University Of Michigan Medical School Research Articles

Current Opinion in Pediatrics was launched in 1989. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The fields of pediatrics are divided into 18 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Editor in Chief and Section Editors for this issue. SECTION EDITORS Elijah PaintsilElijah PaintsilDr Paintsil is Professor of Pediatrics, of Pharmacology, of Epidemiology and of Management. He is the Chief of the Section of Pediatric Infectious Diseases & Global Health, Department of Pediatrics at Yale School of Medicine, USA, and former Program Director of Pediatric Infectious Diseases Fellowship Training Program (2016–2021), the Director of Pediatric AIDS Program at Yale-New Haven Hospital, USA, and the PI of T32 training grant (2T32AI007210-38) aimed at training physician scientists. He is a member of the American Academy of Pediatrics, Society for Pediatric Research, Pediatric Infectious Diseases Society, Infectious Diseases Society of North America, and Academic Pediatric Society. He serves on the Pediatric Scientist Development Program Steering Committee, the Leadership of the HHS Panel on the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children, and as a consultant to Africa CDC on their COVID-19 mitigation efforts. He completed medical school in his native Ghana, Africa, residency at Lincoln Hospital in NYC, USA, and fellowship training in pediatric infectious disease at Yale, USA. Dr Paintsil is both a laboratory-based and a clinical investigator with interest in understanding the effects of antiretroviral therapy (ART) on the biology of mitochondrion and global pediatric HIV treatment outcomes. Dr Paintsil devotes significant professional effort to training and capacity building. In 2006, Dr Paintsil established a bi-directional research and training initiative with the University of Ghana, Africa (Ghana-Yale Partnership for Global Health). In addition to supporting collaborative research between faculty, the program sponsors up to12-month periods of closely mentored research training in New Haven and in Accra for students/fellows from both institutions. Based on the success of the Yale-Ghana collaboration, the program was expanded in 2009—Yale Partnership for Global Health—to include additional partner institutions, the U. of Sao Paolo, Brazil and King Saud U., Saudi Arabia and, in 2014, the U. of the West Indies, Kingston, Jamaica. These five universities comprise a global consortium dedicated to collaborative research and training in infectious diseases. He is the PI of a D43 grant (06/15/20 to 12/31/24) from Fogarty titled “HIV Comorbidities Research Training (HIV-ComRT) in Ghana. He is also the PI of an R01 to study the benefits of pediatric HIV disclosure in Ghana (R01 HD103512-01, 8/15/20 to 6/30/25). Tom HoovenElijah PaintsilTom Hooven, MD is an Assistant Professor in the Department of Pediatrics, Division of Newborn Medicine at UPMC Children's Hospital of Pittsburgh, USA. This is his fifth year as a Current Opinion in Pediatrics section editor. He is a graduate of University of Michigan Medical School, USA, and completed his general pediatrics residency and neonatology training at the Morgan Stanley Children's Hospital of Columbia/New York-Presbyterian, USA. A former fellow in the Pediatric Scientist Development Program, Dr Hooven's research interests centre on maternofetal and neonatal bacterial infections, with an emphasis on genomic and bioinformatics approaches to understanding pathogenesis. He has also published widely on diagnostic and treatment strategies for new-born bacterial infections. He is a member of the Society for Pediatric Research and has NIH funding for ongoing studies of group B Streptococcus colonization and infection. Tara M. RandisTara M. RandisDr Tara M. Randis is an Associate Professor of Pediatrics and Molecular Medicine at the University of South Florida, USA and Chief of the Division of Neonatology. She is a graduate of the University of Scranton, USA and received her MD from Drexel University School of Medicine, Philadelphia, Pennsylvania, USA. She completed her pediatric residency training at St. Christopher's Hospital for Children, Philadelphia, USA, before pursing her fellowship training in neonatal-perinatal medicine at Columbia University, USA. In 2011, she earned a MS degree in biostatistics from the Mailman School of Public Health at Columbia University. She is an active member of the Society for Pediatric Research, American Pediatric Society and The Perinatal Research Society. Her research focuses on the mechanisms of bacterial colonization of the female reproductive tract as it relates to adverse pregnancy outcomes including chorioamnionitis, preterm labour and early-onset neonatal sepsis. Michel BaumMichel BaumDr Michel Baum received his BS and MD degrees from the University of California, Los Angeles, USA. He completed his internship and residency at Yale University School of Medicine, USA. His nephrology fellowship was performed at the University of California, San Francisco, USA, where he was a research fellow at the Cardiovascular Research Institute. Since completion of his fellowship, he has been