There’s no 

other hospital like it 

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

2

DIRECTOR’S ANNUAL REPOR

008

T • NIH CLINICAL CENTER 

PROFILE 

CONTENTS


PROFILE 2008

Message from the Director 3 

Recent Clinical Center Achievements 4 

Patient Activity and Support 6 

Advancing Clinical Research 10 

Organizational Improvement/Teamwork 26 

Training the Next Generation 28 

Noteworthy 34 

Organization and Governance 37 
OUR VISION 

OUR MISSION 

The NIH Clinical Center will serve as the nation’s premier research hospital for 

conducting clinical research to improve the health of humankind. 

The Clinical Center will also serve as a national resource for clinical research 

by fostering dynamic interactions with outside partners; 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: 

• 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. 
MESSAGE FROM THE DIRECTOR 

STRENGTHENING FOUNDATIONS 

The Clinical Center is a key resource in support of clinical research conducted at the National Institutes of Health in Bethesda, Maryland. It’s also 

a unique resource.All patients volunteer to participate in clinical research 

protocols here. Nearly half of those protocols are natural history studies, 

most of which involve rare diseases.The majority of the clinical trials are 

the early phase 1 or 2 trials to evaluate the safety or effectiveness of a new 

drug or treatment. 

Translating ideas from the laboratory into better health and health care has 

been the Clinical Center’s focus since the facility was established as the 

nation’s clinical research hospital in 1953. Over these decades, clinical 

research carried out here has bolstered the body of medical knowledge in 

incalculable ways. Our ability to create and maintain an environment that 

nurtures collaboration and innovation in medical discovery will help sustain 

future progress. 

Strengthening our capability to help train the next generation of clinicianresearchers in innovative ways is essential. Identifying and implementing 

new approaches in organizational efficiency and effectiveness are fundamental 

priorities. 

The dedication and commitment of the Clinical Center team provide a 

strong foundation for the challenges and opportunities we face in 2008. 

Our patients, invaluable partners in medical discovery, look to you—and 

find—comfort, support, and hope. 

John I. Gallin, MD 

Director, NIH Clinical Center 

NIH CLINIC AL CENTER • 3 
RECENT CLINICAL CENTER ACHIEVEMENTS


In 2007 we: 

• 	Improved the environment for Clinical Center patients, staff, and visitors through a renewed 

commitment to a smoke-free Clinical Center. 

• 	Enhanced services for patients by introducing an online resource to provide feedback 

on services and implementing new approaches to minimize wait times for appointments 

and procedures. 

• 	Expanded CRIS, the Clinical Research Information System, and retired MIS, the Medical 

Information System. 

• 	Improved the physical facility and our ability to manage critical projects with the NIH 

Office of Research Facilities. 

• 	Opened the NIH Metabolic Clinical Research Unit that will allow researchers to 

comprehensively study factors that contribute to obesity and associated diseases. 

• 	Made strides in our ability to benchmark costs throughout the organization and use that 

information to more precisely manage resources and project resource use. 

• 	Merged training and education programs from the NIH Office of Intramural Research and 

the Clinical Center to form an expanded CC Office of Clinical Research Training and Medical 

Education. 

• 	Explored the role of the Clinical Center with colleagues and collaborators throughout 

NIH and through the Clinical and Translational Science Award network, culminating in a 

mid-year mini-retreat of NIH institute directors to define options. 

• 	Conducted a review of the Bench-to-Bedside program, begun in 1999, resulting in a 

renewed commitment to fostering these projects. 

4 • ANNUAL REPORT 2008 
There’s no 

other hospital like it 
Patient Activity and Support 

PROACTIVE ENFORCEMENT CLEARS THE AIR


For the Clinical Center, it was a collective New 

Year’s Resolution—a renewed commitment to a 

smoke-free Clinical Center. 

“Our patients, staff and visitors want and deserve 

this,” said Dr. John I. Gallin, CC director, in 

announcing an initiative to eliminate smoking in 

and around building 10 on Jan. 2, 2007, through 

proactive enforcement of no-smoking policies. 

“The work conducted here is dedicated to 

improving the health of the nation, but I receive 

numerous complaints from individuals exposed 

Smoking is not permitted inside any NIH building.At the Clinical Center, it’s also prohibited 

within 100 feet of any entrance and anywhere 

between the north entrance of the Hatfield Center 

and Center Drive, including the stairways to the 

Children’s Inn. 

New signs help ensure that no-smoking areas 

are clearly identified. Red house-shaped posters 

throughout the CC serve as reminders. 

A CC-hired security guard monitors the outside 

no-smoking areas and—when appropriate— 

to second-hand smoke, especially at hospital offers information about smoking cessation. 

entrances.This is a problem we can fix The NIH police continue to monitor 

together.” inside areas, including underground 

garages and stairwells. 

NEW ST ANDARDS GUIDE P A TIENT CARE 

The Medical Executive Committee (MEC) has referring physicians. Dr. Richard Cannon, 

issued Standards for Patient Care at the NIH National Heart, Lung, and Blood Institute 

Clinical Center to address essential principles clinical director and former MEC chair, coorand processes concerning the clinical care of dinated the preparation of the standards.The 

the volunteers who participate in clinical standards are online, along with Guidelines for 

research here and to foster commitment to the Conduct of Research in the Intramural Research 

excellence in patient care.The standards offer Program at NIH and A Guide to Training and 

guidance on objective measurement of medical Mentoring in the Intramural Research Program at 

staff competence, preadmission planning, mul- NIH, http://www.cc.nih. gov/ccc/patientcare/ 

tidisciplinary patient care, and the importance summary.shtml. 

of clear and timely communication with 

6 • ANNUAL REPORT 2008 
CC food service worker Andre Russell delivers a 

tray including several items on the new menu (at left), 

including a tortilla-crusted tilapia with chipotle and 

lime, brown rice, steamed vegetable blend, spinach 

salad, and a seasonal fruit plate. 

PHYSICAL ENVIRONMENT 

IMPROVEMENTS 

Enchanced oversight. A new position created 

in the NIH Office of Research Facilities—chief 

of the hospital physical environment—will bring 

greater responsiveness and flexibility in ensuring 

that the hospital space meets life-safety requirements set by the Joint Commission.This new 

position, which also focuses on building-related 

construction and maintenance, will report to 

both the director of the Clinical Center and to 

the director of NIH research facilities. 

Atrium project. Glass partitions and stainless 

steel mesh now surround the Hatfield building’s 

atrium on all levels.The architects who designed 

the building worked with CC staff and stakeholders to design the alteration, which was 

added as a safety precaution.The final result 

allows critical air flow and preserves transparency 

throughout the atrium’s dramatic open spaces. 

Clinic work. Renovations and realignments of 

the outpatient clinics moved forward in 2007. 

First to undergo transformation, which includes 

increasing the number of exam and patient 

consultation rooms, was outpatient clinic 11. 

The former surgical intensive care unit, 2J, has 

been refurbished to serve as clinic space as areas 

are shut down to accommodate the work.Also 

scheduled for renovations are outpatient clinics 

1, 5, 12, and 13. Remaining clinics (3, 4, 7, 8, 9, 

and 10) will be spruced up with new paint, 

flooring and ceilings, along with new furniture 

for the waiting rooms. 

NUTRITION DEP ARTMENT UPGRADES 

P A TIENT MENUS, ROOM SERVICE 

ORDERING SYSTEM 

Clinical Center patients had 60 more food items to choose from when the 

Nutrition Department introduced its revised standard room service dining 

menu in June.The new selections offer more vegetarian and whole grain 

items.The menus also upgrade the quality of several foods, including soups 

and cheeses; expand selections of herbal teas and baked potato toppings; and 

list flavors available for ice cream, popsicles, and gelatin.This is the second 

major redesign of the room service menu system since 2002. 

The project involved a great deal of behind-the-scenes work, such as tasting 

items, comparing ingredients and cost, coding each offering according to 

compliance with different diets, and training cooks and call center technicians. 

David Folio, chief of the Nutrition Department, said ideas for the new menu 

were gathered from a variety of sources, including patient surveys, meal 

rounds by department staff, and feedback by the Patient Advisory Group 

and clinical dietitians. Incoming patients find the new standard menu on tray 

tables in their rooms.The Housekeeping and Fabric Care Department places 

a menu when a room is cleaned after a patient is discharged. 

The department redesigned its 30 specialized printed menus to make them 

physically larger with a larger type size and a more spacious layout.The CC 

offers more than 160 different diets. Nutrition’s computer system coordinates 

them and makes the room service program possible. 

NIH CLINIC AL CENTER • 7 
•

•

0-99 

HOME ST A TES OF ALL ACTIVE CLINICAL CENTER P A TIENTS 


WA 

605 MT 

116 

ID 

152 WY 

51 

OR 

350 

CA 

2388 

NV 

158 UT 

431 

CO 

523 

AZ 

482 

NM 

210 

AK 

83 

TX 

1599 

OK 

308 

KS 

318 

NE 

175 

SD 

53 

ND 

57 

IA 

265 

MO 

567 

AR 

184 

LA 

469 

IL 

1075 

WI 

634 

MN 

541 

MI 

1190 

IN 

677 

OH 

1375 

MS 

230 

AL 

364 GA 

1123 

SC 

652 

NC 

1412 

TN 

632 

KY 

474 

FL 

2562 

VA 

12492 

WV 

773 

PA 

3345 

NY 

2974 

ME 

192 

100-499 

500-1,999 

2,000-9,999 

10,000 + 

HI 

87 

VT 125 

NH 172 

MA 1031 

RI 103 

CT 605 

NJ 1774 

DE 386 

MD 28438 

DC 6389 

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. 

WORKFORCE DISTRIBUTION 

Nursing & patient care/support 

services 41% 

Administrative & operations 19% 

Clinical departments & 

imaging sciences 

departments 40% 

The Clinical Center has a staff of 

approximately 2,000. 

• 

• 

FY2007 BUDGET BY MAJOR CATEGORY 

$344.8 million 

Salaries and benefits 51%


NIH assessments 5%


Drugs 12% 


Contracts (labor) 6%


Contracts (non-labor) 11%


Equipment 4%


Supplies 7%
 • All other 4%


(Includes travel, training, rentals, 


and printing.)


• 

• 

• 

• 

• 

• 

8 • ANNUAL REPORT 2008 
Admissions 

New patients 

Inpatient days 

Average length 

of stay (days) 

Outpatient 

visits 

Active 

Protocols 

New Protocols 

Principal 

Investigators 

P A TIENT ACTIVITY 

05 

06 

07 

6,619 

05 

06 

07 

9,263 

9,435 

6,096 

5,825 

9,711 

05 

06 

07 

57,718 

51,575 

51,189 

05 

06 

07 

8.8 

8.3 

8.6 

05 

06 

07 

105,004 

95,151 

90,889 

4.7% decrease 

7.9% decrease 

4.4% decrease 

9.5% decrease 

4.6% decrease 

1.9% increase 

0.1% decrease 

10.6% decrease 

0.7% decrease 

3.5% increase 

5.7% decrease 

3.7% increase 

2.8% decrease 

9.4% decrease 

4.5% decrease 

CLINICAL ACTIVITY FOR FY 2001–2007 

01 

02 

03 

04 

05 

06 

07 1.390 

1,122 

1,165 

1,239 

1,329 

1,357 

1,372 

01 

02 

03 

04 

05 

06 

07 

01 

02 

03 

04 

05 

06 

07 

417 

437 

450 

474 

487 

505 

484 

250 

305 

306 

288 

245 

251 

227 

NIH CLINIC AL CENTER • 9 
•

•

•

•

•

Advancing Clinical Research 

PROTOCOLS BY RESEARCH TYPE 

(onsite intramural protocols, fiscal year 2007) 

• 

• 

• 

• 

• 

• 

Total active protocols: 1,390 

Clinical trials: 605 (43%)


Training: 31 (2%)


Sample data analysis 39 (3%)


Screening: 68 (5%) 


Natural history (disease pathogenesis): 642 (46%)


(Five protocols are pharmaco-dynamics/kinetics studies.) 

