U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health

PROFILE 2007

DIRECTOR’S ANNUAL REPORT NIH CLINICAL CENTER There’s 

no other

hospital 

like it

This file is provided for reference purposes only. It was current when it was produced, but it is 

no longer maintained and may now be out of date. Persons with disabilities having difficulty accessing information 

may contact us for assistance (www.cc.nih.gov/contact.shtml). For reliable, current information on this and other health topics, 

we recommend consulting the NIH Clinical Center at http://www.cc.nih.gov/. 

CONTENTS

PROFILE 2007

Message from the Director: Expanded Partnerships,

New Opportunities 3

Recent Clinical Center Achievements 4

Patient Activity and Support 6

Advancing Clinical Research 12

Organizational Improvement/Teamwork 22

Emergency Preparedness 26

Training the Next Generation 28

Noteworthy 34

Transitions 37

Organization and Governance 41
The NIH Clinical Center will serve as the nation’s premier research hospital

for conducting clinical research to improve the health of humankind. It will

also serve as a national resource for clinical research by developing 

diagnostic and therapeutic interventions; enhancing systems to ensure 

the safe, efficient, and ethical conduct of clinical research; training clinical

researchers; and leading the clinical research response to the nation’s

emerging public health needs.

As the nation’s clinical research center, the NIH Clinical Center is dedicated

to improving human health by providing an outstanding environment that

facilitates the

• Development of diagnostic and therapeutic interventions 

• Training of clinical researchers 

• Development of processes to ensure the safe, efficient, and ethical 

conduct of clinical research.

The Clinical Center achieves this mission through a culture that fosters 

collaboration, innovation, diversity, and the highest ethical standards.

OUR MISSION

OUR VISION
The NIH Clinical Center offers an unparalleled environment for clinical and translational science

through its unique complement of resources and expertise—in clinical care, research support,

informatics, and clinical research training. Sharing that environment through extramural 

collaborations—new forms of partnership launched in 2006—offers exciting new opportunities 

to advance biomedical research.

For the first time, NIH’s bench-to-bedside program, which is designed to speed the translation

of promising laboratory discoveries into new medical treatments, was opened to research teams

that included extramural collaborators from medical schools, health-care organizations, and 

private industry.All but one of the 19 projects that received funding involved extramural 

partners.

Through its national Clinical and Translational Science Awards (CTSA) consortium, NIH aims 

to transform how clinical and translational research is conducted. Clinical Center staff members 

are actively involved in this consortium, which will ultimately help accelerate the translation 

of new laboratory discoveries into better treatments for patients.

Clinical Center training programs in clinical research continue to attract participants from

around the world.These programs are mission priorities because they help ensure that 

clinician-scientists have the knowledge and skill to conduct safe, effective, ethical, well-targeted

research.

In 2006, the Clinical Center team successfully underwent its first JCAHO accreditation survey

in our new hospital, the Mark O. Hatfield Clinical Research Center.The JCAHO surveyors

arrived early on September 26, to conduct the first unannounced survey of the hospital.

At the end of three days, we received an outstanding report.The surveyors were impressed 

with the excellent work our collaborative team does in a large and complex organization 

and noted the staff’s palpable commitment to the Clinical Center’s mission and to supporting

each other. I commend and thank our staff for this sustained commitment to excellence.

I also thank the many employees, contractors, and volunteers who make the clinical research 

conducted at the Clinical Center a beacon of hope for people everywhere.As always, our most

important partners in clinical research are the patient volunteers through whom we study various diseases and medical conditions and the healthy volunteers who serve as controls in those

clinical studies.They not only make the research possible but also remind us of our mission to

improve human health.

John I. Gallin, MD

Director, NIH Clinical Center

NIH CLINICAL CENTER • 3

EXPANDED PARTNERSHIPS, NEW OPPORTUNITIES

MESSAGE FROM THE DIRECTOR 
4 • ANNUAL REPORT 2007

Expanded collaborations with partners outside NIH. The Clinical Center is sharing its unique

resources and expertise with the extramural community by developing new programs and expanding old ones. In 2006, the NIH bench-to-bedside program, created at the Clinical Center in 1999,

was extended to extramural collaborators for the first time.

Strengthened organizational effectiveness. Budget constraints over the last few years have

challenged Clinical Center staff to do more with less. Several projects have focused on improving

organizational operations and efficiency to meet the challenge head on, including a CC-wide

benchmarking survey, creation of a think tank for more effective use of protocol resources, operational reviews (beginning with the imaging sciences and nursing departments), and specialized leadership training and consultation for managers and supervisors.

Successfully completed JCAHO survey. In September, a survey team from the Joint

Commission on Accreditation of Healthcare Organizations arrived unannounced to conduct the

Clinical Center’s first accreditation survey since the new hospital opened.The JCAHO surveyors

praised the excellent work our collaborative team does in a large and complex organization and our

unwavering dedication to the Clinical Center’s mission and support for each other.

Enhanced patient services. Easing and enriching the Clinical Center experience for patient

volunteers, our invaluable partners in discovery, is always a high priority. In 2006, in response to

suggestions from patients, the CC shortened wait times in the clinics, expanded patients’ access to

computers in the business center, and created a larger new space for the patient library.

Improved support for clinical research. The Clinical Center’s legacy as a world center for

medical advances continued in 2006. The new hospital, the Mark O. Hatfield Clinical Research

Center, opened to patients in 2005, providing state-of-the-art technology in a healing environment

designed for patient comfort.This year, the CC supported the implementation of new and 

expanded clinical research programs, including studies in obesity, vaccine development,

and childhood autism.

RECENT CLINICAL CENTER ACHIEVEMENTS

In 2006 we:
NIH CLINICAL CENTER • 5
Patient Activity and Support

IMPROVING THE PATIENT EXPERIENCE 

Patients at the NIH Clinical Center are active

partners in both clinical research and patient care.

Improving their experiences here is a continuing

priority.The Patient Advisory Group—all current

or former patients or patient family members—

provides important feedback on what works well

for patients and what doesn’t. In 2006, the Patient

Advisory Group provided advice and feedback on

relocating the patient library, shortening clinic wait

times, improving room service menus, and making

use of information technology easier—for example,

by enhancing bedside access to computers and

keeping the popular business center for patients

and families open longer.

Several group members have represented the

patient’s perspective in at least two other Clinical

Center venues. One member of the Patient

Advisory Group participates in meetings of the

NIH Advisory Board for Clinical Research.

Patients’ voices are also heard in two important

Clinical Center courses:“Introduction to the

Principles and Practice of Clinical Research” and

“The Ethical and Regulatory Aspects of Clinical

Research,” bringing home to participants the practical realities of the patient’s role in clinical research.

A focus for 2006 has been shortening waiting

times for patients, an ongoing project led by

Nursing and Patient Care Services. In a major

shift—supported by a new computerized scheduling

system—clinic patients were given specific

appointment times, eliminating inefficient ‘block’

scheduling. Clinic staff are implementing changes

and continuing to evaluate patient flow and 

identify areas for improvement. In mid-2006, they

conducted a patient shadowing project, tracing the

patient experience in an effort to pinpoint typical

needs or problem points. Regular outpatient satisfaction surveys were re-instituted in 2006.These

surveys, administered to a continuous sample 

of patients, help keep us informed about how

patients regard Clinical Center services.

In 2006, Clinical Center design teams began

planning for renovations in the outpatient clinics

and a redesign of the ambulatory surgery suite.

Work will be done to update clinic exam rooms,

ensure space for confidential conferences between

patients and care providers, and provide ample

waiting areas.
NIH CLINICAL CENTER • 7

NEW PATIENT LIBRARY 

“It’s a welcoming, light-filled environment for

patients and their families,” said Marie Kaplan,

head librarian, describing the new seventh floor

location for the patient library.“We’re thrilled

to be serving their information needs in this

beautiful, spacious setting.”The Patient Library,

now 1,250 square feet, opened in October in

room 7-1580.Also expanded were its hours—

until 9 pm Monday through Thursday.

The library had been located in a smaller space

on the same floor when patients moved to the

Hatfield building in 2005—quarters that soon

proved too cramped.“The Clinical Center’s

patient advisory group suggested that a new

location was needed and worked with us as we

explored options,” said Dr. John I. Gallin, CC

director.The fix was a simple space trade with

other programs sponsored by the Rehabilitation 

Medicine Department.

Patients can browse the library’s collection of 6,500 items in the sunny space in the northwest

corner of the Hatfield building’s top floor.The library will also continue its popular honorreturn system, with books and magazines located in new shelving in the seating areas outside

the library.These resources are available for patient access around the clock.

FOUR-LEGGED 

VISITORS PROVIDE 

MORE THAN 

JUST SMILES

Pediatric patient Ana Lucia

Garcia welcomes her fourlegged visitor, Ross, and his

handler, National Capital

Therapy Dogs volunteer

Barbara Murgo. Ross is one 

of more than a dozen dogs 

that visit patients here.

The recreation therapy section

of the Rehabilitation Medicine

Department started an animalassisted therapy program in

1989. In the beginning, the

dogs came once a month and

visited only pediatric patients.

Now the dogs come once 

a week to visit units throughout

the CC, averaging 1,200 visits 

a year.
8 • ANNUAL REPORT 2007

WORKFORCE DISTRIBUTION FY2006 BUDGET BY MAJOR CATEGORY

$335.9 million

The Clinical Center has a staff of 

approximately 2,000; 80% work 

with patients, as the graph shows.

Another 20% work in administration 

and operations.

Nursing & patient care/support 

services 40% 

Administrative & operations 20%

Clinical departments & 

imaging sciences 

departments 40% 

Salaries and benefits 53%

NIH assessments 7%

Drugs 10% 

Contracts (labor) 6%

Contracts (non-labor) 12%

Equipment 4%

Supplies 6%

All other 2%

Includes travel, training, rentals, 

and printing.

HOME STATES OF ALL ACTIVE CLINICAL CENTER PATIENTS 

Patients come to NIH from 

every corner of America 

seeking answers to their 

scientific and medical questions.

Finding these answers through

leading-edge clinical research 

is the sole mission of the NIH

Clinical Center, guiding all of 

its activity. 

