What Is Multisystem Inflammatory Syndrome in Children (MIS-C)? Q&A with SGU Grads Featured in New England Journal of Medicine Article (UPDATED)

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This article has been updated from its original publication date of September 29, 2020, to name additional SGU graduates who contributed to the New England Journal of Medicine article.

As the novel coronavirus (COVID-19) continues to affect persons young and old, and increasingly in children, the New England Journal of Medicine recently published an article titled “Multisystem Inflammatory Syndrome in U.S. Children and Adolescents.”

Among the nearly 50 contributing physicians, five were St. George’s University graduates:

  • Steven Horwitz, MD ’08, a lead author on the paper who is a pediatric critical care specialist and assistant professor of pediatrics at Rutgers University School of Medicine;
  • Michael Keenaghan, MD ’06, the associate chief academic officer at New York City Health+Hospitals/Kings County;
  • Hussam Alharash, MD ’11, a pediatric intensivist and informatics liaison at New York City Health+Hospitals/Kings County;
  • Shira Gertz, MD ’01, FAAP, an attending physician in pediatric critical care at Saint Barnabas Medical Center in Livingston, NJ, and clinical associate professor in the Department of Pediatrics at Rutgers New Jersey Medical School; and
  • Stacy Ramsingh, MD ’15, a third-year pediatric ICU fellow at Advocate Children’s Hospital in Park Ridge, IL.

 

SGU spoke with three of the SGU-educated doctors to get their take on the article’s findings, and why the research was an important contribution to the expansion of medical knowledge of COVID-19.

St. George’s University: As COVID continues to affect adults and children, what is MIS-C and why is it an important disease to understand?

Drs. Horwitz, Keenaghan, and Alharash: Multisystem inflammatory syndrome in children (MIS-C) is a newly identified inflammatory syndrome affecting children, that is associated with SARS-CoV-2019 infection. The pathophysiology is not clear at this point, and there is much we do not yet know about the long-term prognosis. Some of the children who present with this syndrome are very sick and require ICU-level care, while others have very mild symptoms.

There are several reasons why it is important to understand this disease: Because MIS-C in some ways mimics the presentation of Kawasaki disease, pediatricians are concerned that some of the same sequelae and complications of Kawasaki may develop in children who are diagnosed with MIS-C. We know that some of the children who present with MIS-C are very sick, and since it is unlikely that COVID-19 will disappear in the immediate future, there is a lot of interest in better understanding it and its long-term complications.

SGU: What was the research intending to prove?

Drs. Horwitz, Keenaghan, and Alharash: The study we were involved in aimed to describe the presentation and inpatient course of MIS-C. By looking at a series of patients and characterizing some of the disease’s features, the paper should give clinicians who have not yet seen patients of MIS-C an idea of what to look for and what to expect. It will also help to characterize and pin down the definition of the syndrome, which will help in ongoing research that looks at MISC.

SGU: What were the key findings? Why were the results significant?

Drs. Horwitz, Keenaghan, and Alharash: The study confirmed what many of us suspected. MIS-C was causing cardiovascular symptoms, gastrointestinal symptoms, hematologic abnormalities, and was associated with markedly elevated signs of inflammation.

It also reassured us in some ways because it demonstrated that while a good number of the patients with MIS-C required cardiovascular support in the form of vasopressors and in a few rare occasions extracorporeal membrane oxygenation (ECMO), the vast majority of these kids got better and went home.

SGU: What exactly was your part in the research efforts?

Drs. Horwitz, Keenaghan, and Alharash: As the pandemic took hold in the United States, the Northeast and New York City, in particular, were the epicenter of the new cases of COVID and eventually of MIS-C cases as well. Our contribution to this project was to review the patients at our hospitals who presented with features of what would eventually come to be called MIS-C and prepare detailed case reports about the presentation and hospital course for each of the patients. This data was later included in the multicenter analysis that resulted in the publication in the New England Journal of Medicine.

SGU: What practical advice would you give to medical students who want to get research published?

Drs. Horwitz, Keenaghan, and Alharash: Be curious and follow through. There is much we do not know in medicine—being curious will make it more likely that you will become familiar with the questions that are waiting to be answered. Of course, coming up with the question is just the start. Research can be a very long and drawn-out process with many setbacks. Perseverance and follow-through in the face of adversity will be required to keep going.

