Goochie, Goochie, go - Ragan`s Motivational Resources

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Goochie, Goochie, go
by Megan Maisel
She may appear to be older than the rest of the UT
Television staff, and her wardrobe is a bit out of fashion. But “Ms. Gooch,” a former star of a Texas Education Agency video series, is actually only 12 years old.
The puppet joined UT Television in 1994. She was
created to appear as a nosy neighbor who perched on a
backyard fence and offered sage advice to children in
TEA videos produced by that department.
Ms. Gooch now hangs out in the lobby of the UT
TV facilities in the Houston Main Building, where she
greets (and sometimes creeps out) visitors, and reportedly shares her words of wisdom with co-workers. Ms.
Gooch is joined by a friendly stuffed chimpanzee, her
constant companion.
Ms. Gooch doesn’t get out much anymore, so we’ve
decided to take her on a road trip. The first five employees who guess where on the M. D. Anderson campus Ms. Gooch appears in this photo will be treated to
$5 Dining Services vouchers, courtesy of Messenger.
E-mail Carol Bryce or call her at (713) 792-0654 with
your responses.
The University of Texas
M. D. Anderson Cancer Center
Texas Medical Center
Publications and Creative Services
Unit 229
1515 Holcombe Blvd.
Houston TX 77030-4009
Address service requested
Messenger November/December 2006
Nonprofit Org.
U.S. Postage PAID
Permit No. 7052
Houston TX
published for our employees, retirees and their families
Rescue me
Make the most of meetings
Messenger November/December 2006 november/december 2006
President
John Mendelsohn, M.D.
Vice President
for Public Affairs
Messenger is published six times
a year for our employees, retirees
and their families.
Requests and submissions should be
directed to: The University of Texas
M. D. Anderson Cancer Center,
Publications and Creative Services,
Unit 229, 1515 Holcombe Blvd.,
Houston TX 77030-4009;
(713) 792-0655; or via e-mail to:
messenger@mdanderson.org.
On the intranet:
inside.mdanderson.org/publications/
messenger
Stephen C. Stuyck
Executive
Director, Internal
Communications
Sarah Palmer
Director, Publications
and Creative Services
David Berkowitz
Editor
Carol Bryce
Design and
art direction
Maria Dungler
Production
assistant
Kelley Moore
Contributing writers
Carol Bryce
Jay Edwards
Jonathan Lowe
Megan Maisel
Pam Paaso
Sarah Palmer
Stacy Swanson
On the cover
published for our employees, retirees and their families
november/december 2006
Do you ever walk out of a
meeting and wonder “Why did
we just meet?” Take a peek
inside to discover how to take
control of your meetings.
Rescue me
Make the most of meetings
Contributing
photographers
Barry Smith
F. Carter Smith
Mission
The mission of
The University of Texas
M. D. Anderson Cancer
Center is to eliminate cancer in Texas, the nation and
the world through outstanding programs that integrate
patient care, research and
prevention, and through
education for undergraduate and graduate students,
trainees, professionals, employees and the public.
Vision
We shall be the premier
cancer center in the world,
based on the excellence of
our people, our researchdriven patient care and our
science. We are Making
Cancer History®.
Core values
caring
By our words and actions,
we create a caring environment for everyone.
integrity
We work together to merit
the trust of our colleagues
and those we serve.
discovery
We embrace creativity and
seek new knowledge.
in this issue
Volume 35, Issue 6
NOV/DEC
06
Contents
2 Who is ... ? Ronald Branch
4
3 First person:
Frank Tortorella 4 Meeting in the middle A love-hate relationship
7 State-of-the-institution address
Collaboration is crucial
10 Face to face:
To blog, or not to blog?
14 Above and beyond
Support group facilitators share knowledge, offer comfort
17
Ideas wanted
We’re always looking for story topics that
interest you. The idea for the story on our
support groups on pages 14-15 came from
Mary Fitzgerald, coordinator of the clinical research program in Gynecologic Oncology.
If you have a story idea, send it to Messenger@
mdanderson.org or to Messenger, Unit 229.
Include your name and phone extension or Lotus
Notes address.