0-99

100-499

500-1,999

2,000-9,999

10,000 +

WA

610 MT

119

ID

151 WY

51

OR

364

CA

2416

NV

162 UT

431

CO

531

AZ

488

NM

215

AK

85

HI

88

TX

1622

OK

316

KS

315

NE

172

SD

54

ND

59

IA

269

MO

578

AR

192

LA

482

IL

1089

WI

643

MN

549

MI

1206

IN

688

OH

1398

MS

231

AL

366 GA

1146

SC

657

NC

1440

TN

644

KY

482

FL

2611

VA

12716

WV

771

PA

3410

NY

3023

ME

194

VT 127

NH 177

MA 1036

RI 104

CT 621

NJ 1805

DE 391

MD 28995

DC 6516

•

•

•

• •

•

•

•

•

•

•
NIH CLINICAL CENTER • 9

PATIENT ACTIVITY

Admissions

New patients 

Inpatient days

Average length 

of stay (days)

Outpatient 

visits

2.4% increase

4.7% decrease

7.9% decrease

4.1% increase

9.5% decrease

4.6% decrease

7.6% increase

0.1% decrease

10.6% decrease

7.6% increase

3.5% increase

5.7% decrease

9.4% increase

2.8% decrease

9.4% decrease

6,944 

6,619

6,096

10,731

9,711

9,263

CLINICAL ACTIVITY FOR FY 2001–2006

Active 

Protocols

New Protocols

Principal

Investigators

1,122 

1,165

1,239

1,329

1,357

1,372

417 

437

450

474

487

505

250 

305

306

288

245

251

57,783 

57,718

51,575

8.5 

8.8 

8.3 

108,078

105,004

95,151

01

02

03

04

05

06

01

02

03

04

05

06

01

02

03

04

05

06

04

05

06

04

05

06

04

05

06

04

05

06

04

05

06
10 • ANNUAL REPORT 2007

The patient portal on bedside computers and 

in outpatient areas provides an internet gateway

to significant educational and informative

resources for patients. Information presented

covers important aspects of the patient care 

and research experiences and offers a variety 

of patient education materials, including 

collections developed specifically for Clinical

Center patients and educational videos.The 

site includes an application that allows patients

to develop Web pages to use to keep in touch

with family members and loved ones while

they are hospitalized.

BEDSIDE COMPUTERS

SPECIAL 

CONCERT FOR 

SAFRA LODGE

GUESTS 

Marvin Hamlisch, principal

pops conductor of the National

Symphony Orchestra, offered 

a special holiday concert for

patients and their loved ones 

at the Safra Family Lodge in

December. Opera singer Angela

M. Brown and trumpeter

Brandon Ridenour also performed.All three were in town

for a series of “Happy Holidays”

concerts at the Kennedy

Center. This was the second

year Hamlisch put on a holiday

show at the Lodge.“We look

forward to coming here,” he

told the audience.“You are

inspirational to us.”
LCDR Stacy Barley, a clinical

nurse, conducts an examination

with the help of former CC

interpreter José RosadoSantiago and Alma Luisa

Andrade, an intern with the

CC Language Interpreters

Program for spring 2006.

The interns are part of a

national program sponsored by

the Hispanic Association of

Colleges and Universities.

One student is chosen for the

CC program each fall and

spring semester and summer

break.The interns undergo 

specialized training and work

with seasoned CC interpreters

before working on their own.

“My biggest challenge is understanding each situation and,

optimally, each patient’s disorder

as well as possible treatments 

or procedures, risks, expected

outcomes, and what the doctors

wish to convey to the patients”

said Andrade, a senior at the

University of Arizona. Born in

Mexico and raised in Tucson,

Andrade is fluent in both

Spanish and Portuguese.

LANGUAGE INTERPRETER INTERNS 

HELP BRIDGE LANGUAGE GAP

NIH CLINICAL CENTER • 11
12 • ANNUAL REPORT 2007

Clinical studies are medical research studies (or

protocols) in which human volunteers participate.

Clinical trials are studies developing or investigating new treatments and medications for diseases

and conditions. Natural history studies investigate

normal human biology and the development of 

a particular disease. Screening studies determine if

individuals may be suitable candidates for inclusion in a particular study. Training studies provide

an opportunity for staff physicians and other

healthcare professionals to follow particular types

of patients.

Clinical trials proceed through four phases 

Phase I: Researchers test a new drug or 

treatment for the first time in a small 

group of people (20–80) to evaluate 

its safety, determine a safe dosage 

range, and identify side effects.

Phase II: The study drug or treatment is given 

to a larger group of people (100–300)

to see if it is effective and to further 

evaluate its safety.

Phase III: The study drug or treatment is given 

to large groups of people (3,000 or 

more) to confirm its effectiveness,

monitor side effects, compare it with

commonly used treatments, and collect

information that will ensure safe usage.

Phase IV: These studies are done after the drug 

or treatment has been marketed.

Researchers continue to collect information about the effect of the drug or

treatment in various populations and 

to determine any side effects from 

long-term use.

Advancing Clinical Research

Total active protocols: 1,372

Clinical trials: 602 (44%)

Training: 35 (3%)

Screening: 67 (5%) 

Natural history (disease pathogenesis): 668 (48%)

•

•

•

•

Total clinical trials: 602

Phase I: 212 (35%) 

Phase II: 330 (55%)

Phase III: 40 (7%)

Phase IV: 18 (3%)

•

•

•

•

PROTOCOLS BY RESEARCH TYPE

(onsite intramural protocols, fiscal year 2006)

Breakdown of clinical trials

Note: Two trials are Phase O.
NIH CLINICAL CENTER • 13

NIH provided nearly $4 million in funding for 

19 bench-to-bedside medical research projects in

2006. For the first time, applications for these

awards were open to research teams partnering

intramural NIH researchers with extramural 

collaborators from medical schools, health-care

organizations, and private industry.All but one

project included extramural partners; nine involved

researchers from two or more NIH institutes or

centers. First given in 1999, the bench-to-bedside

awards were designed to speed the translation of

promising laboratory discoveries into new medical

treatments.

“The new bench-to-bedside awards program is a

good example of NIH’s commitment to transforming

medicine through discovery,” says Dr. Elias A.

Zerhouni, NIH director. “It encourages innovative

partnerships between extramural and intramural

researchers and opens new opportunities for

advancing medical science.”

The bench-to-bedside research program was created

within the Clinical Center to encourage collaborations between basic scientists in the laboratories

and clinical investigators who work with patients,

says Dr. John I. Gallin, CC director.“A hallmark of

this program has been support for projects that

involve partnerships between basic and clinical 

scientists from across institutes at NIH.The new

component started this year profoundly expands

the partnerships in medical research to other 

government and non-government scientists.”

This is the first year projects were specifically funded

in women’s health and in minority health and

health disparities. Selection criteria included the

quality of the science, promise for becoming an

active clinical trial, and potential for offering a new

medical treatment or better understanding of an

important disease process. Project teams receive up

to $200,000 over two years to support their work.

NIH EXPANDS BENCHTO-BEDSIDE RESEARCH

Primary investigators 

Dr. Maret G. Traber (left), Oregon State University, and

Dr. Mark A. Levine (right), NIDDK, received a benchto-bedside award for their research project on

women’s health, “Vitamin E Pharmacokinetics and

Oxidative Biomarkers in Normal and Obese Women.”
14 • ANNUAL REPORT 2007

2006 BENCH-TO-BEDSIDE AWARDS

Project

• Role of Cyclin D1 in Myelodysplasia

• Exploring the Anti-Tumor Effects of in vitro Expanded Natural Killer (NK) Cells Against 

Renal Cell Carcinoma Sensitized to NK-TRAIL Cytotoxicity with Bortezomib 

• A New Global Function for a Rare Disease Gene: Clinical Significance of the Regulation of

Mitochondrial Respiration by Tumor Suppressor p53 in Li-Fraumeni Syndrome 

• Therapeutic Approaches for Cancer Stem Cells in Small Cell Neuroendocrine Carcinomas 

• High Density Genotyping in Diffuse Large B-cell Lymphoma (DLBCL) and 

Follicular Lymphoma – Translating Etiologic Clues into Prognostic Relevance 

Within the NCI-SEER NHL Case Control Study 

• Novel Suicide Gene-Modified Donor Th2 Cells for GVHD Prevention 

• A Nutrigenomics Intervention for the Study of the Role of Dietary 

Sitosterol on Lipid, Glucose and Energy Metabolism 

• Pilot Trial of Intravenous Nitrite for Sickle Cell Vaso-Occlusive Pain Crisis 

• The Effect of HIV-1 Infection on Endogenous miRNA Expression in vivo

• Genetic Characteristics of HIV-1 During Suppressive Antiretroviral Therapy

• Evaluation of Molecular Methods for the Non-Invasive Diagnosis of 

Pneumocystis and Tuberculosis and Molecular Evaluation of Non-subtype B HIV 

Quasispecies in the Lung

• Microalbuminuria and Podocyturia in Patients with HIV disease: Detection,

Characterization, and Therapy

• Hemolysis, HIV/AIDS and Parasitic Infections Associated Secondary Pulmonary Arterial

Hypertension in Sickle Cell Diseases

• Novel Bench-to-Bedside Research Methods for Drug Addiction: Development,

Validation and Application

• Breast Cancer Among African American Women:The role of Missense Changes in the 

BRCA1 and BRCA2 Breast Cancer Susceptibility Genes Using a Population-Based Approach

• Melanocortin 3 Receptor Mutations as an Etiology for Obesity in 

African American and Caucasian Children

• Vitamin E Pharmacokinetics and Oxidative Biomarkers in Normal and Obese Women

• Immunosuppression Minimization by Biological Response Monitoring

• A Preliminary Assessment of the Use of Ocular Coherence Tomography and Magnetic 

Resonance Imaging as Outcome Measures for Studying the Optic Nerve in Studies of

Neuroprotection in Multiple Sclerosis 

RARE DISEASES 

Teams

NHLBI,

NIH Clinical Center, Harvard University, Georgetown

University Medical Center, National Naval Medical Center,

Salisbury District Hospital, U.K.

NHLBI, NCI, 

NIH Clinical Center, 

Walter Reed Army Medical Center 

NHLBI,

MD Anderson Cancer Center, NIDDK, 

Medical College of Virginia

NCI, NHLBI, NINDS, Sloan-Kettering Cancer Center

NCI, University of Southern California, the Barbara Ann

Karmanos Cancer Center and Wayne State University, 

the Fred Hutchinson Cancer Research Center, 

University of Washington, Mayo Clinic College of Medicine

NIH Clinical Center, NCI,

University of Toronto/ Ontario Cancer Institute, 

University of Illinois

NIDDK, NHLBI, University of Maryland 

NHLBI, NIH Clinical Center, NCI, NIDDK, Drexel University 

AIDS 

NIAID, St. Michael’s Medical Center 

NCI, Johns Hopkins University, NIAID 

NIH Clinical Center, NCI, San Francisco General Hospital, 

Science Applications International Corporation, 

Mulago Hospital, Makerere University 

NIDDK, Children’s National Medical Center 

MINORITY HEALTH AND HEALTH DISPARATIES

NHLBI, NIH Clinical Center,

Ahmadu Bello University Teaching Hospital, Nigeria

NIDA, University of Pennsylvania 

NHGRI, Fred Hutchinson Cancer Research Center 

NICHD, NIDDK, University of Wisconsin 

WOMEN’S HEALTH

NIDDK, Oregon State University 

GENERAL (INSTITUTE AND NCRR)

NIDDK, Washington Hospital Center 

NINDS, NEI,

Johns Hopkins School of Medicine, 

University of Pennsylvania 
NIH METABOLIC CLINICAL RESEARCH UNIT OPENS 

The state-of-the art NIH Metabolic

Clinical Research Unit will allow

researchers from across NIH to study factors

that contribute to obesity and associated 

diseases.The unit is an important component

of the NIH Strategic Plan for Obesity

Research.The National Institute of Diabetes

and Digestive and Kidney Diseases, working

closely with the Clinical Center, led the 

effort to construct the unit. It’s designed 

to bring together experts from the fields of

metabolism, endocrinology, nutrition, cardiovascular biology, gastroenterology, hepatology,

genetics, and the behavioral sciences.

