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Daniel Dunaief

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Three-year medical school grads Adam Bindelglass, Simrat Dhawilal, William Guo, Maxwell Moore, Justin Bell, Eliana Fine and Brant Lai. Photo from Stony Brook University

Behind every stethoscope is a story.

Chineze Nwebube during the Graduate Address. Photo from Stony Brook University

This year, the stories among the new doctors who recently graduated from the Renaissance School of Medicine at Stony Brook University developed against the backdrop of a pandemic and included numerous firsts for the school and for the families of graduates.

Seven of the 150 graduates, which is the largest medical school class to earn a medical degree from Stony Brook, completed their training in three years, joining a small but growing trend among medical schools that are encouraging more people to consider becoming physicians while reducing the potential debt that can accrue while earning their medical degree.

“This year is really going to stand out,” said Andrew Wackett, vice dean of Undergraduate Medical Education and the director of the Clinical Simulation Center. “This was a group of students that really went through an awful lot. They rose to the occasion. They didn’t complain. Rather than do that, they tried to figure out how to help. It’s a special group of physicians that will make a great impact.”

Indeed, amid the worst of the pandemic, which hit Suffolk County especially hard during the spring of 2020, medical school students performed a host of important tasks, just as so many other health care professionals took on additional responsibilities and put themselves in harm’s way to protect the public.

Students volunteered to help with research, assisted patients who needed to connect with clinicians through in-person or telehealth and did “a lot of work with following up to make sure [residents] were doing okay when they were discharged,” Wackett said. These students were “really important in organizing the vaccine strategy,” as a number of them trained and volunteered to give vaccines. “They doled out thousands of them.”

Wackett suggested that the adversity caused by the pandemic has enabled class members to become resilient.

“What they learned, more than anything, was that they could adapt to whatever the world threw at them,” Wackett said. “It made them a much tougher group of students.”

Wackett said he was moved by the story of Chineze Nwebube, who described in the Graduate Address how she took the MCAT several times and had moments when she thought about giving up.

With the support of her family, she persisted and was “an exceptional medical student and will be an incredible physician,” Wackett wrote in an email.

Wackett said the spotlight on social injustice amid the pandemic also affected the dialog and the didactic efforts at the medical school.

“Certain populations have disparate health care, and we need to be involved to make that better,” Wackett said. That includes an analysis not just of disease or pathology, but also a consideration of how social factors impact the course of illnesses.

“Courses that traditionally taught science [are also] looking at the social context,” he said. “Medicine and public health are way more interconnected than we even realized.”

The graduates are preparing to venture into a world in which new lessons learned in the classroom and the clinic will prove especially valuable. At the same time, they bring a passion, dedication and conviction to the communities they plan to serve.

In between graduating and taking the next steps in their medical careers, some of this year’s graduates shared their inspiring and inspired stories.

Former dean and senior vice president of health services Ken Kaushansky, center, with Jheison and Monica Giraldo, the first married couple to enter and graduate from medical school at Stony Brook together. Photo from Stony Brook University.

Here comes the married couple

Monica Lenis didn’t think Jheison Giraldo, the guy from another class who was making up a lab in undergraduate biology at Stony Brook University, was all that funny. That just made him try so much harder, prompting eye rolls from a tough audience.

“His jokes were not making me laugh,” Monica recalled about that fateful science class eight years ago. “Somehow, we hit it off. We started talking after that and got to know each other.”

Despite Monica’s initial resistance to his charms, the couple started spending considerable time together, where they realized how much they had in common.

For starters, they were born in Colombia, five hours apart by car. Their families had moved to Long Island, his to Brentwood and hers to Bethpage, when each of them was nine years old.

Once they started to get to know each other, they appreciated each other’s strengths.

Jheison, who describes himself as the more outgoing of the two, tried to compete with Monica academically. That didn’t work out too well.

On a test in Biochemistry 2, in which the average was around 40, he reached the high 90s. He confidently went over to Monica, figuring he had to have beaten her.

She scored a 102, getting all the questions right and adding the two extra points.

“If you can’t beat them, join them,” he said. “I knew being next to her, she’s going to push me to excel in every way I could. I would do the same for her.”

Monica appreciated Jheison’s pervasive and persistent positive attitude. She also appreciated how well he interacted with her parents and her family, enjoying the older brother role he took with Monica’s 15-year-old brother.

After they graduated from Stony Brook, they got married. Jheison had always known he wanted to be a physician, dressing up for Halloween close to a dozen times as a doctor. Monica had other interests, including in the law. In addition to falling in love with Jheison, she also developed a deep appreciation for science in college and eventually deciding that she didn’t want to conduct research.

They applied to 30 medical schools. When they decided to go to Stony Brook together, they became the first married couple to enter the medical school together.

“When we first started” meeting people in the class, some of their peers “thought of us as the grown-up couple,” Monica said. Each of them, however, established their own academic and social friend groups.

While in medical school, they supported each other, as they focused on becoming, as Jheison put it, “the best physicians we could.”

Now that he is planning to become a resident in internal medicine and pediatrics and she plans to focus on internal medicine and cardiology, the medical couple has decided to contribute to a community they feel could use their support.

“From day one, we wanted to go to a place where we could be faced with patients who need more equity and diverse doctors working with them,” Jheison said. “We always looked at strong minority areas or historically under-represented areas. Miami stood out for us.”

While Long Island has been her home since she arrived in the United States in 2002 and has a “special place in my heart,” Monica is excited for an opportunity for personal growth. She is also thrilled to get away from the snow and the cold.

As she prepares for the next chapter in her life, she is looking forward to continuing in her journey with Jheison, who is “very positive and very uplifting. He’s always been very supportive, which is really all you could ask for in a partner.”

Eliana Fine with her husband Mark Feld, their 4-year-old son Ezra and their 6-month-old daughter Sophia. Photo from Eliana Fine.