Breakdown of clinical trials 

Total clinical trials: 605 

Phase 0: 6 (>1%) 

Phase I: 204 (34%) 

Phase I-2: 15 (2%) 

Phase 2: 323 (53%) 

Phase 3: 38 (6%) 

Phase 4 19 (3%) 

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. 

10 • ANNUAL REPORT 2008 
IMAGING 

IMPROVEMENTS 

Installation of three new MRIs in Diagnostic 

Radiology in early May signaled a major milestone 

in a multi-year project to enhance the department’s 

physical space and technological capability. 

Clustering the MRIs on the first floor of the 

Magnuson building will centralize MRI clinical 

research in one section, facilitating sharing of tools 

and exchange of information.This clustering helps 

limit the need for costly new steel shielding, extra 

structural fortification, and potential displacement 

of other functioning units. It also will be easier to 

replace equipment in future upgrades. 

These MRIs—weighing 10,000 pounds each— 

arrived in an elaborate logistical ballet involving a 

team of more than 20 from NIH and the manufacturer. Special permits and road closures were 

required for travel to campus. Once here, the eightfoot-tall MRIs were painstakingly maneuvered 

and rotated through the CC’s seven-foot-tall doors 

and ceilings, requiring even temporary relocations 

of walls. 

The children’s playground and ground-level glass 

door passageway on the west side of the Hatfield 

building were closed for a few days in late 

September during the preparation for and delivery 

of a new PET trace cyclotron to the Clinical 

Center. At 28 tons, the new computer-controlled 

cyclotron weighs about half as much as the manually operated one it replaced. It is identical to a 

machine installed in 2002 and complements the 

remaining large CS-30 cyclotron installed in 1985. 

Staff conducted soil compression tests to ensure 

that the soil between the playground and the 

CC could support the weight of the crane and 

the trucks that would move the machines.The 

new cyclotron arrived on three tractor trailers. 

A 300-ton crane lifted out the old cyclotron and 

lowered in the new one. 

NIH CLINIC AL CENTER • 11 
2007 BENCH-TO-BEDSIDE A W ARDS 

The NIH Clinical Center created the Bench-to-Bedside awards program in 1999 to speed translation of promising 

laboratory discoveries into new medical treatments by encouraging collaborations among basic scientists and clinical 

investigators. The program has been open to research teams made up of intramural and extramural partners for two 

years and in 2007 a comprehensive review of the program was completed. 

RARE DISEASES 

Teams 

NHLBI, 

CC, INOVA Fairfax Hospital 

NICHD, 

University of Oxford (UK) 

NHLBI, CC, 

University of Maryland 

NIAID, Uniformed Services University of the 


Health Sciences, NCI, NHGRI, CC, 


University of California, San Francisco


NICHD, NEI, NIDCR, NIMH, NIDDK, 


Georgetown University Medical Center, 


Uniformed Services University of the Health Sciences


NHLBI, NCI, 

University of Virginia 

NINDS, 

University of Pennsylvania 

NINDS, NIDDK 

NICHD, 

Cleveland Clinic Genomic Medicine Institute 

GENERAL CATEGORY 

Teams 

NCI, Hackensack University Medical Center 

AIDS 

Teams 

NIAID, CC, University of Toronto, 

George Washington University 

NIDCR, CC 

NIAID, CC, 

Massachusetts General Hospital 

NIAID, University of Washington 

MINORITY HEALTH & HEALTH DISPARITIES CATEGORY 

Teams 

NIDDK, UCLA 

NHLBI, Johns Hopkins University 

NIDDK, NHLBI, Harvard School of Public Health 

NHLBI, CC 

WOMEN’S HEALTH CATEGORY 

Teams 

NCI, Gynecologic Oncology Group, University of Miami, 

University of Oklahoma 

Project 

•	 Antiproliferative Therapy for Severe Pulmonary Arterial Hypertension 

•	 Characterization of Glycosphingolipid Accumulation in Smith-Lemli-Opitz Syndrome and 

Treatment with N-butyldsoxynojirimycin 

•	 Life-Threatening Pulmonary Complications of Organ Transplantation:An Investigation of 

the Pathogenesis of Bronchiolitis Obliterans and Its Novel Treatment with Aerosolized 

Liposomal Cyclosporine A 

•	 Role of Pathogen-specific IgE and histamine release in the hyper-IgE syndrome 

•	 WAGR Syndrome: Clinical Characterization and Correlation with Genotype 

•	 Sensitivity and resistance to Rituximab therapy in SLL/CLL: the role of antigenic 

modulation, immune effector mechanisms and direct pro-apoptotic signaling 

•	 Quantification of urinary oxidized lipids, 8-hydroxyguanine, and 8-hydroxy-2’­

deoxyguanosine in Friedreich ataxia patients undergoing idebenone treatment in a 

phase II double-blind placebo-controlled study 

•	 Translational Studies of Hereditary Spastic Paraplegias types SPG4 and SPG20 

•	 Genetics of inherited paragangliomas and gastric stromal tumors associated with 

adrenal and other tumors 

Project 

•	 Dynamic Measurement and modeling of Immune Homeostasis and Reconstitution in 

Pre-clinical and Clinical Studies of Cytokine Therapy and Allogeneic Hematopoietic 

Stem Cell Transplantation (AHSCT). 

Project 

•	 Intensification of Antiretroviral Therapy Using HIV Integrase Inhibitor (MK-0518) to 

Assess Decay of Viral Reservoirs in Peripheral Blood and Gut-Associated Lymphoid 

Tissue of Chronically Infected Patients 

•	 Humoral Response Profiling of Viral and Cellular Tumor Antigens for Predicting, 

Diagnosing, and Monitoring HIV Malignancies 

•	 1H Magnetic Resonance Spectroscopy for Quantification of Hepatic Triglyceride Content: 

Validation and Application in HIV-infected Patients 

•	 Development of Immunotoxins against Kaposi’s Sarcoma Associated Herpesvirus for 

Treatment of Multicentric Castleman’s Disease (MCD) 

Project 

•	 Effects of Beta Cell Rest in Young Individuals with Type 2 Diabetes and in 

Relevant Animal Model 

•	 Identification of Predictive Biomarkers of Asthma Exacerbations in Exhaled Breath 

Condensates from High Risk Patients 

•	 Ethnic Differences in Triglyceride Levels and Vascular Disease:A Study of Premenopausal 

African American and Caucasian Women 

•	 Contribution of Stromal Free Hemoglobin, Red Cell Membranes, and Red Cell Lysate on 

Nitric Oxide Inactivation in the Chronic Hemolytic State 

Project 

•	 Targeting HPV E2 as a vaccine against HPV mediated CIN1 and CIN2 

12 • ANNUAL REPORT 2008 
NEW UNIT OPENS 


At the opening ceremony were 

(left to right) National Institute 

of Diabetes and Digestive and 

Kidney Diseases Director Dr. Griffin 

Rodgers; CC Director Dr. John I. 

Gallin; NIDDK Scientific Director 

Dr. Marvin Gershengorn; Dr. Monica 

Skarulis, director of NIDDK’s 

metabolic research core; NIH 

Deputy Director for Intramural 

Research Dr. Michael Gottesman; 

and NIH Director Dr. Elias 

Zerhouni. 

including a treadmill and stationary upright 

and recumbent bikes, allows researchers to 

conduct stress and pulmonary function tests 

to observe the effects of exercise on weight 

loss.Three “Rapid Response Respiratory 

Suites,” located on the seventh floor, allow 

researchers to measure volunteer’s energy 

metabolism over 24 hours using non-invasive 

means and compare comprehensive physiological measurements. By analyzing air composition in the suite, researchers will be able 

to determine how much energy on a minuteto-minute basis a volunteer burns while 

sleeping, eating, or exercising, and whether 

the energy comes from carbohydrate, protein, 

or fat.The metabolic suites also feature custom-designed vacuum-sealed portholes, or 

“isolette systems,” through which measured 

food and other items can be passed and blood 

samples taken without disrupting physiological 

measurements. 

The new NIH Metabolic Clinical Research 

Unit, which houses specialized, state-of-theart facilities for comprehensive research on 

factors driving obesity, opened with a ribboncutting ceremony in January 2007.The unit’s 

fifth floor facility includes ten private inpatient rooms, a metabolic kitchen, an exercise 

room, specialized vending machines, and a 

communal dining area.The design of each 

inpatient room on the unit took into account 

the needs of the patient volunteers, with 

specially reinforced construction, amenities, 

and equipment.The metabolic kitchen allows 

dietitians to precisely control and analyze the 

composition of patient meals to calculate the 

exact nutrients consumed. 

Exercise testing equipment, physical activity 

monitors, and body composition measurement tools are key resources for clinical 

research protocols.The fitness equipment, 

Vaccine research capability 

As part of an ongoing collaboration with the Vaccine Research Center, National Institute 

of Allergy and Infectious Diseases, design and construction began in 2007 on a new outpatient vaccine facility.Also in 2007, work began on a special inpatient clinical studies unit. 

When completed, the components will house the Vaccine Research Center’s clinical 

vaccine testing clinic within the CC and be available to other NIH clinical programs 

involving testing of novel vaccine candidates.The facility also will provide additional 

capability for containment of infectious diseases. 

NIH CLINIC AL CENTER • 13 
RESEARCH SPOTLIGHTS 

Primary investigator Dr. Leslie Biesecker (left) and Flavia Facio, genetic counselor and lead associate investigator, meet with patient volunteer Alan Freeman, who is participating in the ClinSeq clinical trial. 

Human genome sequencing study enrolls 

first patient at CC 

Alan Freeman, a 48-year-old electric utility 

company employee from Silver Spring, in early 

2007 became the first of 1,000 participants to 

enroll in a study led by the National Human 

Genome Research Institute to test the use of 

human genome sequencing in a clinical research 

setting.The investigation—dubbed the ClinSeq 

study—uses high-throughput DNA sequencing to 

determine whether tiny changes in selected genes 

may indicate predisposition to or onset of common diseases. Initially, the study will focus on the 

200 to 400 genes connected to coronary heart disease and will follow participants for as many as 10 

years. 