— Editor
16 Lighten up Choosing to be optimistic
18 I.V. (inside view):
Technology architects design
better ways to work
20 In the eye of the beholder
Meeting the challenges of ‘rare’ cancers
Back cover: Goochie, Goochie, go
2006 Grand Prize
Best Employee Publication,
Nonprofit Magazine
Messenger November/December 2006 Who is ...
Ronald Branch?
?
by Megan Maisel
R
onald Branch has had more
than his share of ups and
downs. The unit services
coordinator in the Clinical Translational Research Center is a member
of American Coaster Enthusiasts,
a club dedicated to the enjoyment
and preservation of roller coasters.
Branch, an M. D. Anderson employee for 19 years, has experienced
the twists and turns of 670 roller
coasters at amusement parks across
the United States.
He first flipped for the rides when
his brother took him to Houston’s
Six Flags AstroWorld, where he
experienced the Serpent, Excalibur
and the Texas Cyclone.
“I loved the Cyclone so much;
at that time it was wild and out of
control,” he says.
That first trip was so enjoyable that Branch took a part-time
position at the park in 1983. That’s
where he learned about American
Coaster Enthusiasts. He joined the
organization four years later.
One of his first AstroWorld
assignments: working at a new freefall ride called Skyscreamer, which
dropped passengers from a 131-foothigh tower. It was a challenge for
someone with a fear of heights.
“Passenger cars got stuck on
top of the tower when the ride
experienced minor mechanical
problems, and we had to climb
up and stand with passengers,” he
recalls. “There was metal grating on
the tower steps, and you could see
right through them. But I got over
my fear real fast, because I really
wanted to be on the Skyscreamer
crew — it was the cool new ride.”
One of Branch’s favorite roller
coasters to work was Greezed Light-
Roller coaster enthusiast Ronald Branch mourns the closing of Houston’s
Six Flags AstroWorld, where he rode his first coasters. Branch acquired the
Texas Cyclone sign on the park’s closing day.
nin’, a catapult-launched loop. His
stint as a “ride lead” for the Excalibur attracted the attention of park
management. Branch’s team was
named “crew of the week” several
weeks in a row, and he became a
member of the theme park’s circle
of champions. He was asked to visit
other parks owned by Six Flags
to evaluate customer service and
safety, something he continues to
do despite AstroWorld’s closure in
October 2005. The park’s demise
threw him for a loop.
“I was angry and upset, but I
decided to continue to ride roller
coasters,” he says. “AstroWorld was a
lifetime for many people. My former
manager met both her husbands
there. I worked there so long that I
saw her children have kids.”
Branch says he applies the things
he learned from his time at the
park to his job at M. D. Anderson.
“It’s all about customer service,” he
says. “You don’t want to come here
and be depressed. I enjoy coming to
work every day.” M
Branch’s best
Favorite wooden roller coaster: The American Eagle at Six Flags Great
America in Chicago. Branch prefers this ride when it’s operated backward to
celebrate special occasions.
Favorite steel roller coaster: Montu at Busch Gardens in Tampa Bay, Fla.
Branch likes this ride because the riders’ feet dangle over grounds populated
by real crocodiles. (He says most people think they’re fake.)
His 600th roller coaster: Superman the Escape at Six Flags Magic Mountain
in Los Angeles. It’s 415 feet tall and was the first ride to reach speeds of 100
miles per hour.
by
Megan
Maisel
first person:
Getting to know Frank Tortorella
F
rank Tortorella, J.D., is
M. D. Anderson’s vice president
for clinical support services.
What word best describes
you?
Authentic.
What’s the most important
thing you’d like to accomplish
at M. D. Anderson?
I want to exceed the expectations of
our patients and employees.
Who has inspired you?
My mom, a registered nurse on the
night shift, and my dad, a telephone
installer, who worked together
to raise six children on a limited
income with a never-ending positive
spirit.
What sparked your interest in
health care administration?
Hearing my mother talk about her
work is what motivated me to get
involved in health care. I spent a
college semester working at a rural
Puerto Rican health care facility, which sparked my interest in
improving health care.