 

— Laurie Chartorynsky

VIDEO: From MMA to MD

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Dr. Anthony McDonald, a 2013 graduate of St. George’s University School of Medicine, turned in his mixed martial arts championship belt to pursue his dream of becoming a physician. He is now the director of cardiopulmonary medicine at San Angelo Community Medical Center in San Angelo, TX.

“What I used to do with fighting and training, it really ingrained in me the discipline that I needed and the structure that I needed to know what I needed to do to be successful,” Dr. McDonald said. “The contrast is very different, but I feel that the idea is still the same. It’s about not giving up. Medical school is challenging. There’s no two ways about it. And I was very fortunate to be able to do it at St. George’s University, where I felt that the entire island was set up to make you succeed.”

World Alzheimer’s Month brings focus to mysterious disease

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Michael Reinhardt, MD ’09

World Alzheimer’s Month, launched in 2012 by nonprofit organization Alzheimer’s Disease International, cast a light on the growing and persistent issue surrounding a condition that affects more than five million Americans, with one in three seniors passing away with the disease’s pathology in his or her brain.

Michael Reinhardt, MD ’09, the associate director of the Center of Excellence for Alzheimer’s Disease at SUNY Downstate Health Sciences University and director of its geriatric psychiatry fellowship program, explained what makes the disease so mysterious and so challenging, and the steps that doctors are taking to treat patients suffering from the affliction. 

St. George’s University: What is Alzheimer’s disease, and what causes it?

Michael Reinhardt: Alzheimer’s disease is the most common form of dementia, making up 60 to 80 percent of all cases. It is neurogenerative, meaning it causes a decline in brain cell health and function, and eventually it results in brain cell death. We haven’t put our finger on exactly what causes Alzheimer’s disease yet, but the most common explanation is that it’s a buildup of what’s called amyloid plaque in the brain. Once you’ve triggered enough amyloid buildup in the brain, there’s this irreversible cascade that happens that leads to progressive decline in brain cell function and healthy brain cells.

SGU: How prevalent is Alzheimer’s in the US? Is the situation getting better or worse?

MR: Unfortunately, it’s getting worse. Between 2000 and 2018, there’s been about an 8 percent decrease in cardiovascular-related deaths, but there’s been a 146 percent increase in Alzheimer’s-related deaths. In 2020, the projection is that Alzheimer’s-related care will cost around $305 billion. By 2050, the costs are going to be around $1 trillion annually.

“We’re looking to 2021 as a possible timeframe in which medication may become available and provide us hope of not only slowing down the illness, but stopping it in its tracks.”

 

SGU: A recent study by University of California, Berkeley suggests that Alzheimer’s may be a byproduct of poor sleep habits. Have you seen such links between sleep and the disease?

MR: This is absolutely in the literature and it’s been a growing area of study over the last several years. We ourselves aren’t doing research on the link between sleep disorders and Alzheimer’s disease, but we do see it clinically. Our patients with more disrupted sleep cycles tend to have a more rapidly progressive course of illness. Knowing what we know about basic physiology, neurophysiology, and the growing knowledge base surrounding the actual functions of sleep and allowing the brain to recuperate—to clear its waste products on a nightly basis—it makes only good sense that if your sleep cycle is disrupted, you’re not going to have that rhythmic cleaning of your central nervous system that’s required for optimal brain health.

SGU: What treatments are used for patients who suffer from Alzheimer’s?

MR: The current treatments comes with limits. We have a couple of approved classes of medication that modestly slow the progress of the illness while you’re taking them, and perhaps have some benefits to the behavioral problems that come with Alzheimer’s disease and related dementias. But they’re not disease-modifying treatments. We’re very hopeful about some compounds that are going through clinical trials. We’re looking to 2021 as a possible timeframe in which that medication may become available and provide us hope of not only slowing down the illness, but stopping it in its tracks.

SGU: At the Center of Excellence for Alzheimer’s Disease, what goals are you aiming for with your patients?

