In focus: COVID-19 vaccines and the Delta variant

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Dr. Purvi Parikh

Like medicine, the coronavirus disease (COVID-19) has shown to evolve over time, and it’s up to doctors like St. George’s University graduate Purvi Parikh, MD ’08, an allergist, immunologist, and vaccine researcher at New York University Langone Health, to guess where it’s going next.

Transmission of the Delta variant has contributed to a rising number of new coronavirus cases in recent weeks, including more than 100,000 cases each day in the United States this month according to the Centers of Disease Control and Prevention (CDC). Dr. Parikh explained what has made the Delta variant so difficult to contain, and how widespread vaccination would contribute to the health of everyone.

St. George’s University: We have seen a rise in the Delta variant in the US and worldwide. What makes it such a threat?

Dr. Purvi Parikh: The Delta variant is much more contagious than original strains of virus, even as contagious as chicken pox. Also, it is far more virulent—1,000 times more virus is found in people’s lungs with the Delta variant compared to previous forms of virus, and thus it can be more dangerous.

SGU: How does a virus mutate and why does the Delta variant present a different challenge than its predecessors?

Dr. Parikh: This is a normal part of viral life cycles. Viruses mutate when they pass from host to host and need to find new ways to survive as our immune systems become used to them. If a virus cannot replicate, it cannot mutate, thus it is much more likely to mutate in unvaccinated hosts rather than vaccinated. However, the challenge is that these mutations are making the virus more contagious and virulent and posing risks. Currently, our numbers of those in hospital and dying are quite high with Delta variant, and the majority of them are unvaccinated.

SGU: Are the symptoms different from earlier variants of COVID-19?

Dr. Parikh: Symptoms are similar; however, by sheer numbers of hospital and ICU admissions, it appears more severe. It is unfortunate because we are in worse shape in some areas of country compared to a year ago despite having the vaccine.

SGU: Do you expect there to be other variants in the future?

Dr. Parikh: If vaccination rates do not improve, yes. The Lambda variant, which is also very contagious and severe, is spreading through south America already.

SGU: How important is it for people to get vaccinated? How does the Delta variant affect the vaccinated versus the unvaccinated?

Dr. Parikh: Extremely important. If you are vaccinated, you have a significantly lower chance of hospitalization and death. Over 95 percent of those hospitalized are unvaccinated, and 99.5 percent of deaths are unvaccinated per the CDC.

 

“The Delta variant is much more contagious than original strains of virus, even as contagious as chicken pox. “

SGU: How are infectious disease and immunology specialists like yourself working to combat the Delta variant? 

Dr. Parikh: I am an immunologist and allergist—like Dr. Anthony Fauci—and I’m currently working on multiple COVID vaccine trials. I am involved with the initial trials with Pfizer, AstraZeneca, and Sanofi, which will be ongoing for next two years, and I’m also working on a booster study with Pfizer given the new variants. I also have a study with the NIH studying the vaccine in new moms and their babies (Momivax). These moms received the vaccine while pregnant. All of these studies are looking into Delta variant given it is the most common strain now.

SGU: What is the most exciting part about your job?

Dr. Parikh: I was attracted to the field for many reasons, but I saw immunology as the future for treatments in virtually every specialty. My father is an allergist and immunologist, and even between when he trained and I did, things have changed immensely. Our understanding of the immune system and its importance is so different.

I took care of a patient with a primary immune deficiency in residency, and I was so impressed at how important an immune system is not only in infections but in cancers and autoimmune conditions. I also realized how important immunology is in a pandemic as I helped with H1N1 vaccine trials when I was an internal medicine resident at the Cleveland Clinic. That was also the first time I came to know Dr. Fauci was an immunologist.

On the flip side of the field, allergies and asthma are also immune conditions on the rise, and being the doctor to effectively diagnose, manage and treat these disorders is so rewarding. Further, I enjoy building lifelong relationships with my patients and being able to treat both children and adults.

SGU: How did SGU set you up to be successful in your career?

Dr. Parikh: SGU gave me the opportunity to be a physician and embark on one of the most rewarding, humbling, and noble professions. Without being a physician, I would not be able to restore health and advocate for the health of others—both passions of mine. And as an investigator on the COVID vaccine trials, I would not have been able to step up when needed to help the world move one step closer to ending the worst pandemic we have seen in 100 years.