What has been the most significant moment in your career?
When the hospital where I previously worked merged with another
large community teaching hospital
in Chicago, I was asked to become
the chief financial officer and
integrate the organizations. It was a
tremendous challenge and prepared
me to be a better leader.
If you couldn’t do what you’re
doing now, what would you
do?
I’d be a photographer for National
Geographic.
Favorite quote:
“Great adventure and great achievements require great risks.” — the
Dalai Lama.
Favorite book:
“The Prelude” by William Wordsworth. I concentrated in English
and American literature in college
and enjoy Wordsworth’s poetry.
How do you manage stress?
I eat chocolate. I also compete in
marathons and have finished the
Chicago Marathon four times.
What are your passions?
Taking extended travel adventures
to remote locations — the more
remote, the better. I’ve climbed to
Base Camp of Mount Everest in
Nepal, trekked throughout isolated
regions of Patagonia in Chile and
Argentina, hiked the Inca Trail to
Machu Picchu in Peru, driven across
the plains of the Serengeti in Tanzania, sailed around the Galapagos
Islands off the coast of Ecuador, and
explored the Milford Trek on the
south island of New Zealand.
What makes you happiest?
Learning new things and having
fun with my 11 nephews and nieces
in the Boston area, where I was
raised.
What’s something that most
people don’t know about you?
For the past six years, I’ve volunteered at the National Runaway
Switchboard, a federally funded
nonprofit organization. I started
out answering hot line calls, helping runaway youth from across the
country by finding them shelter for
a night. It’s become such an important cause for me that I now serve
on the board of directors. M
Messenger November/December 2006 Meeting in the middle
We love them, we hate them, we can’t work without them
Mayday, mayday,
man down
Meetings wearing you out?
Why not try approaching
your meetings from a different angle?
by
Stacy
Swanson
“I
f I didn’t have any meetings,
maybe I could actually get
some work done.”
We’ve all said or heard this
about one of the most controversial
subjects plaguing M. D. Anderson’s
culture: meetings.
Mad about meetings
When employees were asked
“How many meetings do you generally attend each week?” in a recent
Employee Notes poll, 41 percent
answered 2-4 meetings, 12 percent
said 5-7 meetings and 10 percent
said that meetings were taking over
their lives.
See if you can relate to any of
the following comments from our
employees:
• “Typically the meetings I
attend start off on track but fall back into the same rut they were in before.”
• “We don’t meet that often and when we do, we don’t discuss the topics on everyone’s minds.”
• “I get frustrated when leaders pretend to own work done by someone else in the room. I’d rather go to a meeting where the decision-maker gives credit to the people who work hard to make things happen.”
•
•
•
“We could use fewer committees here. Things would be more
efficient if more was done
offline before the meeting, so that the meetings would just
be used to increase decision-
making.”
“Sometimes I think I’ve turned into a professional meeting
attendee or committee member.”
“People should be able to voice ideas in meetings without fear of undue influence from the
group. The meeting leader
should act as moderator and
make sure everyone’s heard.”
A necessary evil
Let’s face it: Meetings are
needed, because nothing replaces
face-to-face interaction. When you
meet in person, you can get instant
feedback, pick up on verbal and
nonverbal reactions, and communicate your message with less chance
of being misunderstood. Talking
about an issue in a meeting often is
less time-consuming than typing an
e-mail and waiting for a response.
Here are some tips from Effective
Meetings.com to help prevent daydreaming, dozing off and doodling
in meetings:
• Hold a meeting only if necessary.
• Set clear objectives for the
meeting.
• Circulate meeting information to everyone beforehand.
• Respect people’s time. Start on time and end on time. If a
meeting is geared to people who work on different shifts, the meeting should be offered at a time that works for everyone or at multiple times.
• Meeting attendees should
participate in a constructive manner and come prepared.
• Evaluate meetings for
effectiveness. Ask for suggestions from attendees to give them a sense of ownership in the
meeting. Then ask for informal feedback and make real changes based on this feedback in the next meeting.
• EffectiveMeetings.com includes
more information about the “Ten
Commandments of Meetings” as
well as an opportunity to ask the
Meeting Guru about your meeting
conundrums.