at the University of Texas, Southwestern Medical Center and Children's Medical Center of Dallas, USA. He is currently Professor of Pediatrics and Internal Medicine. He also holds the Sara M. and Charles E. Seay Chair in Pediatric Research. He is a member of a number of national societies including the American Society for Clinical Investigation, the Association of American Physicians, the Society for Pediatric Research, the American Society of Nephrology, and the International Pediatric Nephrology Association. He has served as a member of the General Medicine B Study Section and the DDKD Study Section for the NIH. Dr Baum's research primarily examines the maturational changes that occur in renal tubular transport during development. He has described many changes in transporters that explain the physiologic difference between the neonatal kidney and the adult kidney. His other research interests include the pathophysiology and pathogenesis of hereditary defects in tubular transport, such as X-linked hypophosphatemia. He is also currently investigating the cause for hypertension in patients with a prenatal insult that are small for gestational age. His research is funded by the National Institutes of Health. He has contributed to over 150 publications. Henry H. BernsteinHenry H. BernsteinDr Bernstein is a Professor of Pediatrics at Zucker School of Medicine at Hofstra/Northwell in New York, USA. He taps into his extensive 38–year experience as a general pediatrician in private practice, the National Health Service Corps, and as Chief of General Academic Pediatrics at urban, suburban, and rural children's hospitals to promote the health and well-being of children, their families, and their communities. His private, community-based primary care (generalist) experiences in combination with academic leadership responsibilities have provided him with a value-added, translational science perspective, unique from many others in academia. This tacit knowledge enables him to fulfil a lifelong passion of communicating, educating, and translating science into clinical settings, educational venues, policymaking, and media interactions to advance the health of children. Research is consistently woven into the fabric of Dr Bernstein's clinical practice, which has served as a “laboratory” for his active studies. His research and quality improvement initiatives focus on issues important to Academic General Pediatrics and community-based practice, including immunizations, infectious diseases, postpartum newborn discharge, childhood obesity, breastfeeding, health promotion, preventive health screening in primary care, technology and medical education. His commitment, innovative spirit, and enthusiasm also encompass many facets of medical education along the continuum from training and mentoring future physicians to fostering lifelong learning and supporting the continuous professional development of practicing pediatricians. Dr Bernstein is a voting member of the US Food and Drug Administration's (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) and a former voting member of the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practice (ACIP). He serves as a consultant on the ACIP COVID-19, Influenza, and Immunization Schedules for Adults and Children workgroups. He also is an ex-officio member of the American Academy of Pediatrics’ (AAP) Committee on Infectious Diseases (Red Book Committee) and was Associate Editor of the AAP's Red Book Online for 12 years. In addition, he is Editor-in-Chief Emeritus of PediaLink, the AAP's online home for lifelong learning, and past Chair of the interdisciplinary Bright Futures Health Promotion Workgroup, which created a distinctive health promotion curriculum, videos, and a companion educational website (www.pediatricsinpractice.org). Dr Bernstein has been Editor of the Office Pediatrics Series in Current Opinion in Pediatrics since 1995 and was Senior Editor of Pediatrics on the public website of Harvard Medical School's Health Publications Division for 17 years. He regularly shares his knowledge and expertise by educating the public, writing for health information websites and often participating in media interviews on a variety of pediatric health care issues including immunizations, diagnosis and treatment of common childhood infectious diseases and conditions, and practical information for parents, teachers and caregivers. In the spirit of lifelong learning, Dr Bernstein earned a masters in healthcare management (MHCM) at Harvard T. H. Chan School of Public Health, USA in 2013 and has been a faculty member in this Executive Education Masters degree program since. He actively maintains his certification by the American Board of Pediatrics. He completed his residency training in pediatrics at St. Christopher's Hospital for Children in Philadelphia, USA after earning his medical degree from the University of Medicine and Dentistry of New Jersey - School of Osteopathic Medicine, USA. Hank and his wife, Sophie, have been married for 43 years, are extremely proud of their 38-year-old daughter, Lauren, and 32-year-old son, David, and are “over the moon” with their 2 granddaughters, Eva and Vienne.