MR: Some of the other treatments that many times prove more meaningful and more useful involve connecting families to the support services and social services they need to maintain their loved one in the home and really improve their outcomes through social connectedness and meaningful preventive programming. Music programming, art therapy, all of the different multimodal social therapies that don’t involve medications, are of utmost importance, both to patients and their caregivers.

– Brett Mauser

A Closer Look at Trends in Telemedicine

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Shyamal Majithia, MD ’14

The emergence of the novel coronavirus (COVID-19) forced just about every individual, and every organization, to discover new ways to achieve their goals and reach positive outcomes.

Shyamal Majithia, MD ’14, a family medicine physician at Western New York Immediate Care in and around Buffalo, NY, has been accustomed to providing in-person urgent and emergent care for patients of all ages and backgrounds. However, in light of recent events, much of that care has shifted online, including Teladoc Health, for which Dr. Majithia serves as an independent contractor.

He sat down with St. George’s University to describe his experience with administering telemedicine during a crucial time in healthcare.

St. George’s University: What has your experience been like working for Teladoc Health?

Shyamal Majithia: During the current pandemic, the need for access to medical advice and care has grown rapidly. Working with Teladoc was relatively easy to get used to from the obtaining of emergency medical records and ‘seeing patients’ aspect. We provide care via video and/or over the phone. For minor complaints, patients can be seen quickly and efficiently allowing them to get a genuine medical opinion from a licensed professional rather than being left to find their own answers during the pandemic.

SGU: What are some of the trends you are seeing in telemedicine?

SM: I believe telemedicine will soon become a staple of most healthcare practices. It provides a much wider access to care. Minor injuries are treated with relative ease. Patients now upload their photos or are being evaluated by a physician over video chat. These trends are particularly used as viable tools in specialties such as dermatology and psychiatry.

SGU: How has the telehealth traffic been affected by the COVID-19 pandemic?

SM: There has definitely been an increase in the use of telemedicine in recent months. I remember logging onto Teladoc and seeing the patient queue with a wait time of over three hours at times of patients waiting for callbacks. It was understandable as everyone was trying to shelter in place and help flatten the curve. Now that the country has been reopening, people have continued to seek telemedicine options because they’ve had their issues resolved, resulting in a positive experience.

“I remember logging onto Teladoc and seeing the patient queue with a wait time of over three hours.”

 

SGU: How have hospitals/medical practitioners had to adjust to practicing telemedicine?

SM: There was a learning curve when it came to adjusting to practicing telemedicine. Medicine is such a personal experience, usually practiced face to face with a physician. It was hard to imagine not doing a full physical exam, or having immediate access to a set of vitals. My colleagues and I have definitely had to adjust the way we navigate health problems over the phone. This is where new features such as being able to see uploaded photos or logging on to a video chat can be a big help in aiding in diagnosis.

In preparation for the upcoming possible second wave coupled with flu season, we have also begun integrating telemedicine into our clinics to allow our patients a safe way to seek care.

SGU: Can you share a time when practicing telemedicine was particularly helpful to you? Also, where do you see it going in the future?

SM: With the shelter in place order, volumes dropped in emergency rooms and urgent care practices. Telemedicine allowed me another way to fill my schedule and feel like I was contributing during the pandemic. It allowed me to set my own work hours, and see patients after my urgent care job as well. I see telemedicine here to stay. With today’s access to technology such as phones, tablets, and computers, patients have almost 24-hour access to care from the comfort and safety of wherever they are.

– Ray-Donna Peters

On the Blog: 5 Benefits of Telehealth in the Zoom Era

VIDEO: SGU Veterinary Grad Describes How She is “Making a Difference”

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Dr. Kendra Baker, a 2015 graduate of St. George’s University School of Veterinary Medicine, describes what it’s like treating an array of aquatic animals, of all shapes and sizes, as a veterinary fellow at the National Aquarium in Baltimore, MD.

“One characteristic [zoo/aquarium veterinarians] all share is the ability to innovate,” Dr. Baker said. “You might have one of the few remaining endangered species in your collection that’s doing something that has never been seen before. And you have to figure it out and treat it. But you have to use tools that weren’t made with this specific animal in mind.”

 

SGU Mourns the Loss of Dr. Mark Lanzieri

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SGU alumnus Dr. Mark Lanzieri implants cardiac pacemakers in OR 1 at St. George’s General Hospital.