Unit components are located on two floors 

of the Hatfield building. On the 5th floor 

are 10 inpatient rooms, a metabolic kitchen,

an exercise room, and dining areas.The metabolic kitchen allows dietitians to precisely

control the makeup of patient meals.Vending

machines will be used in some studies to

monitor aspects of food choice.The unit’s

three metabolic suites have been installed 

on the 7th floor.These self-contained suites 

allow researchers to study a patient’s energy

metabolism over the course of 24 hours using 

non-invasive and comprehensive physiological

measurements.

NIH CLINICAL CENTER • 15

NIDDK’s Dr. Kong Chen (above), a

biomedical engineer and a clinical

investigator, makes sure that the

unit’s equipment is appropriately

calibrated so that protocol-related

physiological measurements are

complete and precise. Exercise

testing equipment, physical activity monitors, body composition

measurement systems such as

the Bod Pod and DXA, and the

three metabolic suites are key

resources for clinical research 

protocols.

Patient rooms are designed for

comfort and safety. 

Clinical Center research dietitians, including LT Merel

Kozlosky (above) and LT Blakeley Denkinger (right), will

play central roles in the studies conducted in the new

unit. In the metabolic kitchen, cooks use highly controlled

preparation techniques and precision weighing of portions for patient meals. Some studies involve offering

patients an array of foods to help researchers determine

how appetite is influenced by various factors. Foods

offered via computerized research vending machines 

will help researchers track a variety of eating behaviors.
ProtoType. This Web-based clinical protocol

writing tool provides investigators with a 

standard protocol structure, online help, and

templates of suggested language. Investigators 

use it to put ideas for new protocols into the

proper format to satisfy regulations and facilitate

review. ProtoType’s 2006 enhancements included

a more intuitive user interface for protocol writing

and a more complete consent-writing module.

Several institutes use ProtoType and others are

evaluating whether or not to mandate its use 

for all new protocols.

CRIS, the Clinical Research Information

System implemented in 2004, continued to

grow and evolve in 2006 to make sure it met

user requirements, supported changing protocol

needs, and accommodated the addition of interfaces from ancillary Clinical Center and institute

systems. New components include a perioperative

information system that automates surgical

scheduling and facilitates documentation of

human resources, equipment, and supplies 

used on scheduled procedures; a system for

admissions/transfer/discharge, which handles

new patient registrations and inpatient 

admissions; and enhancements of the clinical

documentation and order entry functions.

Work now under way on a pharmacy system

will support the internal work of the Pharmacy

Department.

The last module of the CRIS system is 

a “data mart,” which will pool all of the data,

text, and images from CRIS and make them

available to clinical researchers via institute 

clinical research systems. CRIS allows access 

to information based on a single patient.The

data mart will allow analysis of data from multiple

patients across one protocol or many protocols,

and will lay the foundation for a larger clinical

research data warehouse.

INFORMATION TECHNOLOGY ADVANCES

16 • ANNUAL REPORT 2007
As part of the year-long celebration marking the 20th anniversary of the National Institute

of Nursing Research, NINR and the Clinical Center’s Nursing and Patient Care Services hosted

the conference “Celebrating Nursing Science:The Research-Practice Link” on June 16 to mark

achievements in clinical nursing research and their application to practice. Dr. Patricia Grady

(left), director of NINR, and Dr. Clare Hastings (right), chief of CC Nursing and Patient Care

Services, were on hand to introduce the event’s keynote speaker—Dr. Christine Miaskowski,

professor and chair of the Department of Physiological Nursing at the University of California,

San Francisco, School of Nursing.

CELEBRATING NURSING SCIENCE 

About 80 dietetic interns, registered dietitians,

graduate students and nutrition professors gathered on

the NIH campus on March 23 for Nutrition Research

Day. Hosted by the CC Nutrition Department, the

annual event brings area dietetic interns to NIH to

introduce them to the world of federal nutrition

research and—more specifically—to the role of

research dietitians at the CC.This year, Research Day

was coupled with the NCI Division of Cancer

Prevention’s weeklong nutrition practicum, which

offered dietetic interns and visiting students and 

professors the opportunity to participate in an intense,

five-day learning session and gain practical experience

as part of their academic program. Among the speakers

was CDR Nancy Sebring (left). Describing the research

protocols and nutrition services provided at the CC,

she gave students a glimpse into the daily life of a 

CC dietitian, describing how many of them split 

their time between patient care and research support. Other dietitians then described their

involvement in research studies, including specific research diets and pediatric obesity protocols.

RESEARCH DIETITIANS 

NIH CLINICAL CENTER • 17
18 • ANNUAL REPORT 2007

Grant to CC pediatric program will help expand

congenital adrenal hyperplasia research 

Two foundations are helping expand NIH research

into congenital adrenal hyperplasia. Dr. Deborah

Merke, chief of pediatric services for the CC, has

received more funding for her natural history study

of patients with the rare disease.The nonprofit

Congenital Adrenal Hyperplasia Research

Education and Support (CARES) Foundation

began funding this research at the Clinical Center

in 2005.An additional $50,000 grant from the

family foundation Peregrine Charities will allow

Merke to include nurse practitioner Carol Van

Ryzin on the research team.“Having a nurse practitioner dedicated solely to this clinical research has

been invaluable,” says Merke.“It allows us to see

more patients with congenital adrenal hyperplasia

and to start new clinical research studies that otherwise would not have been possible.”

Merke’s study, sponsored by NICHD, will 

chronicle aspects of development over several

years. Researchers want to learn which physiological processes are affected by the disease 

and why, to help scientists design treatments to

address the underlying problems, not just symptoms. CARES funding has helped Merke see 

so many more patients (101 in a nine-month 

period) that she was able to expand the 

research and collaborate with other institutes.

Study finds potential marker to identify 

sickle cell patients at high risk for 

complications 

Researchers studying sickle cell disease have

found that an enzyme that can be measured by 

a simple blood test may help indicate whether 

a patient has a high risk of developing certain

serious complications associated with the disease.

The study, led by researchers from CC and

NHLBI, say the enzyme lactate dehydrogenase

(LDH) appears to hold promise in patients with

sickle cell disease as a marker for risk of pulmonary hypertension and other complications,

including early death. Pulmonary hypertension—

abnormally high blood pressure in the lungs—

is common in sickle cell disease.

“Our findings suggest that patients with sickle

cell disease and high LDH levels should have

especially careful monitoring for pulmonary

hypertension, a life-threatening complication,”

says Dr. Gregory Kato, a clinician in the CC

Department of Critical Care Medicine and

director of the Sickle Cell Vascular Disease Unit

in the NHLBI Vascular Medicine Branch.

A hereditary blood disorder, sickle cell disease 

in the United States is most prevalent in blacks.

An abnormal type of hemoglobin inside red

blood cells distorts their shape and interferes

with blood flow.The enzyme LDH investigated

in the study is found throughout the body, especially in red blood cells, the heart, liver, lungs, and

muscle.A blood test measuring LDH levels is

readily available and commonly used to determine tissue damage, whatever the cause.

Researchers at the Children’s Hospital and 

Research Center in Oakland, California, and 

the University of Pittsburgh School of Medicine

participated in this study.

Research SPOTLIGHTS 

Dr. Deborah Merke (left) is able to see more

patients like Zachary Ward because of foundation

funding.
NIH researchers examine drug interaction 

that may increase bone damage risk in 

HIV patients 

A study led by Dr. Scott Penzak, CC pharmacist, indicates that a corticosteroid medication,

prednisone, taken with an HIV protease

inhibitor, ritonavir, may increase the risk of

bone damage in HIV-infected patients.The

drug interaction may also increase the risk of

Cushing’s syndrome, a hormonal disorder

caused by prolonged exposure of the body’s

tissues to high levels of steroids.The combination of drugs significantly increased the concentrations of prednisolonethe—the active

form of prednisone—in the systems of healthy 

volunteers.

Corticosteroids are used to treat a number 

of conditions, including severe allergies, skin

problems, asthma, and arthritis.They provide

relief from swelling, redness, itching, and 

allergic reactions.“Physicians have noted bone

lesions on scans of HIV patients treated with

steroids for inflammation,” says Penzak.

“We wanted to find out if the problems might

be at least partially explained by an interaction

between the steroids and HIV drugs.”

Researchers tested variously timed combinations of the two drugs on ten healthy volunteers, taking blood samples after each dose of

prednisone to determine steroid levels.

Prednisolone concentrations were 41 percent

higher than the baseline amount after the 

drugs were taken together four days into the

ritonavir regimen and 30 percent higher after

the drugs were taken together 14 days into 

the regimen.

“These are statistically significant increases,”

says Penzak.“They indicate that when the

drugs are taken together, steroid concentrations

in the body may rise to levels that cause side

effects in some individuals.”These results serve

as a caution to clinicians treating HIV patients

on concurrent steroid therapy,” says Penzak.

“They may choose to start with lower steroid

doses or increase their level of toxicity monitoring compared with steroid recipients who

are not taking protease inhibitors.”

The team, which includes investigators from

the Clinical Center and the National Institute

of Allergy and Infectious Diseases, plans to continue studies of the blood levels of individuals

on steroids and other HIV medications.

NIH CLINICAL CENTER • 19

Raul Alfaro (left), study team member, and 

Dr. Scott Penzak (right), lead author, found that

when HIV-infected patients take a steroid 

medication with an HIV protease inhibitor, 

there may be an increased risk of bone 

damage and Cushing’s syndrome. 

Nursing, Indian Health

Collaboration

Nursing and Patient Care

Services and the Indian Health

Service collaborated in 2006 to

begin training staff at Indian

Health Service clinical facilities

on the conduct of research and

evidence-based practice projects.

This is part of a joint agenda to

increase clinical nursing research

capabilities in the IHS and supports their quest for Magnet

Hospital recognition, which is

granted by the American Nurses

Association to hospitals that

demonstrate an outstanding practice environment for professional

nursing. Nurse executives and

staff from Hastings Indian

Medical Center in Tahlequah,

Oklahoma, visited NIH for 

training in June.

A $50,000 intramural grant was

awarded by the National Center

of Minority Health and Health

Disparities in July to further support interagency collaboration

with the Indian Health Service,

specifically creating a clinical

research infrastructure and

expanding nursing research capabilities to address health disparities in American Indians and

Alaska Natives. In August, twoday training workshops were held

at the Acoma Canoncito Laguna

Hospital Service Unit and at the

Northern Navajo Medical

Center, both in New Mexico.

In November, Clinical Center

nursing leaders and nurse

researchers from the Native

Alaska North American Indian

Nurses Association (NANAINA)

met in Tempe,Arizona, after the

NANAINA Annual Summit, to

set the agenda for a training

workshop to be funded by the

grant and held in Bethesda in

April 2007.
20 • ANNUAL REPORT 2007

Discovery of a new bacterium may 

be only tip of iceberg 

Dr. Patrick Murray, chief of the Microbiology

Service in the CC’s Department of Laboratory

Medicine, remembers the day a medical technologist ran into his office and announced she had

found an organism she could not identify.

Technologist Alexandra Wong recalls that day, too.

“I grabbed Dr. Murray and said we may have

something unusual here.”

They did.