Dr. Mom

Like many of her friends in the Orthodox Jewish community, Eliana Fine got married soon after high school, at the age of 19. Within two years, she gave birth to her son Ezra and, six months ago, to her daughter Sophia.

She could have dedicated herself and her time to becoming a stay-at-home mom, enveloping herself in a culture that emphasizes family and community and that keeps many women incredibly busy taking care of their often numerous children.

Instead, with the valuable and necessary support of her husband Mark Feld, Eliana decided to go a different route, not only pursuing a career as a doctor but also earning her degree in three years.

“I come from a community where most of the women don’t work,” Fine said. “I honestly didn’t even know any other orthodox Jewish woman who was a physician or was a medical student or physician trainee.”

Fine, however, wanted to develop her own career, particularly in the field of obstetrics and gynecology, where she felt she could help women, particularly in her community.

She described how the women in her community often don’t have extensive knowledge about reproductive and sexual health education before they get married. Women often have a kallah teacher, who is usually the wife of a rabbi.

“Your education is really based on the knowledge of your teacher,” Fine said, and “what they feel comfortable teaching you.”

Fine wanted to give back to her community, educating women about medical and health issues that can help “empower them to make better health care decisions.”

As a physician, Fine hopes to help other orthodox Jewish women understand more about women’s health and fertility.

“If women are having difficulty conceiving, the peer pressure can be stressful,” she said. “All of your friends are having kids and you’re not moving forward with your family.”

She wanted to give back to a community that she loves and that provides the context and framework for her life.

“There’s a lot of misconceptions when it comes to contraception,” Fine said. “People think contraception causes infertility. People don’t necessarily utilize contraception because of various misconceptions about it.”

To get to this point in her career, Fine said she had to overcome some of the expectations of a culture that sometimes places a stronger emphasis on family, particularly for women, than it does on developing careers.

She appreciated and is grateful for the support of her husband and her grandfather, Dr. Richard Fine, who was a dean of Stony Brook Medical School. When she was younger, she knew he was a physician, but wasn’t aware of his extensive career beyond that. She appreciated his regular questions to her about what she wanted to do when grew up, which allowed her to think for herself about what motivates her and how to make a difference in the world.

Fine believes that her experience and background as a member of the Orthodox Jewish community will help her relate to and communicate with her patients.

“Women have these family purity laws and it’s really important to go to an OB/Gyn who is very familiar with these laws. To be a part of the culture and come from the same community, you understand how to provide care.”

Fine, like several of her colleagues in the inaugural three-year medical program, felt closer to the incoming class of 2018 than to the graduating class of 2021, with whom she interacted primarily in the last six months of her medical school training.

During graduation, Fine appreciated the opportunities she feels she had that others don’t always get.

“I want to make sure I do something great with the opportunity I was given and make a difference in the world,” Fine said.

As for her children, Fine would like them to see that they, too, can choose how they live their lives, regardless of any expectations that others place on them.

“I would like to show my kids, if I can do it, they can do it,” she said. “I want them to know they have choices in life and that I will support whatever they choose. They should know they have the wings to fly, in terms of having a career and going to college.”

Adam Bindelglass. Photo from Stony Brook University

Early challenges

When Adam Bindelglass was five years old, the car he was in slid across black ice into oncoming traffic, which took the life of his two-year-old sister Amy.

Bindelglass also sustained serious injuries, breaking both his arms, his left leg, collar bone, and fracturing his neck. During his recovery, he had to wear a halo on his head to keep his spine aligned until it healed. The halo and the injuries left numerous scars, which triggered questions from his classmates.

“I have a pretty long scar from the base of my skull down my neck,” Bindelglass said. “I was self-conscious about those scars.”

Additionally, he has scars on his right bicep, and he has a mark that used to stretch the entire length of the long bone on his leg.

Motivated by the desire to help other people, particularly in difficult medical situations, Bindelglass said that day, and the scars he now bears as a mark of his career commitment, brought him to this landmark career moment.

A recent medical school graduate, Bindelglass said his experiences early in life have come up several times when he interacts with patients in high-stress situations in the hospital.

He recalled one incident when he spoke with a patient who was about to undergo spinal surgery.

He described how he could “live a full, fulfilling life without complications from these operations,” Bindelglass said. “I hope to continue to bring that [empathy], especially since the patients I’ll be working with [could be] in an acute situation where I’m going to see them right before one of the potentially the biggest operations or procedures of their life.”

He hopes to bring comfort and peace of mind going into surgery.

A three-year graduate from medical school, Bindelglass plans to continue in a residency at Stony Brook in anesthesia. Bindelglass said the pandemic showed him the importance of managing patients’ airways.

Bindelglass said he thinks about his sister “all the time” and hopes she “would be proud” of his commitment to helping others with his career choice.

Simrat Dhaliwal. Photo from Stony Brook University

The magic of threes

Simrat Dhaliwal graduated from Northeastern with her bachelor’s degree in neuroscience in three years and repeated the pattern at Stony Brook’s Renaissance School of Medicine, where she recently earned her medical degree.

The pattern of moving through degree programs in one fewer year is a by-product of several factors.

Dhaliwal is “efficient with time,” she said. “Medicine is a very long route. I know the path I want to take.”

Dhaliwal, whose mother Tejwinder Dhaliwal is a nurse practitioner at Rochester Regional and served as a health care role model, wanted to be a doctor from the time she was in kindergarten. As she attended middle school and high school, she became fascinated with science. She majored in neuroscience at Boston University.

Comparing the accelerated pace of her undergraduate years to medical school, Dhaliwal said the medical education is considerably more rigorous.

“As an undergraduate, once you finish a course, you can forget [some of the material] and move on,” she said. In medical school, students build “on the foundation. If you never had that strong foundation, there’s no way to move on. You’ll be responsible for patients” someday and “you need to know as much as possible.”