Here are some ways to shake up
your meetings:
• Meet in a different location. Get
out of the conference room and go
off-site, or meet in an unexpected
place in the building.
• Meet for one-half the time. Try
to meet for 30 minutes instead of an
hour, and get down to business.
• Ask for questions ahead of time.
This may help you gauge the types
of questions that will be asked at
the meeting.
• Ask your guests where they’d like
to meet instead of making them
come to you.
• Try different types of meetings. “Death by Meeting,” a book
about the dilemmas of meetings
in the workplace, discusses using
variations of four different types of
meetings, depending on your needs:
the daily check-in, the weekly tactical, the monthly strategic and the
quarterly off-site review.
• Keep the topics fresh. Attendees
will be more likely to pay attention
and recall information if it’s interesting.
• Use visual aids when you can.
People are more likely to stay
focused if they’ve got something in
front of them.
Putting it into practice
One large M. D. Anderson
meeting that’s attracting attention
Yawning, doodling and game-playing are telltale signs of meeting boredom.
Messenger November/December 2006 Meeting in the middle ... continued
is the twice-a-year all-employee
meeting for Clinical Operations
that uses themed ideas and a quick,
informative style to keep employees
engaged.
The most recent meeting, called
“Clinical Operations: The Reunion
Tour,” turned Hickey Auditorium’s
normal crowd of employees into an
excited audience at a concert, complete with a disc jockey and rock ’n’
roll music.
It all began with an entertaining
PowerPoint presentation in which
photos of senior operations team
members were superimposed on
photos of their favorite musical acts.
Thomas Burke, M.D., executive vice
president and physician-in-chief,
was featured as a member of the
band Black Sabbath. The leaders
gave their remarks dressed in concert T-shirts, and one even ran on
stage and played an air guitar.
The new meeting style mixed
entertainment with education
about topics such as financial status,
divisional goals and departmental
changes. The meeting received
overwhelmingly positive feedback
from employees. Comments included, “This was fun and informative!
Do more!” and “It’s not every day I
get to go to a meeting I enjoy!”
Another example of meeting
improvement is in Diagnostic Imaging Nursing, where staff members
have transformed their monthly
meeting based directly on feed-
“Sometimes I think I’ve
turned into a professional
meeting attendee or
committee member.”
back from 2002 Employee Opinion
Survey results. They formed a survey
committee and found that much of
the miscommunication in their area
could be prevented with education
about other cultures. So the Cultural
Tip of the Month was born.
Each month, a nurse volunteers to
talk about a different cultural background. The information presented
may include commonly accepted
greetings, unacceptable phrases, and
nonverbal communication expressions such as eye contact, touching
and hand gestures that may cause
misunderstanding.
After the presentation, nursing staff members have meaningful
conversations in which they can ask
questions, bring up situations they’ve
observed and ask for advice. Nearly
140 nurses attend one of the two
meetings offered each month to
accommodate different shifts.
These are only a few examples
of how to make over a traditional
meeting. You may often sit in meetings and complain about how they’re
conducted or why you have to be
there. Why not take action yourself?
Try making the meetings in your
area better by leading them in a different way. Or pass this information
along to those who are in charge.
Whether you attend more than
20 meetings a week or just a monthly
staff meeting, the power of improving them is in your hands. M
State-of-the-institution address
by Carol Bryce
Charting new horizons
I
mproving the quality and efficiency of our care
and reducing costs will require better integration
of care delivery systems and even more teamwork,
President John Mendelsohn, M.D., reported in his
annual state-of-the-institution address Sept. 21.
“Today, more than ever, the opportunity to ask sophisticated and complicated research questions that apply
current knowledge and technology to clinical programs
requires collaboration,” Mendelsohn said.
Messenger November/December 2006 State-of-the-institution address
Developing new institutes
To foster such shared efforts,
M. D. Anderson’s senior leaders are
putting together a proposal to create
new institutes that will be clustered
around the cancer care continuum.
Under the proposed organization
that is under consideration, three
new research institutes will be
developed and an existing institute
expanded over the next six years.
