Our New President—Anil K. Rustgi, MD

Abstract

Anil K. Rustgi will take the helm as the 108th president of the American Gastroenterological Association (AGA) in May 2013. We have each known Anil for nearly 2 decades and have been in awe of what he has been able to do for the field of gastroenterology, countless trainees, and the AGA, yet carry himself with utmost modesty and self-effacement. At this juncture, it is only fitting and an honor for us to provide the AGA membership a glimpse into Anil's upbringing as well as his training, skills, and accomplishments to provide insight into his abilities as a remarkably talented and compassionate individual who is ideally suited to lead the AGA. After learning more about Anil, we have no doubt that you will share our tremendous excitement and enthusiasm as he becomes president of the AGA. Anil's father's only books were those he won in competitions. He taught himself nuclear physics by a kerosene lamp and was good enough to win an Atomic Energy fellowship to come to do graduate work (PhD) in the United States … Anil was exposed to this value system from birth.—Vinod K. Rustgi, MD, MBA, Fairfax, Virginia Anil's paternal grandparents were a poor couple who migrated at a young age from villages in India to Delhi. Even though his grandfather did not attend school beyond the second grade, he had a fierce dedication to education and was self-taught in languages (Hindi, Urdu, Persian, and even some English). Anil's father, Moti Lal, was the first in the entire family to go to college. He was also the first in his family to come to the United States, and after completing his doctorate, he held different faculty positions at Yale University, Harvard University, and University of Southern California; he spent much of his career as a professor of physics at the University of Buffalo (1966–1992). He was a world authority on the photodisintegration of the deuteron and other nuclei. As an accomplished physicist and fellow of the American Society of Physics, he trained generations of physicists. He was also a leader in education and helped many in his field and various communities. He and Anil's mother (Figure 1) came to the United States in the 1950s. Anil's mother was, and still is, the backbone of the family in her loving way, while his father was the inspirational and courageous leader who overcame much to expand what his extended family and various communities could accomplish. Anil and his brother, Vinod, have established awards and scholarships in honor of their parents, including the Moti L. and Kamla Rustgi International Travel AGA Awards, which are given annually to young basic, translational, and clinical investigators residing outside North America to cover travel expenses so they can attend Digestive Disease Week. Anil's mother and her 2 sons have also endowed a professorship and lectureship at the University of Buffalo in honor of Dr Moti L. Rustgi. Anil was born in 1959 in New Haven, Connecticut, and was the first Rustgi born in the United States. He moved to India at 2 years of age and returned to New Haven when he was 6 years old. This was quite a transition for Anil, who only spoke Hindi at that time and had never seen a television. Indeed, Anil would look inside the television from the back and ask where the people were; his favorite show was “Combat” with Vic Morrow. As a child, Anil had a fabulous memory for sports trivia and baseball statistics, not only an early indication of his prodigious memory but also his lifelong fondness for sports. However, according to Vinod, Anil was a bit lackadaisical in grade school, a situation that was quickly addressed by both his father and brother, who would make him read books. Vinod would then grade Anil's book reports mercilessly until he achieved an appropriate grade. Nevertheless, it is believed that is one of the first cases of grade inflation! Thus, in addition to Anil's father, Vinod strongly influenced Anil's love for scholarship during his formative years and triggered his fondness for history and literature in particular. After graduating from high school in Amherst, New York, Anil graduated summa cum laude from Yale University in 1980 and from Duke University Medical School in 1984, where he was elected to the AOA Honor Medical Society and won the Trent Prize in the History of Medicine. He received Duke's Davison Scholarship to study tropical diseases in Brazil during one summer. Anil's father strongly encouraged his sons to pursue careers in medicine because of his belief that it is a very honorable profession. In fact, as described by Vinod, a typical discussion on career development in the Rustgi household would go something like this:Father: What would you like to do when you grow up?Anil: I, uh, would … uh …Father: OK, you're going to medical school – end of story. You will like what you do … . . don't do what you like.Anil: Thank you. I agree wholeheartedly. This sentiment is, in part, a reflection of a different era and a different world but is one that many immigrant families can understand. It was during his gastroenterology fellowship at Massachusetts General Hospital (MGH), while in the laboratory of Dr René Bernards, that Anil met Poonam Sehgal. After completing her residency in anesthesiology at Albert Einstein College of Medicine in New York, Poonam and Anil married; she moved to Boston, where she joined the faculty at Beth Israel Hospital. By this time, Anil was starting to establish his own laboratory. Poonam and Anil (Figure 2) spent many happy years in Boston, where they lived in an apartment