Indeed, the pandemic reinforced Dhaliwal’s decision to become a doctor, showing her that doctors had to “fall back on that foundation to help patients in need,” she said. “This pandemic made me want to become a physician even more because it is [a combination of] public service and critical thinking at the same time. There is no greater service to the public than helping someone, especially when it is in such high demand.”

Dhaliwal, who is starting her residency in internal medicine at Stony Brook on July 1, said her parents are originally from a rural part of India.

In her travels to visit family in India, she has “seen the health care disparity that exists in a non-developed nation.” For people in rural India, the nearest hospital is a 45-minute drive, which can create a dangerous delay for people who are having a heart problem or a stroke, where minutes can make the difference in a prognosis.

One of the most important lessons she learned from medical school is to keep learning. The same holds true for her expectations of herself when she practices medicine. She hopes to help educate people about how “preventive medicine is as important as treatment.”

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From left, Shawn Serbin, Scott Giangrande and Chongai Kuang. Photo from Brookhaven National Laboratory

By Daniel Dunaief

Chongai Kuang is doing considerably more than standing in the middle of various fields throughout the southeast, looking up into the sky, sticking his finger in the air and taking notes on the potential appeal of the area.

Entrusted with finding the right spot for the third ARM Mobile Facility, or AMF3, Kuang, who is an Atmospheric Scientist in the Environmental & Climate Sciences Department at Brookhaven National Laboratory, is gathering considerable amounts of information about different areas in the southeast.

In March of 2023, the ARM3 mobile facility, which has been operating in Oliktok Point, Alaska, will have a new home, where it can gather information about atmospheric convection, land-atmosphere interactions and aerosol processes.

In addition to finding the right location for this facility, Kuang will coordinate with the larger science community to make recommendations to ARM for observations, measurements, instruments and sampling strategies. Observations from these fixed and mobile facilities will improve and inform earth system models.

Kuang would like to find a strategic place for the AMF3 that is “climactically relevant to provide important observations on clouds, aerosols, and land atmosphere interactions that are needed to answer science drivers” important in the southeastern United States, Kuang said. These facilities will help researchers understand how all these atmospheric phenomena interact with solar radiation and the Earth’s surface.

The AMF3 should provide information that informs climate, regional and weather models.

In 2018, the Department of Energy, which funds BNL and 16 other national laboratories, held a mobile facility workshop to determine where to move the AMF3. The group chose the Southeastern United States because it has atmospheric convection, high vegetative-driven emissions and strong coupling of the land surface with the atmosphere. This area also experiences severe weather including tornadoes and hurricanes, which have significant human and socioeconomic impacts, said Kuang.

The most violent weather in the area often “tests the existing infrastructure,” Kuang said. “This deployment can provide critical observations and data sets,” in conjunction with regional operational observational networks.

Atmospheric phenomena as a whole in the southeastern United States includes processes and interactions that span spatial scales ranging from nanometers to hundreds of kilometers and time scales spanning seconds to days.

Kuang’s primary research interests over the past decade has focused on aerosol processes at nanometer scales, as he has studied the kinds of miniature aerosol particles that form the nuclei for cloud formation. These aerosols affect cloud lifetime and spatial distribution.

“Our research is challenged by disparate scales relevant to phenomena we’re trying to characterize, from nanometers to the length scale of convective systems, which are tens of kilometers or even larger,” Kuang said. These scales also present opportunities to study coupled science with convection, aerosol and land-atmosphere interactions.

The ARM observatories around the world provide atmospheric observations of aerosols, clouds, precipitation and radiation to inform and improve Earth system models.

“We are going to leverage as much as we can of the existing networks,” Kuang said. The ARM has a fixed site in Oklahoma, which provides data for the Southern Great Plains Site, or SGP. The Southeastern site, wherever it winds up, will provide a context for large-scale atmospheric phenomena.

The way aerosols, clouds and weather systems form and change presents a challenge and an opportunity for research stations like AMF3, which will seek to connect phenomenon at spatial and time scales that affect where Kuang and his team hope to locate the site.

Kuang is also staying abreast of the latest technology and is also contributing to the development of these capabilities. The technology the AMF3 may use could be developed between now and when the site starts gathering data.

“We have the opportunity now to start thinking about what the next generation measurement capabilities and emerging technologies are that could be operational in 2023,” he said. “We are in conversations with the broader community and with different vendors and with a number of different investigators who are developing new technologies.”

Researchers hope to understand the coupling between the land surface and atmospheric phenomenon. “That will have feedback on radiation and precipitation and the impact on land-surface interactions,” Kuang explained. The current plan is for the new facility to operate for about five years.

While Kuang is focused on the scientific drivers for the site selection, he has also been exploring the dynamic with potential research partners, including universities, seeking ways to add educational partners.

“We have hopes and plans for this kind of deliberate, targeted outreach within the region,” Kuang said. “We want to organize activities like summer school, to provide young scientists with primers and an introduction about how observations are made within their backyard.”

The work he’s trying to do now is “setting the table and preparing the soil for the eventual siting” of the station.

Kuang will measure his success if the new site improves poorly represented model processes.

Once the DOE chooses a site, Kuang plans to develop and execute an initial science plan that uses AMF3 observations. As an ARM instrument mentor, he will also be responsible for a set of instruments that measure aerosol size and concentration.

A resident of Wading River, Kuang started working at BNL in 2009 as a postdoctoral researcher. When he’s not working, he describes cooking as “therapeutic,” as he and his wife, Anyi Hsueh, who is a psychiatric nurse practitioner, have explored Southeastern Asian and Middle Eastern cuisines.

Kuang is working with Associate Ecologist Shawn Serbin and Meteorologist Scott Giangrande, in site selection. The work presents an “important responsibility and our site science team envisions the AMF3 southeastern united States [site] to enable transformational science,” he said.