The three new institutes will
focus on cancer prevention and risk
assessment, personalized cancer
therapy (clinical trials), and basic
research. In addition, our current
hospital-based Institute for Healthcare Excellence will expand to
include survivorship. The projected
institutes are based on the model
used in the McCombs Institute for
the Early Detection and Treatment
of Cancer, whose six centers of excellence are each designed to bring
the results of collaborative science
involving multiple departments to
clinical care.
Some current centers at
M. D. Anderson include those in
the McCombs Institute, as well as
the multidisciplinary care centers
that will be part of the Institute for
Personalized Cancer Therapy.
The preliminary plans for additional centers of excellence, which
were developed during a series of
research strategy retreats, will be
widely circulated for discussion and
comment, Mendelsohn said.
“We also will need to update
our capital (facilities) plan and set
attainable goals for philanthropy
over the next six years,” he added.
The result will be a six-year research plan that will begin in 2007
and be similar in scope and cost to
the plan that started in 2002.
To accommodate this growth in
clinical and research activity, senior
leaders are considering expanding
existing laboratory research space
and building two new moderatesize facilities, probably at a midcampus location.
The research strategy retreats
brought out the desire to focus
on strengthening our existing
programs, fostering collaboration,
and reducing the emphasis on
construction of large new facilities.
“We will take on a new area of
research or expand existing areas
only if they are felt to be critical
to our mission, and only if we are
willing to provide adequate support to achieve nationally recognized status,” Mendelsohn said.
Integrating research with
patient care
The decision to develop multidisciplinary care centers and
organize cancer care around the patient’s medical condition instead of
by physician specialty “has turned
out to be brilliant,” Mendelsohn
said.
But we must continue to improve
quality and efficiency of care while
reducing costs by better integrating
clinical and laboratory research into
our patient care delivery systems.
“The product we seek is the very
best outcome for individuals who
entrust their care to us as they enter
and progress through each step of
the cancer care continuum,” he
noted.
Since cancer risk assessment,
screening and survivorship activities
don’t have to take place in
M. D. Anderson buildings, senior
leaders are looking into developing
facilities at other sites and setting
up partnerships with selected referring or primary care physicians. We
also are considering partnering with
carefully selected M. D. Anderson
international affiliates.
“If our mission is to eradicate
cancer in Texas, the nation and
the world, and our vision is to be
the world’s premier cancer center,
we must expand our international
activities to include patient service,”
Mendelsohn said.
Creating a nurturing
environment
M. D. Anderson’s vision statement focuses on advancing the
excellence of our people as well as
our research and patient care. Each
of our 16,000 employees should
have opportunities to grow and
advance in his or her career, under
the direction of considerate and
nurturing leadership, Mendelsohn
said. Several activities are helping to
make this goal a reality.
Leadership training programs for
faculty members and senior administrators will be extended this year
future based on the adage “Make no
little plans.”
“I am proud and pleased that
M. D. Anderson continues to be
characterized by bold plans and
continual innovation,” he said.
“Based on where our research and
patient care are heading today,
we can say, ‘Make bold plans that
embrace collaboration.’ ” M
How we’ve grown
In the past 10 years:
• M. D. Anderson’s work force has increased by 102 percent.
• The total square footage of our facilities has increased by 161 percent.
to midlevel managers. The “I Am
M. D. Anderson” program has been
initiated to promote our core values,
and assessment of the core values
is incorporated into yearly performance evaluations.
Our Ombuds program has expanded, and Institutional Diversity
continues to help us better understand how to treat our colleagues
respectfully and supportively.
Programs for students and trainees have grown in size and stature,
as evidenced by our recent accreditation by the Commission on Colleges of the Southern Association of
Colleges and Schools.
Mendelsohn said the commitment of our employees was especially evident in the response to
the $16 million revenue deficit that
occurred as a result of hurricanes
Katrina and Rita. We more than
made up this deficit in the last eight
months of Fiscal Year 2006, due to
increased activity in the delivery of
clinical care, continued improvements in billing and collections, a
reduced rate of filling new positions,
and increased grant funding and
philanthropy.
