A Festive Weekend 250 Years in the Making

Majestic fireworks dazzled the night sky over the Phila­delphia Museum of Art, where more than 1,200 people had come to celebrate. More alumni and families than ever before fanned out for parades and lectures on campus and reunion dinners throughout the city. An impersonator playing the role of John Morgan, the visionary behind the creation of Penn’s medical school, made the rounds in the crowd along with the more traditional Ben Franklin impersonator. Faculty members explored some of the exciting trends in medicine, and visiting representatives from educational and professional institutions in Scotland, England, and Italy described some of what the enterprising and ambitious Dr. Morgan found as he traveled throughout Europe before returning to Philadelphia with his grand plans. Visitors packed the Henry A. Jordan M’62 Medi­cal Education Center, one of the most forward-looking educa­tional sites in the nation, for its official opening. During the gala at the art museum, Philadelphia’s mayor, Michael Nutter, a Wharton alumnus, made welcoming remarks, and Andrea Mitchell, a College alumna and chief foreign affairs corre­spondent for NBC news, served as master of ceremonies. And helping to enliven the mood were bagpipers, a choir, and Harry Connick Jr. with his band. 

The Perelman School of Medicine was celebrating a birth­day. And not just any birthday – its 250th, more than any other medical school in America can claim. At the Museum of Art, J. Larry Jameson, M.D., Ph.D., dean of the school, aptly called it “a once-in-a-lifetime gala event.”

Some Important Trends in Medicine

The weekend’s faculty panel was “The Next 250 Years of Medicine,” featuring some of Penn Medicine’s most accom­plished physicians and researchers. Fittingly, it was held in the Rubenstein Auditorium of the modern Smilow Center for Translational Research. After welcoming alumni back to cam­pus, Dean Jameson cited the first four professors of the young school: John Morgan, William Shippen Jr., Benjamin Rush, and Adam Kuhn. “Those four professors and the subjects they taught encompassed every branch of medical knowledge known to John Morgan,” said Jameson. Then he added: “Fast-forward 250 years,” and today Penn Medicine has more than 2,000 faculty members in 28 basic science and clinical departments.

The session’s moderator was Glen Gaulton, Ph.D., professor of pathology and laboratory medicine, who is soon to step down from his role as executive vice dean and chief scientific officer. The first topic he raised was “personalized” medicine – or “precision medicine,” which he said was a more accurate term. A major emphasis today at Penn Medicine, it promises to loom even larger in the years ahead. “How’s it playing out?” In response, Garret FitzGerald, M.D., the Robert L. McNeil Jr. Professor in Translational Medicine & Therapeutics, pointed out that medical researchers used to look for large, average ef­fects in medicine. Now, however, treatments are becoming more individualized, given the detailed genomic and psycho­social information on patients that has become available. The movement is toward more linkages and more insights that were impossible in individual practices. On the other hand, with companies like 23 and Me actively seeking customers for genomic screening, he said, “it’s a bit like the wild west” in marketing. 

Two more very current areas of research are biological clocks and the individual’s microbiome. The “bugs” inside you can affect the drugs you take; and so can the time you take your drugs. Said Gaulton, “and if you’re taking statins” – and he paused as he pretended to peer into the audience – “looks like 50 percent?” Amid the laughs, he continued: “They work bet­ter at night.”

Another booming area of medicine the panel touched on was gene therapy. Jean Bennett, M.D., Ph.D., the F. M. Kirby Professor of Ophthalmology, was called upon to relate her ex­perience. “This is an incredibly exciting time for gene therapy,” she said, adding that “the eye has really taken the lead” in that field. Within a year, she continued, the first gene-therapy drug for blindness may be approved. After early success in restor­ing vision in dogs, it was only seven-and-a-half years ago that Bennett’s team, with members from The Children’s Hospital of Philadelphia, reported similar success with children born with Leber congenital amaurosis. The children’s behavior changed dramatically; one, she said, has cast aside the cane he used and even has his driver’s license. The treatment, Bennett emphasized, has a very high safety profile.

Such progress in gene therapy, Gaulton noted, seems to take place with rare diseases, affecting smaller groups. When will similar therapy be offered for larger diseases, like age-related macular degeneration? “A very big question,” said Bennett. The risk-benefit ratio of new treatments is ideal for the smaller groups. However, she added, “within a matter of two years or so” they could be testing for a larger population. Gene therapy, Gaulton said, might eventually provide a one-time treatment that fixes the problem. But how would such a new paradigm affect drug companies that rely on patients to take many drugs over many years? And how would the treatment be priced? He asked FitzGerald to comment. “It’s a time of promise, and it’s a time of challenges,” FitzGerald replied. There is a dynamic tension between the investments of the pharmaceutical firms “and what the country can afford to pay.”