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Photo from Pixabay

Working with the rideshare company Lyft, Suffolk County is offering free rides for senior citizens, veterans and people who are driving impaired to get their vaccinations for COVID-19 at county-run sites.

Starting on June 1, seniors who are over the age of 60, veterans and driving impaired residents can contact Suffolk 311 to schedule a pick-up and drop off to receive their inoculations.

The county would like residents to have an “equal ability to get their vaccines,” regardless of whether they have easy access to transportation, Suffolk County Executive Steve Bellone (D) said at a press conference announcing the program. “It’s not only good for them and their health: it’s good for all of us. It means that we will get closer to the numbers and the level of vaccinations we need to say that we have put this virus behind us.”

Suffolk County will be able to schedule and pay for the rides on behalf of residents, according to a Lyft spokeswoman.

The effort is a part of Lyft’s Universal Vaccine Access program, which started in December of 2020. Lyft has created more than 100 such partnerships and is facilitating access to rides throughout the country.

Lyft drivers will not wait outside while residents receive shots. County staff can arrange for pick up and drop off up to seven days in advance when residents call 311.

When seniors, veterans or driving impaired residents need transportation for their shots, county staff can request a ride using Lyft’s Concierge platform, which allows groups to request rides on behalf of those who may not have access to a smartphone or a bank account.

Bellone indicated that the county put out a competitive process to select a partner who could allow residents who don’t have access to a smartphone or who haven’t downloaded an app to secure a ride.

Lyft is committed to helping communities reach an “immunity that is going to get our economy back on track and our community back to normal,” Jen Hensley, head of government relations at Lyft said at the press conference.

Bellone shared his appreciation for the efforts of Senator Chuck Schumer (D).

“Without [Schumer’s] support, we wouldn’t be in a position to be able to offer a program like this,” Bellone said.

Vaccination efforts have helped reduce the spread of the virus, according to a recent interview with Gregson Pigott, commissioner of the Suffolk County Department of Health Services.

Lyft has also partnered with the White House. 

From May 24 through July 4, anyone going to get their shots can get a ride code through the Lyft app or web site for two free rides during normal pharmacy hours of 6 a.m. until 8 p.m. of up to $15 each.

The county’s partnership with Lyft is the latest effort by Bellone to increase the number of people who have received the Pfizer, Moderna or Johnson & Johnson vaccines.

Through a “Lift Your Spirit, Take Your Shot” campaign, residents who are 21 years old and over and who receive their shot at a Suffolk County run site during the month of May will get a ticket that they can redeem at a participating brewery, winery and distillery for a free beer, tasting, glass of wine or cocktail.

Eight businesses are participating in that effort, including Del Vino Vineyards in Northport.

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County Executive Steve Bellone with Dr. Gregson Pigott in front of the vaccine pods in Hauppauge. Photo by Julianne Mosher

Thanks to vaccines for COVID-19, the percentage of positive tests recently dropped below 1% for the first time since the third week of October.

“That’s a big deal,” said Dr. Gregson Pigott, commissioner for the Department of Health Services in Suffolk County.

Indeed, Adrian Popp, chair of Infection Control at Huntington Hospital/Northwell Health and associate professor of medicine at Hofstra School of Medicine, said the infection rate was closer to 10 percent in the middle of the winter.

The current positive tests represent a “really low number,” Popp said.

Infections are coming down even more than they did last year amid the economic shutdown because of the vaccine, Pigott said.

Pigott added that the vaccines have proven effective against the most predominant mutated form of the virus, B117 or the UK variant, which is also the most common mutation throughout the country.

“We haven’t seen evidence of resistance to the vaccine,” he said. “The vaccine is working against it.”

The number of people hospitalized with the virus also has been declining in recent weeks. Throughout the county, under 150 people were in the hospital battling symptoms of the disease that caused the pandemic. That’s down from a high of 863 on Jan. 19.

The age of those hospitalized is generally younger than the people who needed urgent medical care in 2020. They are in their 40s and 50s, and they generally don’t stay in the hospital for long.

Because they are younger and healthier, even if they are hospitalized, they generally are discharged sooner, Pigott said.

“I expect we’ll be under 100 soon,” Pigott said.

Indeed, area hospitals reported lower numbers of Covid patients. As of May 10, Stony Brook Hospital had 42 COVID-19 patients, with 13 in the Intensive Care Unit.

As of the same date, Huntington Hospital had 17 COVID-19 positive patients.

Vaccinations

The population of people who are older than 65 have generally embraced the opportunity to receive vaccinations. Pigott said about 80% of this population in Suffolk County have been vaccinated.

The elderly, who were among those representing the larger groups hospitalized or killed by the virus, were the first group eligible to receive the vaccination. Children as young as 12 are now eligible to receive a vaccine.

The medical community has been wondering how to “cross this barrier” to encourage more people to receive a vaccine that could continue to reduce the risk of the spread of the virus, Popp said.

Popp urged medical professionals to have conversations with each person to figure out why he or she might be reluctant. He attributed some of the fears of the vaccine to misinformation spread on the Internet or over social media.

Popp recognized that some of those who are unwilling to consider the vaccine don’t have a personal or regular connection with a member of a medical community they trust.

He suggested that doctors and nurses should visit people at cultural centers and schools.

Among workers at Huntington Hospital, the rate of vaccinations has slowed and is about 73%.

“We did quite well” to get to that point, but the hospital “can not go much further” without overcoming some resistance, Popp said.

Pigott said that the halt in the use of the Johnson & Johnson vaccine on April 13 tamped down on the vaccination rate.

When the Centers for Disease Control and Prevention and the Food and Drug Administration stopped the use of that vaccine pending an analysis of rare side effects, the county “never recovered momentum.”

Pigott said he has participated in webinars and has encouraged people to gather information to make informed decisions.