• Our budget has grown by
226 percent.
Going boldly
M. D. Anderson today is a
very different place from when
Mendelsohn began his tenure as
president in 1996 (see “How we’ve
grown,” at right). “We’re larger,
certainly, but more accomplished as
well. We have achieved and deserve
the reputation for being the world
leaders in cancer care and translational cancer research,” Mendelsohn said.
“But this is not just about winning a leadership competition. It’s
about conquering the disease that
is the leading cause of death for
Americans under age 85,” he added.
Mendelsohn recalled that
M. D. Anderson’s first president,
R. Lee Clark, M.D., approached the
In the past nine years:
• Total research expenditures
have increased by 183 percent.
• Philanthropic support has grown by 257 percent.
In the past eight years:
• The total number of patients
served has grown by
63 percent.
•
The number of patients
enrolled in clinical trials of
new therapies has increased by 185 percent.
•
The total number of patients
registered for all types of
clinical trials has grown by 362 percent.
Messenger November/December 2006 Face to face:
Draw your own conclusion
To blog, or not to blog?
A
Web log, or “blog,” is an online diary or chronology
of thoughts. Blogs are a hot topic in the social media
arena (see Web 2.0 lingo, page 13). M. D. Anderson
already has Spiritual Pathways, a new blog from Chaplaincy
and Pastoral Education. Several internal blogs also are in
development, but they don’t face the same inherent sensitivity issues as a patient blog. That’s the focus of this feature.
Both sides here agree that journaling is therapeutic for
patients. But that’s where the similarities end. One view is
that patients writing publicly about their cancer experiences
at M. D. Anderson could open us up to liability and to the
release of potentially inaccurate or private information. The
other perspective is that blogs are simply another vehicle
for people to share information (think e-mail, phone calls,
instant messaging), and that by playing an active role in the
dialogue, we’ll lend authenticity, engage and recruit patients,
and even help shape public perception of our institution.
Here are the question and their answers; draw your own
conclusion.
How do you think M. D. Anderson should approach
the use of blogs as a social media tool for patients?
Michael Fisch, M.D., associate professor in
Gastrointestinal Medical Oncology and director of
the Community Clinical Oncology Program
One of my patients recently showed me an essay that she
wrote describing her own illness with cancer, including her
mastectomy, her daughter’s role as caregiver, her granddaughters’ experiences with genetic testing, the appreciation for her physicians, her faith, and her emotional
reactions to her experiences with cancer and other
grief-provoking life events. The act of writing was
healthy for her, her family and her friends.
If she’d had a different preference or style, perhaps this could have been transmitted through
a blog. Rather than feeling lonely, isolated,
powerless or bored, patients may choose writing a blog as an outlet and a coping mechanism, and as a way of reaching out.
Overall, I believe that M. D. Anderson
should approach this modern communication technology by embracing it, much in
the same way that we’ve embraced integrative medicine. Social media tools and
integrative medicine are part of the real
10
by Sarah Palmer
M. D. Anderson’s success with innovative
research and patient care stems, in large
part, from the diversity of its people, not
only in background, experience and culture, but also in thought. This article continues a periodic series in which two members of our work force with differing views
focus on a topic of attention in health or
cancer care. Both were given the same
questions and a limited amount of space
to “make their case.”
Michael Fisch, M.D.
world that our patients must sort through, and
about which they must make choices. Both appeal
to some patients and not others. Both carry an element of perceived risk by institutions and cancer
professionals.
Our natural reaction to these kinds of changes
in public attitudes and behaviors is to avoid
acknowledging them for some time, then to approach them cautiously. In the case of integrative
medicine, M. D. Anderson embraced it and developed it with close attention to our mission, vision,
and core values of caring, integrity and discovery.
We now have a world-class program in integrative
medicine, and have learned to manage our fears
and perceived risks.
Carrie Lyons, J.D.
Cancer blogs can be found everywhere.