With the resources and collaboration that are

hallmarks of the CC environment, NIH researchers

from NIAID and the CC went on to make a rare

discovery.They identified a new bacterium that

causes human disease.

“Novel organisms are being found all the time,

but it’s quite rare to find an organism that actually

causes disease in a human being,” explains

NIAID’s Dr. David Greenberg.“This has been

exciting.” Greenberg, a physician, is the lead

author of a recently published study of the new

bacterium.A clinical fellow working with Dr.

Steven Holland, chief of NIAID’s Laboratory of

Clinical Infectious Diseases, Greenberg has been

part of this scientific journey from the start.

It began in 2003 when a man with chronic 

granulomatous disease (CGD) was hospitalized in

the CC. CGD is a genetic immune disorder that

affects about one in 250,000 people worldwide.

People with CGD are susceptible to serious 

infections of the skin, lungs, bones, and lymph

nodes.They may also experience obstructive and

inflammatory lesions in the digestive and urinary

tracts.

The 39-year-old patient had fever, chills, fatigue,

and weight loss, and later developed swollen

lymph nodes.When doctors at other medical

centers could not make a diagnosis, he was

referred to the CC.As part of his diagnostic

workup, several of his lymph nodes were removed

and sent to the microbiology lab, which does

diagnostic testing for CC patients and develops

tests for clinical research protocols.

Wong, with research technologist Frida Stock and

Fogarty fellow Dr.Adrian Zelazny, became the

microbiology service team that worked tirelessly

and creatively to isolate and identify the organism.

When cultures were done, an organism could be

seen growing on a plate, but conventional tests

did not reveal what it was. Lab staffers then

turned to genetic sequencing and concluded that

the bacterium was a novel member of the

Acetobacteraceae family.This family of bacteria is

prevalent in the environment but had not been

associated with human disease before.

“That’s how we knew we had something

unique,” says Murray, whose doctorate is in

microbiology and immunology. He credits the

technology in the lab and the tenacity of the scientists for making the identification. Murray says

other labs might have discounted the organism as

just a contaminant when conventional tests could

not determine what it was.“But we could go on

because we have the resources to perform gene

sequencing,” he says.“If we don’t get an identification by traditional biochemical tests, we send it

right to sequencing. It’s a very powerful tool to

help us classify organisms.”

“Without the microbiologists, none of this would

have happened,” says Holland,“We couldn’t have

done it without them.”

Working together in the bacterium

discovery and identification were

(back row from left) Drs. Patrick

Murray, Adrian Zelazny, David E.

Greenberg, and Steven Holland.

In front are Dr. Li Ding, Frida

Stock, and Alexandra Wong.

“FINDING AN ORGANISM THAT HAS NOT BEEN FOUND BEFORE—AND IS 

KNOWN TO BE A PATHOGEN IN SOME INDIVIDUALS—SUGGESTS THAT 

WE MAY HAVE SEEN ONLY THE TIP OF THE ICEBERG,” says Steven M. Holland, MD
NIH CLINICAL CENTER • 21

Identifying the organism and verifying its novelty

were important steps in discovery. Holland and

his team from NIAID and the CC then wanted

to know if this bacterium was causing disease in

the patient and whether it was associated with

chronic granulomatous disease. Dr. Li Ding and

other researchers in Holland’s lab confirmed that

the organism was relevant to the patient and the

disease.

Since that initial discovery in the 39-year-old

patient, researchers found the bacterium in two

other CGD patients at the CC and have been

told of a case in another state.The scientists say

learning about the case outside of Bethesda is

gratifying because it indicates a broader occurrence. It’s possible the organism accounts for a

significant number of infectious episodes in

CGD patients for whom doctors have never had

a clear diagnosis. So the findings may prove to

be very important for people with that disease.

Researchers want to know if the bacterium also

plays a role in other diseases—such as Crohn’s

disease or rheumatoid arthritis—for which

infectious causes have been proposed but not

demonstrated.“Finding an organism that has not

been found before—and is known to be a

pathogen in some individuals—suggests that we

may have seen only the tip of the iceberg,” says

Holland. Because of the discovery, the work in

Holland’s lab is taking a new direction. His team

has developed new collaborations and new techniques to learn more about the organism and

the impact it may have on health.

Greenberg is developing a screening test to find

out how many people, with and without CGD,

have been exposed to the organism.The team

wants to know how prevalent the bacterium 

is in the environment, where exactly it comes

from, and why it appears to favor CGD patients

as a host.

Researchers have much more to learn, but the

collaboration between Holland’s team and the

microbiology service has already had an impact

on CGD patients here.The CC’s microbiology

lab does antibiotic susceptibility testing that

helps doctors determine treatments for patients.

During the first patient’s course of therapy,

antibiotic susceptibility testing led the team to

use previously untried antibiotics that proved

successful. Because of what they learned in that

first case, doctors were able to use that treatment

from the beginning on the two patients identified later.

“It’s a nice personal feeling when you have contributed to the better health of patients,” says

Zelazny.“Now when patients with the same

underlying disease are admitted here or to any

other hospital, microbiology labs will know to

look for this type of bacteria.” He is thankful for

a work environment that encourages discovery.

“NIH has the people, the resources, and the

right setting for different people to come

together. I was very fortunate to be here at 

the right time and to meet the right people.”

Zelazny will be moving from microbiology to

Holland’s lab to continue work on this project,

in what Greenberg calls “a fantastic partnership.”

Greenberg, Zelazny, Holland, and Murray named

the new bacterium.After many brainstorming

sessions, they chose Granulibacter bethesdensis, in

recognition of chronic granulomatous disease

and of Bethesda, the town where the bacterium

was discovered.

The three CGD patients known to have the

bacterial infection are all said to be doing well.

“One patient hung a picture of Granulibacter 

in the foyer of his house,” says Greenberg,

“So there’s some semblance of pride that he was

one of the patients with a novel pathogen.”
Third-party reimbursement

Exploring new options for coping with tight

budgets is a priority at the Clinical Center.

The feasibility of billing insurance companies for

patient-care services rendered during clinical trial

participation was examined in a comprehensive

study completed in 2006.The NIH Advisory

Board for Clinical Research recommended to 

the NIH Director that this option not be pursued

at this time because of the nature of the CC’s

research portfolio, the relatively low projected

revenue, and how collections may affect patient

volunteers.

Benchmarking

The Clinical Center’s benchmarking project 

was an outgrowth of cost-containment efforts;

delineating costs of services and comparing them 

with costs for similar organizations offers a way to

gauge efficiency. In the Clinical Center’s benchmarking effort, expenses were categorized as 

clinical care services, patient support services,

imaging, nursing, information technology and

administration. Services unique to clinical research

were identified so that the CC’s budget expenditures could be compared directly with similar

organizations. Future efforts will focus on developing national benchmarks for clinical research.

Organizational Improvement, Teamwork

A keynote address from Dr. Patricia Benner, acclaimed

author and professor at the University of California, San

Francisco’s School of Nursing, kicked off 2006 Nurses Week

activities at the Clinical Center in May. The week concluded

with an awards ceremony and reception. Based on nominations

submitted by their colleagues, the nurses of 3NW received the

Team Excellence Award.“You are one of the most active groups

to affect nursing practice here,” said Dr. Clare Hastings, Nursing

and Patient Care Services chief.“You ensure flawless patient

experience every day.” Pictured from left are Clara Borrell,

Barbara Rawlings, Jennifer Breeskin, Keith Marin, Leigh 

Kiger,Tye Mullikin, Clare Hastings, Debbie Nathan, and 

Lori McIntyre.The 3NE nursing team for oncology/

hematology was recognized as the runner-up.

The annual gingerbread house decorating contest drew

long lines and lots of oohs and aahs from patients, visitors, and

staff.Twenty-eight houses created by staff teams representing a

dozen different departments were put on display in the Clinical

Center atrium in December.The contest attracted so much interest

that more than 1,900 ballots were cast during the week the houses

were on display.The Recognition and Retention Committee of

Nursing and Patient Care Services began the contest three years

ago, with nursing units participating. It was open to all CC staff

the next year. Taking first-place honors in 2006 was 5NW.

Representing the team at the announcement (left to right):

Subramania Varadarajan, Diana Chepurko, Noreen Giganti,

Joyce Linderman, Yumi Lee, Catherine Seamon, and Lisa

Twedt. Not pictured is gingerbread house designer Philip Bernaldez.

MIXING CREATIVITY AND COLLABORATION 

NURSES WEEK 
Leadership development

As part of its 2006 leadership development program,

the Clinical Center piloted a six-month program

in personalized executive coaching offered to 

six senior managers. Executive coaching gives

participating individuals a tailored opportunity 

to develop the skills they need to support 

development of effective leadership competencies.

One way to support effective workforce succession planning, the program will be offered again

in 2007 to six Clinical Center senior managers.

NIH CLINICAL CENTER • 23

As part of National Volunteers Week

2006, the Clinical Center celebrated the

more than 200 volunteers currently working

here, including (back row, from left) Dr. Joe

Held, Patricia Cosgrove, Betty Sanders, and

Fay Darya; (front row, from left) Dr. Franz

Jemio, Dalia Isicoff, and Michael HarrisLove. Programs supported by CC volunteers

include the Red Cross, the animal therapy

program, the family friend program, and the

language interpreters.

VOLUNTEERS HONORED
24 • ANNUAL REPORT 2007

Drs. JoAnn Lee and Hilary Eichelsdorfer

of the CC pharmacy department received the

2006 Clinical Center patient safety champion

award for their sustained commitment to 

creating and maintaining a safe environment 

for patients. Shown with them here are Andrew

Wilson, pharmacy chief, and John I. Gallin,

CC director.The pharmacists distribute 

medications to, and counsel, HIV patients.

As clinical liaison, Lee splits her time between

the outpatient pharmacy and the clinic, working

at the pharmacy window as well as attending

weekly meetings in the clinic to discuss patient

issues with the nurses. Lee says she appreciates

the dual responsibility because it allows her to

get to know the conditions of the patients

whose drug orders she manages.

Eichelsdorfer, who is outpatient pharmacist,

assumes Lee’s duties when needed. She says 

that the OP8 method of processing and filling

medication requests has proved to be efficient

and beneficial to the patients. In a typical pharmacy, a physician requests a specific medication

for a patient and the prescription is printed in

the pharmacy, where a pharmacist checks the

label and counsels the patient, when needed.

“In addition, we take an extra step,” says

Eichelsdorfer.“After the labels come off the

printer, we screen them all to make sure they

correspond with a patient’s profile.We are able

to prevent errors right away.”

This extra step succeeds in the OP8 environment because Lee and Eichelsdorfer have daily

contact with the patients and nurses. Because

they get to know the patients as individuals—

learning the various details of their conditions,

treatments, and histories—they are better

equipped to notice an error or inconsistency 

in their prescriptions.“HIV patients are on 

a complex drug regimen,” says Lee.“By having 

a couple of pharmacists dedicated to this 

particular treatment, we are more familiar with

the intricacies. Patients feel more comfortable

knowing they are dealing with someone who

knows their individual treatment program.”

PATIENT SAFETY CHAMPIONS 
NIH CLINICAL CENTER • 25

Meeting need is the essence of quality, said Dr. Donald Berwick (below)

president and CEO of the Institute for Healthcare Improvement, during a Great

Teachers lecture, part of CC Grand Rounds, in January.The search for quality

improvement in health care—making things better—begins by understanding

what the needs are and acting on them.