John Morgan in Europe

Another of the weekend’s popular panels was “Inspiring History: The Founder’s Itinerary,” which brought together rep­resentatives from three of the major medical institutions that John Morgan visited during his years in Europe. Again, Dean Jameson welcomed the attendees, encour­aging them to think deeply about the his­tory of the medical school even as they looked to the future. “We have global roots as part of our history,” he said. In Morgan’s time, such places as Edinburgh, London, Paris, and Padua stood out; today, Jameson continued, our multi­ple and varied connections include Botswana and Central and South America, and we are now embarking on a closer rela­tionship with China.

Victor A. Ferrari, M.D. ’86, a professor of medicine and ra­diology at Penn Medicine, was the session’s moderator. Ferrari, in fact, has previously done research on Morgan’s European travels and knowledge-seeking. In 2012, he delivered the keynote address at a historical conference at the University of Padua. The occasion: the 300th anniversary of Giovanni Morgagni’s ap­pointment as professor at the university. And Morgagni was one of the teachers that Morgan sought out during his years in Europe.

Ferrari characterized Morgan as “remarkably intellectually curious,” but also called him a tragic Greek figure – brilliant but flawed. In his travels after receiving his medical degree from the University of Edinburgh, Morgan made many stops and at one point traveled with the Duke of York (George III’s brother) and his party. Morgan also made a stop to visit Vol­taire. According to Ferrari, at that time Morgan was in effect “the most famous American physician in the world!” Morgan came to Padua to communicate with the man known as the father of modern anatomy, Morgagni. As Gaetano Thiene, M.D., professor of pathology at the University of Padua School of Medicine, explained, the roots of his university can be traced back to 1222. Over time, it became the most im­portant and desirable site to study anatomy. Students came because bodies were available for dissecting. In 1594, Padua established an anatomical theater – “the first laboratory of investigation in the history of medicine,” said Thiene. Morgan was impressed by the emphasis on pathology, and in his fa­mous Discourse upon the Institution of Medical Schools in America, he noted how essential pathology was – linking the causes and effects of disease. In fact, Thiene asserted that even some phrasing of Morgagni’s found its way into the Discourse, written when Morgan returned to Philadelphia.

Thiene referred to an entry in Morgan’s diary about his visit with the elderly Morgagni: “He received me with the greatest politeness imaginable.” The 82-year-old Paduan was still “alert.” The scholars exchanged gifts as well, and Thiene noted that a copy of Morgan’s thesis on pus, written at the University of Edinburgh, is still in the Padua collection.

Neil Turner, Ph.D., head of Undergraduate Medical Educa­tion and professor of nephrology at the University of Edinburgh, began his presentation matter-of-factly: “Why did all these people travel halfway around the world” to Edinburgh? All four of Penn’s first medical professors were among them. In part, Turner answered his own question: the university was “a real magnet for intellectual characters,” including, in the era, Benjamin Franklin and Voltaire. Unlike other universities in the British isles, Edinburgh’s was not founded by a religious group. In addition, it became a center for anatomy – and on this matter Turner acknowledged the influence of Padua.

It is no surprise that London, with its cultural institutions and its hospitals, was another irresistible attraction for people like Morgan. “The London Experience” was the topic of Linda Luxon, a professor in neuro-otology at University College London and treasurer of the Royal College of Physicians. The latter, she noted, was established in 1518, as its charter stated, to protect “the rude and credulous populace” from wicked men who would take advantage of their desire for medical help. William Fothergill, who earned his medical degree at the University of Edinburgh, settled in London, where he became a generous host to visiting Americans. He met both Morgan and William Shippen, as well as Benjamin Franklin, Thomas Bond, the founder of Pennsylvania Hospital, and Benjamin Rush. Another prominent Londoner at the time was William Hunter, who with his brother John taught anatomy and dissection there. Shippen enrolled in their course. Morgan, Luxon noted, presented his thesis on pus to William. 

It was nearing the time for John Morgan to return to Phila­delphia – and make history.

Distinguished Indeed!

Moving 250 years ahead, in 2015 two alumni received one of the Perelman School of Medicine’s highest honors – the Distinguished Graduate Award, which recognizes alumni whose careers have received national and international acclaim. This year’s recipients are Patricia A. Gabow, M.D. ’69, G.M.E. ’73, and Robert M. Wachter, M.D. ’83. The awards are traditionally presented during Medical Alumni Weekend.