“The best you can do is show the numbers,” Pigott said, as the number of people who are over 65 who have been hospitalized has declined dramatically as a result of the use of the vaccine.

Reopening in stages

Employers throughout the county have been monitoring the health of their workers and keeping track of the vaccination rate.

Cold Spring Harbor Laboratory has been working its way through various phases of reopening, from phase 1, which occurred on June 1 and involved bringing back most of the scientists, to phase 2 in late September, with the return of more administrators, to phase 2A, which started May 3 and involved bringing back even more people.

The lab, which has historically hosted well-attended scientific meetings that bring together some of the best researchers from around the world, has not yet entered phase 3, when it would be open without any restrictions.

On any given day, the lab probably has 60 to 65% of its staff working on site, according to John Tuke, the chief pperating officer.

“We aspire to be 100% vaccinated, but we’re realistic to know that that’s probably not going to happen,” Tuke said. “Before we move into phase 3, we’re going to want to see that percentage be very high.”

The lab is hoping to bring some conferences back in the fall on a limited basis.

In the last week, the lab tested 400 people, with one test coming back positive. The highest the positivity rate ever got was around 1%.

The percentage of people who have received the vaccine at CSHL is in the low 80s.

While the lab has restrictions on travel, it has made exceptions for staff members to travel through requests to the director of research, the president of the lab or to Tuke.

BNL, meanwhile, continues to have about a third of its staff on site, while most of the staff continues to work remotely. Like CSHL, BNL is not requiring staff to be vaccinated.

BNL is not planning any in-person events this summer or fall. The lab has slightly expanded user access to facilities on a case-by-case basis. BNL has had 10 positive tests in the past month.

At Stony Brook University, about 82% of health care workers have been vaccinated, while 77% of students are vaccinated, with 16% looking to get it sooner rather than later, according to a spokeswoman. As with other SUNY and CUNY schools, Stony Brook will require a vaccine for everyone who returns to school in the fall.

Stony Brook is no longer requiring fully vaccinated people to wear a mask outdoors, except in crowded settings or venues.

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METRO photo

By Daniel Dunaief

Daniel Dunaief

No one asked me to give a graduation speech. I haven’t done anything to merit standing in front of a group of people who have poured their blood, sweat and tears into their education and who are eager for a memorable, but short send-off. If they’re like me, some of them are probably trying not to sweat on or wrinkle their diploma while they wonder who came up with the idea of turning a piece of cardboard into a hat.

Anyway, I can’t help imagining what I might say to graduates who have ended one phase of their lives and are preparing for another.

I’d start by urging people not to get angry. Adults have mastered the fine art of being angry, yelling at each other, expressing outrage at the way other’s drive, think, live and date. We can and should learn to be as patient with others as we would like them to be with us. You know those student driver bumper stickers? Maybe we should treat each other as if we’re students of life. Let’s assume, for just a moment, that the worst of what you think someone else might have said to offend you or to cause you to gnash your teeth and pull at your hair isn’t actually what they intended.

After all, during the course of your education, you likely wrote or said something in class that your teacher might have misinterpreted or that a fellow student might have taken the wrong way. Perhaps an effective metaphor here might be to imagine that you are laying out the road ahead of you. Wouldn’t it be better to create streets with turnoffs and that allowed traffic in two ways, instead of building an express lane to the world of outrage, anger and disappointment?

I would also urge you, the current graduates and the keys to an effective future, to listen to ideas and opinions that don’t mirror your own. It’s easy to live in an echo chamber, where people say what you want to hear or what you already think, but you don’t learn and grow much listening to the same ideas and expressions endlessly.

Think about your audience when you share an insight, an idea or even a joke. Your boss is probably not the best person for bawdy humor or a racy compliment, no matter how cool he or she seems. While some story might be incredibly funny to people who were there with you at the time, were inebriated, or have concluded that you couldn’t possibly offend them no matter what you said, the same preconditions don’t exist for your boss or a potential customer. Humor is like flavors of food. What constitutes funny varies greatly, with some people nearly falling over in hysterics watching someone stumble on a sidewalk and others failing to see the amusement from physical humor.

Now, this one might be the toughest to hear, but, just because your parent said it or did it doesn’t mean it’s wrong. As graduates, you have likely decided to turn your parents’ words into the sounds of teachers from the Charlie Brown animated series. While that may help you create enough distance to leave the nest, you should remember that those flawed humans who have loved and supported you from your first steps until this one are on your side and are trying to help.

Finally, I’d like to suggest that what you do is almost always much more important than what you say. It’s easy to throw words and labels in the air — “I’m an environmentalist” or “I love animals” — but it’s much more important for you to turn those words and ideas into actions. Your best intentions are great, but your best actions are that much more valuable.

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METRO photo

By Daniel Dunaief

Daniel Dunaief

After setting the American record for the longest consecutive streak of 340 days away from Earth aboard the International Space Station, astronaut Scott Kelly returned and flopped into a pool.

While we all haven’t been away from Earth for any length of time, we have been living in a modified version of the normal we knew.

Like Kelly, we have spoken with our close friends and family through electronic devices that beam them onto a screen in front of us.

We have watched some of their drained faces, as they isolated themselves for a month or more, battling through the cough, fever and discomfort of COVID-19.

We have also seen our relatives at much greater than arm’s length as we celebrated landmark birthdays, the birth of new family members, and socially-distanced graduations and limited-attendance weddings.

In two weeks, I am anticipating the familiar feeling of diving into a familial swimming pool. That’s when I will see family members I haven’t seen in over a year.

We worked around our busy schedules not only to get vaccinated before we saw each other in real life, but also to do so long enough in advance of that meeting that our immune systems would have time to arm themselves against viral spike proteins.

This is the longest period my wife and I have ever been separated from our parents. We know how fortunate we are that our parents didn’t get sick.