• National Public Radio: www.npr.org
(go to Health & Science, then to “Blog: My Cancer”)
• Industry-sponsored sites: www.thecancerblog.com
• Individual patient sites: www.cewilton.blogspot.com
• American Cancer Society: www.cancer.org/aspx/
blog
By hosting blogs, we can bring our institutional warmth
and credibility and offer “listening ears” to our patients and
their families, young and old; locally, nationally and internationally. And when visiting the blog’s site, rather than seeing
paid advertisements, patients, family members and employees
could find links to cancer information, clinical trials and
other topics of value to this audience. Perhaps we could even
invite faculty and staff to offer professional commentary on
selected blogs.
There are many possibilities, but the first step is to be
authentic, benevolent and accessible in asking “how” best to
embrace this technology.
Just as people develop and grow over time, so does an
institution and its sanctioned activities. We can model openmindedness for change; empathy and interdependence with
others; and transparency and nonjudgmental witnessing
of experience. We have the talent to develop policies and
processes for blogs that will be innovative and exceptional
in serving our patients and meeting our goals.
How do you think M. D. Anderson should approach the use of blogs as a social media tool for
patients?
Carrie Lyons, J.D., vice president and chief
compliance officer
Although no hard data is readily available to
support the position that blogging improves health
outcomes for cancer patients, there’s unobjectionable logic that journaling or expressive writing
may result in improved health outcomes. In fact,
M. D. Anderson already supports that logic and
offers multiple journaling courses to patients.
Additionally, we’re currently collecting data for
a research protocol to evaluate the benefits of a
writing-based emotional expression program in
kidney cancer patients.
There also is a generally accepted belief
that consumer blogs are the Internet’s “word-ofmouth advertising,” arguably the best advertising that cannot be bought or, at times, the
worst advertising that cannot be contained.
Messenger November/December 2006 11
“Depending upon where or how patient blogs are
maintained, certain information contained in a patient blog could qualify as protected health information. This would legally require us to obtain the
patient’s authorization for its disclosure.”

— Carrie Lyons, J.D.
Depending upon where or how patient blogs are
maintained, certain information contained in a patient
blog could qualify as protected health information.
This would legally require us to obtain the patient’s
authorization for its disclosure. And because of the
casual nature of blogs, patients might not only disclose
their own PHI, but also unintentionally disclose PHI
about other patients without permission, in which case
regulatory agencies (and under certain circumstances,
courts of law) may hold M. D. Anderson ultimately
responsible for those disclosures.
In addition, unproven claims contained in patient
blogs may be misinterpreted by the public as
M. D. Anderson-endorsed information and/or education. This issue could pit our core value of integrity,
which arguably supports patient blogging, against our
mission to educate the public, which requires educating
the public with credible information.
The Texas Attorney General’s Cyber Crimes Unit
warns that “once a blog is posted, it’s out there.” It can
be taken down, but it can’t be taken back. The “permalink” and “trackback” features, as well as a blog culture
that encourages heavily borrowing from, and quoting
of, other blogs, can create an unending and thus uncorrectable trail of inaccurate information permanently
linked to our institution.
Finally, blogging often is used as a complaint platform. For example, many Dell customers have used
12
their blogs to chronicle dissatisfaction with the company’s customer service. The result, according to market
researchers, is sustained long-term damage to Dell’s
brand image.
In light of the benefits and risks, M. D. Anderson
could approach patient blogging in one of two ways.
• One option is to maintain patient blogs on our Internet site, similar to the site maintained by North Carolina’s HighPoint Regional Health System,
www.highpointregional.com/blogs/index/asp.
This option takes full advantage of the potential marketing power of blogs, but exposes us to all of the above-identified risks.
• Another option is to use a service provider that
allows patients the ability to blog on a free,
password-protected Internet site that’s accessible only to registered users who have the specific site
address of the patient’s blog, such as www.carepages.
com. Like St. Luke’s Episcopal Hospital and Texas Children’s Hospital, which are listed as clients of
a patient blog provider, M. D. Anderson would limit our ability to harness marketing power but also would limit our exposure to risk.
Regardless of which blogging road M. D. Anderson
decides to take, the answer to the question at hand is
that our approach to patient blogs should be farsighted
and sure-footed. M
“Rather than feeling lonely, isolated, powerless
or bored, patients may choose writing a blog
as an outlet and a coping mechanism, and as a
way of reaching out.”