Health care, Berwick explained, should be safe, effective, patient-centered, timely,

efficient, and equitable—the six dimensions of health-care ‘needs’ described in the

Institute of Medicine’s 2001 report,“Crossing the Quality Chasm.” Health care 

is effective, he said,“when we match what we do to the known science base.

Timeliness means not making anybody wait—not caregivers or patients.

Efficiency is not wasting money or time or ideas or spirit.” These aspects of

health care translate to what

Berwick calls the ‘no-needless’

list.“The health-care system

I want and envision has no

needless deaths, no needless

pain, no helplessness on the

part of the workforce, the

family or the patient, no

unwanted waiting, no

waste—for anyone.That’s

where we are headed.”

BERWICK LECTURE LOOKS AT

HEALTH-CARE NEEDS 

HEALTH CARE IS EFFECTIVE, 

“WHEN WE MATCH WHAT WE DO TO THE 

KNOWN SCIENCE BASE.” 

© Alan Karchmer
CC’s emergency response capability 

The terrorist attacks on September 11, 2001,

were a major impetus for the emergencyresponse partnership formed in 2004 by the

NIH Clinical Center and its neighbors, the

National Naval Medical Center and Suburban

Hospital.

“The partnership hospitals have complementary

strengths,” says Dr. John I. Gallin, CC director.

“Physicians from the NIH Clinical Center 

represent almost every medical and surgical 

specialty and subspecialty.The skilled Naval

Medical Center staff are trained to respond to 

all kinds of emergencies, and Suburban Hospital

is a level II trauma center.”

Accommodating a surge in demand for medical

services is the Clinical Center’s major role under

the partnership. Navy and Suburban can transfer

or divert certain types of patients to the CC so

incoming sick and injured can receive care at

the best facility.

This collaboration is special in that it includes

hospitals from the private, government, and 

military sectors. Recognizing the partnership’s

potential early on, DHHS delivered a 250-

bed contingency hospital for its support.The 

contingency hospital—200 containers covering

3,000 square feet—comprises pre-positioned

supplies and equipment ready for quick set-up

within the Clinical Center.This “within the

walls” deployment is both practical and unique,

notes Dr. David K. Henderson, the CC’s deputy

director for clinical care and liaison for the 

partnership.“We have space to put the beds and

we have staff from throughout NIH who have

volunteered to provide the care.”

26 • ANNUAL REPORT 2007

Emergency Preparedness

CONTINGENCY HOSPITAL OFFERS 

NEW RESOURCE TO SUPPORT PREPAREDNESS

CAPT Elaine Ayres

inspects contingency

hospital inventory. 
The CC was to have received the nation’s first

of 10 such pre-positioned hospitals in 2005,

but supplies and equipment being assembled 

in Atlanta were redirected to areas affected by

Hurricane Katrina, explains Elaine Ayres,

project officer for the contingency hospital.

“The inventory, tailored to supplement what 

we already have at the CC, allows us to be 

self-sufficient for at least 72 hours,” says Ayres.

If the hospital were activated in response to an

emergency, staff here would simply unpack the 

200 containers and set up the beds, equipment,

and supplies in pre-determined areas throughout

building 10.

The boxes are color coded, meticulously 

inventoried, and precisely arranged to simplify

logistics.They include everything from beds for

patients and cots for staff to IV poles and blood

pressure cuffs.There are no pharmaceuticals and

there are few supplies that can’t be stored 

indefinitely.

Ayres, CC assistant director for ethics and technology development, was the Public Health

Service team leader for another contingency

hospital sent to Mississippi in the aftermath 

of Katrina and staffed by NIH volunteers.

The experience provided invaluable insight 

into how such resources can best be set up 

and used, says Ayres.

The members of the Emergency Preparedness

Partnership staged their third preparedness 

drill in December 2006.The previous exercises 

provided opportunities to practice and refine

response processes under fairly realistic 

circumstances.“Our goal is to be flexible 

and creative in our response to emergencies,”

says Henderson.

NIH CLINICAL CENTER • 27

A simulated fire and patient evacuation drill

held in June tested the Clinical Center level

of emergency preparedness.Although CC

staff knew the drill was scheduled, the location of the simulated emergency—a fire—

was not known until the alarm sounded 

in the patient-care unit midday.The drill

focused on the CC’s communication 

strategies, unit evacuation procedures,

and emergency plans.

EMERGENCY DRILL 

TESTS STAFF 

READINESS
Training clinical researchers of the future

Much of what clinical researchers learn, they

learn by doing and through collaborations 

and interactions with mentors and colleagues.

But with the growing complexity of medicine,

medical research, and the regulatory environment governing them, the Clinical Center 

some time ago recognized the need for formal

training as well—a need that in the early 

1990s was not being met.

A formal curriculum in clinical research has

been developed at the Clinical Center and 

consists of four courses:

• Introduction to the Principles and Practice 

of Clinical Research

• Ethical and Regulatory Aspects 

of Clinical Research

• Clinical Research Training and

• Principles of Clinical Pharmacology.

In 1995, the Clinical Center introduced the

course Introduction to the Principles and Practice 

of Clinical Research (IPPCR), to provide formal

training on how to effectively design a clinical

trial and implement clinical protocols, in full

awareness of ethical and regulatory issues.The

course teaches researchers how to design a good

clinical trial. It covers epidemiological methods,

study design and development, protocol preparation, patient monitoring, quality assurance, and

FDA issues. New material helps students navigate regulatory procedures, the grants process,

and such practical aspects of research as patient

perspectives and how to deal with the media.

The year IPPCR was first offered as a pilot,

25 students enrolled in the course, held at NIH.

The second year, enrollment at NIH jumped to

216. By 1997/98, distance learning technology

made it possible to broadcast the lectures, so in

addition to 291 students enrolled at NIH, 11

students participated at remote sites.The number

of students enrolled at NIH grew steadily—to 

419 in 2006/07—and the growth in distance

learning grew even faster.This year, a total of

942 students enrolled in the course, with 523

from 16 remote sites, ranging from Harbor

UCLA Medical Center (in southern California)

and Morehouse School of Medicine (in

Georgia) to the Universidad Peruana Cayento

Heredia and the U.S. Naval Medical Research

Center Detachment (both in Lima, Peru). Since

1997, a total of 5,880 students have registered

for this course, and 1,981 have received 

certificates. From 1997 to 2005, the course 

was teleconferenced to 22 domestic and five 

international locations.

Students in a convenient time zone can participate in real time through live teleconferencing.

But many students participate through archived

content—available through a Webcast or a

DVD—from as far away as Singapore, Seoul

(South Korea), Bergen (Norway), and Rabat

(Morocco). Sometimes a group of students

watches the course together; sometimes students

go through the material on their own.

The course Ethical and Regulatory Aspects of

Clinical Research is administered by the CC

Department of Clinical Bioethics.To date, 2,723

students have enrolled.A textbook, Ethical and

Regulatory Aspects of Clinical Research: Readings

and Commentary, was published by Johns

Hopkins Press.

Clinical Research Training, required of all intramural NIH principal investigators, is an active component of the Clinical Center training portfolio.

All NIH principal clinical investigators must take

the course and pass an exam before receiving

approval to conduct new clinical protocols.

The course was developed in 2000 to address

the NIH Training and Education Standard for

conducting intramural clinical research.To date,

8,516 people worldwide have successfully 

completed the course, which is available online at

http://www.cc.nih.gov/researchers/training/crt.shtml.

Now in its ninth year, the course Principles of

Clinical Pharmacology started with 11 intramural

students in two institutes in 1997/98.The 2006-

07 program, serving 620 students, is being 

teleconferenced live to 10 sites.To date 3,398

students have enrolled.

28 • ANNUAL REPORT 2007

Training the Next Generation
NIH is not a degree-granting institution, but

physicians, dentists, and allied health-care 

professionals who successfully complete the

three mandatory components of the training

(the first three courses listed above), plus an 

IRB experience can receive a Clinical Research

Curriculum Certificate from the Clinical

Center.

Clearly, clinical research is no longer the mythical

scientist working alone in a laboratory but a

team activity involving both laboratories and

patient care facilities, with all the support that

requires. Medical fellows take the courses, but 

so do the pre- and post-PhD researchers with

whom they may collaborate.Also enrolled are

many other health care professionals, including

pharmacists, nurses, respiratory and other 

therapists, and even a few lay people.

Another distance-learning program designed 

to strengthen training opportunities in clinical

research is a collaboration between the 

NIH Clinical Center and Duke University.

Participants complete coursework mainly

through videoconferences with faculty at Duke.

NIH staff teach other courses as Duke adjunct

faculty.The Duke University School of Medicine

awards a Master of Health Sciences in Clinical

Research for successful completion. Eight 

students are enrolled in the current session.

Fifty students have earned the degree since 

the program began in 1998.

NIH CLINICAL CENTER • 29

KEEPING THE PASSION FOR CLINICAL RESEARCH ALIVE 

The medical and dental students who

came to NIH from across the country to

attend the fourth annual Clinical Investigator

Student Trainee (CIST) forum were told they

had come at a pivotal time in their careers

and in medicine, which is changing in

important ways.

“Three p’s will characterize medicine in 

the future,” said Dr. Michael M. Gottesman,

deputy director for intramural research at

NIH, citing Dr. Elias A. Zerhouni, NIH

director.“It will become more personalized,

predictive, and pre-emptive. Each patient will

have more molecular and cellular analyses of

their specific disease so the medical community can predict what’s going to happen with

the disease and pre-empt, as much as possible,

the development of serious disease.”

Dr. Brad Wood 

(in white coat), who 

is acting head of 

CC research programs 

in imaging sciences, 

leads a tour for 

CIST participants. 
“You really are the shock troops for this transformation,” Gottesman told the students.“You

are the people in the next generation who are

going to work in the labs, work in the clinics,

and figure out how to change the face of medicine.Therefore this program is extremely

important to the NIH.”

The two-day CIST forum is designed for students participating in clinical and research fellowships at NIH and academic medical centers. Roughly 250 students attended.

“The speakers are so encouraging.They keep

telling us ‘You are the future of biomedicine,’”

said Kristin Weeks. She was the first student

from the University of Kentucky College of

Medicine to be a fellow with the Clinical

Research Training Program (CRTP) at NIH.

The students were encouraged to find the

right mentor and to connect with the other

students at the forum.“You’ll be meeting for

the first time some people who will undoubtedly influence your careers,” said CC Director

Dr. John I. Gallin.“Don’t underestimate the

role of your peers in your career development

as you move forward.”

“It’s invigorating to imagine what’s ahead,” said

Gregory Nelson, a fellow with the Howard

Hughes Medical Institute (HHMI) from Yale

University School of Medicine. He said the

physician-scientists at the forum encouraged

the students to find their niche and not to

decide prematurely that the road was too hard.

“For me, the most interesting thing has been

talking to other students, hearing about how

they approach scientific problems,” said Eric

Buras, an HHMI fellow from Baylor College

of Medicine. Buras had already decided to

become an endocrinologist and a physicianscientist, but he liked learning about new fields

and the career directions other students are

taking.