The SGU community mourns the passing of Mark Lanzieri, MD ’85, a dedicated and beloved alumnus of the School of Medicine who provided much-needed heart care for adult Grenadians at no cost under the Visiting Cardiology Program at SGU. Dr. Lanzieri, an interventional cardiologist at Steward Health Care in Massachusetts, passed away at the age of 60 on Sunday, August 9, 2020, surrounded by his family at his home in Monmouth, ME.

In addition to an esteemed career, having been one of the founding members of Central Maine Heart and Vascular Institute in Lewiston, where he practiced for more than 17 years, it was Dr. Lanzieri’s interests in travel cardiology and his passion for volunteering that were two of the biggest themes of his life.

His desire to volunteer in Grenada in particular motivated him to visit three times a year to treat the island’s residents, who in the past would have had to fly to other Caribbean islands or as far away as New York or Miami to have complicated heart procedures done. In his time, he and his team implanted more than 100 pacemakers and performed 20 coronary angioplasty procedures, arguably adding a collective thousand or more years to the lives of many Grenadians.

“We are eternally grateful to Dr. Lanzieri for his more than 20 years of life-saving cardiology service to the Grenadian people,” said Dr. Charles R. Modica, chancellor of SGU. “Mark represented the spirit of pure humanitarian medicine at its best and he loved what he did. Our thoughts are with his wife, Annie, and their children and grandchildren. He will be greatly missed.”

Dr. Lanzieri’s multiple visits were arranged through the SGU-Physician Humanitarian Network (SGU-PHuN), a program that he was instrumental in creating. His team included his wife, who was an X-ray technologist and cardiovascular specialist, as well as many other volunteers who treated a wide variety of patients since the program’s inception. The value of their time and the equipment they donated exceeded $1 million.

Prior to performing Grenada’s first angiograms in 2013, Dr. Lanzieri and his team of volunteers were also the first in Grenada’s history to implant a cardiac pacemaker in 2001. For these and his many other selfless contributions, St. George’s University honored Dr. Lanzieri by awarding him with a Doctorate of Humane Letters at the 2019 School of Medicine commencement ceremony in New York City.

  • A 1985 graduate of St. George’s University, Dr. Mark Lanzieri returned to Grenada three times a year to provide crucial cardiac care at no cost to the patient.

  • Dr. Lanzieri explains his patient’s cardiac condition to a small group of medical students at SGU’s Adult Cardiology Clinic in 2012.

    Preparing Students for USMLE at SGU School of Medicine

  • At the 2019 SOM commencement ceremony in New York City, Dr. Lanzieri was bestowed an honorary Doctorate of Humane Letters for providing cardiological services at no cost to Grenadian citizens for more than 20 years.

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“More than 30 years after he graduated from SGU, Dr. Lanzieri who wasn’t born in Grenada, but educated here—continued to return here to take care of the Grenadian people,” commented Dr. C.V. Rao, dean of students at SGU. “The Visiting Cardiology Program that he started once hailed from the humble beginnings of a single room at the General Hospital. Today, his legacy will live on in the clinic which has a dedicated center at Grand Anse with more and more St. George’s University alumni and friends of SGU signing on and dedicating their time and expertise just as he once did.”

Dr. Lanzieri is survived by his wife, Annie, their three children, Mark Lanzieri Jr. and partner Kassie Haugen, Casey Conroy and partner Alaina Gayton, and Kristi and Jordan Hirsch; grandchildren Karsyn, Myla, Kameron, and Levi; and siblings Charles, Louise, and Eric.

St. George’s University sends its deepest condolences to Dr. Lanzieri’s family, friends, colleagues, and all those whose lives he touched. His invaluable impact on the growth and success of SGU will not be forgotten.

– Ray-Donna Peters

SGU Grad Fosters Hope Through Curative Cancer Treatments

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Treating and giving hope to the untreatable—they’re the reasons that Eric Tam, MD ’13, went into medicine in the first place, and what drive him to search for more positive results each day. After completing a bone marrow and transplant fellowship at Stanford University School of Medicine, the St. George’s University graduate has just been appointed an assistant professor of clinical medicine at the University of Southern California, Keck School of Medicine.