“My family has lost some to heart attacks,” 

Freeman said, noting that he was told about the 

study by his cardiologist, whom he was seeing for 

a heart checkup prompted by some undiagnosed 

chest pains. Study goals include detecting genetic 

changes that increase the risk for cardiovascular 

disease, developing the process by which genomic 

sequencing can be used as part of medical care, and 

assessing whether participants want to learn genetic 

information and how they respond to this information. 

The study also explores the use of large-scale 

genome sequencing, a tool once reserved for basic 

bench research, as a potential test that clinical 

researchers can use with their patients. Participants 

also receive education about understanding and 

interpreting genotype information.Although 

the researchers will monitor some indicators of 

participant’s interest in genetic test data and their 

responses to those data, the study primarily focuses 

on clinical research application of sequencing technology—not behavior. 

Dr. Leslie Biesecker, chief of the genetic disease 

research branch at NHGRI, conducts the ClinSeq 

study with a team of NIH researchers.“ClinSeq is 

the first study in which results from high-throughput sequencing will be communicated back to 

individual patients,” he said. Collaborators include 

researchers from the CC, National Heart, Lung, 

and Blood Institute, the National Institute of 

Biomedical Imaging and Bioengineering, and 

the NIH Intramural Sequencing Center. 

Alan Remaley, an investigator in the CC 

Department of Laboratory Medicine who helped 

draft the gene list and design the study, is assisting 

with the study in two ways: performing the standard lab tests for coronary heart disease and conducting new serum tests for proposed coronary 

heart disease markers that will be banked for future 

studies.“This will probably be the most comprehensive study to sequence genes involving a complete DNA-sequencing approach for cardiovascular 

disease risk,” Remaley said. 

The study’s first participant shares the researchers’ 

curiosity and excitement.“I am by nature curious. 

I have been following human genome research 

because of my coronary problems and heart,” 

Freeman said.“Just the fact that they can look at a 

gene and perhaps even treat you before a problem 

occurs—just the fact they are headed that way— 

fascinates me.” 

14 • ANNUAL REPORT 2008 
Virtual environment lab opens at the CC 

The National Human Genome Research 

Institute’s Immersive Virtual Environment Testing 

Area, located near the Occupational Medical 

Service’s sixth floor clinic, opened in June to 

conduct the first of many social and behavioral 

research studies at the Clinical Center. 

The concept of using virtual reality technology 

in research and health care is not new. But the 

research lab is the first facility to combine the 

two and ask questions about how to promote 

health, prevent disease, and improve health care, 

according to NHGRI staff. 

Social and Behavioral Research Branch investigator Dr.Kim Kaphingst’s protocol,“Using Virtual 

Reality to Test Communication Strategies for 

Genomic Concepts,” will be the first study to 

use the new lab. 

Study participants will be healthy adult volunteers 

without specialized genetics knowledge so that 

the study can see how the general public learns 

best about the topic. Each participant will answer 

an initial questionnaire, complete one 15-minute 

activity in the virtual arena, and then complete a 

test of how they remember the content that was 

presented or apply that material to new situations. 

To preserve the integrity of the study, the investigators can’t reveal the topics of the virtual reality 

environments, except to say that they deal 

with genetics. Participants will see the virtual 

environment through a headpiece and use 

a handheld pointer, which functions as an 

extension of the hand, to make selections in the 

computer-generated scenarios. An investigator 

in the room with the participant sees the images 

in the headpiece on a computer screen. 

NHGRI plans future studies exploring how to 

teach genomic concepts, the understanding of 

disease risk, influences on physician-patient interactions in clinical environments, and the potential 

role of genetic information in improving clinical 

outcomes for people with stigmatized diseases, 

such as obesity. 

NHGRI Social and Behavioral 

Research Branch staff scientist 

Dr. Susan Persky observes NHGRI 

scientific director Dr. Eric Green 

interacting in a virtual environment 

through a headpiece displaying 

computer-generated 3-D images 

and a handheld pointer. 

NIH CLINIC AL CENTER • 15 
CC neuroradiologist and lead 

study author Dr. John Butman. 

CC imaging study focuses on von 

Hippel-Lindau patients’ hearing 

The results of an imaging study conducted at the 

Clinical Center could help doctors protect and 

preserve the hearing of people with the rare 

genetic disorder von Hippel-Lindau disease (VHL). 

VHL causes the abnormal growth of benign and 

cancerous tumors in numerous parts of the body. 

This imaging study focused on endolymphatic sac 

tumors (ELSTs).The connection between ELSTs 

and hearing loss has been a curiosity because the 

endolympatic sac is on the temporal bone that 

contains the ear but is not part of the inner ear 

associated with hearing. Some cases of hearing loss 

in VHL can be attributed to large tumors on the 

sac that invade the hearing apparatus. But CC 

neuroradiologist and lead study author Dr. John 

Butman noticed, and set out to explain, why some 

patients lost hearing when they had only a very 

small tumor outside the sensory part of the ear. 

He says he could see blood flowing from the 

endolymphatic sac into the inner ear in about half 

of the small tumors he imaged. Researchers then 

talked to patients to correlate the images with their 

symptoms.“It turned out virtually all patients who 

had evidence of bleeding had a sudden hearing 

loss,” Butman explains.“For example, they were 

talking on the phone and suddenly their hearing 

went out, which is characteristic of a hemorrhage.” 

Other patients with small tumors experienced 

gradual hearing loss, but no bleeding. Butman says 

in those cases the ELST was disrupting the flow of 

fluids in the inner ear and causing and condition 

known as endolymphatic hydrops, which creates 

pressure, ringing in the ears, vertigo, and gradual 

hearing loss. 

NINDS neurosurgeon Dr. Russell Lonser, senior 

author on the study, says the findings prompted 

a change in thinking about how to manage these 

tumors. Previous practice was a wait-and-see 

approach. Given that the tumors were benign, 

slow-growing,and their natural history was unknown, 

doctors monitored their growth and did not 

remove them until they became big enough to 

threaten hearing. 

“It was believed these tumors probably would be 

best observed,” Lonser says,“Now we believe they 

probably should be operated on very early on, as 

soon they are identified on imaging.” Butman used 

CT imaging to study the bone and MR technology 

for the soft tissue and inner ear. He studied the 

inner ear with an imaging technique that is typically 

used for the brain to detect some of the cases of 

hemorrhage. 

“Part of radiology is solving puzzles,” Butman says. 

“Being able to figure out most of the story from 

imaging findings alone is very satisfying.Then having the clinical findings correlate so well with the 

imaging gives a sense of the solution to the puzzle. 

The fact that this has affected the thinking on how 

to manage patients is very nice.” 

16 • ANNUAL REPORT 2008 
Dr. Barbara Bryant gives 

Maureen McDonnell her pack of 

iron supplements when she 

comes to donate. 

Iron-deficient NIH blood bank donors 

receive something extra 

Some donors at the NIH blood bank are 

getting something extra at the end of their 

visit—a packet of oral iron supplements as 

part of a novel protocol. 

Clinical Center researchers are giving iron 

supplements to donors with low iron and low 

hemoglobin levels. Researchers want to know if 

this could help treat and prevent iron deficiency 

in people who donate regularly or would like to 

donate regularly. 

Dr. Barbara Bryant, a clinical fellow in the 

CC Department of Transfusion Medicine, is 

the principal investigator of the study known as 

IRON, which stands for Iron Replacement or 

Not. She says the NIH blood bank may be the 

only blood bank doing a large-scale study on 

iron replacement for donors. 

“If we prove that iron replacement for donors 

can be done safely and efficiently in blood 

banks, it has the potential to increase the blood 

supply by decreasing the number of donors who 

are deferred,” explains Bryant. 

When people donate blood, they lose about 

one-quarter of the storage iron in their body. 

Some people rebuild their iron stores quickly, 

through diet, and are ready to donate again in 

about two months. But other people do not 

rebound as quickly. If people are iron depleted 

or deficient, it will show up during the donation 

screening process, when a fingerstick blood test 

is done to measure hemoglobin levels. People 

who do not meet the required hemoglobin level 

for giving blood are temporarily deferred from 

donating—sent home and told to come back 

and try again in a month or two. 

At the NIH blood bank, people who do not 

pass hemoglobin screening are invited to talk 

with Bryant and colleagues about participating 

in her study. But before passing out iron pills, 

Bryant does an extensive screening questionnaire 

and more blood work to make sure there is no 

serious underlying problem causing the low 

hemoglobin levels. If nothing abnormal is found, 

people are then asked to be part of her protocol. 

Participants take supplements for 60 days, return 

for follow-up, and if they pass their hemoglobin 

screening, they are allowed to donate. 

Maureen McDonnell, a management analyst in 

the CC Office of Organizational Development, 

says she had low hemoglobin during her three 

pregnancies so she was not surprised by her 

fingerstick test result at the NIH blood bank. 

She now is taking iron supplements as part of 

the study and says she is experiencing the benefits of the boost in iron.“I don’t feel as tired 

mid-day. I am much more energetic.And, I’ve 

been able to donate again, so that feels good too.” 

Both men and women can become iron depleted 

or deficient. But Bryant says the problem is 

more common in women, particularly those 

who are pre-menopausal. 

“I like studying blood,” Bryant says of her career 

in blood banking, first as a technologist and now 

a clinician. She says having a good supply of 

blood is a huge challenge and deferring donors 

is frustrating to donors and blood centers. 

“The practice of giving iron replacement to 

donors is probably a good thing,” Bryant says. 

“The blood banking community has acknowledged it, but nobody has had the resources 

to do this study.That’s where we came in. 

This is a fabulous opportunity here at the NIH.” 

NIH CLINIC AL CENTER • 17 
Hutchinson’s cake reads 

“Happy 30th to Mr. H. and 

his virus.” With him are 

(back row, from left) Dr. Barbara 

Rehermann, NIDDK; Dr. Harvey 

Alter, CC; Dr. T. Jake Liang, 

NIDDK; Dr. Robert Purcell, 

NIAID; Dr. Patrizia Farci, NIAID; 

and Dr. Susan Leitman, CC. 

In front are Kimiyo and 

William Hutchinson and 

Cathy Schechterly, CC. 

Trailblazer marks 30 years as a hepatitis 

clinical research participant 

July 25, 2007, was a milestone for William 

Hutchinson. It was about 30 years ago that he 

contracted hepatitis, beginning a unique clinical 

research relationship with scientists around the 

globe. 

As result, he has contributed more than any other 

patient in the world to NIH researchers’ understanding of the hepatitis C virus.Although 

Hutchinson has attended lectures at NIH where 

researchers with a technical interest in his blood 

convened, this was the first time that he met the 

researchers who had pored over his cells. 

Hutchinson, now 90, thinks it was his career of 

international travel and diplomacy that prepared 

him for these past three decades of his life and the 

resulting renown among medical researchers across 

the globe. Before he retired in 1973, Hutchinson 

served as a public affairs officer for the U.S. government in countless countries. He estimates that 

he spent time in about 25 African countries, where 

he’d encounter indigenous infectious disease strains 

with every river and valley he crossed. 

Unbeknownst to him, Hutchinson’s immune system grew stronger and developed antibodies as he 

traveled the globe.“It did a remarkable job on my 

immune system to live in so many different 

places,” Hutchinson said. 