We took nothing for granted, staying away from our parents and extended family. We might as well have been on the International Space Station, which was probably among the safest places people have ever lived, given the limited social contact in a controlled environment 254 miles from the nearest pool, family member or pizza restaurant.

We feel so much closer to a more familiar life than we have in over a year, as we anticipate seeing our parents and family members who can attend our son’s graduation. The planned visit has become a dominant and daily topic of conversation in our house. We are wondering what food and drink to serve, how to move everyone from nearby hotels to socially-distanced seating at graduation and what games to prepare in our backyard for our grown children to play with their cousins.

These questions and decisions might have seemed like a responsibility prior to the pandemic, as hosting anyone requires attention to detail and consideration for our guests. That responsibility has transformed into the kind of privilege we might have taken for granted in other years, before the pandemic disrupted family gatherings and turned the calendar into a reminder of delayed gratification of family gatherings.

While we will likely engage in the Texas two-step, trying to gauge how close we can get physically to each other, it’s easy to imagine that hugs, kisses and appreciative smiles will bubble up from the excitement of a backyard that has hosted more routine gatherings of birds, squirrels and chipmunks than of the people who stare at flickering screens in our home.

As we prepare to dive into our own family pools of support, affection and love, we are incredibly grateful to everyone who made such a return to normal possible, from those who explored the basic science that led to the vaccine, to those who developed and tested the vaccine, to those who treated family and friends, to those who stocked the shelves with the food and drinks we needed to take us from the uncertainty of the pandemic to the anticipation of a celebration. Absence made our hearts grow fonder for family and increased our appreciation for everyone who allowed us to reunite with the most important pieces of ourselves. In just a few weeks, we look forward to diving into a more familiar world.

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Linda Van Aelst. Photo from CSHL

By Daniel Dunaief

Different people respond to the same level of stress in a variety of ways. For some, a rainy Tuesday that cancels a picnic can be a minor inconvenience that interrupts a plan, while others might find such a disruption almost completely intolerable, developing a feeling of helplessness.

Scientists and clinicians have been working from a variety of perspectives to determine the cause of these different responses to stress.

From left, graduate student Nick Gallo, Linda Van Aelst and Postdoctoral Researcher Minghui Wang. Photo by Shanu George

Cold Spring Harbor Laboratory Professor Linda Van Aelst and a post doctoral researcher in her lab, Minghui Wang, recently published a collaborative work that also included graduate student Nicholas Gallo, postdoctoral researcher Yilin Tai and Professor Bo Li in the journal Neuron that focused on the gene Oligophrenin-1, which is also implicated in intellectual disability.

As with most X-linked diseases, the OPHN1 mutation primarily affects boys, who have a single X chromosome and a Y chromosome. Girls have two X chromosomes, giving them a backup gene to overcome the effect of an X-linked mutation.

In addition to cognitive difficulties, people with a mutation in this gene also develop behavioral challenges, including difficulty responding to stress.

In a mouse model, Wang and Van Aelst showed that the effect of mutations in this gene mirrored the stress response for humans. Additionally, they showed that rescuing the phenotype enabled the mouse to respond more effectively to stress.

“For me and [Wang], it’s very exciting,” Van Aelst said. “We came up with this mouse model” and with ways to counteract the effect of this mutated analogous gene.

As with many other neurological and biological systems, Oligophrenin1 is involved in a balancing act in the brain, creating the right mix of excitation and inhibition.

When oligophrenin1 was removed from the prelimbic region of the medical prefrontal cortex, a specific brain area that influences behavioral responses and emotion, mice expressed depression-like helpless behaviors in response to stress. They then uncovered two brain cell types critical for such behavior: the inhibitory neurons and excitatory pyramidal neurons. The excitatory neurons integrate many signals to determine the activity levels in the medial prefrontal cortex.

The inhibitory neurons, meanwhile, dampen the excitatory signal so they don’t fire too much. Deleting oligophrenin1 leads to a decrease in these inhibitory neurons, which Van Aelst found resulted from elevated activity of a protein called Rho kinase.

“The inhibitor keeps the excitatory neurons in check,” Van Aelst said. “If you have a silencing of the inhibitory neurons, you’re going to have too much excitatory response. We know that contributes to this maladaptive behavior.”

Indeed, Wang and Van Aelst can put their metaphorical finger on the scale, restoring the balance between excitation and inhibition with three different techniques.

The scientists used an inhibitor specific for a RhoA kinase, which mimicked the effect of the missing Oligophrenin1. They also used a drug that had the same effect as oligophrenin1, reducing excess pyramidal neuron activity. A third drug activated interneurons that inhibited pyramidal neurons, which also restored the missing inhibitory signal. All three agents reversed the helpless phenotype completely.

Japanese doctors have used the Rho-kinase inhibitor fasudil to treat cerebral vasospasm. which Van Aelst said does not appear to produce major adverse side effects. It could be a “promising drug for the stress-related behavioral problems” of oligophrenin1 patients, Van Aelst explained in an email. “It has not been described for people with intellectual disabilities and who also suffer from high levels of stress.”

From left, graduate student Nick Gallo, Linda Van Aelst and Postdoctoral Researcher Minghui Wang. Photo by Shanu George

Van Aelst said she has been studying this gene for several years. Initially, she found that it is a regulator of rho proteins and has linked it to a form of intellectual disability. People with a mutation in this gene had a deficit in cognitive function that affected learning and memory.

From other studies, scientists learned that people who had this mutation also had behavioral problems, such as struggling with stressful situations.

People with intellectual difficulties have a range of stressors that include issues related to controlling their environment, such as making decisions about the clothing they wear or the food they eat.

“People underestimate how many [others] with intellectual disabilities suffer with behavioral problems in response to stress,” Van Aelst said. “They are way more exposed to stress than the general population.”