While there, Dr. Tam will specialize in malignant hematology and allogeneic bone marrow transplant, as well as be involved in direct patient care across three institutions: Keck Hospital of USC, Norris Cancer Center of USC, and LAC+USC Medical Center.

“I have always wanted to be a doctor, particularly an oncologist,” said Dr. Tam. “In addition to having a strong personal interest in malignancies, I chose hematology/oncology because of the vast advances in science and improvements in treatment. Specializing in bone marrow transplant has allowed me to be able to provide curative treatments for otherwise generally incurable malignancies.”

“My experience at St. George’s was much more than I could have expected. I loved the island, the people of Grenada, and it was especially insightful to see clinical medicine in its truest form.”

For Dr. Tam, California has always been home. He grew up in Danville, CA, about a half hour east of San Francisco, before moving to Southern California, where he earned his bachelor’s degree in chemical engineering at UCLA. His biggest move, however, was to Grenada, a small island in the Caribbean that provided him with a very big opportunity—the chance to attend medical school at SGU.

“I chose to apply to SGU because it offered a strong curriculum and had very promising residency placements,” stated Dr. Tam. “My experience at St. George’s was much more than I could have expected. I loved the island, the people of Grenada, and it was especially insightful to see clinical medicine in its truest form.”

Currently, with the effects of COVID-19 still rippling throughout the nation, Dr. Tam has had limited contact with the virus, but acknowledges its repercussions and impact on the healthcare system and his colleagues in the medical community. Proud of their contributions on the front lines, he continues to advocate for their safety and the resources that they require.

“Most of my patients are already severely immunosuppressed, and already take appropriate precautions against infections even prior to the spread of the virus,” Dr. Tam said. “Personally, my family and I have had to adjust our lifestyles, and follow the necessary safety protocols just like the rest of the population.”

Today, Dr. Tam resides back in his home state where he’s married to a very supportive wife who is an attorney, and helps to raise their two toddlers together. As for the future, he remains true to his mission of fostering hope where it is lacking, currently working on the next generation of Chimeric Antigen Receptor T-Cell (CAR-T) therapy to hopefully improve outcomes of many patients with hematologic malignancies.

– Ray-Donna Peters

Washington Post: Grad’s Quick Thinking Saves Life of Mother, Newborn Twins

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Earlier this month, The Washington Post chronicled what one physician, a 22-year veteran, at Saint Barnabas Medical Center called “the craziest day of [her] career.” That’s when a 40-year-old mother, whose condition quickly worsened due to the coronavirus disease (COVID-19).

Upon being told that the patient’s blood pressure and oxygen level were dropping, Fariborz “Bobby” Rezai, director of critical care and medical/surgical intensive care at Saint Barnabas, made the decision to do an emergent C-section on the mother. In a matter of minutes, the babies were delivered, each at just over two pounds. His team’s attention continued on the mother, and in a span of 48 hours, she was “a new person.”

“I’ve been a critical care physician for over 13 years, and I’ve never seen anything like that,” Dr. Rezai told the Post. “Especially with COVID patients, you know when a patient is going to survive or not, and Ebony was not looking like she was going to survive. The decision to do the C-section really saved her life.”

Read the complete story on the Washington Post website

From Pediatric Heart Patient to Pediatric Heart Doctor: Meet SGU Grad Thomas Glenn, MD ’16

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Tom Glenn, MD '16

As someone who has suffered from congenital heart disease and survived five heart surgeries, Thomas Glenn, MD ’16, is now in a unique position as an up-and-coming pediatric heart surgeon. Today, Dr. Glenn is a PGY-5 pediatric cardiology fellow at UC San Diego – Rady Children’s Hospital, dedicating his life to taking care of and managing pediatric patients with both congenital and acquired heart disease, all while inspiring them to live their lives to the fullest.

“Luckily for me, I had many amazing cardiologists—one specifically during my teenage years, and she was one of the most inspiring individuals I’ve known,” said Dr. Glenn. “She took the time to ask me how I was doing, ask what my long-term goals were, and even encouraged me to live my life to its fullest potential without any restrictions.”