– Brett Mauser

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SOMAA Charity Drive Aids Thousands Affected by St. Vincent Volcano Eruption

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SGU alumni contributed more than $20,000 to relief efforts in St. Vincent.

Drawing on the generous contributions made by the St. George’s University alumni community, the School of Medicine Alumni Association (SOMAA) held a successful charity drive this spring to help those affected by the La Soufriere volcano eruption on the island of St. Vincent and the Grenadines.

“On behalf of the SOMAA, we are so thankful to our devoted alumni for helping us raise more than $20,000 for this worthy cause,” said Bruce Bonanno, MD ’83, president of the SOMAA. “SGU has had a rich history with the people of St. Vincent. As the volcano erupted again this spring, we felt it crucial that we do our part as an organization to support the island during its time of need, and we could not have done it without your participation.”

More than 20,000 people were displaced when La Soufriere erupted in April. While many have since returned home, more than 2,000 people still live in shelters, with hundreds of homes needed to be rebuilt according to Dr. Rosalind Ambrose, president of the St. Vincent and the Grenadines Medical Association and a 1983 graduate of the SGU’s School of Medicine.

SOMAA gifted the money to the SVG Medical Association, which encompasses medical professionals—many of whom are SGU graduates—who live on the island. The association initiates a number of community service and public health outreach events for the people of the island and plans to use the money to help people replace lost household objects.

SGU donated 8,000+ meals to St. Vincent in early 2021.

“We are ever grateful to the heartwarming efforts by SGU’s Alumni Association and the alumni community to assist St. Vincent right now,” Dr. Ambrose said. “A number of evacuees from the ‘Red Zone’ have lost everything, and the government is relocating them entirely. The donation will be used to help these families replace everyday items in their homes and help them regain a sense of normalcy.”

Seismologists are still monitoring the volcano and are not yet in the position to say whether it has returned to a “sleep state” because it is still giving off ongoing steam and gas emissions and causing minor earthquakes, Dr. Ambrose said, adding that the recent tropical storm/hurricane produced several lahars that further damaged villages near the volcano.

For more than 25 years, School of Medicine medical students completed a semester of their basic sciences on the island. When the last eruption happened in 1979, students who were there studying and working jumped in to help the island, even as medical students. Years later, they helped to donate more than 8,000 meals to those affected by the volcanic eruption.

“We will continue to help the people of St. Vincent in any way we can and we thank our alumni for their support,” Dr. Bonanno said.

The SOMAA continues to accept donations of any size for those affected by the volcano. To contribute, please send monetary donations to: https://www.sgusomaa.org/donations/

– Laurie Chartorynsky

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What does research have to do with treating ER patients? Everything

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For Nicholas D. Caputo, MD ’08, the associate chief of emergency medicine at NYC Health + Hospitals/Lincoln in the Bronx, investigating diseases like COVID-19 to learn more about their origins and health effects has allowed his team to more effectively care for critically ill patients that come through the busy hospital’s emergency room.

Dr. Caputo, along with colleagues, have published multiple articles in various medical journals and based on their experiences and patient encounters within the ER, including several related to findings about the COVID-19 disease.

For instance, in the spring of 2020, the team published the first study on awake self-proning for COVID-positive patients as a means to stave off intubation, according to Dr. Caputo. The study was published in Academic Emergency Medicine (the official publication of the Society for Academic Emergency Medicine) and cited in The New York Times.

Earlier this year, his team published the only reported outcomes data for the New York City public hospital system in the Journal of General Internal Medicine, which had some “gut-wrenching findings in regard to inequities and disparities in COVID outcomes,” he said.

Sharing the correlation between research and emergency medicine, and specifically how it helps him approach his job every day, were among the topics that Dr. Caputo spoke with SGU News about in a recent interview.

SGU: How do you apply findings from your research to your role as an EM doctor?

Dr. Caputo: Research allows me to go into each shift with a different perspective. On the one hand, it allows me to deliver care to patients with the mindset of treating their individual situation based on what we know from previous research findings. On the other hand, it also allows me to take those patient interactions and formulate hypotheses about broader issues that other ER doctors may encounter and ultimately help advance the emergency medicine specialty.