on Coolidge Corner in Brookline. Their son, Naryan, was born in 1996 at Beth Israel Hospital, and Anil has passed on his love for Boston sports teams, particularly the Celtics (especially from the Larry Bird era) and Patriots, to his son. All in all, Anil and Poonam shared many major life moments in Boston: first jobs, first child, and eventually first house. A lot of milestones and memories! Anil and Poonam moved to Villanova, Pennsylvania, in 1998, and their daughter, Sabrina, was born in 2000. Naryan and Sabrina enjoy school, and Naryan is an avid tennis player. Sabrina also loves drawing and art. Anil and Naryan indulge both Sabrina and Poonam's appreciation for the arts by accompanying them to museums such as the Prado in Spain and the family's favorite, the Uffizi in Florence, on past family trips. I consider Anil Rustgi to be one of the most accomplished gastroenterologists to have passed through the portals of our fellowship program over the 30 years that I was head of the GI Unit at the MGH. From the very beginning his remarkable talents were very much in evidence. At a clinical level, his singular acumen was coupled with both unusual commitment and compassion in the care of his patients. In the laboratory, his compassion turned to passion and determination as he applied his intuitive skills in achieving his research objectives. Anil is a man who innately approaches people and issues with utmost modesty and humility. He embodies those valuable personal qualities that one hopes to find in a distinguished leader and thus the AGA Institute is indeed most fortunate to have a person of such caliber as its next president. My personal respect for him knows no bounds.—Kurt Isselbacher, MD, past chief of gastroenterology and past director of the cancer center at MGH, and member of the National Academy of Sciences and Institute of Medicine; Dr Isselbacher is also past president of both the AGA and the American Association for the Study of Liver Diseases Anil completed his internal medicine residency and chief residency at Beth Israel Hospital (1984–1987), followed by a gastroenterology fellowship at MGH (1987–1990) and an instructorship of medicine (1990–1992) and his first faculty position at Harvard Medical School/MGH (1992–1998). Anil's research interests and academic pursuits were shaped by multiple experiences, but no doubt the critical seeds were planted by his father's passion for investigation. Experiences and mentors who played an important role in Anil's early career development include Dr Gerhard Giebisch (with whom Anil spent a summer research fellowship at Yale College), Dr Joseph Greenfield (former chair of medicine at Duke University), Dr Eugene Braunwald (former chair of medicine at Brigham and Women's Hospital and Beth Israel Hospital), Dr Lewis Landsberg, firm chief at Beth Israel Hospital (before becoming chair of medicine and then dean at Northwestern University), Dr Kurt Isselbacher as previously noted, and Dr Daniel Podolsky (then chief of gastroenterology and vice-chair of research in the Department of Medicine and later also head of academic affairs at Partners). In particular, Dr Podolsky influenced Anil to become a meticulous scientific writer and reader and assisted him greatly in the growth of his career. Together, Drs Isselbacher and Podolsky have been larger-than-life figures for Anil in gastroenterology and gastrointestinal (GI) cancers. When asked, Dr Podolsky (now president of the University of Texas Southwestern, a member of the Institute of Medicine, and a past president of the AGA) said of Anil:Having had the good fortune to work with Anil at the MGH, first during his fellowship followed by the years he was a member of the junior faculty while I served as chief, I have had ample opportunity to see his outstanding talents as a clinician, investigator, and teacher. Whether as associate editor of Gastroenterology when I served as its editor, or in the many other efforts in which we have worked together, he has consistently brought both expertise and outstanding judgment to all of his responsibilities (which was manifest when he himself served as editor-in-chief of Gastroenterology). Since his departure from the MGH, I have admired the leadership he has provided to the GI Division at the University of Pennsylvania, where he has nurtured many careers. Given the breadth of these experiences and his many talents, our organization is fortunate to have him serve as our next president. Thus, it was the Yale–Duke–Beth Israel–MGH trajectory that propelled Anil to his current position at the University of Pennsylvania. Anil is the quintessential academic leader. Remarkably effective as a scientist, he manages a large clinical operation and is one of the strongest advocates I have seen for his faculty. He does it all, and always with a gentle humility which is striking.