An avid hiker and mountain climber, Hutchinson 

first came to the NIH Clinical Center in April 

1977 when he had a heart attack on a trail in New 

Hampshire. He received 18 units of blood following his open heart surgery, and one of them was 

contaminated with what is now called hepatitis C, 

then known only as non-A/non-B hepatitis.There 

was no way to screen the blood supply for hepatitis 

at that time, because no screening test existed. 

Although the virus remains in his bloodstream, 

Hutchinson has no symptoms related to the infection, and liver biopsies have shown that he has had 

no disease progression in 30 years. Hutchinson’s 

immune system has contained the virus, but not 

eradicated it. Investigators continue to study this 

balance between virus and host. 

Dr. Harvey Alter, chief of the CC Department of 

Transfusion Medicine’s infectious disease section, 

said Hutchinson was the right patient at the right 

time in the right place.“Because he was being followed in an NIH protocol, we detected the onset 

of hepatitis very early in its course and obtained a 

plasma sample just when, as we later found, his 

virus was growing rapidly and was in its most 

infectious state,”Alter said.Working closely with 

the lab of Dr. Robert Purcell in the National 

18 • ANNUAL REPORT 2008 
Institute of Allergy and Infectious Diseases 

(NIAID),Alter divided the plasma into vials to 

determine the titer of the virus, estimate its size and 

density, show that it had a lipid envelope and physically characterize the virus even before researchers 

knew what it was. NIAID’s Dr. Patrizia Farci 

cloned the Hutchinson (H) strain virus and 

demonstrated that his viral agent contained a large 

family of closely related viral variants, rather than a 

single agent, so that antibodies to the virus would 

not be able to contain all the variants present in his 

blood. Because of this unique characteristic of the 

H strain virus, it became the standard challenge 

dose for most subsequent studies of prototype 

hepatitis C vaccines and has been used to develop 

tissue culture models.“All this was possible because 

of Hutchinson’s interest in science and his willingness to provide blood samples and to allow investigators to distribute them to laboratories throughout 

the world. Hutchinson’s name is known throughout the global hepatitis community and we are all 

indebted to him,”Alter said. 

Hutchinson says he’s pleased that his blood could 

be useful, even if his involvement with clinical 

research was mostly an accident.“If my blood saves 

even one life, that’s good. If it saves more, so much 

the better.” 

The NIH researchers who gathered to meet 

Hutchinson assured him of how much they, and 

other hepatitis patients, have learned from him. 

Alter told Hutchinson that researchers are working 

with purified antibodies isolated from his blood to 

measure their ability to neutralize the virus and to 

see if these antibodies could be useful as a prototype therapeutic agent.The group presented 

Hutchinson with a framed aerial photo of NIH for 

his 30 years of participation in clinical research, as 

well as a letter that they all signed expressing their 

deep gratitude for “his selfless and unwavering willingness to be a research subject. His efforts have 

helped to diminish the risks and chronic consequences of this highly prevalent infection and to 

vastly improve the safety of the blood supply.” 

Dr. Alter received a 2000 Lasker Award for clinical medical 

research, an award he shares with Dr. Michael Houghton, 

a scientist with the Chiron Corporation. It recognizes Dr.Alter’s 

ongoing studies to uncover the causes and reduce the risks of 

transfusion-associated hepatitis and Dr. Houghton’s continuing work 

in molecular biology to isolate the virus, hepatitis C.Thirty years ago, 

Dr.Alter spearheaded a project at the NIH Clinical Center that 

created a storehouse of blood samples used to uncover the causes and 

reduce the risk of transfusion-associated hepatitis. Before this, about a 

third of transfused people received tainted blood, which later inflamed 

their livers, producing a condition known as hepatitis. Because of 

Dr.Alter’s work, the U.S. instituted blood and donor screening programs 

that have served to increase the safety of the nation’s blood supply. 

Presidential visit 

President George W. Bush visited the Clinical Center on Jan. 17.While here 

he met with staff and patients, including Dale Miller of Montana. During 

the visit, Bush’s fifth to NIH, he said,“I love coming to the NIH. It is an 

amazing place because it is full of decent, caring, smart people, all aiming to 

save lives.And I truly believe the NIH is one of America’s greatest assets. 

And it needs to be nourished.” (White House photo by Eric Draper) 

NIH CLINIC AL CENTER • 19 
ADV ANCING INFORMA TION TECHNOLOGY


Tim Maloney and Susan 

Houston, Department 

of Clinical Research 

Informatics, stand behind 

a palette stacked with 128 

disk drives from MIS. 

MIS has left the building 

The Clinical Center surplused the Medical 

Information System (MIS) mainframe in 

September. It had served the hospital since June 

1976.The CC was the nation’s fifth hospital to 

install the system and the first to configure and 

enhance it to support protocol-based clinical 

research. MIS allowed physician order entry, 

result reporting, medication administration, and 

nursing documentation long before others began 

using electronic medical records—and provided 

access to patient data at rates difficult to match 

even after 30 years. 

CRIS, the Clinical Research Information 

System, replaced most of MIS in 2005, but MIS 

continued to be used for patient registration and 

for managing admission, discharge, and transfers 

until late in 2007. 

Dr. Jon McKeeby, CC CIO, marked the historic 

transition by lauding the enduring efforts of 

Dr.Thomas Lewis—the “heart and soul of MIS” 

since the beginning. Lewis, former associate 

director of information systems and currently 

a consultant to the Department of Clinical 

Research Informatics, led the original MIS 

selection and implementation team. 

“As you might imagine,” said Lewis,“the step 

from a billing-oriented, community hospital to 

the complex research-oriented CC environment 

was large and with significant risk.” It was a 

risk work taking. Lewis credits staff involved in 

clinical programs—even for brief periods— 

during MIS’s lifespan who “worked hard to use, 

contribute to, critique, explore, and expand the 

use and advancement of information technology 

for better patient care and clinical research.This 

is a group of literally thousands of individuals, 

many of whom may not even realize how much 

they contributed, to patients, the CC, the NIH, 

and beyond.” 

20 • ANNUAL REPORT 2008 
•

CRIS I enhanced, CRIS II envisioned 

Significant upgrades to the Clinical Research 

Information System in 2007 included the ability to use CRIS for physician progress notes, 

expanded capability for medical record documentation, and improvements to how clinical 

summaries can be viewed. Planning is under 

way for CRIS II, which will be a clinical 

research data repository comprising clinical 

and research information by patient, protocol 

or disease state.This resource will help identify 

promising new avenues for research and foster 

data sharing across institutes and with extramural collaborators.The Clinical Center created a new position to oversee CRIS II and, 

through a dual appointment with the National 

Library of Medicine, to guide development of 

an NIH intramural training program in medical informatics. 

Dr. James J. Cimino has been named chief 

of this new Laboratory for Informatics 

Development. He comes to NIH from 

Columbia University where he was as 

professor of bioinformatics and medicine. 

(For more, Go to: page 34) 

Clinical research & NIH on the web 

The Clinical Center introduced a new Web site 

in 2007 that offers a broad overview of clinical 

research for the public. It includes options for 

participating, questions to ask if considering 

joining a trial, ethical issues to explore, and how 

to find out details on trials conducted at the 

Clinical Center and around the country. 

Go to: http://clinicalresearch.nih.gov. 

©Alan Kar

NIH CLINIC AL CENTER 21

chmer 
Joyce Bohn, who came from 

a family of 10 children and 

couldn’t afford college, was 

one of several in the group 

who received a year of tuition 

at American University in 

exchange for her services as 

a healthy control subject. 

Bohn bonded so closely with 

her roommate, an osteoporosis 

patient, that she loaned Bohn 

all of her university expenses 

without interest so she could 

continue her studies and the 

two friends would not be 

separated. “My life changed 

tremendously because of NIH,” 

Bohn said, wiping away her 

tears. 

MENNONITE, BRETHREN 

HEAL THY VOLUNTEER 

GROUPS REUNITE 

Eating only lima beans. Sleeping with weights 

on your eyes. Drinking a mixture of corn oil 

and skim milk. It might seem strange now, but 

these were some of the diets that a group of 

Mennonites and Church of the Brethren members who served as healthy volunteers consumed 

while participating in clinical research studies at 

the Clinical Center from 1954 to 1975.About 

25 volunteers, together with their family members, reunited here on Sept. 8, 2007, and traced 

how their contributions decades ago changed 

the course of clinical research for the better. 

The reunion, spearheaded by Dr. Jim Conrad, 

a member of the Mennonite Church from 

Perkasie, Pa., provided an opportunity for the 

group to reflect on their experiences as “creatures made in the image of God need to express 

God’s love by how we live our lives.” For these 

faith communities, service to those who are 

ill provides a powerful metaphor for assisting 

brothers and sisters in need by choosing “another way of living.” Both groups are recognized 

peace churches affiliated with the National 

Service Board for Religious Objectors, now 

the Center on Conscience & War. 

One of the volunteers recounted how his mother 

often said to him,“Someday you’ll serve your 

country in the Brethren Volunteer Service (BVS) 

instead of the military.” Local draft boards 

accepted boys’ participation in public service 

projects in lieu of military service. Girls from 

both churches generally contributed one or 

two years to youth service activities, such as 

medical or social work. 

CC Director Dr. John I. Gallin noted that like 

many of the researchers in his generation who 

joined the U.S. Public Health Service, healthy 

Mennonite and Brethren volunteers also share a 

commitment to “save life and not destroy it,” to 

quote former president Franklin D. Roosevelt’s 

1940 NIH dedication speech.Although many 

came to the Public Health Service during the 

Vietnam War from 1959 to 1975, the Mennonite 

and Brethren volunteers came to NIH as early 

as the Korean War in 1954. 

Mandy Jawara from the CC Office of 

Communications, Patient Recruitment & Public 

Liaison updated the group on the Clinical 

Research Volunteer Program, which began in 

1954 as a collaboration between NIH and the 

Mennonite and Brethren church’s service agencies, which in turn formed their own volunteer 

services. Until 2006, 50 to 100 students a year 

came to live at the CC while participating in 

clinical research and earning academic credit for 

their service. Jawara, who coordinates the program, said that although it has changed—healthy 

volunteer students no longer live on the patient 

care units—its mission of providing assistance to 

NIH investigators whose research involves 

healthy volunteers remains the same. 

In his welcome to the group, Gallin described 

the numerous medical advances from CC history— 

none of which would have been possible without healthy volunteers’ participation as control 

subjects.“We will never be able to thank you 

appropriately. Your contributions to society have 

been enormous,” Gallin said. Dr.Allan Mirsky, 

National Institute of Mental Health, and Dr. 

Robert Shamburek, National Heart, Lung, and 

Blood Institute, detailed how the volunteers’ 

participation in mental and cardiac health 

research has affected medical knowledge. 

According to Mirsky, many volunteer control 

patients helped NIMH researchers to standardize 

tests of attention, in part by participating in a 

1956 study that has been cited in the literature 

more than 1,000 times and led to the development of the continuous performance test (CPT). 

