Hurst, mother of twins Alex and Levi, shares how one thoughtful second made a world of difference. Hear her story:


In Honor of Martin Luther King, Jr., An Interview with My Father

We all have dreams. Dr. Martin Luther King, Jr.’s dream was of a just and equal society in which all individuals were respected for their contributions and where all citizens have equal basic rights and opportunities.

Today, an area in which we continue to experience vast inequality is in health care. This is true when you consider a global perspective, but also when you look at the United States alone.  When it comes to infant mortality rates, which are commonly used to indicate a nation’s health status, the U.S. has a rate that continues to be higher than the OECD average. If you do a simple Google search on “health disparities in the U.S.,” statistics from the CDC, AHRQ and other agencies indicate that unacceptable disparities across gender, geographic, racial and socioeconomic lines continue to exist in our country.

Clearly, we have a lot of work to do to ensure that all citizens have access to the right care, at the right time and in a setting close to home. At UMHS, we are working to find solutions to prioritize work on health care disparities in a variety of ways but, most demonstrably, through the newly created UMHS Office of Health Equity and Inclusion. In the coming weeks, we will announce the new Director of this Office.

Today, in honor of Dr. King’s life and dreams, I asked Allison Krieger to interview my father, Rabbi Richard G. Hirsch, about a period in his life when he worked with Dr. King during the Civil Rights Movement of the 1960s. His memories and lessons continue to remind me personally that if you doubt what we can do for the future, you need only look at some of the great lessons from our past.

* * *

In honor of his efforts on behalf of the legislation, President Lyndon B. Johnson presents Rabbi Richard G. Hirsch with a pen he used to sign the Civil Rights Act of 1966. (Photo courtesy of From The Hill To The Mount)

How did you meet Dr. King?
In 1962, I was selected as the Founding Director of an exciting new institution in Washington called the Religious Action Center of Reform Judaism.  The RAC was founded to represent Jewish social concerns and bring to bear the social justice message of Judaism on the major issues confronting society.  We testified before Senate and Congressional committees on issues of social concern, convened conferences, established training programs for clergy and lay leaders, issued publications and activated members of congregations to participate in the political process.  Wherever possible we participated with Protestant and Catholic groups, civil liberties and civil rights organizations, and a host of like-minded organizations.

Martin Luther King and I had a mutual friend who suggested that, because we shared common interests and goals, we should meet.  So, shortly after I arrived in Washington, Dr. King visited me and we immediately struck up a friendship. Within the first few minutes of meeting him, I recognized his passionate commitment to social justice, his love of the biblical message and his intellectual brilliance. 

Dr. King used your office when he would go to Washington, D.C., correct?
Yes. When I discovered that he made frequent trips to Washington, but did not have an office, I told him that he would always have one at the RAC and he graciously accepted my invitation. An additional incentive for him was the fact that the offices of the Leadership Conference on Civil Rights were located in our Center.  The Leadership Conference on Civil rights was an umbrella group which included the NAACP, the National Urban League, the Southern Christian Leadership Conference, the Protestant and Catholic groups, and a host of labor groups, women’s groups and other organizations advocating full rights for minority groups, with special emphasis on rights for African Americans. 

Is it accurate that much of the Civil Rights legislation in place today was drafted in your offices?
Yes. In fact, the RAC’s conference room was where critical meetings were held and where public civic groups debated the complex issues of the civil rights legislation. Today, that venue is considered an historic landmark.


How did you and your organization become involved in the 1963 March on Washington?
When Martin Luther King first proposed the March even liberal backers feared that it would lead to violence, and that the interruption of the normal Washington routine would be counterproductive.  We – the RAC and I personally – disagreed. Though I initially underestimated the potential significance of the event, I knew that it would be important and productive.  So, RAC staff and I became active in every aspect of the planning and implementation of the event.  And contrary to some of the nay-sayers, I insisted that it would be peaceful – so much so that we brought Ora, not yet seven years old, with us.  It is a day she has never forgotten.  For our country and for the world it is a day enshrined in history. It reinforced and became a symbol for the struggle for human rights for all human beings and for all eras

You personally played a significant role in the 1965 Selma, Alabama demonstration, too. Tell me about that.
Yes. I received a call from a friend in the Washington Council of Churches and he told me that Dr. King had issued a call to clergy of all faiths to join him in Selma to demonstrate their support for voters’ rights. They already had 13 Protestant clergymen and one Catholic priest. They wanted me to represent the Jewish clergy. It was considered extremely dangerous – several people had already been killed. I called Bella at home, explained the situation and asked if she would agree to let me go. Of course, she responded as she always has, that I had to do my duty and she encouraged me to go.

When I arrived in Selma, my fellow travelers and I were immediately taken to the church where the demonstration was being held. Thousands of people were gathered outside, and the church itself was packed to the rafters. We were lead to the pulpit where Dr. King was addressing the crowd. When he finished, he came up to me and said “Dick, you’re next.” I was totally unprepared!

For the next 30 minutes, I offered three thoughts – the words of the Midrash. First, I said that Jewish tradition teaches us that when God created man, he created only one man. Why? So that no man would ever be able to say my father is better than your father.

Next, I shared my second thought that according to Jewish tradition, God created man using dust from the four corners of the earth. Why? So that no person would ever be able to say the place from which I come is better than the place from which you come.