Van Aelst said she and Wang focused on this gene in connection with a stress response.

Van Aelst wanted to study the underlying cellular and molecular mechanism that might link the loss of function of oligophrenin1 with the behavioral response to stress.

At this point, Van Aelst hasn’t yet studied how the mutation in this gene might affect stress hormones, like cortisol, which typically increase when people or mice are experiencing discomfort related to stress. She plans to explore that linkage in future studies.

Van Aelst also plans to look at some other genes that have shown mutations in people who battle depression or other stress-related conditions. She hopes to explore a genetic link in the brain’s circuitry to see if they can “extend the findings.” She would also like to connect with clinicians who are studying depression among the population with intellectual disabilities. Prevalence studies estimate that 10 to 50 percent of individuals with intellectual disability have some level of behavioral problems and/or mood disorders.

Reflecting the reality of the modern world, in which people with various conditions or diseases can sequence the genes of their relatives, Van Aelst said some families have contacted her because their children have mutations in oligophrenin1.

“It’s always a bit tricky,” she said. “I don’t want to advise them yet” without any clinical studies.

A resident of Huntington, Van Aelst arrived at CSHL in the summer of 1993 as a post doctoral researcher in the lab of Michael Wigler. She met Wigler when he was giving a talk in Spain.

After her post doctoral research ended, she had planned to return to her native Belgium, but James Watson, who was then the president of the lab, convinced her to stay.

Outside of work, Van Aelst enjoys hiking, swimming and running. Van Aelst speaks Flemish, which is the same as Dutch, French, English and a “bit of German.” 

She is hopeful that this work may eventually lead to ways to provide a clinical benefit to those people with intellectual disabilities who might be suffering from stress disorders.

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Eszter Boros. Photo from SBU

By Daniel Dunaief

And the winner is … Eszter Boros. An Assistant Professor in the Department of Chemistry at Stony Brook University, Boros recently won the 2021 Stony Brook Discovery Prize, which includes $200,000 in new funding.

The prize, which was established in 2013, is designed to fund higher-risk research for scientists who are no more than five years beyond tenure and promotion at the Associate Professor level or who are on a tenure track as an Assistant Professor. The research might not otherwise receive financial support from agencies like the National Institutes of Health.

Eszter Boros. Photo from SBU

Stony Brook awards the prize to a faculty member who is considered a rising star.

Boros’s proposal suggests using a radioactive light switch to activate anticancer molecules.

The goal behind Boros’s work is to target cancer cells in particular, while avoiding the kinds of painful side effects that typically accompany chemotherapy, which can lead to gastrointestinal discomfort and hair loss, among others.

Boros, who has been at Stony Brook since 2017, was pleased to win the award. “It’s really exciting,” she said. “I’m kind of in disbelief. I thought all the finalists had convincing and exciting projects.”

The four finalists, who included Eric Brouzes in biomedical engineering, Gregory Henkes in geosciences and Kevin Reed in climate modeling, went through three rounds of screening, culminating in a Zoom-based 10-minute presentation in front of four judges.

Bruce Beutler, the Director of the Center for the Genetics of Host Defense at the University of Texas Southwestern Medical Center, served as one of the four judges.

In an email, Beutler wrote that Boros’s work had an “inventive approach” and was “high risk, but potentially high impact.”

Beutler, who won the 2011 Nobel Prize in Physiology and Medicine, suggested that the Discovery Prize may give a start to “a bright person with relatively little track record and a risky but well reasoned proposal.”

The success from such a distinction “does build on itself,” Beutler wrote. “Other scientists hear of such awards or read about them when evaluating future proposals. This may influence decisions about funding, or other awards, in the future.”

Boros said she would use the prize money to fund work from graduate students and post doctoral fellows, who will tackle the complexities of the work she proposed. She will also purchase supplies, including radioactive isotopes. She hopes to stretch the funds for two and a half or three years, depending on the progress she and the members of her lab make with the work.

The idea behind her research is to send radioactive materials that emit a light as they decay and that bind to the cancer cell. The light makes the chemotherapy toxic. Without that light, the chemotherapy would move around the body without damaging non-cancerous cells, reducing the drug’s side effects.

She is thinking of two ways to couple the radioactive light-emitting signal with an activated form of treatment. In the first, the two parts would not be selectively bound together.

The chemotherapy would diffuse into tissues around the body and would only become activated at the target site. This may affect healthy neighbors, but it wouldn’t cause as many side effects as conventional chemotherapy. This could take advantage of already clinically used agents that she can combine.

In the second strategy, she is taking what she described as a “next level” approach, in which she’d make the radioactive agent and the chemotherapy react with one another selectively. Once they saw one another, they would become chemically linked, searching to find and destroy cancer cells. This approach would require new chemistry which her lab would have to develop. 

Beutler suggested that Boros’s work might have other applications, even if cancer might currently be the best one. Some focal but infectious diseases can be treated with antimicrobial therapy which, like cancer directed chemotherapy, is toxic, he explained.

The same principle of using a drug activated by light that is connected to a site-specific marker “could be used in such cases,” he said.

While the potential bench-to-bedside process for any single treatment or approach can seem lengthy and filled with unexpected obstacles, Beutler said he has seen certain cancers that were formerly fatal yield to innovation. “People who are battling cancer can at least be hopeful that their cancer might fall into this category,” he said.

Boros appreciated the opportunity to apply for the award, to bond with her fellow finalists and to benefit from a process that included several sessions with experts at the Alan Alda Center for Communicating Science, who helped prepare her for the presentation in front of the judges. She developed her full proposal during the course of a week, over the December holiday, when her lab had some down time.

In the final stage, she met weekly for an hour with Louisa Johnson, an Improvisation Lecturer at the Alda Center and Radha Ganesan, an Assistant Professor of Medicine, to hone her presentation.