22 • ANNUAL REPORT 2008 
Thanks to these volunteer control patients, 

NIMH researchers also compared psychological 

test performance in seizure disorder patients; 

described behavioral effects of the first effective 

anti-psychotic drugs used to treat schizophrenia; 

contrasted behavioral and physiological effects of 

anti-psychotic drugs and sedatives; contrasted 

effects of anti-psychotic drugs in healthy volunteers and patients; and described effects of stimulant drugs in healthy volunteers through sleep 

deprivation studies. Mirsky reminisced about 

coming to campus in the middle of the night to 

play billiards with a BVS volunteer who hadn’t 

slept for 70 hours.“She couldn’t do a CPT, but 

she could complete more challenging tests, 

including beating me at pool!” 

Many cardiovascular and lipid concepts now 

taken for granted were major new findings from 

protocols in the 1960s.The NHLBI investigators 

leading protocols involving these volunteer 

control patients reads like a who’s who list of 

leaders in the field of lipid research: 

• 	Drs. Michael Brown and Joseph Goldstein, 

who won the 1985 Nobel Prize for their 

work with cholesterol that led to the 

development of statins; 

• 	Eugene Braunwald, the first Heart Institute 

chief of cardiology, author of more than 

1,000 publications, and editor of the definitive 

text, Braunwald’s “Heart Disease;” 

• 	Frederic Bartter, discoverer of five different 

metabolic syndromes; and 

• 	Donald Fredrickson and Robert Levy, the 

first to describe the movement of HDL and 

LDL through the blood stream. 

The Amish and Mennonite populations have the 

highest percentage of a rare genetic disorder 

called sitosterolemia, in which plant cholesterol 

becomes extremely high because the body is 

unable to excrete it into the bile for removal 

from the body. By observing volunteers from 

these communities, researchers developed drugs 

to block cholesterol’s absorption in the intestines 

that are now used in millions of patients with 

ordinary cholesterol disorders. Marian Payne, a 

normal volunteer in 1956 who returned to the 

CC in the late 1990s as a sitosterolemia patient 

and participated in investigational treatments, 

said that if it wasn’t for NIH’s research, 

“I wouldn’t be here today or be in the health 

I enjoy today.” 

Shamburek also unearthed hundreds of historic 

documents to show the group, including media 

coverage from the time, much of which brought 

exclamations from his audience as several people 

present recognized themselves.After tours of the 

new Hatfield Building, the group reconvened to 

tell stories of their experiences and pore over 

photos and articles brought to share with the 

group.Their recollections shared a common 

theme: how much their life changed as a result 

of coming to the CC. Carson Good discovered 

the social work profession, which became his 

career path, during his time at the CC.Two 

couples in the group—Marilyn and Dave 

Verbeck and George and Judy Reimer— 

met at the CC and married shortly after their 

time here. 

The volunteers, all of whom were 18 years or 

older, many of them away from their rural community for the first time when they came to 

NIH, especially appreciated the exposure to 

diverse cultures in the Washington, DC, area that 

they enjoyed in their free time, such as attending 

Washington Senators baseball games, boating on 

the Potomac, or attending concerts and sporting 

events. One participant said,“The culture and 

social learning we received while at NIH 

molded our lives to this very day.” 

Reunion participants look at 

photos and newspaper clips 

documenting their experiences 

as research volunteers. 

NIH CLINIC AL CENTER • 23 
ASTUTE CLINICAN LECTURER 

A NOTED HEMA TOLOGIST 

“Harnessing the power of the scientific 

method to promote health and alleviate 

suffering from disease is humankind’s 

proudest achievement,” said Dr. Barry 

Coller, vice president for medical affairs at 

the Rockefeller University, in presenting 

2007’s Astute Clinician Lecture at the 

Clinical Center in November. 

“What excites me about translational 

research,” he added,“is the ability to unite 

humanism and science in the service of 

medicine.”The title of his lecture,“From 

the Rivers of Babylon to the Coronary 

Blood Stream,” is taken from Psalm 137, an 

apt reference to a rare platelet disorder— 

Glanzmann thrombasthenia—that helped 

trigged his interest in cardiovascular 

research. 

The rivers of Babylon refer to an area near 

modern-day Baghdad where, in ancient 

times, captives from Jerusalem were held. 

Over the centuries, members of this Jewish 

community in Iraq intermarried, which 

ultimately led to a high frequency of the 

recessive disorder. It affects about one person in a million and involves lifelong excessive bleeding. Clinical observations have 

contributed to the development of 

therapeutic and diagnostic strategies for 

coronary artery disease, one of the most 

common causes of death in the world. 

Coller studied a defect in these patients’ 

platelets that affects the platelets’ ability to 

aggregate. Based on this knowledge, Coller’s 

laboratory developed an antibody that 

blocks the ability of normal platelets to 

aggregate. 

A derivative of that antibody (abciximab) 

received FDA approval in 1994 and has 

been used to treat more than two million 

patients worldwide to prevent complications of coronary interventions such as 

angioplasty and stent insertion.Treatment 

with abciximab prevents clots from forming 

in stents used to open the diseased arteries 

in patients with heart attacks.A recipient or 

co-recipient of 13 U.S. patents, Coller also 

developed an assay to assess platelet function and has received FDA approval to 

monitor antiplatelet therapy with aspirin 

and other agents. 

Coller has received numerous awards, 

including the American Society of 

Hematology’s Henry M. Stratton Medal 

and the Robert J. and Claire Pasarow 

Foundation Award for Cardiovascular 

Research in 2005. His antibody in 1995 

was named best new therapeutic 

product by the Biotechnology Industry 

Organization and innovation of the year 

by Pharmazeutische Zeitung. In 1997 he 

was named inventor of the year by the 

New York Intellectual Property Law 

Association and received the International 

Society on Thrombosis and Haemostasis’ 

distinguished career award. 

Coller, who also serves as David 

Rockefeller Professor of Medicine, head of 

Laboratory of Blood and Vascular Biology, 

and physician-in-chief of the Rockefeller 

University Hospital, is a member of the 

Association of American Physicians, the 

Institute of Medicine of the National 

Academies, and the National Academy of 

Sciences. He is a Fellow of the New York 

Academy of Medicine, the American 

Association for the Advancement of 

Science, and the American Academy of Arts 

& Sciences, and a Master of the American 

College of Physicians. He has served as a 

member of National Heart, Lung, and 

Blood Institute’s Board of Extramural 

Advisors and co-chair of NIH’s Advisory 

Board for Clinical Research. He also 

worked at the Clinical Center from 1972 

to 1976 in the Clinical Pathology 

Department’s Hematology Service. 

The Astute Clinician Lecture was established 

through a gift from the late Dr. Robert W. 

Miller and his wife, Haruko. It honors a 

U.S. scientist who has observed an unusual 

clinical occurrence, and by investigating it, 

has opened an important new avenue of 

research. 

24 • ANNUAL REPORT 2008 
CLINICAL RESEARCH NURSING 2010


Nursing and Patient Care Services in 2007 

launched a four-year strategic plan to strengthen nursing practice and expand contributions 

to clinical research at the Clinical Center.This 

plan—Clinical Research Nursing 2010—was 

guided by the vision that the Clinical Center 

will lead the nation in developing a specialty 

practice model for Clinical Research Nursing. 

As part of the effort, teams addressed eight 

charter projects defined for 2007, each focusing 

on a key issue identified by clinical staff as a 

priority or through the Nursing operational 

review.The CRN 2010 Teams, as they came to 

be called, were launched in March and presented 

results and findings in December, including: 

confirmation and refinement of primary nursing as the Clinical Center’s clinical research 

nursing model of care; delineation of outcomes 

and results from more than 20 evidence-based 

practice projects carried out in 2006 and 2007; 

pilot testing of a clinical research nursing intensity measurement tool in all clinical areas; proposal for a process and documentation tools to 

promote continuity across care settings; proposal 

of a framework and organizational structure to 

strengthen communication and education for 

research participants and their families; collaboration with nurses from the institutes with 

large numbers of nurses to define, categorize, 

and clarify the various roles nurses perform at 

the CC and throughout NIH in support of 

research; assessment and resolution of documentation of clinical and research activities in 

the Clinical Research Information System; 

and a proposal of structured approaches to 

improving consistency of communication and 

performance across all clinical care areas. 

A critical success factor for CRN 2010 has 

been collaboration with clinical research nursing colleagues around the country, primarily 

those who were in leadership roles with the 

General Clinical Research Center / Clinical 

and Translational Science Awards 

(GCRC/CTSA) network. 

Informal collaboration was formalized through 

the creation of the Clinical Research Nursing 

Consortium, which includes nurse leaders from 

the Clinical Center, GCRCs, CTSAs, academic 

centers (including those in England and 

Switzerland), and the National Center for 

Research Resources.The consortium’s Think 

Tank met three times at Rockefeller University 

in New York City to draft ideas for a White 

Paper on the importance and role of nurses in 

clinical research and to create practice and 

management tools that support specialty development. Dr. Clare Hastings, Chief Nurse for 

the Clinical Center, has taken a leadership role 

in this group, and presented the specialty 

development work being done at the Clinical 

Center at the GCRC nurse manager meeting 

in March and the American Academy of 

Nursing meeting in November. 

©Alan Karchmer 

NIH CLINIC AL CENTER • 25 
Organizational Improvement/Teamwork 

ICU CRIS TEAM WINS CC P A TIENT 

SAFETY CHAMPION A W ARD 

The ICU CRIS interdisciplinary team on May 8 received the CC’s third Patient Safety


Champion Award, which is given annually to individuals or teams demonstrating a sustained 


commitment to a safe patient environment.The team, created in 2004, identified and implemented


several initiatives to benefit patients in the ICU and throughout the CC.These included a CRIS


medication start time alert; the ability to view results in some order forms to avoid duplicate


blood draws; 18 computers on wheels for bedside nurse access to patient data; a critical care 


assessment flow sheet to standardize ICU patient information; and the ICU profiles and continuous


venous-venous hemofiltration order sets.


ICU CRIS team members and additional ICU and CC staff at the award presentation included


(Back row, from left): Brad Moriyama, Dr. James Shelhamer, Dr. Naomi O’Grady, Connie Kotefka,


Dr. Peter Eichacker, Dr. David Vitberg, Deborah Kolakowski, Christine Callahan, CC Director 


Dr. John I. Gallin, Gina Ford, Susy Postal, Dr. Henry Masur, Dr. John Beigel, Carrie Patricola, and


Lauren Stringi. (Front row, from left):Therese Kent, Nancy Ames, Pamela Horwitz, Parvin Safavi,


and Gloria Cruz.


26 • ANNUAL REPORT 2008 
THE REAL THING? 


Rose Simpson (left) and Wendy Moore, 

both clinical research nurses on 3NE, participate in a live-action scenario in the clinical 

simulation classroom, 4th floor of the Hatfield 

building. Critical Care Medicine launched the 

service, which features high-fidelity, full-body 

mannequin, more advanced than the basic 

models used for CPR training. It can simulate 

emergency events, such as a blocked airway, 

cardiac arrest, or internal bleeding after surgery.The mannequins can also be used to 

practice chest tube insertion, tracheostomies, 

and periocardiocentesis.The mannequin— 

called William Simman for a male patient or 

Wilma Simman for a female patient—can also 

be shocked and intubated and can produce a 

variety of life-like heart and breath sounds. 