—Brian L. Strom, MD, MPH, executive vice dean for institutional affairs, Perelman School of Medicine at the University of Pennsylvania Anil was recruited to Penn in 1998 to head the Division of Gastroenterology, where he is currently the T. Grier Miller Professor of Medicine and Genetics. Under his leadership, the division has grown to 46 faculty members, 19 fellows (Figure 3), and nearly 200 clinical and research staff. Clinically, the division is responsible for more than 26,000 endoscopic procedures and nearly 30,000 patient visits annually. He has also worked closely with community practices in the region. Anil also plays critical roles as the leader of multiple research programs as the director of the National Institutes of Health (NIH)/National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) P30 Center for Molecular Studies in Digestive and Liver Diseases; founder of the Penn-CHOP Joint Center in Digestive, Liver and Pancreatic Medicine, which focuses on transitional medicine from adolescence to adulthood; and codirector of the Tumor Biology Program of the Penn Abramson Cancer Center, funded by the National Cancer Institute. In addition to chairing, directing, and serving on innumerable task forces and committees at Penn, Anil is one of the most visionary and influential leaders in both the Perelman School of Medicine and the Penn Health System. Indeed, as Dr John Glick, president of the Abramson Family Cancer Research Institute, vice president of the University of Pennsylvania Health System, and associate dean for resource development of the Perelman School of Medicine at the University of Pennsylvania, points out,Anil is one of the key leaders in both Penn Medicine and the Abramson Cancer Center of the University of Pennsylvania. An exceptional scientist, a talented clinician, and a superb administrator, we are very proud of Dr Rustgi's many accomplishments. In addition to these roles, Anil sees patients on a weekly basis, with a focus on high-risk GI cancer genetics, and regularly performs endoscopic procedures. He attends and teaches on the inpatient gastroenterology service, takes night-time endoscopy call, conducts intern and resident reports, and enjoys patient care very much. He is invigorated by the constant interplay between patient care and research, and he very much understands the strengths and challenges of practice, whether in community or academic centers. Over the course of our work together on Gastroenterology, I came to see Anil not just as an outstanding editor-in-chief, but also as a friend, mentor, and confidante. Anil's perpetual trust in me significantly increased my ability to manage the journal with newfound confidence. His mentorship also transformed my management style—I learned from observing him that genuine acknowledgement of hard work and success is critical to managing others. Anil treated each of the journal's staff members with the utmost respect, considering us as peers who had the necessary experience to run a successful publication. Those five years flew by and I'm proud that Anil will be the next AGA President.—Erin Dubnansky, senior director of scholarly publishing for the AGA Anil has held several leadership and committee membership positions in the AGA during the past 2 decades, and it all started in 1989 as a member of its Gastrointestinal Oncology Section (with subsequent service many years later as chair). He has done it all, including service with the Abstract Committee for GI Oncology (with service as chair), Development Committee, Education Committee (with service as chair), Leadership Cabinet, Manpower and Training Committee, Nominating Committee (with service as chair), Program Evaluation Committee, Publications Committee, and Research Committee. Another important contribution, not only to the AGA but to the digestive health and disease field at large, was his service as associate editor (1996–2001), special section editor (2001–2006), and then editor (2006–2011) of Gastroenterology. This is the setting in which we had the opportunity to work under Anil's tutelage as associate editors and observe him firsthand. It is hard for us to imagine anyone working as hard and caring as much as Anil. It was typical to find an e-mail from Anil when we awakened in the morning, no matter how late we signed off our computers, to the point that many of us wondered if he actually lived in San Diego or Hawaii, but that theory was immediately put to rest when he would call us the next morning from his office at Penn. He has an encyclopedic memory and fund of knowledge; was always fair to authors and reviewers; was inclusive, humble, and always promoting others and never himself; treated everyone with utmost respect and caring; led by example (a recurring attribute that comes up over and over); and was an absolute inspiration to all of us. Therefore, his selection as president of the AGA not only takes advantage of his intimate knowledge of the successes and challenges of the AGA over more than 2 decades but also brings in his caring and amazing work ethic and his effective way of getting things done no matter what the challenges. He practices but rarely preaches, and as Mohandas Ghandi, one of the great leaders of history, said, “An ounce of practice is worth more than tons of preaching.” This is what Anil has done and continues to do within and outside the AGA. Anil has been an articulate and effective advisor to the NIDDK … He has an extraordinary breadth of scientific knowledge and understanding of the complexities for supporting scientific research in a rapidly changing research environment.