Boros said she appreciated how the Alda Center guides helped her focus on the obsession she and other scientists sometimes have of putting too much text in her slides. “I put text and conclusions on every slide,” she said. Ganesan and Johnson urged her to focus on what she wants to say, while letting go of this urge to clutter her presentation with the same words she planned to use in her presentation. “That was a huge shift in mindset that I had to make,” she said.

As for the work this prize will help fund, Boros said she’ll start with targets she knows based on some research she’s already done with prostate, breast and ovarian cancers.

Boros, who was born and raised in Switzerland, described herself as a chemist at heart.

Outside of work, she enjoys spending time with her husband Labros Meimetis, Assistant Professor of Radiology at the Renaissance School of Medicine at Stony Brook, and their nine-month-old son.

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Photo from Pixabay

By Daniel Dunaief

Daniel Dunaief

We live such a two-handed life these days. On the one hand, we are emerging from our pandemic shells. On the other, we don’t want to race out too quickly, undermining all the work we did to protect ourselves, our families and our school communities. To that end, I had a few topics on the two-handed nature of our lives:

The weather

On the one hand, it’s a relief that we can enjoy warmer weather. The summer is approaching. The calls from seagulls blend with the steady rhythm of water lapping up on the shores, urging the fortunate residents of Suffolk County to return to the peace and harmony of the water.

On the other hand, the temperature will undoubtedly climb into the hazy, hot and humid zone at some point. While the beaches are wonderful, we won’t all have time to stroll on a sandbar during the week.

Vaccinations

On the one hand, many people are getting vaccinated, increasing the likelihood that we’re taking an immunological stand against a deadly virus. With a greater percentage of the population inoculated, we stand a better chance of coming together, revisiting family and friends we’ve only seen on Zoom for over a year.

On the other hand, a subgroup of people are reluctant to take the vaccines, worried about side effects, the speed at which the vaccine was developed, and a host of other concerns. If enough of them don’t get vaccinated and/or if variants evade the vaccine, we may not be able to beat back this virus as quickly as we’d like.

Graduations

On the one hand, we are so incredibly proud that our children have made it through whatever stage concludes this year. We appreciate all they have done to get here and to become the incredible people they are.

On the other hand, wait, hello? How did the time go by so quickly? Did we prepare them for the real world? What is the real world? What does it mean to graduate into the second year of a pandemic and how can we prepare them for some of the unknowns and unknowables ahead? 

Politics

On the one hand, we can, potentially, talk about politics again without the echoes of personal animus reverberating from an angry White House. In theory, we can even agree to disagree or to consider compromise.

On the other hand, has the left become too powerful even as the right engages in party strife? Are calmer waters really around us, or is it a temporary reprieve until the tempest returns with the elections in 2022 and 2024?

Freedom

On the one hand, we are freer than we’ve been in over a year, to travel and visit family, to take our masks off outside and read people’s lips and study their smiles. We can even consider traveling outside the country.

On the other hand, after living with a fear of human contact, how much can we set aside our concerns about the public health dangers of interacting with other people? 

A return to offices

On the one hand, we have a chance to speak with each other in person, to share stories about our lives and our children and to discuss the surprising run of a Knicks team guaranteed to have a winning record this year.

On the other hand, we have to deal with traffic, parking spots, lines at lunch, and conversations that keep us from returning to the homes we couldn’t wait to leave.

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Photo from Huntington Hospital Facebook

Huntington Hospital scored a five-star rating from the U.S. Centers for Medicare & Medicaid Services in its annual 2021 hospital rankings.

The hospital, which is the only one in Suffolk County to achieve a five-star rating this year, has climbed the rankings over the last year, with three stars in 2019 and four stars in 2020.

“This is a reflection of the dedication of all the staff here,” said Huntington Hospital Executive Director Nick Fitterman. “What it means for the community is that they can get great care in their backyard.”

The top 13.56 percent of hospitals nationwide received five stars in 2021, according to the CMS website.

The rating measures five qualities, including mortality, safety, readmission, patient experience and timely and effective care. The first four categories receive a 22 percent weighting, while timely and effective care receives 12 percent.

The star rating encompasses over 100 measures CMS publicly reports, including the death rate for heart attack patients, surgical site infections for colon surgery, percentage of health care workers given influenza vaccinations, and the percentage of patients receiving appropriate recommendations for follow-up screening colonoscopy, among other measures.

“The five-star quality rating system is ultimately grounded in helping patients and their families make informed care decisions,” a CMS spokesman said in a statement. The ratings provide a general indication or what to expect in the future based on how a facility performed in the past.

Fitterman suggested that the rating reflects the hospital’s dedication to its mission, rather than focusing on achieving a specific rating.

Delivering excellence in clinical care is “the best and only strategy,” Fitterman said. “We don’t perseverate on what the rating agencies are looking for: we perseverate on what we think we’re doing for our patient.”

The improvements over the last few years have been incremental in numerous areas, including in neurosurgery and stroke care, cardiovascular care, and orthopedic care, which is ranked in the top 50 in the country, Fitterman said.

Fitterman praised the nursing staff, which he described as “first class,” and suggested that their culture is “contagious.”

While Huntington Hospital, which is part of Northwell Health System, doesn’t negotiate independently as a hospital, he said companies and payers “want to align themselves with high quality institutions and providers in their networks, because good [care] equates to less expensive care.”

After Fitterman received the news last week about the five stars, he walked through the hospital, high-fiving and fist pumping everyone from valets to engineers, to the food and nutrition workers and the doctors and the nurses.

“There was such excitement and jubilation and everyone realizes the hard work, the blood, sweat and tears, that go into the job,” the executive director said. “They put their heart into what they do. To get that public recognition was outstanding.”

Fitterman said he walks the halls each day, thanking staff for what they do and reminding them that they don’t just do their own task. They are all “helping relieve the suffering of others.”

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