D A T A 

TRANSFORMA TION 

The Departments of Laboratory Medicine and Social Work participated 

in a pilot project to improve the collection and automation of management 

data.The pilot phase and its follow-on projects involving other CC departments will yield a new structure to more precisely define and predict the costs 

of conducting clinical research, enable benchmarking of Clinical Center services 

that are similar to other hospitals, and delineate costs that are unique to a 

clinical research environment. CC managers and the NIH scientific community 

can use this information to make more informed decisions about directions for 

research and to identify efficiencies. 

NIH CLINIC AL CENTER • 27 
Training the Next Generation 

FIFTH CIST FORUM FOCUSES ON OPPORTUNITIES, 

INSIGHTS ABOUT CLINICAL RESEARCH CAREERS 

Approximately 275 medical and dental students 

from across the country recently attended the 

fifth annual Clinical Investigator Student Trainee 

(CIST) Forum at NIH in November 2007.The 

forum is designed for students who are participating in clinical and research fellowships at academic 

medical centers and NIH and is structured to 

further engage and encourage them as they 

become the next generation of clinician-scientists. 

The two-day event included presentations by 

well-known researchers from inside and outside 

the NIH and gave students the opportunity to 

network with their peers and with established 

clinical investigators. 

“You are the future physician-scientists,” 

Dr. Michael Gottesman, NIH deputy director for 

intramural research, said in his welcome to the 

group.“We invited you here so we could get to 

know you and have you get to know us and each 

other. The people sitting next to you will review 

your papers and your grants and give you comments, so it’s important for you to begin creating 

networks now.” Dr. John I. Gallin, CC director, 

invited the students to tour the Clinical Center, 

“a gift that you as taxpayers and future clinical 

researchers, have all given to yourselves.” 

A highlight of the program was a keynote address 

by NIAID Director Dr.Anthony S. Fauci. He 

said his undergraduate studies of the humanities 

including Greek philosophy, Latin, and French— 

with the minimum amount of pre-medical school 

courses—influenced how he thought about 

diseases and global health issues. Fauci said he was 

absolutely convinced that he wanted to return to 

New York to practice until he heard about the 

Public Health Service during a presentation on 

military service options given by a Marine captain.This brought him to NIH before the discovery of HIV/AIDS, the disease that would define 

his career.“Never in my wildest dreams would 

I have thought I would later be working for 

presidents and Congress,” Fauci said. 

According to Fauci, the “extraordinary payback” 

in scientific understanding, new treatments, and 

lives saved as a result of the funding and focus 

dedicated to HIV/AIDS is an excellent example 

of what is possible with a great investment in 

clinical research. He noted that there are currently 

25 FDA-approved drugs for HIV/AIDS—more 

than the sum total of drugs for every other viral 

disease combined. Fauci asked,“If we put the 

money and focus into HIV/AIDS research, why 

can’t we put it into other infectious diseases?” 

Fauci advised students to think beyond publishing 

the next prestigious paper.“It takes a collective 

commitment from the scientific community. 

No one individual scientist can conduct the basic 

research, develop a useable product for people, 

and deliver it to those who really need it.At some 

point, you have to collaborate with colleagues in 

the biotechnology and pharmaceutical industries, 

but as those making the discoveries, you can have 

a say in how the treatments based on those 

advances are used.” 

Forum panels included updates in cardiovascular 

diseases, moderated by Dana Boyd, executive 

director of the Sarnoff Cardiovascular Research 

Foundation; practical tips for career development, 

including funding support, grants, and loan repayment, moderated by Gallin; and how to succeed 

The breaks between presentations provided opportunities 

for students to get to know 

each other and share research 

interests. 

28 • ANNUAL REPORT 2008 
NIAID Director Dr. Anthony Fauci, who gave the 

keynote address at the fifth CIST forum, answers 

student questions after his lecture. 

as a physician-scientist, moderated by 

Dr. Frederick P. Ognibene, director of the 

CC Office of Clinical Research Training and 

Medical Education and the lead organizer of 

this annual event. 

This year the program expanded by inviting 

medical students from the Centers for Disease 

Control and Prevention Applied Epidemiology 

Program, the NIH MD/PhD Partnership 

Training Program, and institutions that have 

received NIH Clinical and Translational Science 

Awards.They joined participants from Howard 

Hughes Medical Institute-NIH Research 

Scholars and Fellows, Doris Duke Clinical 

Research Program Fellows, Fogarty International 

Clinical Research Scholars, NIH CRTP Fellows, 

and Sarnoff Cardiovascular Research Foundation 

Fellows. 

OFFICE OF CLINICAL RESEARCH 

TRAINING AND MEDICAL EDUCA TION: 

The Clinical Center programs to train the next generation of clinical 

researchers continue to expand. Established in 2003, the Office of Clinical 

Research Training and Medical Education offers three courses (Introduction 

to the Principles and Practice of Clinical Research, Principles of Clinical 

Pharmacology, and the required Clinical Research Training for principal investigators) and manages the NIH-Duke program in clinical research leading 

to a Master’s degree, Clinical Center Grand Rounds, and the Annual Clinical 

Fellows’ Orientation. More than 25,000 students worldwide have participated 

in CC clinical research educational programs, most of which are online. 

In 2007/2008, there are 836 enrollees (390 NIH/446 from remote sites) in 

the Introduction to the Principles and Practice of Clinical Research course 

and 596 enrollees (372 NIH/224 from remote sites) for the Principles of 

Clinical Pharmacology course. 

In 2007, the Medical Education Program in the NIH Office of Intramural 

Research merged with the CC office. Responsibilities now include the 

Accreditation Council for Graduate Medical Education fellowships, the 

Clinical Research Training Program for medical and dental students, the 

Clinical Elective Program for medical and dental students, the Resident 

Elective Program, and Continuing Medical Education. 

NIH CLINIC AL CENTER • 29 
CLINICAL RESEARCH TRAINING PROGRAM 

10-YEAR REUNION 

Members of the Clinical 

Research Training Program 

class of 2005-2006 (from left) 

Alison Rager; Bryan Traughber; 

Ezinma Achebe; Mehrdad 

Alemozaffar; CRTP Director 

Dr. Frederick P. Ognibene; 

Tony Wang; NIH Director 

Dr. Elias Zerhouni; Obinna 

Emechebe-Kennedy; Clint 

Allen; Frank Hwang; Lan 

Chang; Richard Robison; 

and Veronique Nussenblatt. 

“You are the people who will form the bridge 

and provide the most valuable part of translational 

medicine.You are the vanguard of innovation in 

health,” said Dr. Elias Zerhouni, NIH director, 

speaking to alumni and current fellows in the 

NIH Clinical Research Training Program 

(CRTP). He presented the keynote address 

during a dinner that capped the program’s 10th 

year reunion in March 2007. 

“What is important in life is not what organization you belong to, but the values that you hold. If 

the values are there, things will happen,” he said, 

expressing appreciation to the fellows for “translating their passion for clinical research, which is 

critical to the well-being of human kind, for the 

benefit of others in the world.” 

The program’s strengths, Zerhouni said, include 

creating friendships and networks that will last a 

lifetime, uniting “like minds with like values 

coming together for something greater than 

themselves,” and providing a “thinking space” 

with mentors and facilities to encourage scientific 

innovation. He advised the group to “remember 

key mentors” and to have the courage to take risks 

to follow their dreams.“You never know what 

turns your life will take, if you’re willing to take 

a path that no one else will take.” 

During the reunion, current and alumni fellows 

heard updates on the clinical and translational 

research agendas from the directors of the CC, 

NIAID, NIDDK, NHGRI, NIMH and NCRR. 

Many alumni took to heart the quote NHGRI 

Director Dr. Francis Collins shared at the conclusion of his presentation:“As for the future, your 

task is not to foresee, but to enable it,” he said, citing Antoine de Saint-Exupery. 

Reflecting on how things have changed since the 

first class came to campus, Dr. John I. Gallin, CC 

director, traced Clinical Center accomplishments 

that have occurred since the birth of program, 

noting “this has been an era of extraordinary 

growth and transition.” Milestones include celebration of the CC’s 50th anniversary in 2003; 

opening of the new hospital, the Mark O. Hatfield 

Clinical Research Center, in 2004; and responses 

to the Katrina disaster in 2005. 

During the alumni panel on career development 

post-CRTP, several speakers echoed stressed 

opportunities the program offers for professional 

growth. Dr. Lynn Henry (CRTP 1999-2000) said 

she came to the program thinking she wanted to 

work in infectious diseases. Exposure to various 

clinical and translational research opportunities as a 

fellow led her in a different direction. She’s now a 

hematology/oncology fellow at the University of 

Michigan Comprehensive Cancer Center. 

“I don’t think I could have planned a more perfect route, and nine years ago I wouldn’t have 

guessed that this would be my research,” said 

Dr. Stacy Suskauer (CRTP 1998-1999), pediatric 

rehabilitation fellow at the Kennedy Krieger 

Institute and Johns Hopkins School of Medicine. 

“At some point, you have to bring up the younger 

generation of clinical researchers, which is why we 

30 • ANNUAL REPORT 2008 
have this fabulous program,” Dr. Stefan Weiss 

(CRTP 1999-2000), senior medical director at 

Connetics Corporation, said.Weiss described his 

“alternative track,” beginning with work as a 

CRTP fellow with Dr. Ezekiel Emanuel, chief of 

the CC Bioethics Department, followed by specialization in dermatology and learning business 

development in the pharmaceutical industry. 

Nine former CRTP fellows have returned or will 

return to NIH for additional fellowship programs, 

post-residency training in NCI, NINDS, NIAID, 

and the CC. Several fellows credited CRTP with 

helping them create contacts and networks that 

are still fruitful today. Dr. Jonathan Samuels (1997­

1998), assistant attending physician and clinical 

instructor in medicine for the Division of 

Rheumatology at New York University Hospital 

for Joint Diseases, described a current collaboration with a colleague he met at NIH who is now 

in Oklahoma. Dr. Uri Lopatin (1997-1998), 

associate director, hepatology branch, ScheringPlough, called CRTP a “great learning experience 

with fabulous role models and mentors that creates a network of people,” many of whom remain 

in contact years later.The experience is “very 

enabling for those who begin a very long, difficult 

road. It’s an invaluable resource to have a community of peers. It’s a wide, wide world full of really 

smart people who all have something to offer the 

clinical endeavor.” 

At the event’s keynote dinner,The Honorable 

John E. Porter, vice chair of the board of directors 

for the Foundation for NIH, acknowledged the 

“risks and real sacrifices” made by the fellows to 

pursue their vocation of helping patients.“The 

Foundation for NIH takes pride in your persistence and the excellence of your work,” Porter 

said, adding that scientists have the utmost of 

America’s respect. Pfizer Chief Medical Officer 

Dr. Joseph Feczko praised the endurance and 

expansion of CRTP. “Seeing the success of this— 

where you’ve all ended up or are going—is a 

tremendous credit to you and to this program,” 

Feczko said.The Foundation for NIH and Pfizer 

Inc sponsored the reunion. 