 

“A good scientist always keeps an open mind in the pursuit of truth. Keeping an open mind allows one to critically think outside-the-box which may lead to a better solution to treatment—and a positive outcome for the patient.”

 

SGU: What lessons have you learned from the global health crisis that can be applied to ongoing patient care?

Dr. Caputo: The most important lesson I learned is that a good scientist always keeps an open mind in the pursuit of truth. Keeping an open mind allows one to critically think outside the box, which may lead to a better solution to treatment—and a positive outcome for the patient.

SGU: What appeals to you about emergency medicine?

Dr. Caputo: The biggest appeal to me in emergency medicine is that on any given shift—no matter where you are working—you have the potential to see anything across the spectrum of medical pathology. That’s the great thing about emergency medicine—we truly see it all.

SGU: What responsibilities do you have as associate chief of emergency medicine?

Dr. Caputo: In this position, I help coordinate the daily operations of the emergency department, and oversee the quality review process, performance improvement, and research, among other necessary roles to help ensure the department runs smoothly so we can deliver the highest quality of care, safely to our community.

SGU: You are also an Army Reservist—how does your medical background help you when you are called up for service?

Dr. Caputo: My working in a Level 1 Trauma Center in one of the busiest single-site emergency departments in the country has provided me the experience I need to treat our soldiers on the battlefield who have similar if not even more devastating traumatic injuries. That’s one of the things I am most grateful for in working where I work.

SGU: How did SGU help prepare you for your current hospital role?

Dr. Caputo: SGU gave me the drive to want to do more—to stand out by showing up early, leaving late, and doing research on my own time in order to better myself.

SGU: What was the moment that you realized you’d made the right decision to come to SGU?

Dr. Caputo: When I matched in the specialty I wanted at the place I wanted for residency and where I still work today.

SGU: What if you hadn’t said yes to SGU?

Dr. Caputo: I don’t really want to think about that!

– Laurie Chartorynsky

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Thai alum cites “fast-paced nature” as major appeal to emergency medicine

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Although Natcha Rummaneethorn, MD ’20, will continue her career amid the hustle and bustle of New York City, her passion for medicine began during medical mission trips to the rural villages outside of her native Bangkok, Thailand. While the two areas look almost nothing alike, she said there are similarities when it comes to healthcare.

“Ever since those mission trips, I’ve wanted to work in underserved areas where people need the most help and don’t have adequate healthcare access,” said Dr. Rummaneethorn, who is a first-year emergency medicine resident at NYC Health + Hospitals/Metropolitan.

Dr. Rummaneethorn shared what she looks forward to most in her residency and how prepared she feels for the next step in her career.

SGU: What led you to go into medicine?

Dr. Rummaneethorn: My father is a dermatologist, and my mom is an ICU nurse. They influenced me to go into medicine to a certain point, but what really drove me was a medical mission in Thailand through my church. We provided medical care and supplies to rural areas in Thailand, such as villages in the mountains or hills where there’s difficult access to healthcare and hospitals. They are without basic equipment and simple medications like aspirin or ibuprofen that we have commonly, and for them, it’s two to three hours to the nearest hospital.

SGU: Why did you choose to enter emergency medicine?

Dr. Rummaneethorn: I enjoy the fast-paced nature of an emergency department. In general, I try to do things as efficiently as possible, and I like that kind of nature in emergency medicine. Also, there’s always something new for you to see, and we have to have at least basic knowledge for every specialty because we receive patients with a wide array of problems. I’m looking forward to practicing in New York City because of the diverse patient population and the level of training I’ll obtain to handle the most severe situations.

SGU: How would you describe your time at SGU?

Dr. Rummaneethorn: My academic experience at SGU was great due to the rigorous curriculum as well as a number of excellent faculties that provided superb education, such as the biochemistry and pharmacology professors in particular. Also, being on the island of Grenada, the location gave me numerous opportunities to have hands-on experiences with local Grenadians. These experiences allowed me to grow my clinical knowledge and skills as an aspiring physician. On top of that, I had a chance to learn about the Caribbean culture, enabling me to be equipped for taking care of my patients who are of diverse backgrounds during my clinical rotations in Brooklyn.