Back to table of contents Previous article Next article ProfessionalFull AccessPsychiatrists Explore Their Inner HemingwayNick ZagorskiNick ZagorskiSearch for more papers by this authorPublished Online:26 Jan 2023https://doi.org/10.1176/appi.pn.2023.02.12.9AbstractMany psychiatrists have used their empathy and understanding of human psyche to write novels shedding light on mental illness and recovery.PCH-VectorAfter a long and fulfilling psychiatric career, which included pioneering work in the development of computerized cognitive-behavioral therapy (CBT), Jesse Wright, M.D., Ph.D., was ready to try something different. As an academic, Wright was familiar with publishing, having put forth eight textbooks and over 50 research articles; he also had experience creating dozens of informational CBT videos. But he wanted to share a more personal story of mental health based partially on the experiences of his father and uncle, both of whom fought in World War II and came home from that trauma to suffer in silence. He decided to write a novel.It ended up being an arduous process. “I had some naiveté in how fiction gets published,” Wright told Psychiatric News. But with the support of some colleagues who had been down this same path, he successfully released his first novel, A Stream to Follow, in 2022.Essential Elements of Fiction Found in Clinical EncounterThe ambition to write a novel is hardly unique to psychiatrists. Yet as Wright and other successful psychiatrists who have written fictional books will attest, psychiatrists possess skills that are key to good fiction writing, as well as a wealth of stories that deserve a louder voice. Anton Chekhov, one of the most celebrated authors of the 19th century, was a physician who parlayed his interest in mental illness to develop stories with a profound psychological impact.“To be a good psychiatrist requires strong clinical knowledge, empathy, and creativity,” said Monica Starkman, M.D., a consultation-liaison psychiatrist and an active emerita professor of psychiatry at the University of Michigan Medical School. “You need to bring all of this to bear when writing a novel.” Starkman authored the 2016 novel The End of Miracles.Starkman noted that psychiatrists’ clinical experience is valuable for developing accurate and compelling stories involving mental health and illness—a trove of fascinating story ideas. Her novel, for instance, centers around a woman with a rare condition known as pseudocyesis, or false pregnancy. It is a somatic disorder in which women experience classic symptoms of pregnancy—such as loss of menstruation, breast tenderness, and even abdominal distention—without being pregnant. “I became fascinated with the biology and psychology of the condition when I provided psychiatric consultation and treatment for two such women,” said Starkman, who specializes in psycho-endocrinology. “The prospect of inventing a story involving pseudocyesis was intriguing to me,” she said. She then worked on the book over the course of a decade during her academic career, writing more than 20 drafts during the process. The End of Miracles is about a woman whose seemingly miraculous pregnancy following years of battling infertility ends in a late miscarriage; she subsequently develops pseudocyesis, which provides relief from her all-consuming grief. When this false belief inevitably clashes with ultrasound reality, she falls into a deep depression and develops a new fantasy that propels her to commit a crime, setting off a suspenseful chain of events. Along the way, Starkman aims to convey the personal shame and social stigma of someone dealing with a mental illness, building empathy for a character that eventually finds the road to recovery with the help of inpatient and outpatient care. “As a psychiatrist, your job is to listen to people’s private thoughts and try to imagine life from their perspective,” noted Wright, who credited his years of practicing and researching CBT with helping him to craft his story. A Stream to Follow tells the story of a young World War II battlefield surgeon who returns to his small Pennsylvania town with what would now be recognized as posttraumatic stress disorder to begin a journey of healing, reconnection, and recovery. Though inspired by family history, the fictional characters in A Stream to Follow also take elements from many of the patients Wright has seen over the years, he explained. Many psychiatrists are likely familiar with creating such character amalgams when developing case studies for medical books or presentations. “You try to provide details to make the subject interesting and emotionally resonating,” he said.