Making sense of 2011

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A year with great science and continued challenges

2011 has challenged us all as we have borne the sustained burdens of budget cuts, job losses (people losses), less support and more work. Still, we have continued to discover, teach and apply what we know to solving real public health problems. I am gratified that in the tough environment of 2011, we got a slight boost in our U.S. News & World Report ranking. That’s a reflection of the outstanding students, faculty and staff at the School now as well as the people who came before us. The very generous gift from Joan and Dennis Gillings helped us a lot. So have gifts of different sizes from many friends! We’ve fought hard to maintain our outstanding quality, a challenge as other states have recovered from recession more quickly than North Carolina. I’ll return to this topic with a bit of a year in review next week.

The year ended on an ecstatic scientific and public health note when UNC Associate Vice Chancellor for Global Health, J. Herbert Bate Distinguished Professor of Medicine and SPH joint Professor of Epidemiology Mike Cohen, MD, and his research project were selected by Science magazine as science story of the year. From the UNC website:  “HPTN 052 evaluated whether antiretroviral drugs can prevent sexual transmission of HIV among couples in which one partner has HIV and the other does not. The research found that early treatment with antiretroviral therapy reduced HIV transmission in couples by at least 96 percent.”

It is rare in public health and medicine to conduct research so transformational that it changes the paradigm. Cohen and colleagues’ study does this. The fact that use of AIDS medications can prevent transmission of the AIDS virus to uninfected partners could make a huge difference worldwide. Results of this study are exhilarating. This research is altering how the public, health professionals, patients and opinion leaders think about AIDS prevention.

Celebrating National Cancer Act

Friday December 23rd was the 40th anniversary of President Nixon signing the National Cancer Act which created the modern National Cancer Institute and program. I was called by PBS producer Jason Kane shortly before I left for Marci Campbell’s memorial service last week. Mr. Kane’s piece is a new look at the war on cancer metaphor. (Fortunately, executive assistant Mae Beale understood that this was a fact that might buoy people at the memorial service.) Marci used the team metaphor in contrast to the cancer as war metaphor. In contrast to the situation in the 1960s, today, only a small proportion of Americans have experienced war firsthand (either loved ones or themselves going to war). Yet, most of us at some time participate in team sports, either personally or vicariously. Teams pervade, from cancer discoveries, which rarely are made by a single individual working alone, to the way patients are treated and cope with cancer and how we control cancer on a population basis. Most of us work in teams. Patients are treated by multidisciplinary teams (or should be). And as Marci showed so powerfully, if patients are fortunate, they have their personal teams who support them. She talked movingly about the people who brought her dinner, took her to appointments, visited with her, supported her emotionally and so much more. She also pointed out that while war is hell, and cancer is no picnic, she had experienced moments of joy that may only have been possible because of cancer.

A lot of progress has been made in understanding the genetics and biology of cancer, how to treat it and how to control it. Still, each death from cancer presents a challenge to us all to move more quickly to answer the unsolved questions. And there still are so many. We must play smarter, harder and with more passion.

Learning from loss

Like most people who participated in the memorial service for Marci Campbell last Tuesday I was overcome with sadness and a sense of loss that this truly remarkable woman was no longer with us.

I also wanted to think about how I and we who remain can be better because of what she taught us.

Here are a few lessons I gleaned from what we learned collectively about Marci Campbell’s life. (I’m not an exemplar in several of these areas.) In 2012, I am going to try to apply some of these lessons to my own life. There’s nothing to lose, and maybe some quality of life and living to gain.

1. Find joy. Marci Campbell was a person who, even in the face of metastatic cancer, laughed, worked and became even closer to the people she loved. Photographs of her in the period after diagnosis of an aggressive and ultimately terminal cancer show a woman with zest, energy and huge lust for life. In her own words, “But that’s just it—the war metaphor doesn’t describe the richness, the gifts, and the beauty of living more in the moment, taking time to enjoy life, and continuing to be productive and involved in our lives and the lives of those we touch.”
2. Laugh. Scientists, philosophers, writers and patients, including Norman Cousins, writer-patient, have written about the healing power of laughter. According to Marci’s friends and family members, even the day before she passed away, Marci laughed and cracked jokes. She found humor in everyday events. We remember her hearty laugh.
3. Live life. Death will take care of itself. I am going to attend to life. That’s a paraphrase of how Tom Campbell, Marci’s wonderful husband, said he thought Marci felt about her situation and why she was able to keep thinking ahead, planning and focusing on the here and now and future. She didn’t waste time being angry or bemoaning her fate.  She knew her calendar was finite, but that did not keep her from living each day and every minute.
4. Loosen the bonds between our professional lives and the rest of our lives. Some of the most compelling stories about Marci’s impact were from people who talked about how she’d invited them to family reunions and other events, because she wanted time with family, and this was the only way to meet with the faculty member or student. As a result, they felt more a part of the School and their departments. Former students talked about Marci attending their weddings, visiting them at their new positions out of town, and continuing to advise them long after graduation. In trying (and succeeding) to make time for people in her personal and professional lives, Marci enriched both.
5. Make time for friends and family.
6. Expand collaborations. While not a scientific study, I compared Marci’s collaborators’ list in REACH NC to several other faculty members of similar rank in our School. She had more collaborators than most and continued to expand her collaborators even in the last year of her life.
7. Take on new topics. Branch out. It’s okay not to be THE expert. Learning and mastering new areas are challenging and fun.
8. Make music. Play music, write music or if you are like me and pretty hopeless at playing, enjoy music. I’m awed by how many people in this School make music—writing and playing different instruments.
9. Live social justice. Pay attention to people at the bottom of the wealth pyramid. Make their lives better.
10. Listen to people. It not only makes us better people in general. It makes us more effective teachers, mentors and researchers.

I found a YouTube video of Fiddler’s Green being played. It’s the haunting song sung by Lee Campbell at the memorial service.

Fiddler’s Green (by John Conolly)
Dress me up in my oilskins and jumper
No more by the docks I’ll be seen
Just tell my old shipmates I’m taking a trip mates
And I’ll see you some day in Fiddler’s Green
As I roved by the dockside one evening so rare,
To view the still waters and take the salt air
I heard an old fisherman singing this song
Oh take me away boys my time is not long
Now Fiddler’s Green is a place I’ve heard tell
Where fishermen go if they don’t go to hell
Where the weather is fair and the dolphins do play
And the cold coast of Greenland is far far away
Where the weather is fair and there’s never a gale
And the fish jump on board with a flip of their tail
You can lie at your leisure, there’s no work to do
And the skipper’s below making tea for the crew
And when you’re in port and the long trip is through
There’s pubs and there’s clubs and there’s lassies there too
The girls are all pretty and the beer is all free
And there’s bottles o’ rum growing under each tree

Have a good week and New Year’s Eve! Barbara