Alexander Diaz de Villavilla, a Yale medical student

and HHMI fellow who was concerned that 

he had too many interests and no focus, said,

“The forum was helpful in that I got exposure

to what top researchers are doing and I 

realized many are multidisciplinary. I wasn’t

expecting that, so it was encouraging to me.”

Dr. Frederick P. Ognibene, director of clinical

research training and one of the forum organizers, says the number of physicians going into

academic or research careers is falling somewhat, so the forum was about much more than

learning.“It also was an attempt to continue to

keep the passion they have in clinical research

an active passion—to let them know this is an

interesting, exciting, and viable career,” says

Ognibene.

Participants included Howard Hughes Medical

Institute Scholars (Cloister) and Fellows

(non-Cloister); Doris Duke Clinical Research

Program Medical Students; National Center

for Research Resources/GRC Students in

30 • ANNUAL REPORT 2007

HHMI fellow

Gregory

Nelson solicits

the opinions 

of panelists

during the 

session, “How

to Succeed 

as a

PhysicianScientist.”
year-long research programs; Sarnoff Cardiovascular

Research Foundation fellows; Fogarty International

Center/Ellison Foundation Overseas Fellowship

fellows; and NIH Clinical Research Training

Program for Medical and Dental Students fellows.

The first forum was held in October 2003. It is

supported with public and private funds from 

the Howard Hughes Medical Institute, the 

Doris Duke Charitable Foundation, the 

Sarnoff Cardiovascular Research Foundation,

the Fogarty International Center/Ellison

Foundation, and the National Institutes of

Health.

NIH CLINICAL CENTER • 31

WELCOME

RECEPTION 

FOR NEW 

FELLOWS

After a week working 

in their new jobs at the

Clinical Center, July’s 

incoming NIH clinical 

fellows enjoyed a welcome

reception, which has 

become an annual tradition.

Dr. Katherine Calvo (right),

co-chair of FelCom, the

NIH fellows committee,

talks with a group of new 

fellows.
32 • ANNUAL REPORT 2007

Also in 2006, 30 high school seniors from

Brooklyn’s Arthur Ashe Health Sciences

Academy (below) visited the CC and learned

from staff about opportunities for careers 

in allied health and research.The Clinical 

Center hosted a one-day orientation to 

the NIH for Howard University 

undergraduate science and mathematics 

students enrolled in the university’s 

Reach Back Program.

STUDENTS LEARN

ABOUT CAREERS IN

SCIENCE

April was a busy month for student 

visitors to the Clinical Center. Eighth

graders from the Landon School in

Bethesda (top) listened to lectures on

infectious diseases by experts from

Critical Care Medicine and Laboratory

Medicine and watched as one of their

classmates was sent through the PET

scanner under the supervision of 

Dr. Ron Neuman, chief of Nuclear

Medicine. Hundreds of youngsters 

visited the CC on Take Your Child 

to Work Day (bottom).Among the

things some learned: how to draw

blood, record their movements in the

state-of-the-art clinical movement

analysis laboratory, perform CPR on

the mannequin “Mr. Simmons,” and

touch everything from a pig’s lung to 

a microscope.The annual event 

introduces children to the world of 

biomedical research and to the wide

array of skills and services needed to

support it.
NIH CLINICAL CENTER • 33

2006 

DISTINGUISHED TEACHER 

NCI’s Dr. Elaine Jaffe (center) received the 2006 Distinguished Clinical Teacher’s Award, the

highest honor bestowed on an NIH senior clinician, staff clinician, or tenure track clinical investigator by the NIH Clinical Fellows. Recipients of the award, given annually since 1985, are recognized for their excellence as a mentor and teacher and their contributions to clinical research.

Dr. NaYoung Kim, NIAID fellow, chaired this year’s award committee and read a few comments

from fellows as she introduced Jaffe.“Fellows are in awe of her amazing clinical skills, and there

is often a sense that we are in the presence of greatness as she teaches the intricacies of diagnosis

while signing out clinical cases at the microscope,” was one.Another tribute:“Whenever clinicians have questions or want to discuss issues surrounding patient care, Dr. Jaffe stops whatever

she is doing and devotes her undivided attention to the clinical team to help manage difficult

clinical issues.” Jaffe joined the NCI as a resident in anatomic pathology and has been a senior

investigator since 1974. Her current area of expertise is the molecular basis of lymphoma and

the use of targeted inhibitors to develop more effective treatments for cancer.As the 2006

DCTA award recipient, Jaffe will deliver the Fourth Annual John Laws Decker Memorial

Lecture during a NIH Clinical Center Grand Rounds in June 2007.
CC hosts young scientists in 

Discovery Channel Challenge 

“People have two kinds of reaction to virtual

colonoscopies,” says Dr. Ron Summers, staff 

radiologist and senior investigator in the Clinical

Center.“Either they’re fascinated or they’re

grossed out.”

The forty middle school students who competed

in the Discovery Channel Young Scientist

Challenge (DCYSC) in late October were not

grossed out. Navigating their way through a 

virtual colon looked a little like playing a

videogame: Spot the polyps! Working in eight

teams of five students each, they listened to

Summers’ mini-lecture, got a hands-on experience

detecting polyps with computer software, played

around with a colonoscopy simulator, and finally

produced a kid-to-kid video explaining the

nature and benefit of a colonoscopy—all in 

90 minutes.

In the movies, young science buffs rarely have

social skills. Hollywood might have a problem

stereotyping this group, which seemed as comfortable working in groups and appearing on

camera as it did looking at zebrafish embryos

under a microscope (a nearby challenge).

The adult talent looked equally at ease, especially

after guiding eight teams in a row through the

same challenge, thanks to the remarkable 

adeptness at people-moving displayed by the

Discovery team.This was the first time NIH

hosted the event, and NIH employees were

amazed at how quickly—in two fairly lastminute days—the Discovery team transformed

a few somewhat drab NHGRI labs on the 

10th floor of building 10 into brightly decorated

stage-set laboratories.

“It was indeed a challenge to turn the empty lab

into a television-friendly learning arena,” said

Steve Jacobs, or Judge Jake, science educator and

creator of the Discovery program,“Jake’s Attic.”

Jacobs develops and administers the challenges.

“I tip my hat to the creative ability of the

Discovery production team. However, I fall to

my knees in praise of the volunteers from the

NIH staff. It is not difficult to make television

shine when working with such jewels.The 

people at NIH are truly amazing. Just amazing.

I stood in awe of their scientific expertise, and

even more, their ability to communicate an

excitement for their work.They are just the

inspiration we needed for motivating young

people to consider careers in science and medicine.”

The Young Scientist Challenge is a national science contest for students in grades 5 through 8.

Discovery Communications, Inc., launched the

competition in partnership with Science Service

to nurture the next generation of U.S. scientists

at that critical age when interest in science

begins to decline.To enter the contest, students

must first compete in a local or regional science

fair affiliated with Science Service.The 40 finalists

34 • ANNUAL REPORT 2007

Noteworthy
who competed in the Clinical Center on

October 24-25 were selected from the top 400

national semifinalists, based on the scientific

merit of their original science project and their

ability to communicate its goals.The semifinalists

had been chosen from among over 1,900

entrants representing 273 affiliated science fairs

from 47 states, the District of Columbia, Puerto

Rico, and the Virgin Islands. For two days the

Final 40 competed in complex, team-based,

hands-on challenges.They competed as teams

but were judged individually on their performance in challenges, understanding of the science

process, teamwork, and ability to communicate

about science, including their original science

project. It always comes down to finalists who

“possess the ability to inspire and inform others

of the delights of scientific discovery,” says 

Judge Jake.

Disease detectives

This year’s theme,“Disease Detectives,” featured 

a series of challenges in which the finalists 

investigated the causes and impact of global

health concerns, from avian flu to obesity. NIH

collaborated with DCYSC in the final round 

of the 2006 challenge and hosted this year’s 

program.The scientists leading the challenges

worked with Steve Jacobs to formulate and

design the experiments, built around current

health issues.The finalists were given eight fairly

formidable tasks to accomplish, in small teams,

in segments of 90 minutes or less.

“The opportunities are greater now than they

were when I was a kid,” says Summers, who in

seventh grade learned about physics and science

through the “discovery” approach to learning 

science provided in the Intermediate Science

Curriculum Study (ISCS). Instead of yawning

through the old “chalk-and-talk” approaches, in

which often-bored students memorized facts

delivered through lectures and textbooks, students

in discovery-science classes spend far more time

engaged in inquiry-oriented activities that

require interpreting data, suggesting hypotheses,

conducting experiments, working on projects,

and sharing results.

The Discovery Channel’s show about the

Discovery Challenge will air in February 2007.

Read more about the winners, the science 

projects of the Final 40, a dozen or more 

additional awards (including a “dream science

trip”), and the Challenge itself at

http://school.discovery.com/sciencefaircentral/dysc/

NIH CLINICAL CENTER • 35
CC staff receive NIH directors awards 

Leadership requires heart,spine,and brains,said Dr.

Elias A.Zerhouni,NIH director,offering an anatomy

lesson in remarks opening his 2006 awards ceremony

in July.Heart because we’re “the National Institutes

of Hope to millions,” and spine because it’s important “to stand up for what you believe in, believe

in what you say, and say what you believe...stay

true to your principles and core values.”

Staff in the Office of the CC Director honored

with individual awards were Patricia Piringer, for

outstanding management and oversight of the

bench-to-bedside program; Laura Lee, for leadership in emergency preparedness planning and creation of an emergency preparedness partnership;

and Hillary Fitilis, for exemplary leadership and

guidance in improving performance management

here. Dr. Robert Danner, in Critical Care

Medicine, received an individual award for 

creating a multi-user genomics facility, yielding

substantive insights into the physiology of sepsis.

A mentoring award went to Dr. Mark Gladwin,

Critical Care Medicine and NHLBI, for his 

contributions to understanding the role of nitric

oxide in the regulation of sickle cell anemia.

36 • ANNUAL REPORT 2007

American College of Physicians 

honors Gallin, Young

Two NIHers were honored during the annual

convocation of the American College of

Physicians. In April, Dr. John I. Gallin, CC

director, received a prestigious Rosenthal Award

for his “contribution to the advancement of

clinical research, to the teaching structure, to

the principles of patient care and to the overall

productivity of hospital programs.” Dr. Neal S.

Young, chief of the hematology branch in

NHLBI’s intramural program, was cited for his

election as a Master of the American College

of Physicians, which recognizes outstanding

career accomplishments and contributions.

Susan Whitehead (center), daughter of the

late Edwin C.Whitehead, was at the Clinical

Center in October for a ceremony marking

her family’s gift of the Sky Horizon sculpture

to NIH. She is flanked by John Burklow (left),

NIH associate director for communications,

and CC Director Dr. John I. Gallin.The steel

work by artist Louise Nevelson was dedicated

in 1988 and displayed here since then courtesy

of the Whitehead family. Originally located at

the Clinical Center’s front entrance on Center

Drive, the piece was relocated to its present site

at the end of West Drive during construction

of the Mark O. Hatfield Clinical Research

Center. Sky Horizon was selected in the 

mid-1980s when Dr. James B.Wyngaarden,

then NIH director, established a committee 

to advise him on selection of a sculpture that

would “stand as a reminder of the accomplishments of NIH to the health of mankind and 

a salute to those who made those accomplishments possible” to mark NIH’s 1987 centennial

celebration. It was purchased by Edwin

Whitehead, founder of the Whitehead Institute

for Biomedical Research and the Technicon

Corp. In his later years, he was a founder and

chairman of the board of Research!America.