SGU: How often did you come across an SGU grad during your clinical rotations?

Dr. Rummaneethorn: One of the major benefits of SGU is its large alumni network. If utilized appropriately and effectively, this will turn into a very useful tool in preparing for a residency application. During my clinical rotations, I was extremely surprised at how many attendings I met who turned out to be SGU alumni. They were ready to help me as well as other SGU students rotating with them.

SGU: What advice would you have for a Thai student who was entering medical school?

Dr. Rummaneethorn: Students should also reach out for help early. I prepared myself for my residency application from day one. In my first semester, I attended a lecture with Dr. [John] Madden, who’s an SGU grad and former emergency physician, about emergency medicine, and from there I tried to attend all the seminars that I could. I feel like they really paid off because each helped prepare me for the application process.

– Brett Mauser

 

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SASAA President Receives Commonwealth Award for Inspirational Voluntary Service

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Tamika Gilbert, BSc ’11

Tamika Gilbert, BSc ’11, received recognition by Her Majesty Queen Elizabeth II as the 183rd Commonwealth Points of Light awardee.

With the COVID-19 pandemic affecting so many throughout the world, Tamika Gilbert, BSc ’11, is doing her part to help aid the lives of those hit hardest in the Grenadian community—and being internationally recognized for her efforts.

In April 2020, driven by her two passions—voluntary service and entrepreneurship—Ms. Gilbert created The Art of Giving (TAG), a charitable foundation encouraging donations of relief items to help vulnerable families following the coronavirus outbreak. Her humanitarianism did not go unnoticed—Ms.  Gilbert recently received recognition by Her Majesty Queen Elizabeth II as the 183rd Commonwealth Points of Light awardee.

“I am both grateful and humbled to receive recognition for something that comes so naturally to me,” said Ms. Gilbert, who is the president of St. George’s University’s School of Arts and Sciences Alumni Association (SASAA). “What started as a simple response to a mother’s cry for help during the lockdown period, has now grown into the TAG foundation—giving help wherever and whenever it can, which to me is the true essence of The Art of Giving.”

 

“I have always wanted to make a difference in the world. The current health crisis presented an opportunity for me to do so. “

 

The Commonwealth Points of Light awards were established during the Commonwealth Heads of Government Meeting in London in 2018. The award recognizes inspirational volunteers across the 54 Commonwealth nations for the difference they are making in their communities and beyond.

“I have always wanted to make a difference in the world,” shared Ms. Gilbert. “I remember visiting the Kennedy and Richmond Hill children’s homes as a child. The extreme need that existed in these places has remained etched in my heart and mind since that day. I knew then that I wanted to do more to help people—the current health crisis presented an opportunity for me to do so.”

So far, over 200 families in Grenada have been supported by the foundation. In addition, the foundation has distributed emergency supplies to people affected by the recent volcanic eruption in St. Vincent and the Grenadines.

TAG’s newest initiatives will include helping future students enroll at the New Life Organization (NEWLO) in Palmiste, Grenada to pursue technical and vocational education and training, as well as supporting women on the island, who lack access to proper feminine hygiene products, a problem exacerbated by the pandemic.

“TAG on its own cannot help everyone—but everyone can help someone,” stated Ms. Gilbert. “As such, the foundation has adopted a targeted approach to giving aid—we don’t do mass distribution. We speak to recipients individually to ascertain their exact need. We have helped with food hampers for individuals and families, assisted with minor medical bills such as, purchasing medication and glasses, and we’ve held clothing drives. We are willing to do whatever we can to help improve the lives of people in need. In essence, TAG’s message is to spread the joy of giving by providing an avenue to do so.”

 

– Ray-Donna Peters

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SAS and SGS grads encouraged to “profoundly impact the world”

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On June 12, students from 44 countries came together with family, friends, and well-wishers for their last virtual meetup and to celebrate their academic achievements at the annual School of Arts and Sciences/School of Graduate Studies commencement ceremony.  

Over 420 graduates were encouraged to achieve outside the box as they start their new journey into the workplace around the world.  Degrees were conferred to the SAS and SGS Class of 2021, as well as the SAS Class of 2020, which could not hold its ceremony last year due to the COVID-19 pandemic.