Then, I delivered my third and final thought, that when God created man, he used every color of dust. Why? So that no man would ever be able to say the color of my skin is better than the color of your skin.

Thunderous applause lasted for several minutes. Never in my life have I experienced such exaltation and gratification from an audience.

In your book From the Hill to the Mount, you shared your observation that when it comes to civic controversies “No individual and no organization is omniscient and no one has a monopoly on the solution.”  Do you think that we, as a nation, have become more adept at dealing with major civic issues?
I consider it to be a great privilege to have engaged in many major public controversies. What did I learn? Human society is not like the human body. When it comes to the body, you can discover cures for diseases through research and discovery.  But, when it comes to the ills of society, there are no quick cures, no panaceas.  There are no experts who have all the answers and who project sure-fire solutions to poverty, injustice, discrimination, inequity and a host of other afflictions confronting every society.

What we desperately require are leaders who are passionate advocates for social justice, but who understand that in a democracy the active participation of a majority is essential for social progress.  To achieve a majority requires a willingness to consider the validity of divergent views, and to seek compromise.  To the extent that I was involved in the deliberations resulting in the civil rights legislation of the 1960′s, I was involved in compromise.  Martin Luther King himself was a great compromiser.  But he never lost sight of the ultimate goal.  He knew that future generations would continue the struggle, even as his efforts were grounded in the struggles of previous generations.  Without the generation of Martin Luther King, would we have the generation of President Barack Obama?

 * * *

Dr. Martin Luther King, Jr. was assassinated on April 4, 1968. Three days later, on April 7. 1968, my family attended a memorial service in his honor convened by the Washington, D.C.-area Jewish community and attended by more than 2,000 people. Because of their relationship, my father, was asked to deliver the eulogy. Below is an excerpt from that speech. Though my specific memories of that day have suffered the toll of time, the feelings remain with me as if it were 45 days ago instead of 45 years.  And those feelings are sadness and loss, but also hope and promise.

“[Dr. King] made us look at ourselves in the light of eternity. He made us stand firm on our foundations. He showed us the gap between America’s promise and America’s fulfillment. He would not let us forget that there were human beings who were being treated less than human. From bus to waiting room to lunchroom to hotel room to voting booth to slum house to ghetto school to university campus to employment offices, he confronted us with the America we had refused to believe existed.

He shattered our illusions, but he restored our dream – the American dream. He helped us to see that our fundamental goal was not to make the world safe for democracy, but rather to make democracy safe for the world. And in doing so, he became our conscience. His pulpit was the street, his congregation all mankind, and his message universal.

And that is why he was struck down. The forces of hatred always seek to destroy our noblest symbols. But they seek in vain. . . . The assassins never learn that the symbol is more than a man’s body. It is a man’s life, his work, his deeds, his values. The destruction of the body only serves to enhance the value of the spirit. The wanton taking of life only generates new life for the forces of good. The symbol in death becomes more than the symbol in life. It assumes a new life, a new mission of its own. Freed from the frailties of the human body, it soars to new heights of influence.”

The Gift of Service

The University of Michigan Health System is a remarkable place with exceptional people who never forget the reason why they come to work every day of the year: to promote health and prevent disease, and to serve patients and families.

At this time of the year, many of us are able to take time off to celebrate the holidays with friends and family. But, for many UMHS faculty and staff who work at our hospitals, a holiday is simply another workday.

Our hospitals operate 24/7/365. Our doors never close – not on holidays, not during inclement weather and not during seasonal downtime enjoyed by others. We are always open and we must always be ready to serve.

I have often asked staff members how they feel about working on special holidays. Without exception, each person shared a version of the same answer. They always take it in stride and are proud to bring a little holiday joy into the lives of our precious patients. They tell me that they and their families are happy to celebrate before or after their shift because they recognize how fortunate they are to have the opportunity to spend time together at home. This is an opportunity that our patients do not have.

These people who sacrifice for others and this commitment to putting our patients and families first are what have always defined Leaders & Best in our Health System.

Every year, thousands of patients spend the holidays in our hospitals and thousands of employees spend their holidays caring for them. I ask you to join me in thanking all of the people in our Health System who give of themselves in the service of others. There is no more admirable or rewarding gift than giving of yourself, your time and your talents to help others, especially when they need it the most. And in the wake of the terrible tragedy in Newtown, Connecticut, this message of sacrifice and service has never been more poignant.

This holiday season, let’s keep those families in our thoughts and let’s hope for peace in the New Year.

Ora

VIDEOS: Demonstrating our Values; Achieving our Goals

To remind us all of the incredible impact of the work we do at the University of Michigan Health System, each  month I will be posting videos of faculty and staff talking about how their work connects to our seven strategic goals, and of patients and family members sharing their experiences with patient and family-centered care.

STRATEGIC GOALS IN ACTION: CREATING THE IDEAL PATIENT CARE EXPERIENCE
Greg Maxwell, music practitioner with Gifts of Art, discusses the healing power of music and his experience with one very special patient:

PATIENT- & FAMILY-CENTERED CARE
Ann Fitzsimons lost her sister, Maureen, to colon cancer. At the same time, she found out what it means to experience patient- and family-centered care at UMHS. Hear her story:


Thankful

I am thankful for many things – my wonderful family and friends, a job that I love and a workplace comprised of truly amazing individuals like those featured in this video taken during a visit I made to our KMS building.

Wishing you and your loved ones a festive Thanksgiving!