Growing up with congenital heart disease in the 1990s was much different than it is today. Back then there was no social media and no long-term outcome data to show that patients do well in the future and could go on to live normal lives.

However, having undergone five heart surgeries himself, the St. George’s University graduate knew from an early age exactly what he wanted to do with his future. His chosen field would be pediatric cardiology, a field he had been exposed to since birth. He knew that he could train in this field and have the opportunity to take care of and inspire patients like himself that needed that kind of encouragement in their life.

“I actually first told my parents when I was 10 years old that I wanted to become a pediatric cardiologist so that I could help encourage and motivate individuals like myself,” he said. “Thanks to everything my cardiologist taught me and instilled in me, I knew this was possible and I made it happen.”

He has made that prediction come true, yet the path to getting there wasn’t so straightforward. Born in California, Dr. Glenn’s family moved around often. He ultimately settled in Arizona where he attended the University of Arizona in Tucson, obtaining a Bachelor of Science in health sciences with a degree in physiology. Later, after having difficulty getting interviews at medical schools in the US, he chose to apply to SGU, where he could begin training at medical school immediately after graduating college, rather than taking more time off.

“I had a great experience at SGU,” stated Dr. Glenn. “I was especially impressed with many of the outstanding professors, who also taught at US medical schools as well. And while it was certainly nerve wracking trying to move to another country and start medical school all within a week, I was surrounded with an incredible group of friends, many of whom I am still close with to this day.”

Grateful for their support back then, today Dr. Glenn lends his support to those same colleagues as many of them who are currently training in the New York, New Jersey and Pennsylvania area have been impacted by COVID-19. He explains that being part of the medical community during this pandemic has been both eye-opening and humbling, even though he has been lucky enough to work with a patient population that has not been greatly affected by the virus.

“While I have only had a few patients with congenital heart disease that have been impacted by COVID-19, I am continuously inspired by everything my colleagues have been able to do for their patients,” said Dr. Glenn. “It is always a big reminder that, no matter what field or specialty you go into, what schooling or education you have behind you, or what your position at your institution is, we are all in this together and we need to continue to stick together to get through these tough times.”

In spite of the present global health crisis, the future continues to shine brightly for Dr. Glenn. Currently on track to finish his pediatric cardiology training in June 2021, he then plans to apply for a fourth-year fellowship in pediatric heart failure and transplantation.

“I am also involved in many national and worldwide collaboratives,” added Dr. Glenn. “We’re looking at improving the outcomes for patients living with single ventricle physiology, something that has a special place in my heart. I am extremely excited for what is to come, and I look forward to everything the future has in store for me.”

 

— Ray-Donna Peters

Pathology Resident Making Impact Through COVID-19 Research at Mayo Clinic

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Nicholas Boire, MD '19

Photo courtesy of the Mayo Clinic.

Being a pathologist is an important specialty in the medical field that is critical to understanding how diseases affect the human body. It is a specialty that is particularly applicable as the healthcare industry grapples with treating those affected by the novel coronavirus (COVID-19), according to Nicholas Boire, MD ’19, a pathology resident at the Mayo Clinic in Rochester, MN.

“Infectious disease pathology has never been more relevant than now, when we’re actually in a situation where we have a new disease and we, as a science community, are not yet sure how this disease functions,” Dr. Boire said. “We’re still uncovering how COVID-19 affects each body system and its pathophysiology. There are a lot of unknowns with the disease and that’s where my specialty comes into play.”

As an anatomical and clinical pathology resident in the Department of Laboratory Medicine and Pathology at the Mayo Clinic, the top hospital in the United States according to the U.S. News 2020-21 Best Hospitals Honor Roll and Medical Specialties Rankings, Dr. Boire is already making strides within the specialized field. The Long Island, NY, native was part of a team of the institution’s pathologists who performed some of the early autopsies on COVID-19 patients. The group recently published a case report citing its findings.

“COVID-19 (as a pathogen) has been fascinating with regards to my specialty,” he said. “What we saw [in the findings] was a spectrum of neuropathology, including white matter hemorrhages, acute axonal injury, and some lesions that resemble acute disseminated encephalomyelitis. All of this has not been documented before. As our research and understanding of COVID-19 continues to evolve rapidly, it’s helping to highlight what could happen over a clinical course in patients who are hospitalized, which will ultimately help to identify and manage the disease.”