In a profound keynote address, Dessima Williams, ambassador for Grenada and permanent representative to the United Nations from 2009 to 2013, challenged SGU’s newest alumni to live a life of service and to commit to doing something special and impactful.  

“Go from SGU into the world and help to transform everything that you can—make it better,” said Ambassador Williams. “You are graduating, so you must have gotten some good marks. Go now and make good marks on the world.” 

Jonathan Silwanes, BSc ’20, class speaker for the SAS Class of 2020, added that success is not only about achieving your goals, but about being triumphant when faced with hardships. 

 

“As we embark on our respective paths, there will be harder challenges to come, but as long as you persevere, you will be an unstoppable force.“

 

“As we celebrate our successes together today, I challenge all my fellow graduates to appreciate the journey you’ve been through, applaud yourselves for your accomplishments, and remember the adversity you’ve overcome to reach this point,” he said. “Continue to believe in yourself amidst the challenges that await you in the future. Continue your quest to your dreams and continue to succeed every day.” 

Namratha Guruvaiah Sridhara, BSc ’20, class speaker for the School of Arts and Sciences Class of 2021, shared a short story that alluded to the importance of turning one’s struggles into positive learning outcomes.  

“Standing here today, our perseverance and willpower to endure has proven to be stronger than any obstacle. Hence, I urge you all to remember this time, not just as a period of difficulty, but look at it as a way to see what you have achieved and what you have overcome. As we embark on our respective paths, there will be harder challenges to come, but as long as you persevere, you will be an unstoppable force.” 

Samantha Antoine-Purcell, MEd ’21, class speaker for the School of Graduate Studies, thanked her predecessors for paving the way and implored her fellow classmates to think beyond the assignments and projects and step into alumni roles to pay it forward. 

“Today, our graduation is not just the end of the journey,” she said. “Indeed, it is the beginning of our commitment to learning and growing, our commitment to leading lives of purpose and intent. It is our commitment to embracing that which we are—the embodiment of phenomenal thought and action. We have a responsibility to use our collective experiences to profoundly impact our world and positively do so as change agents.”

– Istra Bell

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How to lead a healthy life? Grad says to start with a good night’s sleep

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Mixed in with classes, exams, studying, and time to unwind, medical students have to squeeze in all-important sleep. Getting enough sleep, and implementing bedtime habits to do so, is a challenge not only for aspiring physicians but for everyone, this according to Sam Al-Saadi, MD ’05, the sleep medicine director at the University of Pittsburgh Medical Center (UPMC) Carlisle location, and assistant clinical professor of psychiatry for Penn State Health in Hershey.

According to the American Sleep Association, more than 50 million US adults have a sleep disorder, most notably insomnia and obstructive sleep apnea. Dr. Al-Saadi shared his perspective on what people can do to improve their sleep, and also the journey he took to lead the discussion in addressing the oft-ignored health crisis.

St. George’s University: How important is sleep to a person’s health?

Dr. Sam Al-Saadi: Sleep medicine is the secret of all secrets to good health. People have no idea how influential sleep is to the quality of their lives. To compensate, they pick up bad sleep habits, and they don’t believe that they need to fix them. The fact is that when they’re younger they can compensate, but when they get older, it just gets worse and they aren’t able to.

Sleep disorders are associated with each other. If you have one, you likely have another, whether it’s snoring, sleep apnea, insomnia, narcolepsy, or something else. The quality and quantity of sleep impact diabetes, cardiac disease, cerebral circulation, cognitive function, blood pressure, and other systems.

Sleep medicine is a subspecialty that has evolved from multiple specialties. It is a relatively new and evolving field. It started in psychiatry, moved to pulmonology and now includes neurology, ENT pediatrics, family medicine, and internal medicine.

SGU: What are some ways that people can improve their sleep?

Dr. Al-Saadi: Everyone can start by making a few minor adjustments that will make a big difference.