—Stephen James, MD, director of the Division of Digestive Diseases and Nutrition, NIDDK In addition to his outstanding contributions to the AGA, Anil has made substantial contributions to numerous other professional organizations. For example, he is currently a member of the scientific or medical advisory board of many GI disease–centered organizations, including the Pancreatic Cancer Action Network, National Pancreas Foundation, National Colorectal Cancer Research Alliance, and Caring for Carcinoid Foundation. Mirroring his service to the AGA, Anil's service to the American Association for Cancer Research (AACR) has been exemplary. He either serves or has served on numerous AACR committees in the past 2 decades. Other important contributions to the AACR include serving as past associate editor of Cancer Research, the flagship AACR journal, and as an organizer for the Special Conference on Colorectal Cancer: Biology and Therapy in 2010 and the International Conference on New Horizons in Cancer Research: Biology to Prevention to Therapy in 2011. An equally important and major service contribution by Anil is one he renders to the NIH. A notable example is his current membership on the NIDDK Advisory Council, a position appointed by the Secretary of Health and Human Services. In this important capacity, Anil provides secondary peer review, as required by law, and advises the NIDDK on the broader issues of scientific programs, procedures, and policies of the institute. For the record, Anil has participated in more than 50 NIH review and advisory panel meetings, which include 16 regular study section meetings, 23 special emphasis panels, and 11 advisory and board meetings. In addition to his administrative duties, Anil is principal investigator of a longstanding, NIDDK-funded digestive disease center grant based at Penn. He is a past member of the scientific advisory boards for several centers, including those based at Mayo Clinic-Rochester, University of Chicago, Stanford University, and Baylor College of Medicine, helping each in their own NIDDK-funded digestive diseases centers. What Anil impresses on me most is his complete focus, organization, and dedication.—Timothy C. Wang, MD, chief of the Division of Digestive and Liver Diseases and professor of medicine at Columbia University As a leader in the field of GI cancer research, Anil has made seminal contributions to understanding the mechanisms underlying the pathogenesis of several major GI cancers, notably esophageal, pancreatic, and colorectal cancer. Anil's group has worked in model systems and translated that knowledge in GI cancer. His contributions to the scientific literature include more than 200 peer-reviewed journal articles, close to 100 review articles, book chapters, editorials, and commentaries. Anil's research is supported by several organizations but primarily by the NIH, including the NIDDK and National Cancer Institute. His NIH support comes in the form of R01, P01, P30, T32, U01, and U54, which represent a broad spectrum of funding designed for individual projects, collaborative projects, research centers, and training. Importantly, his scientific accomplishments have garnered him numerous awards and recognition, among which are the prestigious American Cancer Society Research Professorships and memberships in the prestigious American Society for Clinical Investigation and Association of American Physicians, to name a few. Anil began his scientific career as a gastroenterology fellow at MGH and studied in the laboratory of René Bernards, now head of the Molecular Carcinogenesis Group at the Netherlands Cancer Institute in Amsterdam. Anil's effort was concentrated on the mechanisms by which the c-Myc oncoprotein causes cellular transformation. Following the completion of his glowingly successful fellowship training, Anil began an independent line of research under the auspice of a Physician Scientist Career Development Award funded by the National Cancer Institute. He concentrated on 3 common GI malignancies, esophageal cancer, pancreatic adenocarcinoma, and colon cancer; major areas of studies that Anil keeps active even to date. His earlier effort was focused on the role of oncogenic viruses such as human papillomavirus and Epstein–Barr virus in the pathogenesis of squamous cell neoplasia. At the same time, Anil made the novel observation that human cyclin D1, a major cell cycle regulatory protein, is amplified and overexpressed in approximately half of esophageal squamous cell carcinoma specimens. Anil generated transgenic mice that overexpressed cyclin D1 in the squamous cell epithelium of the GI tract. These mice developed squamous epithelial dysplasia in the esophagus, rendering the mice the first in vivo model of esophageal squamous cell carcinoma. Anil also studied the role of inflammation, tumor microenvironment, and stem cells in influencing cancer formation in the esophagus. In particular, Anil's group developed a groundbreaking 3-dimensional organ culture model system with which to study the mechanisms of esophageal epithelial cell transformation at a molecular level. Much of this work has appeared in highly cited journals, including Cancer Cell, Cancer Research, Gastroenterology, Genes and Development, Journal of Biological Chemistry, Journal of Clinical Investigation, and Nature. Anil has enjoyed equal accomplishments in research involving pancreatic cancer. Here he examined the role of the mutant KRAS gene, which is mutated in more than 90% of cases of pancreatic cancer, in the formation of pancreatic cancer using highly innovative mouse models. He then showed the mechanisms by which KRAS and p53 mutations promote pancreatic cell migration, invasion, and disruptive tissue architecture. Anil's prominence in this field also led to his election to the advisory boards of several international foundations on pancreatic cancer research, including the Pancreatic Cancer Action Network and National Pancreas Foundation. It is clear from the significant research accomplishments cited previously that Anil is one of the leading physician scientists in cancer research. A notable trait of Anil's is his ability to engage trainees and colleagues in collaborative efforts and achieve a level of synergism that would not be possible if the research were conducted by individual groups. Many of his former research trainees have gone to highly successful careers, including Drs Ned Sharpless, Felix Brembeck, Antoni Castells, Oliver Opitz, Hiroshi Nakagawa, Claudia Andl, Doug Stairs, and others. Claudia Andl, PhD, currently a faculty member at Vanderbilt University Medical Center, states, “Of all of Anil's great attributes, his endless patience and positive attribute are the two that I admire most.” It has been my observation that he works hard to make it all but impossible for us to fail, then fades into the background looking on proudly as we move forward to claim our successes.