Photo courtesy of the Mayo Clinic.

At the Forefront of COVID-19 Research 

The Mayo Clinic has been doing its part to provide critical COVID-19 information and education to the public, to physicians, and to laboratory scientists. In February, the institution developed its own test and had it validated within three weeks—an “incredible and daunting task to those that know how the process works,” Dr. Boire said. In the following days, the institution brought in other commercial tests, and now has those at its disposal as well.

By the end of August, the institution expects to be able to perform up to 30,000 tests a day on the COVID-19 virus, with results within 48 hours if not sooner, according to Dr. Bobbi Pritt, MD, MSc, DTM&H, chairperson of the Division of Clinical Microbiology at the Mayo Clinic and director of the clinical parasitology laboratory at the institution. As an international reference lab, the institution has been asked by the state of Minnesota and nationwide to help out with testing patients.

In terms of research, the Mayo Clinic has concentrated on four main areas, according to Dr. Pritt: finding new ways to detect the virus itself; finding new ways for detecting antibodies to the virus; looking at ways to detect protective immunity from the virus from those who are infected so that their plasma could be given to other sick patients; and also looking at innovative ways for those who are possibly infected to collect a specimen for testing from the comfort and safety of their own home.

COVID-19 has “really brought pathology to the forefront,” Dr. Pritt said. “It’s a powerful opportunity for us as pathologists to be at the table as part of the team making decisions about testing and treating people.”

Working under Dr. Pritt, his mentor, Dr. Boire has thrived in his residency.

“He is a very enthusiastic, innovative, and an intelligent resident. He is very passionate about microbiology and pathology in general. I can see he has a very promising career ahead of him,” she said of Dr. Boire.

Nicholas Boire, MD '19, with mentor Dr. Bobbie Pritt

Nicholas Boire, MD ’19, with his pathology mentor, Dr. Bobbi Pritt. Photo courtesy of the Mayo Clinic.

A Dream Come True

Obtaining a residency at the Mayo Clinic was a dream come true for Dr. Boire, given the institution’s extensive facilities and strong commitment to patient care and research impressed him.

“The size and scope of their microbiology department is incredible. Each individual pathology subspecialty here is larger than most hospital’s entire pathology department,” he said. “But it’s not only the facility; it’s about the individuals I work with. No matter how difficult a case, there’s always someone to help and one case can be shared with five or six pathologists—each one an expert in a different specialty.”

Dr. Boire spends his days reviewing cases alongside attending physicians involved in his specialty.

“The guiding principle of the Mayo Clinic is that ‘the needs of the patient come first.’ If they believe something will help a patient, they will invest,” he said. “When people around the world don’t know what they have, they come to us. It has been an incredible educational opportunity.”

Nicholas Boire, MD '19

Photo courtesy of the Mayo Clinic.

A Scientist from an Early Age 

Growing up, Dr. Boire was always interested in science and wanted to be a research scientist. With a natural curiosity to learn more, he gravitated toward biology and chemistry. Dr. Boire received his undergraduate degree in biochemistry/molecular biology at Gettysburg College.

Following undergrad, he decided to tackle one of his bucket-list items—by spending time in Africa to serve in the United States Peace Corps. It was while in Africa, volunteering in various clinical settings and shadowing physicians who were providing care to local populations, that Dr. Boire became fascinated with pathology, specifically that of infectious diseases, which were prevalent in the area.

“Pathology interested me because, in medicine, it’s the closest thing to basic science research—uncovering the how and the why of diseases,” he said. “Pathologists are considered the doctor’s doctor.”

Upon returning to the states, he obtained his master’s degree in molecular biology and immunology from the Johns Hopkins Bloomberg School of Public Health. Soon after, Dr. Boire decided to take the next step in his career path by entering St. George’s University School of Medicine MD program.

“SGU got me to where I am and made sure I had the foundational knowledge to be considered competitive during residency interviews,” Dr. Boire said. “The school gave me a foot in the door by helping me get a residency position in one of the best, if not the best, hospitals on the planet, doing exactly what I want to do.”

 

— Laurie Chartorynsky