PROGRAM HISTOR Y 

Two hundred and twenty medical and dental 

students representing 68 schools have participated in the Clinical Research Training Program 

since it was established in 1997. Former NIH 

Director Dr. Harold Varmus instituted the 

program to provide creative, research-oriented 

students with an opportunity to become 

involved in clinical research early in their 

careers.According to Dr. Frederick P. Ognibene, 

director of the CC Office of Clinical Research 

Training and Medical Education and of CRTP, 

“During the CRTP year the students learn the 

principles of clinical research and conduct either 

clinical or translational research alongside energetic NIH investigators who serve as mentors. 

It’s truly a life-changing experience that would 

be hard to replicate elsewhere.” 

Support from Pfizer Inc allowed the program to 

grow to 15 students annually starting with the 

1998-1999 class.The company renewed its 

commitment four times, most recently in late 

2006 for another three-year cycle.“The partnership between Pfizer and the Foundation extends 

back to 1998—nearly to the birth of the 

Foundation—and includes contributions, 

pledges, and in-kind gifts totaling $38.9 million, 

including $7.4 million in support of CRTP,” 

said Amy McGuire, executive director of the 

Foundation for NIH. In 2004, the NIH 

Roadmap provided additional funds and allowed 

the program to increase in size from 15 to 30 

students. 

DISTINGUISHED 

CLINICAL 

TEACHER 

Dr. Elaine Jaffe delivered 

the 2007 John Laws Decker 

Memorial Lecture in June. 

Named the NIH Fellows 

Committee’s 2006 

Distinguished Clinical 

Teacher—the highest honor 

bestowed collectively on an 

NIH senior clinician, staff 

clinician, or tenure/tenuretrack clinical investigator by 

the NIH Clinical Fellows— 

Jaffe was invited to deliver the 

2007 address. 

Chief of the Hematopathology 

Section and acting chief of the 

Laboratory of Pathology at 

NCI’s Center for Cancer 

Research, Jaffe came to 

NIH in 1970 as a resident in 

anatomic pathology and has 

been a senior investigator since 

1974. Her current area of 

expertise is in the relationships 

between the immune system 

and malignant lymphomas and 

leukemia. In her lecture, Jaffe 

described how microscopy 

complements molecular diagnostic technologies and illustrated its role in describing 

Hodgkin’s disease, anaplastic 

large cell lymphoma, and in 

situ follicular lymphoma. 

John Laws Decker began his 

career at NIH in 1965 as 

chief of the Arthritis and 

Rheumatism Branch, which is 

now NIAMS. He was director 

of the NIH Clinical Center 

from 1983 to 1990 and was 

named scientist emeritus. 

NIH CLINIC AL CENTER • 31 
MIRABAL SISTERS’ MIDDLE SCHOOL STUDENTS 

EXPLORE CLINICAL CENTER 

Middle school students from the Mirabal Sisters Campus, a community school operating in Harlem, 


New York, in collaboration with The Children’s Aid Society, spent a May afternoon at the Clinical Center


exploring some of the diagnostic and therapeutic tools available to clinical researchers. After a welcome


and introduction from CC Director Dr. John I. Gallin, who compared the workings of a clinical research 


hospital to a city, the students participated in interactive presentations about DNA, science and probability,


using virtual colonoscopy to find polyps, and laboratory medicine.


T AKE YOUR 

CHILD TO 

WORK DA Y 

CONNECTS 

EARTH, HEAL TH 

NIH's combined TakeYour 

Child to Work Day and Earth 

Day observances in April gave 

children and their grownups 

the opportunity to explore 

biomedical research, environmental awareness, and the 

connections between the two. 

Laetitia Sangwa and her 

brother Dan enjoyed looking 

through the microscopes in 

the CC’s Department of 

Laboratory Medicine. 

32 • ANNUAL REPORT 2008 
SCIENCE F AIR WINNERS VISIT 


PHYSICAL 

THERAPY IN 

ACTION 

About 70 seventh grade 

students from Roberto 

Clemente Middle School’s 

math, science, and computer 

science magnet program in 

Germantown toured the 

Clinical Center’s 

Rehabilitation Medicine 

Department in March.They 

learned about the role physical therapy plays in patient 

rehabilitation and clinical 

research. CC patient Bernadia 

Lovely (right) talked to the 

students, including Jamie 

Palmer,Victor Ying,Tiffany 

Le,Anika Jain, and Rakhee 

Jain, about her diagnosis with 

osteosarcoma, a pediatric 

cancer, and her experiences. 

Lovely, a college art major, 

wants to become a cartoonist 

and works with an art therapist to express herself during 

her treatment. She’s also 

writing a book about her life, 

what she has learned, and 

how she has grown from her 

experience with cancer. 

“People think of having 

cancer as being the end of 

the world. But it’s not.” 

The 12 winners of the Bushy Park Elementary 

School’s science fair toured the Clinical Center 

on May 18. Dr. Gregory Kato, staff clinician in 

CC Critical Care Medicine Department and 

director of NHLBI’s Sickle Cell Vascular 

Disease Unit, collaborated in judging the projects and hosted the students, who ranged in 

age from kindergarten through fifth grade. 

NHLBI nurse Inez Ernst gave the young visitors toy stethoscopes to keep, taught them how 

to listen to their heart beats and demonstrated 

an echocardiogram. Joshua Joseph and Candice 

Bereal, Clinical Research Training Program 

medical students, showed the students a method 

of testing blood circulation in the forearm. 

Kato involved the students in microplate 

protein assays. Dr. Nalini Raghavachari of 

CCMD and the NHLBI Genomics Core 

Facility, assisted by NHLBI’s Ronald Cooper, 

demonstrated gene expression microarray 

analysis and use of robotics. 

The students learned about gait analysis in the 

CC Rehabilitation Medicine Department’s 

Clinical Movement Analysis Laboratory from 

Physical Disabilities Branch members Alex 

Razzook and Dr. Saryn Goldberg. 

NIH CLINIC AL CENTER • 33 
Noteworthy 

International health leaders 

visit the CC and NIH 

The ministers, secretaries, and commissioners 

of health from Canada, France, Germany, Italy, 

Japan, Mexico, the United Kingdom, the United 

States, and the European Union completed their 

eighth ministerial meeting—the first to be held 

in the US—of the Global Health Security 

Initiative (GHSI) in November. HHS was the 

official host, with most events occurring at NIH. 

During special tours of the Clinical Center, 

ministers and their staffs visited a patient room 

outfitted with supplies and equipment that typify 

components of the 250-bed contingency hospital 

housed at the CC. 

Accommodating a surge in demand for medical 

services is the CC’s primary role as a member 

of the NIH emergency preparedness partnership 

with Suburban Hospital, National Naval Medical 

Center, and National Library of Medicine. 

Dr. John I. Gallin, CC director, discussed the 

partnership and surge capability with attendees, 

including Roselyn Bachelot-Narquin, France’s 

health minister (above right). 

Created in 2001, GHSI is a partnership to strengthen 

public health preparedness and response globally 

to the threat of international chemical, biological, 

and radio-nuclear terrorism, as well as pandemic flu. 

34 • ANNUAL REPORT 2008 

Chan elected to IOM 

The Institute of Medicine 

elected Dr. Leighton Chan, 

chief of the Clinical Center 

Rehabilitation Medicine 

Department, as one of 65 

new members in October. 

IOM membership, now 

totaling 1,538, is considered one of the highest 

honors in the fields of medicine and health.The 

criteria for election are distinguished professional 

achievement in a field related to medicine and 

health; demonstrated and continued involvement 

with the issues of health care, prevention of disease, 

education, or research; skills and resources likely 

to contribute to the Institute’s tasks of assessing 

current knowledge, conducting studies, and considering policy issues; and willingness to be an 

active IOM participant. 

Unique for its structure as both an honorific 

membership and advisory organization, IOM 

was established in 1970 by the National Academy 

of Sciences and is recognized as a resource for 

independent, scientifically informed analysis and 

health recommendations.With their election, 

members make a commitment to devote a 

significant amount of volunteer time as members 

of IOM committees, which engage in a range 

of studies on health policy issues. 

New chief, new lab 

Dr. James J. Cimino has 

been named chief of the 

Clinical Center’s new 

Laboratory for Informatics 

Development and will lead 

the development and 

implementation of CRIS 

II, a clinical research data 

repository.Through a 

dual appointment to the 

National Library of Medicine, Cimino will also 

spearhead development of an NIH intramural 

training program in medical informatics. 
He comes to NIH from Columbia University 

where he was a professor of bioinformatics and 

medicine. Cimino’s primary areas of research 

interests include medical concept representation 

and using it to support clinical decision-making. 

Since 1991, he has received significant grant 

support, primarily through the NLM, as principal 

investigator on projects to begin the development 

of the Unified Medical Language System (UMLS), 

a resource NLM says is to facilitate the development of computer systems that behave as if they 

“understand” the meaning of the language of 

biomedicine and health. His latest work involves 

infobuttons, which are automated, context-sensitive 

links inserted into clinical information systems to 

anticipate and resolve the information needs of 

clinicians as they provide patient care. 

Cimino has been an active member of the NLM 

Board of Scientific Counselors, co-chair of the 

HL-7 Vocabulary Technical Committee,and on 

the board of the American Medical Informatics 

Association. He is currently an associate editor of 

the Journal of Biomedical Informatics and on the 

editorial board of BioMed Central. Cimino has 

published more than 250 peer-reviewed 

articles on medical informatics and is the co-editor 

of the leading text for medical informatics 

“Biomedical Informatics: Computer Applications 

in Health Care and Biomedicine,” published in 

2006. 

A graduate of Brown University, Cimino earned 

the MD degree at New York Medical College. 

He interned and completed residency training 

in medicine at Saint Vincent’s Hospital in 

New York. He went on to complete a research 

fellowship in medical informatics at Massachusetts 

General Hospital and in biostatistics at Harvard. 

He is a fellow of the American College of 

Medical Informatics and the American College 

of Physicians. In 2006 he received the Medal of 

Honor from the New York Medical College and 

was elected to fellowship in the New York 

Academy of Medicine. 

Two CC leaders head national societies 

Dr. Frederick P. Ognibene (left), director of the 

CC Office of Clinical Research Training and 

Medical Education, became the 37th president of 

the Society of Critical Care Medicine (SCCM) 

in February 2007.With more than 13,000 members worldwide, the Society is the only professional organization devoted exclusively to the 

advancement of multi-professional intensive care 

through excellence in patient care, professional 

education, public education, research, and advocacy. 

Dr. Henry Masur (right), chief of the CC 

Critical Care Medicine Department, is current 

president of Infectious Diseases Society of 

America (IDSA). IDSA represents about 8,000 

infectious disease specialists and seeks to improve 

health by promoting excellence in infectious 

disease patient care, education, research, public 

health, and prevention. 

NIH CLINIC AL CENTER • 35 
Shirley Winford, Floride Canter, 

Harry Canter, and CC patient 

Clenton Winford visit over coffee 

and cookies from the Red Cross 

hospitality cart. 

cart. Her husband, 

Harry, a 14-year 

volunteer, worked at 

NIH for 43 years 

before retiring as chief 

of the research, analysis, and evaluation 

branch in NCI’s 

Division of Extramural 

Activities.Their 

daughter Susan has 

volunteered at NIH 

for about 15 years. 