“My father was enormously proud the 

sculpture was at NIH,” said Susan Whitehead.

“It’s a privilege for me and my family to 

make this gift.”

NEVELSON WORK NOW 

OFFICIALLY PART OF NIH
New CIO a veteran 

in advances here 

Dr. Jon McKeeby 

was named the Clinical

Center’s chief information officer in July.

Acting CIO since

January, McKeeby, who

has been at the CC 

since 1991, will also

oversee the Department of Clinical Research

Informatics. McKeeby led the development and

implementation of interfaces between MIS (the

CC’s original medical information system), CRIS

(NIH’s current clinical research information system),

and other key information systems, including radiology, hospital statistics, nutrition, and surgery.

He earned a BS degree in computer science

from Hope College in Michigan and an MS in

computer science from Bowling Green State

University. McKeeby succeeds Dr. Stephen

Rosenfeld, who had served as CIO since 2004

and was leader of the CRIS development team.

Rosenfeld left the CC to become CIO for

MainHealth in Portland.

——

Lertora heads clinical

pharmacology 

program The CC office 

of clinical research training

welcomed Dr. Juan Lertora 

as the new director of the

CC clinical pharmacology

program in July.

As program director, Lertora will teach and 

oversee the Principles of Clinical Pharmacology

course and will be involved in issues related to

training clinical investigators. Before accepting

the job at the Clinical Center, Lertora worked 

as a professor and head of the section of clinical

pharmacology at Tulane University’s Departments

of Medicine and Pharmacology in New Orleans.

In addition to his academic positions at Tulane,

he was a staff physician at Tulane Medical Center

Hospital and Clinic, Charity Hospital, and the

Veterans Administration Medical Center—all in

New Orleans. He was also a principal investigator in the Tulane-Louisiana State University

Adult AIDS Clinical Trials Unit (funded by

NIAID) and program director of the General

Clinical Research Center (funded by NCRR).

When Hurricane Katrina hit in August 2005,

Lertora evacuated the city—his home for more

than 20 years—with thousands of others, ultimately ending his journey in Houston. So when

he became aware early in 2006 that the CC

position was still open, he was ready to consider

the opportunity. Dr.Arthur Atkinson, who served

in the role until October 2005, was a friend and

mentor.“I remember congratulating Art when he

retired from his position as director of the clinical

pharmacology program last year.At the time,

I had no idea I would be looking for a new

opportunity,” Lertora says.

——

Chan named chief of

rehabilitation medicine 

Dr. Leighton Chan of the

University of Washington

will be the new chief 

of CC’s Rehabilitation

Medicine Department.

He was chosen from a highly

competitive field of candidates after an extensive

national search. His appointment is effective in

January 2007.

Dr. Chan will oversee the Clinical Center’s 

rehabilitation medicine programs, including

patient care, research, training, and support.

On the rehabilitation medicine faculty at the

University of Washington in Seattle since 1994,

he has been recognized as an outstanding teacher

and a strong clinical researcher and collaborator.

He served as co-director of the university medical center’s pulmonary rehabilitation program,

assistant medical director for the rehabilitation

clinic, and consultant to the lung transplant 

committee.

NIH CLINICAL CENTER • 37

Transisitons
Of special note is his work as a regional medical

epidemiologist for the Centers for Medicare and

Medicaid Services. He and colleagues used large

databases to evaluate the quality of rehabilitation

care, work that resulted in sweeping changes in

reimbursements and payments.

Dr. Chan earned his undergraduate degree at

Dartmouth, completed pre-medical work at

Bryn Mawr College, and earned his MD at the

UCLA School of Medicine. He also holds master

of science and master of public health degrees

from the University of Washington.After residency training in the Department of Rehabilitation

Medicine there, Dr. Chan completed a Robert

Wood Johnson Fellowship.

——

Dr. King Li, associate director for radiology and

imaging services and chief of the diagnostic radiology department since 2001, left the Clinical

Center in October to join the Cornell Methodist

Hospital in Houston.

——

Tom Reed, former director of the CC Office of

Human Resources Management, retired in April

after 34 years of federal service.While at the CC,

Reed was able to influence much-needed reform

in a key civil service law that would allow the

hospital to improve nurses’ salaries (and later

those of allied health staff) using the authority of

the Veterans Administration (Title 38). In 2001,

further human resource gains were made using

Title 42 (the Public Health Service Act) to pay

and appoint clinical research support staff

engaged in direct or indirect services related to

clinical patient care.

——

Known for bringing relaxation to CC patients,

Dr. George Patrick, chief of recreational therapy, has opted to start some relaxing of his own—

he retired in June. Patrick began his NIH career

in 1988.“The available treatments were different

back then,” he said.“At the time, our department

compiled a list of what patients were doing—

things like tai chi and

other relaxation techniques—and we also

looked at what patients

were asking for.”With

that information,

Patrick and others

began forming discussion groups to determine what new offerings they could bring to the

CC.Today patients can take advantage of a host

of options, including acupuncture, biofeedback,

massage, meditation, and music therapy. Patrick

is the author of 41 publications, covering such

topics as complementary and alternative medicine, novice wheelchair athletics, developmental

psychology and geropsychiatric recreation,

and day camping for developmentally disabled

children.

——

Dr. Paul Plotz stepped

down as chair of the

acclaimed CC Grand

Rounds Great Teachers

lecture series in May.

Plotz originally conceived the idea for the

series when he was

chair of the NIH/FAES

continuing medical education committee.

Charged with enhancing education programs on

campus, Plotz and the committee surveyed NIH

physicians to find out what clinical topics would

be of interest to them.With the survey results in

hand, the committee invited physicians from the

United States and abroad who were best suited

to address a particular topic, based on their reputations as outstanding clinicians and great teachers. Since its inception in 2001, the successful

Great Teachers series has fueled enthusiasm

among clinical physicians and has delivered practical medical advice. Comprising ten lectures

annually, the series is part of the weekly Clinical

Center Grand Rounds. Dr. Jeffrey Cohen,

National Institute of Allergy and Infectious

Diseases, is current chair.

38 • ANNUAL REPORT 2007
NIH CLINICAL CENTER • 39

After 35 years employment with NIH,

Jan Weymouth retired from her position as

executive director of the Safra Family Lodge.

“It’s been amazing,” says Weymouth.

“It’s almost like a family, there’s so little

turnover and everyone is so dedicated.

Everyone feels compelled to push forth the

mission of improving the health of the nation.

It’s been a privilege to work in some small

capacity to do that.”

She began working at NIH in 1970, straight

out of college. In 1977 she moved to the

Division of Space Management, in the NIH

Office of the Director, at a time of unprecedented growth at NIH.After the Ambulatory

Care Research facility was built, the Clinical

Center created a new position just to manage

the CC’s growing space and facilities. So

much new construction happened over the

next 35 years that moving people and things

became an important skill.The work was

interesting, but required the mindset of 

a politician, with so many institutes seeing

patients and vying for space in the 

Clinical Center.

In 1999 she helped launch the CC’s hospitality

services program, at the suggestion of the

Patient Advisory Group. Existing staff were

retrained and redeployed to welcome patients

and give them guidance.After 9/11, security

was tightened, and patients had so much 

trouble getting on campus that they were 

turning around and going home. In 2001,

Weymouth helped develop and set up the

extended-visitor pass program, which allowed

patients and other visitors to be screened,

identified, photographed, and given a pass that

allowed them to come and go with the same

ease as employees. She issued the first passes 

to the Patient Advisory Group.

In 1999, approval was given to begin program

and design work on what would become the

Safra Family Lodge, with an early enough 

start that when funding for the lodge became

available, construction could begin without

delay. From 2004 on, she worked full-time 

on the Family Lodge, on everything from 

construction to staffing.

“Jan is the kind of person who knows how 

to get things done,” says Maureen Gormley,

CC’s chief operating officer.“Jan knows the

‘art of the possible.’ Not only did she make

sure the Family Lodge would be comfortable

and supportive of guests’ needs, she gave the 

place a heart.”

JAN WEYMOUTH,

SAFRA FAMILY LODGE 

DIRECTOR, RETIRES

“JAN IS THE KIND OF PERSON WHO KNOWS 

HOW TO GET THINGS DONE.”
40 • ANNUAL REPORT 2007

Dottie Cirelli, who retired as

director of patient recruitment,

is a case study in how to build 

a career at NIH.

Cirelli served for 9 years as a 

substance abuse counselor for

the Arlington County Department of Human Resources.

Most of her clients came to her

through court orders.“One of my dreams was to work at the NIH,

which was the premier place to be for research and medicine,” she

says. In 1980, she landed a job as a research psychologist with the

National Institute on Alcohol Abuse and Alcoholism. She moved 

to the Clinical Center in the mid-1980s as a hospital administrative

officer, responsible for patient care unit budgets and administrative

and facility issues.“It was never boring,” says Cirelli.“Something

always needed attention. I liked interacting with the patients, the

nurses, and other patient care staff. I felt I was part of the heartbeat

of the organization.”

In 1997, a subgroup of the Medical Executive Committee decided

that more active patient recruitment was needed to fill intramural

clinical trials. Dottie soon took on her most challenging career

post, actively managing a centralized patient recruitment service.

With a staff of three, she was asked to develop a proposal to

increase recruitment for the Clinical Center, with a special mandate to recruit more minority patients.“The four of us literally

worked night and day, not only conducting recruitment but initially answering all of the calls, developing our own database, and

creating forms to collect data,” she says.

By opening a call center, attending health fairs and national 

conferences, sending mailings to doctors, advertising, and getting

media attention, the department went from 125 patient enrollments (out of about 9,000 calls) in fiscal 1997 to 3,041 patient

enrollments out of 46,796 calls and 12,492 referrals to protocols

in fiscal 2006.

“The mission of this organization is wonderful and the people

who work here really care. I am proud to have been a part of it.”

DOTTIE CIRELLI, DIRECTOR OF PATIENT

RECRUITMENT, SAYS GOODBYE

Dr. Robert Warwick Miller, scientist emeritus

at NCI and founder of the Astute Clinician

Lecture series, died on February 23, 2006.

He was 84 years old.Throughout a distinguished

career spanning 45 years at NCI, Miller stressed

the importance of alert clinical observations 

in providing initial clues to the causes of cancer,

birth defects, and other diseases, as well as 

the value of interdisciplinary approaches that

integrate the epidemiologic, clinical, and basic

sciences.

As an extension of his research interests, Miller

founded the Astute Clinician Lectureship,

which is part of the NIH Director’s Wednesday

Afternoon Lecture series, coordinated by the

Clinical Center.The series specifically honors the

path-breaking work of clinical scientists. Now 

in its ninth year, it was established through a gift

from Miller and his wife, Haruko “Holly” Miller.

“Dr. Miller recognized that insightful clinical

observations often lead to innovative research

and medical breakthroughs,” said Dr. John I.