“Good fiction should be humanizing, even to the bad guys,” said psychiatrist and author Daniel Mason, M.D., a professor at Stanford University who has published multiple novels. “As a physician, you don’t portray your patients in black and white terms, and the same goes for a storyteller.”Mason’s path differs from those of Wright and Starkman in that he wrote his first novel, The Piano Tuner, while in medical school. The story explores life in 19th century colonial Burma as an English piano tuner travels to the region to repair a grand piano made unplayable by the region’s humidity. Mason was inspired by his own trip to the border of Myanmar and Thailand to conduct malaria research, during which time he became fascinated by the local culture. The success of The Piano Tuner led Mason to transition to full-time writing after completing medical school. He published two more novels and was researching materials for his fourth book—set in a World War I hospital that was treating soldiers for “shell shock”—when he realized he missed medicine. He then completed a residency in psychiatry at Stanford while continuing his novel on the side.Having now spent years as a novelist and a psychiatrist, Mason said he is amazed at how much overlap there is in the mindset of both professions. “I’ve noticed that the questions residents will ask me about patients (such as ‘Why did this event happen now?’ or ‘What role is the person’s family playing in this situation?’) are the exact same questions my editor asks me about my books.”One of the areas where fictional writing and the practice of psychiatry differ is in how much information you share with your “audience,” Mason continued. When describing clinical observations to patients and their families as well as other clinicians, clarity is of the utmost importance, Mason emphasized. “The more they understand, the more we can help,” he said. In fiction, however, it is usually better to pull the curtain back slowly for storytelling purposes. “When writing, I’m often tempted to explain all these character details based on the rules I’ve come to learn from medicine, but then I tell myself I need to keep some mystery.”Before You Start Writing The psychiatrists/writers who spoke with Psychiatric News agreed that there is no right or wrong way to enter the world of fiction writing; authors can be early career or retired psychiatrists, engaging in writing part time or full time. As Starkman pointed out, many psychiatrists have extensive writing duties already—papers, grants, textbooks, forensic reports, and more—so the skill and discipline are there. “Writing good fiction can be stimulating, but also demanding,” Wright said. “There are days you hit that brick wall, which can be extremely frustrating.” Writing—particularly full-time writing—can also be lonely business, and Wright stressed the value of making time to be social. “I was fortunate to be able to recruit a coach who would meet with me for an hour every few weeks to discuss my ideas and give me feedback on characters and plot; sort of like writing therapy,” he said. In lieu of a writing coach, he suggested writers could meet with friends and colleagues to share drafts or exchange ideas.Finding an agent can also prove challenging, Wright said, but there are online services such as QueryTracker that compile agent data. The site includes such information as agents’ success rates, what genres they work in, and what they expect in a query (the opening letter to an agent in which writers make their pitch).“Most publishing houses still require you to have an agent, so this is an important step,” Wright noted. However, the publishing options in today’s market have expanded. In addition to traditional publishers who take on all the production costs, hybrid publishers are emerging as a popular alternative. In a hybrid model, the author puts in a deposit to cover some production costs (rather than receiving an advance) but gets higher sales royalties. “You have to put some skin in the game, but since some costs are offset, hybrid publishers are more willing to take on nonestablished authors,” he said.If all else fails, self-publishing is always an option (paying for your own printing and selling on places like Amazon), but Wright noted that self-published novels rarely receive reviews or placement in a bookstore. “Most novelists don’t make a lot of money anyway, so don’t factor that in when deciding how to publish,” Wright noted. Starkman agreed. “My goal was to try and move people emotionally and tell a good story about our profession.” She noted that while some popular fiction negatively portrays patients and psychiatrists, she looked for ways to highlight the field in a more nuanced way.Stigma is a big theme of Wright’s follow-up novel, A Dance in the Madhouse, which is already in the works. This title takes the reader back to 1905 and follows a young doctor who is institutionalized following typhoid-induced psychosis. “It’s styled as a mystery thriller, but I hope to highlight the poor conditions mental patients have faced through much of history.” Starkman is also ready to get back to writing again. “I admit I still felt some imposter syndrome right after publishing, but when some positive professional reviews came in, I felt validated,” she said. She has started to work on a memoir, which she notes is a different challenge. “It won’t be quite as much creative fun, since I already know the plot of this story.” ■ ISSUES NewArchived

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