—Kyong-Mi Chang, MD, associate professor of medicine, University of Pennsylvania, and associate chief of staff for research and development, Philadelphia VA Medical Center Evidence for Anil's distinguished impact as a mentor is demonstrated at multiple levels: within his own laboratory, within the Division of Gastroenterology and the Department of Medicine at the University of Pennsylvania, and at the national level. Within his laboratory, Anil has trained more than 25 students and 35 postdoctoral fellows and/or research associates, many of whom have now established their own independent laboratories and obtained leadership positions both nationally and internationally. As a superb and compassionate clinician, educator, basic scientist, and effective administrator, Anil is a role model for trainees both locally and nationally. He has been the director of 2 T32 training grants to support research training for fellows: one T32 for basic science training and one that supports clinical epidemiology training (with Dr James Lewis as director). Moreover, Anil's role as a mentor at Penn is not limited to members of his own division or department; in particular, he has overseen the training of numerous pediatric GI fellows on the GI Division's T32 training grants. He has provided superb mentorship to trainees and young faculty in both the clinical and basic sciences. He gives his time freely and has an open-door policy for discussion and advice. Anil regularly reads the grant applications and manuscripts of the fellows and young faculty, providing effective critiques and guidance. Although these achievements are outstanding and unparalleled, Anil's accomplishments are even more impressive when viewed at a personal level. He has impacted the careers and lives of a multitude of trainees in profound ways. In recognition of his role as a mentor, Anil was the recipient of the Arthur K. Asbury Outstanding Faculty Mentor Award in 2012; in addition, he received the Distinguished Mentor Award from Penn's biomedical postdoctoral program in 2012, with the former being the highest mentorship award provided throughout the University of Pennsylvania Medical School. Here are just a few of the comments extracted from support letters from former laboratory mentees, Penn GI faculty mentees, and fellows and new faculty mentees:never fails to find a positive aspect in any person or any situation …takes the time to think of each person, no matter where they are in their career, as equally important …incredible eye for seeing the traits that make each person unique, and utilizing these traits in a fashion to best ensure their personal success …always finds time for me. He is the quintessential mentor. I can call him/email him/page him … and he never delays with a response … Anil's enthusiasm for medicine is infectious, and his outstanding mentorship is also recognized at the national level.Anil is a tremendous advocate for women and diversity. He created the Underrepresented Minority Committee in the GI Division dedicated to recruitment and retention of underrepresented minorities at all levels to the Division of Gastroenterology; career development and mentorship of current underrepresented minority fellows and faculty; and fostering research in multicultural GI related health issues, outcomes and policy. Anil also established the Women in Gastroenterology committee, which focuses on “recruitment to and retention of women in the field of Gastroenterology; and educating and encouraging research in women's health issues in Gastroenterology.” More recently, Anil was instrumental in the planning and submission of a grant to the NIH that resulted in the funding of a 5-year R25 grant to the AGA entitled “Investing in the Future to Promote Diversity in GI Training.” His pride and joy are the distinguished GI faculty, fellows, and staff at the University of Pennsylvania. Nothing makes him more professionally happy than working with them and for them. Shaped by a family with a dedication to compassion, scholarship, and hard work, Anil has developed into a true “quadruple threat” as a compassionate physician, internationally renowned scientist, devoted mentor, and accomplished administrator. Anil has served the AGA in many capacities over decades and has a full understanding of the multifaceted nature of our organization, which requires a careful and diligent approach to maintain the appropriate balance between the practice and science of gastroenterology as well as its collaborative relationships with the many other digestive disease–related societies both at home and abroad. He is a visionary leader with the ability to inspire by example, and he has the perfect skill set to lead the AGA as its membership navigates the rapidly changing landscape in the practice of clinical gastroenterology and biomedical research. It is an honor and privilege for us to introduce Anil K. Rustgi as our new president.