Gallin, CC director.“Because of the generous

gift he and his wife made to NIH, scientists who

exemplify this path to discovery give lectures

here annually as a celebration of clinical

research.”

Miller is survived by Haruko “Holly” Miller,

his wife of 51 years, who served as a research

chemistry technician in NCI’s Laboratory of

Molecular Carcinogenesis.
NIH CLINICAL CENTER • 41

NIH CLINICAL CENTER

Organization Chart

Deputy Director for

Management &

Diversity

Walter Jones, MS

Social Work

Department

Adrienne Farrar, DSW

Office of Patient

Recruitment and

Public Liaison

Dinora Domingues, 

BS, RN

(acting)

Spiritual Ministry

Department

Walter Jones, MS,

(acting)

Chief Operating

Officer

Maureen E. Gormley,

MPH, RN

Office of

Administrative 

Management

Lynda Ray

Nutrition Department

David Folio, MS, RD

Office of Worforce

Planning and

Development

Deborah Gardner,

PhD, RN

Senior

Communications

Advisor

Sara Byars

Office of

Communications

Colleen Henrichsen 

Office of Facility

Management

James Wilson

Safra Family Lodge

Lawrence Eldridge,

MSHA

Office of Purchasing

and Contracts

Sydney Jones

Chief, Nursing and

Patient Care

Services

Clare Hastings, 

PhD, RN, FAAN

Deputy Chief

Ambulatory Care

Services

Karen Kaczorowski,

MHSA, RN

Deputy Chief

Inpatient Services

Tannia Cartledge,

MS, RN 

Chief, Research 

& Practice

Development

Service

Gwenyth Wallen,

PhD, RN

Chief Financial

Officer

Lisa A. Lacasse, MBA

Office of Financial

Resource

Management

Daniel P. Rinehuls, BA

Clinical Bioethics

Department

Ezekiel Emanuel,

MD, PhD

Chief Information

Officer

Jon W. McKeeby, DSc

Department of

Clinical Research

Informatics

Jon W. McKeeby,

DSc

Diagnostic

Radiology

Department

Elizabeth Jones, MD

(acting)

Bradford J. Wood,

MD (acting)

Nuclear Medicine

Department

Ronald D. Neumann,

MD

Positron Emission

Tomography

Department

Peter Herscovitch,

MD 

Laboratory of

Diagnostic

Radiology Research

Joseph A. Frank,

MD

Deputy Director for

Clinical Care

David K. Henderson,

MD

Department of

Anesthesia and

Surgical Services

Zena Quezado, MD

Department of

Laboratory Medicine

Thomas A. Fleisher,

MD

Critical Care

Medicine 

Department

Henry Masur, MD

Pharmacy

Department

Andrew Wilson,

PharmD

Rehabilitation

Medicine

Department

Leighton Chan, MD

Transfusion

Medicine

Department 

Harvey Klein, MD

Medical Record

Department

Patricia Coffey, RHIA

Credentials Office

Joseph Hendery

Pain and Palliative

Care Service

Ann Berger, RN, MD

Internal Medicine

Consult Service

Fred Gill, MD

Pediatric Consult

Service

Deborah Merke, MD

Veterinary Care

Program

Lisa Portnoy, VMD

DIRECTOR

John I. Gallin, MD

Chief Operating Officer

Maureen E. Gormley, MPH, RN

Office of Clinical Research Training

and Medical Education

Frederick P. Ognibene, MD

Assistant Director for Ethics and

Technology Development

Elaine J. Ayres, MS, RD

Housekeeping and

Fabric Care

Department

Henry Primas, MBA

Materials Management

Department

Francis LaBasco, 

MS, PD
Governance

The NIH Advisory Board for Clinical

Research oversees the Clinical Center’s

resources, planning, and operations.

The Board also advises on NIH’s overall

intramural program, including priority 

setting, the integration and implementation of research programs of the individual

institutes and centers, and overall strategic

planning for the intramural program.

Comprised of a mixture of NIH clinical

and scientific leaders and outside experts

in management of health care, and clinical

research, the Board advises the NIH

deputy director for intramural research

and the Clinical Center director and

reports to the NIH director

Chair:

Edward J. Benz, MD 

President, Dana Farber Cancer Institute

Vice Chair:

Barry S. Coller, MD

David Rockefeller Professor of Medicine

Head of Laboratory of Blood and 

Vascular Biology

Physician in Chief 

Rockefeller University Hospital

Vice President for Medical Affairs 

Rockefeller University

Duane F.Alexander, MD 

Director

National Insitute of Child Health 

and Human Development

Barbara M.Alving, MD 

Acting Director

National Center for Research Resources

Elizabeth B. Concordia, BA, MAS

Senior Vice President,Academic and

Community Hospital

President, Presbyterian Shadyside 

University of Pittsburgh Medical Center 

Robert M. Dickler

Senior Vice President

Division of Health Care Affairs

Association of American Medical Colleges

Ronald G. Evens, MD 

Senior Executive Officer 

Barnes Jewish (BJC) HealthCare

Maria C. Freire, PhD 

Chief Executive Officer and President

Global Alliance for TB Drug Development

Lee J. Helman, MD 

Scientific Director for Clinical Science

Center for Cancer Research 

National Cancer Institute

Thomas R. Insel, MD 

Director

National Institute of Mental Health

Daniel L. Kastner, MD, PhD 

Clinical Director

National Institute of Arthritis and 

Musculoskeletal and Skin Diseases

Talmadge E. King, Jr., MD 

Professor and Vice Chairman

Department of Medicine

San Francisco General Hospital

Michael J. Klag, MD, MPH

Dean

Johns Hopkins Bloomberg 

School of Public Health

Henry F. McFarland, MD 

Clinical Director

National Institute of Neurological 

Disorders and Stroke

Lynnette K. Nieman, MD 

Senior Investigator 

Reproductive Biology and Medicine Branch

National Institute of Child Health 

and Human Development

Olufunmilayo (Funmi) Olopade, MD 

Professor of Medicine and Director

Center for Clinical Cancer Genetics,

University of Chicago

Monica Skarulis, MD 

Chief, Clinical Endocrine Section

National Institute of Diabetes and 

Digestive and Kidney Diseases

Ex Officio Members

John I. Gallin, MD

Director, Clinical Center

National Institutes of Health

Michael M. Gottesman, MD

Deputy Director for Intramural Research

National Institutes of Health

William A. Gahl, MD, PhD 

Chair, Medical Executive Committee 

Executive Secretary

Maureen E. Gormley, MPH, RN

Chief Operating Officer, Clinical Center

National Institutes of Health

Senior Staff Support

Richard Wyatt, MD

Executive Director, Office of 

Intramural Research

National Institutes of Health

ADVISORY BOARD FOR CLINICAL RESEARCH 

NATIONAL INSTITUTES OF HEALTH (2006/2007)

42 • ANNUAL REPORT 2007
NIH CLINICAL CENTER • 43

William A. Gahl, MD, PhD 

(Chair)

National Human Genome Research Institute 

Henry F. McFarland, MD 

(Vice Chair)

National Institute of Neurological 

Disorders and Stroke 

Frank M. Balis, MD

National Cancer Institute

James E. Balow, MD

National Institute of Diabetes and 

Digestive and Kidney Diseases

Perry J. Blackshear, MD, DPhil 

National Institute of Environmental 

Health Sciences 

Richard O. Cannon, III, MD

National Heart, Lung, and Blood Institute

Carlo Contoreggi, MD 

National Institute on Drug Abuse 

Raymond A. Dionne, DDS, PhD 

National Institute of Nursing Research 

Frederick L. Ferris, III, MD 

National Eye Institute 

Thomas C. Hart, DDS, PhD

National Institute of Dental and 

Craniofacial Research 

Clare E. Hastings, PhD, RN, FAAN

NIH Clinical Center 

Markus Heilig, MD, PhD 

National Institute on Alcohol Abuse 

and Alcoholism 

David K. Henderson, MD 

NIH Clinical Center 

Stephen G. Kaler, MD, MPH

National Institute of Child Health and

Human Development 

Daniel L. Kastner, MD, PhD 

National Institute of Arthritis and

Musculoskeletal and Skin Diseases 

H. Clifford Lane, MD 

National Institute of Allergy and 

Infectious Diseases 

Dan L. Longo, MD 

National Institute on Aging

Henry Masur, MD 

NIH Clinical Center 

Melissa A. Merideth, MD, MPH

Clinical Fellow

National Human Genome Research Institute 

Deborah P. Merke, MD, MS 

NIH Clinical Center 

Robert Nussenblatt, MD 

National Center for Complementary 

and Alternative Medicine 

Steven A. Rosenberg, MD 

National Cancer Institute 

Donald L. Rosenstein, MD 

National Institute of Mental Health

Carter Van Waes, MD, PhD 

National Institute on Deafness and 

Other Communication Disorders 

Ex Officio Members 

John I. Gallin, MD 

NIH Clinical Center 

Patricia A. Kvochak, JD

Deputy NIH Legal Advisor

Richard G.Wyatt, MD

Office of the Director, NIH 

Laura M. Lee, RN 

NIH Clinical Center 

MEDICAL EXECUTIVE COMMITTEE MEMBERS (2007)

NIH Clinical Center 

The Medical Executive Committee is made up of clinical directors of the NIH intramural clinical research programs and other senior medical and administrative staff.
(the institutes, in alphabetical order)

National Cancer Institute (NCI)

National Eye Institute (NEI)

National Heart, Lung, and Blood Institute

(NHLBI)

National Human Genome Research Institute

(NHGRI)

National Institute on Aging (NIA)

National Institute on Alcohol Abuse and

Alcoholism (NIAAA)

National Institute of Allergy and Infectious

Diseases (NIAID)

National Institute of Arthritis and

Musculoskeletal and Skin Diseases

(NIAMS)

National Institute of Biomedical Imaging 

and Bioengineering (NIBIB)

National Institute of Child Health and

Human Development (NICHD)

National Institute on Deafness and Other

Communication Disorders (NIDCD)

National Institute of Dental and Craniofacial

Research (NIDCR)

National Institute of Diabetes and Digestive

and Kidney Diseases (NIDDK)

National Institute on Drug Abuse (NIDA)

National Institute of Environmental Health

Sciences (NIEHS)

National Institute of General Medical

Sciences (NIGMS)

National Institute of Mental Health (NIMH)

National Institute of Neurological Disorders

and Stroke (NINDS)

National Institute of Nursing Research

(NINR) 

National Library of Medicine (NLM)

(the centers, in alphabetical order)

Center for Information Technology (CIT)

Center for Scientific Review (CSR)

John E. Fogarty International Center (FIC)

National Center for Complementary and

Alternative Medicine (NCCAM)

National Center for Minority Health and

Health Disparities

National Center for Research Resources

(NCRR)

NIH Clinical Center (CC)

Mark O. Hatfield Clinical Research Center 

Warren Grant Magnuson Clinical Center 

NATIONAL INSTITUTES OF HEALTH

44 • ANNUAL REPORT 2007

DEPARTMENT OF HEALTH AND HUMAN SERVICES

National Institutes of Health

NIH Clinical Center

clinicalcenter.nih.gov

NIH Publication Number 07-6140

January 2007