  1. Your bed should be for sleeping and intimacy only. Many people use an iPad or phone in bed or watch TV, but these are bad habits that can disrupt your sleep. If you don’t fall asleep within 10 minutes, you should get out of bed and come back later.
  2. A fixed wakeup time. Yes, it’s difficult for medical students and residents, but it’s good to have the same wakeup time, which will then dictate when you go to sleep.
  3. Be careful with caffeine intake. This can be cultural—you have people drinking tea at night, an energy drink to keep up with studying, coffee, or something with caffeine. The thing is, if you drink caffeine six hours before you go to bed, you still have half that caffeine in your body when you’re trying to sleep. Because of that, you’re more likely to have arousals—when you wake up for less than 30 seconds—that you aren’t even aware of. You may not be aware of these, but you’re likely to be more tired the next day.
  4. Limit long naps. Some people take long naps, but then you’re not going to be able to fall asleep later that night. Naps need to be just to catch up and keep you going for that day—no more than 30 minutes.

SGU: How did you make the journey from the UAE to the US and finally Grenada?

Dr. Al-Saadi: I was born and raised in the UAE. My dad was a microwave communications engineer, and my mom worked at the library, so I didn’t have any medical background in my family. When I came to the US at 17, I was on my own, had no money, and my English wasn’t very good. But I worked hard. I was taking courses to take the MCAT while working and supporting my family the entire time I was doing it.

I was a chemical engineering major at the University of South Florida, but when I got out, I just didn’t feel like I was using the skills I had learned. I was more fine-tuning things that were already set up. So I went and got a master’s in biomedical engineering and then when it came time to decide whether to go for an DO or MD, I went for an MD. I chose SGU because it had a lot of rotations in Florida and New York.

SGU: How was your experience in Grenada?

Dr. Al-Saadi: My experience was great. The campus was phenomenal, and I felt safe both on and off campus. We had a good time, and I think the students who came after me had it even better.

SGU: What advice would you give to a student entering medical school?

Dr. Al-Saadi: It’s important to have a plan for what you’re going to do after you graduate. It could change of course, but where you do your rotations will influence your path to residency, not only in terms of location of the residency but the individuals who you get your letters of recommendation from. I recommend that you have a plan, a backup plan, and overall a clear image in your mind of where you want to go with your career and how to get there.

– Brett Mauser

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South Korean Grad Provides Critical Care at a Critical Time

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Responsibility has followed and increased throughout Ki (Steve) Lee’s time as an internal medicine resident at Newark Beth Israel Hospital in New Jersey. A year after helping the department through the COVID-19 pandemic as an intern, the St. George’s University graduate is now in a managerial role, overseeing a team of medical staff and full ward of patients. This spring, Dr. Lee will become one of four chief residents in the department, helping to supervise and train its more than 40 residents.

The South Korea native looks back on the path that led him to one of the state’s most high-traffic, high-impact critical care units.

St. George’s University: What has it been like supervising such a critical element to healthcare at Newark Beth Israel?

Dr. Steve Lee: In your first year of residency, you’re learning how to help and figuring out how things work. In my second year, you’re asked to do a lot more. In my case, I’m managing a team that is overseeing the 16 patients on our floor. It’s been a great experience, I have a lot of autonomy, and it has allowed me to grow as a team leader and a decision maker.

SGU: What’s the best part about doing residency at NBI?

Dr. Lee: It’s amazing how much clinical experience we get here. We’re the only lung transplant hospital in New Jersey and the only heart transplant facility too. The most critically ill patients get transferred here, and it’s up to us in the ICU and critical care unit to take care of them. We get a lot of hands-on experience, use all these state-of-the-art devices, and I feel like we learn a lot. If you do residency here at NBI, you can go anywhere else and be comfortable.

 

“You go to Grenada and meet all these new people on day one, and you’re all there to help each other out.”

SGU: You were a first-year resident during the height of the COVID-19 pandemic in and around New York City. What was that like?

Dr. Lee: COVID was very difficult. We typically have a maximum of 16 patients on our list, but at that time we were managing 30-40. Our department was running the entire hospital, and there were so many different teams on the floor—pediatricians, radiologists, and many, many others—helping out in any way that they could. What was so difficult was that patients’ outcomes could change in a matter of minutes. Fortunately, for our staff, we all had each other to lean on. We were able to talk through things and we covered each others’ shifts when needed.

SGU: How would you describe your experience at SGU?