“Very few people 

can greet anyone, 

Long-time volunteers say good-bye 

Clinic waiting rooms throughout the 

Clinical Center became a little quieter in 

November after Floride, Harry, and Susan 

Canter—a family that has given more than 

25 years of service and friendship to CC 

patients and staff—spent their last day as 

volunteers. 

Floride,American Red Cross chairwoman 

at the CC, served a continental breakfast to 

the phlebotomy patients each morning 

before making rounds with a hospitality 

anywhere better than 

Floride,” Harry said.“She can open her 

heart to everyone. It’s the best part of her 

personality.” Monica Sullivan, a volunteer 

Spanish interpreter at the CC since 1988, 

agreed that Floride’s friendliness and kindness are her greatest gifts to patients, volunteers,and staff.“She always has something 

nice to say about everybody and tries to 

help in any way possible.” 

Andrea Rander, director of volunteer services and language interpreters programs at 

the CC, called the Canters “the epitome of 

volunteerism” and an inspiration to her, as 

well as volunteers and staff.“I cannot convey enough thanks for all the hours they 

have devoted to our volunteer program: 

Floride more than 27,000; Harry 15,000. 

Rarely has either Floride or Harry said ‘no’ 

to any chore asked of them.They have 

passed along this spirit of service to their 

daughter Susan, who also added to the 

beauty of volunteer services at the Clinical 

Center. I will miss them individually and as 

a family.They are irreplaceable.” 

CC and Red Cross staff feel the same way. 

“I cannot imagine more generous people,” 

said CC patient representative Laura 

Cearnal.“Perhaps even more important 

than the many services they’ve provided to 

CC patients and families is the spirit in 

which their service is offered.They 

approach every task with a can-do attitude 

and a willingness to do whatever it takes. 

They are an inspiration and so steady.” 

The family has move to Harrisonburg,Va., 

where Floride and Harry grew up and met 

60 years ago.When asked what they’ll do 

in their new town, Floride immediately 

responds,“We’re going to volunteer! Most 

likely at the new hospital.” 

Spiritual Ministry chief named Holy Cross Home Care and Hospice, a community-based hospice 

John M. Pollack has been named chief of program serving hospice patients and their families in Montgomery 

the Spiritual Ministry Department. He had and Prince George’s Counties. 

been director of Pastoral Care and Mission 

Operations at Holy Cross Hospital in Silver Pollack holds a BS degree in accounting from the Pennsylvania 

Spring, Maryland, where he served on the State University and a master of divinity degree from the Union 

hospital’s Ethical Advisory, Perinatal Ethics, Theological Seminary in the City of New York.He completed 

and Ethics Education Committees. He has chaplaincy training at Sibley Memorial Hospital and Georgetown 

been active in Holy Cross Hospital’s end-of- University Medical Center in Washington, DC. 

life care initiatives, including initial implementation of a hospitalbased palliative care service and launching an annual conference He is board certified as a chaplain through the National Association 

series,“Conversations for the End-of-Life,” which focused on issues of Catholic Chaplains. As a member of the association he has been 

of death and dying as they relate to various types of caregivers active in the chaplain certification process and recently joined their 

in the community. For several years he was staff chaplain for Board of Directors. 

36 • ANNUAL REPORT 2008 
NIH CLINICAL CENTER


Organization Chart


Chief Operating Officer 

Maureen E. Gormley, 

MPH, RN 

Social Work 

Department 

Adrienne Farrar, PhD 

Deputy for 

Administration/ 

Office of Administrative 

Management 

Lynda Ray 

Deputy for Operations/ 

Special Assistant for 

Workforce Management 

Hillary J. Fitilis, JD 

Nutrition Department 

David Folio, MS, RD 

Edmond J. Safra 

Family Lodge 

Lawrence Eldridge, 

MSHA 

Spiritual Ministry 

Department 

John M. Pollack, 

MDiv, BCC 

Office of 

Communications, 

Patient Recruitment, 

& Public Liaison 

Sara Byars 

Office of Organizational 

Development 

Deborah Gardner, 

PhD, RN 

Office of Facility 

Management 

James Wilson 

Office of Purchasing 

and Contracts 

Sydney Jones 

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 

Diversity Management & 

Minority Outreach 

Walter Jones, MS 

Chief Nursing Officer 

Clare Hastings, 

PhD, RN 

Deputy Chief, 

Ambulatory Care 

Services 

Karen Kaczorowski, 

RN, MHSA 

Deputy Chief, 

Inpatient Services 

Tannia Cartledge, 

RN, MS 

Chief Financial Officer 

Daniel Rinehuls, 

acting 

Office of Financial 

Resource 

Management 

Daniel Rinehuls 

Office of Management 

Analysis & Reporting 

Melissa B. Moore, 

MSW, MBA 

Office of Protocol 

Services 

Kim Jarema, RHIA 

Bioethics Department 

Ezekiel Emanuel, 

MD, PhD 

Laboratory for Informatics 

Development 

James J. Cimino, MD 

Chief Information 

Officer 

Jon McKeeby, DSc 

Department of 

Clinical Research 

Informatics 

Jon McKeeby, DSc 

Radiology and Imaging 

Sciences 

Chief, Vacant 

Deputy Director for 

Clinical Care 

David K. Henderson, MD 

Nuclear Medicine 

Department 

Ronald D. Neumann, MD 

Positron Emission 

Tomography 

Department 

Peter Herscovitch, MD 

Laboratory of 

Diagnostic 

Radiology Research 

Vacant 

Diagnostic Radiology 

Department 

Elizabeth Jones, MD 

(acting) 

Bradford J. Wood, MD 

(acting) 

Department of 

Anesthesia and 

Surgical Services 

Zena Quezado, MD 

Chief, Research 


& Practice 


Development Service


Gwenyth Wallen, 


PhD, RN


Housekeeping and 

Fabric Care 

Department 

Robert B. Mekelberg, 

MBA 

Materials Management 

Department 

Francis Labosco, 

MS, PD 

Pediatric Consult


Service


Deborah Merke, MD


Veterinary Care


Program


Lisa Portnoy, VMD


Clinical Epidemiology & 

Biostatistics Service 

Robert Wesley, PhD 

Department of 

Laboratory 

Medicine 

Thomas A. Fleisher, MD 

Critical Care Medicine 

Department 

Henry Masur, MD 

Pharmacy Department 

Robert DeChristoforo, 

MS 

Rehabilitation Medicine 

Department 

Leighton Chan, 

MD, MPH 

Department of 

Transfusion Medicine 

Harvey Klein, MD 

Medical Record 

Department 

Patricia Coffey, RHIA 

Credentials Office 

Joseph Hendery, RHIA 

Pain and Palliative 

Care Service 

Ann Berger, MSN, MD 

Internal Medicine 

Consult Service 

Fred Gill, MD 

NIH CLINIC AL CENTER • 37 

Hospital Epidemiology


Service


David K. Henderson,


MD

ADVISORY BOARD FOR CLINICAL RESEARCH 

N ATIONAL INSTITUTES OF HEALTH (2007–2008) 

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 and Chief Executive Officer 

Dana Farber Cancer Institute 

VICE-CHAIR: 

Ronald G. Evens, MD 

Senior Executive Officer 

Barnes Jewish (BJC) HealthCare 

Duane F. Alexander, MD 

Director 

National Institute of Child Health 

and Human Development 

Barbara M. Alving, MD 

Director 

National Center for Research Resources 

Elizabeth B. Concordia, BA, MAS 

Senior Vice President,Academic 

and Community Hospitals 

University of Pittsburgh Medical 

Center (UPMC) 

President, UPMC Presbyterian Shadyside 

Robert M. Dickler 

Senior Vice President 

Division of Health Care Affairs 

Association of American Medical Colleges 

Maria C. Freire, PhD 

Chief Executive Officer and President 

Global Alliance for TB Drug Development 

Lee J. Helman, MD 

Scientific Director for Clinical Research 

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 Chairman 

Department of Medicine 

University of California, San Francisco 

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 

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 

Neal S.Young, MD 

Chief, Clinical Hematology Branch 

National Heart, Lung, and Blood Institute 

Ex Officio Members 

John I. Gallin, MD 

Director, Clinical Center 

National Institutes of Health 

Willam A. Gahl, MD, PhD 

Chair, Medical Executive Committee 

National Human Genome Research Institute 

Michael M. Gottesman, MD 

Deputy Director for Intramural Research 

National Institutes of Health 

Executive Secretary 

Maureen E. Gormley, RN, MPH 

Chief Operating Officer, Clinical Center 

National Institutes of Health 

Senior Staff Support 

Richard G.Wyatt, MD 

Executive Director, Office of 

Intramural Research 

National Institutes of Health 

38 • ANNUAL REPORT 2008 
MEDICAL EXECUTIVE COMMITTEE MEMBERS (2008) 

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. 

William A. Gahl, MD, PhD David K. Henderson, MD Ex Officio Members 

(Chair) NIH Clinical Center John I. Gallin, MD 

National Human Genome Research NIH Clinical Center 

Institute Stephen G. Kaler, MD, MPH 

National Institute of Child Health and Patricia A. Kvochak, JD 

Donald L. Rosenstein, MD Human Development Deputy NIH Legal Advisor 

(Vice Chair) 

National Institute of Mental Health Daniel L. Kastner, MD, PhD Richard G.Wyatt, MD 

National Institute of Arthritis and Office of the Director, NIH 

Frank M. Balis, MD Musculoskeletal and Skin Diseases 

National Cancer Institute Laura M. Lee, RN 

H. Clifford Lane, MD NIH Clinical Center 

James E. Balow, MD National Institute of Allergy and 

National Institute of Diabetes and Infectious Diseases 

Digestive and Kidney Diseases 

Dan L. Longo, MD 

Katherine R. Calvo, MD, PhD National Institute on Aging 

Clinical Fellow, representing the 

NIH Fellows Committee Henry Masur, MD 

National Cancer Institute NIH Clinical Center 

Richard O. Cannon, III, MD Deborah P. Merke, MD, MS 

National Heart, Lung, and Blood Institute NIH Clinical Center 

Carlo Contoreggi, MD Robert Nussenblatt, MD 

National Institute on Drug Abuse National Center for Complementary and 

Alternative Medicine 

Raymond A. Dionne, DDS, PhD 

National Institute of Nursing Research Steven A. Rosenberg, MD 

National Cancer Institute 

Frederick L. Ferris, III, MD 

National Eye Institute Carter Van Waes, MD, PhD 

National Institute on Deafness and 

Mary Kay Floeter, MD Other Communication Disorders 

National Institute of Neurological 

Disorders and Stroke Darryl C. Zeldin, MD 

National Institute of Environmental 

Thomas C. Hart, DDS, PhD Health Sciences 

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 

NIH CLINIC AL CENTER • 39 
N ATIONAL INSTITUTES OF HEALTH


(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 

©Joe Fox 

40 • ANNUAL REPORT 2007 

DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

NIH Clinical Center 

clinicalcenter.nih.gov 

NIH Publication Number 08-6419


January 2008


©Alan Karchmer