Gabow served for 20 years as CEO of Denver Health, retir­ing in 2012. She continues as a professor of medicine at the University of Colorado School of Medicine. Gabow is credited with having transformed a city department into a successful independent government body. This transformation earned Denver Health the Shingo Bronze Medallion for Operational Excellence, the first such recognition of a health-care entity. Her most recent book is The Lean Prescription: Powerful Medicine for Our Ailing Healthcare System (2014), written with Philip L. Goodman. Gabow has received several national and international honors, including the American Medical Association’s Nathan Davis Award for Outstanding Public Servant, the National Healthcare Leadership Award, the David E. Rogers Award from the Association of American Medical Colleges, and the Health Quality Leader Award from the National Committee for Quality Assurance.

In addition to receiving her award, Gabow was a panelist at another MAW session called “Front Row Seats: Penn Medicine Alumni Share Their View of Penn’s Leading Role in Medicine.” During that session, Gabow recalled the words of one of her former deans, Alfred Gellhorn, M.D., who pointed to the medical want in the midst of medical riches. While at Penn, Gabow helped treat the most vulnerable patients. That expe­rience, she said, made her decide to work at a “safety net” hos­pital. Typically, 40 percent of the patients of Denver Health couldn’t pay, and 20 percent were homeless. That’s why, she said, medicine “was not a job but a calling.” As she put it in a profile in Penn Medicine (Fall 2006): “I started out as a doctor caring for one patient at a time. When I became medical di­rector and CEO, I started thinking about caring for whole communities and populations of patients.”

Robert Wachter is a professor and associate chair of the Department of Medicine at the University of California, San Francisco, where he directs the Division of Hospital Medicine. He coined the term “hospitalist” in 1996 and wrote a highly influential article in The New England Journal of Medicine on the emerging field with Lee Goldman, M.D., then his depart­ment chairman. The hospitalist specialty is thought to be the fastest-growing in modern medical history. Wachter has writ­ten two books on safety, Internal Bleeding: The Truth Behind America’s Terrifying Epidemic of Medical Mistakes (2005) with Kaveh Shojania, M.D., and Understanding Patient Safety (2007; 2nd edition 2012). He received the 2004 John M. Eisen­berg Award, the nation’s highest honor in patient safety, pre­sented by National Quality Forum and The Joint Commission. For the past six years, Modern Healthcare magazine has named him one of the 50 most influential physicians in the United States. His newest book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, was published in April, and his blog, www.wachtersworld.org, is one of the nation’s most popular health-care blogs.

When the Hospital of the University of Pennsylvania added its first four hospitalists to its Division of General Internal Medicine in the summer of 1998, Penn Medicine (Fall 1998) featured an article on the new specialty. Wachter was featured as well, and the article noted that if his preliminary studies were borne out, “the addition of hospitalists should lead to shorter patient stays and more efficient use of resources.”

Cutting Ribbons and Reminiscing

The Perelman School’s Lifetime Achievement Award is be­stowed not every year but as merit warrants. It recognizes ca­reer-long and exceptional commitment, loyalty, and dedica­tion to the School and to Penn Medicine’s development and alumni relations programs. This year, the late Henry A. Jor­dan, M.D. ’62, G.M.E. ’67, was named the recipient. His wife, Barrie Jordan, accepted the award in his honor during Medi­cal Alumni Weekend. The Jordans established scholarships and contributed to the creation of the Jordan Center for Gy­necological Cancer, housed in the Ruth and Raymond Perel­man Center for Advanced Medicine. Extremely active as a volunteer, Henry Jordan served as chair of the Campaign for Penn Medicine and as co-chair of the University’s Making History campaign. He was the recipient of the first Medical Alumni Service Award and also received the University’s Alumni Award of Merit.

As Dean Jameson said, “This year, there is no more fitting recipient than the late Henry Jordan, who was one of our most esteemed and engaged alumni.”

The official ribbon-cutting for the Henry A. Jordan M’62 Medical Education Center took place during Medical Alumni Weekend.

One other major award was presented at the 250th gala: the 2015 Dean’s Medal to Walter Gamble, M.D. ’57, a pediatric cardiologist, and his wife, Anne. Together they established the 21st Century Scholars Program at Penn. Starting in 1993, the fund was to cover the full four-year tuition at Penn’s school for six students in each class. Over the years, that total has in­creased to 14 Scholars in each class. To date, the scholarship program the Gambles created has provided more than 220 Penn medical students with full, four-year scholarships.