Dr. Lee: You go to Grenada and meet all these new people on day one, and you’re all there to help each other out. The education was great, and many of my classmates are now attendings at these major hospitals. They’re doing amazing, and I feel like everyone has done great.

– Brett Mauser

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Grad Reflects on Role in World’s First Successful Face and Double Hand Transplant

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Zoe Berman, MD ’17

More than a year of preparation came down to one day for one patient and the surgical team that was about to change his life. Joseph DiMeo, a 22-year-old man from New Jersey, had been severely injured in a motor vehicle accident, and in an effort to regain his independence, he turned to NYU Langone Health to perform the world’s first-ever successful face and double hand transplant.

Over the 23-hour operation last August, Zoe Berman, MD ’17, stood alongside the surgeons, confirming each critical step as the hands and face were detached from both the donor and Mr. DiMeo, and then the donor hands and face were carefully affixed to the recipient. For Dr. Berman, a reconstructive plastic surgery research fellow under world-renowned doctor Eduardo D. Rodriguez at NYU, the “groundbreaking” operation was a culmination of in-depth research and planning that she and her colleagues had contributed to in order to ensure its success.

After finishing up her fellowship at NYU, Dr. Berman will return to Maimonides Medical Center to complete a surgery residency this July, not without an experience she deemed “life-changing” just as it was for the patient. She shared what it was like to participate in the planning and execution of such an intricate procedure.

St. George’s University: How unique of an undertaking was this for Dr. Rodriguez and his team?

Dr. Berman: This was the first-ever hand transplant to be performed at NYU. There have been two face transplants done at the institution—one in 2015 and another in 2018—but NYU physicians had never done a hand transplant. Only 150 or so have been performed worldwide, and the combined face and double hand transplant procedure had never been done before successfully.

SGU: What was your role prior to and during the operation?

Dr. Berman: I was a part of the four-person research team that helped procured the necessary information to build the foundation for this procedure to happen. We started with a review of the peer-reviewed literature on hand transplant and other combined transplants, where we evaluated more than 1,800 articles and ended up critically appraising 93 of those articles to see how we could use that information to inform what our procedural steps were going to be, and how to execute the surgery safely and successfully. We were looking for what elements contributed to the successes of past surgeries, and perhaps even more importantly so, where the unsuccessful operations fell short—whether they were too ambitious in terms of the amount of skin that they took, the blood supply wasn’t adequate, or the patient simply wasn’t the best candidate. We then centralized all of this information and presented it to the surgical team.

Our research team also worked with the surgeons over a series of monthly rehearsals to develop the procedural steps for the hand transplant element. We created a surgical checklist to ensure adherence to every single agreed-upon step of the donor procurement, the recipient operation, and the re-attachment of the hands. Each operative sequence had between 30 and 50 steps and it took all the guesswork out of it.

SGU: Describe what it was like the day of the operation.

Dr. Berman: We had two adjacent operating rooms functioning simultaneously. Our team physically stood alongside the surgeons during all the cadaver rehearsals as well as the actual transplant to ensure that everyone was adhering to the procedural steps. When you’re talking about connecting multiple blood vessels, tendons, bones, and lot of different structures that meld together, it can make it a very complicated procedure.

  • Dr. Berman working with Dr. Rodriguez in the cadaver lab.

  • The NYU plastic surgery team

  • The research team

  • SGU grads Matthew and Zoe Berman, with father Peter

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SGU: How has Mr. DiMeo fared since the procedure?

Dr. Berman: Joe is a very motivated young man. It was important to him to get back to work, get back to the gym, to be independent, and to really get back to the life that he was living before his accident. I think it’s the most remarkable thing about him and part of the reason why Dr. Rodriguez and the team thought he was an exceptional candidate for this surgery.

Since the operation, he’s done very well with his rehabilitation and continues to improve functionally every day. He has been monitored very closely for any signs of rejection and he continues to heal and to accept all three of his allografts (face and both hands).

SGU: What prompted you to pursue this fellowship at NYU?

Dr. Berman: My father is a head and neck surgeon, so I think I’ve always had that influence me to a degree. There’s something about the symmetry and the intricacies of that part of the body that I find extremely fascinating. I’ve always had an appreciation for the face and what it represents for a human being in terms of providing a sense of identity and an outlet to communicate verbally and emotionally. To help restore that identity is very meaningful in somebody’s life. When I learned about the remarkable things Dr. Rodriguez and his team were doing at NYU, I jumped at the opportunity to be a part of it. Face transplant is the ultimate reconstructive surgery.

SGU: How has being part of this procedure changed your life?

Dr. Berman: It has been an extremely unique, once-in-a-lifetime opportunity. I feel so fortunate to be able to partake in this incredible experience that has truly pushed the field of reconstructive surgery forward. To be a part of this patient’s journey, to see him continue to be so motivated and so beautifully supported by his parents has really been a privilege.

More so than anything, I’ve been so fortunate to have had the mentorship of Dr. Rodriguez, who is a real visionary. He put trust in me to be a part of this, and to be able to contribute to changing somebody’s life—that’s why I went into medicine in the first place—to give someone the opportunity to live a better life, a more fulfilling life, and to have a second chance.

SGU: Why did you choose to go to SGU, and how has it set you up for success in your career?

Dr. Berman: I would have never had the opportunity to do anything I’m doing if I hadn’t first made the decision to go to SGU to get my MD. At the time, I was ready to go to medical school, and I didn’t want to wait for another US application cycle.

The foundation that the education at SGU provided me has allowed me to grow beyond what I ever imagined to be possible. I think coming from SGU gives you a sense of humility that will serve anybody well in the medical field. I have never felt entitled to anything. For me, I’ve always considered being a doctor and working with vulnerable patients to be an unbelievable privilege.

There’s also something sacred and beautiful about the island. I met my husband there (Matthew Bushman, MD ’16), who’s now an anesthesiologist, and my brother (Matthew Berman, MD ’17) also followed me to the island a semester later, who met his wife there (Taylor Dodds, MD ’19), and they’re both in residency now and doing well. We all had an incredible time at SGU, and considering where we all are now, I would never change my decision to go there.

– Brett Mauser

Related Reading

SAS Grad Serves as Grenada’s Guardian of Official Etiquette

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As Adrian Joseph, BSc ’10, sees it, every day is an opportunity to grow, to learn, and to serve his home country. Today he directs and coordinates the activities as head of the Protocol Division in Grenada’s Ministry of Foreign Affairs, a position he’s held for nearly a decade.

Mr. Joseph shares why he went into public service, as well as how SGU afforded him the opportunity to remain close to home and family while furthering his education.

St. George’s University: What are your responsibilities in the Ministry of Foreign Affairs?

Adrian Joseph: As chief of protocol, I oversee the security, logistics, and etiquette in diplomatic and national events or functions. In this role, I am also responsible for all consular matters and for serving the diplomatic corps/regional and international organizations accredited to Grenada in accordance with the Vienna Convention.

SGU: Did you always want to work in public service?

AJ: I’ve always wanted to serve my country in some way or another. However, it was while serving as the vice president of the SGU Model United Nations that in many ways piqued my interest in the field of modern diplomacy. That experience provided a wonderful opportunity to interact and learn from different cultures.

I chose this field because, in my opinion, it is quite extraordinary given that its main objective is to achieve a sense of harmony in the world. I find the work that I do very fulfilling as it allows for facilitation in communication and knowledge exchange and in promoting peace. I am also working on further strengthening my business acumen by earning a doctorate in business administration with a specialization in global business at Keiser University in Florida.

SGU: How have you been affected by the events of this past year?

AJ: This pandemic has been tough on many of us, but despite the adversities, it has also shown us the importance of family and friends and how grateful we should be for our health. For me personally, it has given me a new insight on issues such as food security and self-reliance. As a result, I have been dabbling in farming, which has turned out to be quite interesting and rewarding. I hope to expand on it because, apart from providing an additional source of food, it’s also a great form of exercise and I find it very relaxing.

SGU: What advice would you give to someone pursuing a similar path as you at SGU?

AJ: I will always be grateful to SGU for affording me the opportunity to earn a degree that has helped me in so many ways in becoming a well-rounded individual. The University is fully equipped with all the essential instruments for learning and for preparing its students for the professional environment. I am proud to be an alumnus of an esteemed institution that continues to produce distinguished graduates who are thriving in their respective fields.

 

— Ray-Donna Peters