— Michael Fisch, M.D.
Web 2.0 refers to a second generation of services available
on the World Wide Web that lets people collaborate and share
information online. Web 2.0 is more interactive than traditional
first-generation pages, which are static.
Web 2.0 lingo
A blog, short for Web log, is a site that displays entries in
reverse chronological order. Blogs, similar to journals, often
provide commentary or news on a particular subject, such as
food, politics or news; some function as more personal online
diaries. A typical blog combines text, images and links to other
blogs related to its topic. The word also can be a verb, meaning to add an entry to a blog.
A wiki is an Internet site that allows users to easily add,
remove, edit or change most available content, sometimes
anonymously. This ease of interaction makes a wiki an effective
tool for collaborative writing. The term also can refer to collaborative software used to create such a site.
by
Jonathan
Lowe
RSS (rich site summary or, more recently, really simple
syndication) is a way of sharing news using a technology called
XML (extensible markup language) to deliver headlines and
summaries to your desktop or Web browser, providing a regular stream of the latest news (for example, if you want to see all
the CNN stories on cancer). RSS feeds are different from podcasts (see below); they don’t contain audio. To use RSS, copy
the feed address and paste it into an RSS news reader. You
also can use a Web browser that supports RSS feeds, such as
Safari for Macintosh OS X. Microsoft Internet Explorer 7, when
it’s available, will have a built-in news reader.
Podcasting is a method of distributing multimedia files,
such as audio programs or music videos, over the Internet
for playback on mobile devices and personal computers. The
term podcast, like “radio,” can mean both the content and
the method of delivery. The host or author of a podcast often is called a podcaster. Podcasters’ sites may offer direct
downloading or streaming of their files; a podcast, however, is
distinguished by its ability to be downloaded automatically.
Above and beyond
by
Carol
Bryce
Support group facilitators share knowledge, offer comfort
Left: Kim Medlin is a longtime
member of our ovarian cancer
support group.
Opposite page, from left: Alycia
Hughes, Medlin and Mary Fitzgerald talk before a recent support
group meeting. Hughes and
Fitzgerald have been co-facilitators of the ovarian cancer support
group since 2001.
I
magine you’re a patient who has come to M. D. Anderson for
cancer treatment. You’re already worried and apprehensive. Now
you’re trying to navigate a complex medical institution, perhaps
in an unfamiliar city, far from family and friends. It can be overwhelming.
But our patients don’t have to face it alone. Support groups led by health
care and mental health professionals give patients, family members, and
caregivers the opportunity to talk about their concerns and learn more about
their disease.
Patients frequently share experiences and resources with one another in
waiting rooms or treatment centers. But support groups differ from such informal exchanges because they’re facilitated by professionally trained staff from
Social Work, Psychiatry, Nursing and Chaplaincy.
“Our staff members often see the need to form a support group to provide
education for patients in a more structured format,” explains Laura BaynhamFletcher, director of Place … of wellness, where many of the groups meet.
“It’s really important for a support group to have a facilitator, because that
person can offer reliable information, help members talk about difficult issues
and put them in touch with appropriate services,” she says.
Some support groups are ongoing and have a fluctuating membership; others
have a limited number of meetings or participants. Most groups are open not
only to our own patients, but also to those who have been treated elsewhere.
14
Something in common
Many of our support groups
are for those with a specific
disease. “We’ve found that people
usually prefer to join a group
where everyone has the same
type of cancer,” explains Alycia
Hughes, Social Work counselor.
Hughes is one of two facilitators of an ovarian cancer support
group that began in January
2001. That group meets monthly
and is open to any ovarian cancer
patient. “You can come when you
feel like it and when the topics
interest you,” she says.
Hughes and co-facilitator
Mary Fitzgerald structure the
group to meet the needs of its
members. The 90-minute meeting used to include a presentation
and separate supportive sessions
for patients and caregivers. But
members decided they didn’t
want to split into smaller groups,
because they could get that support elsewhere.
“We’ve found that women in
our group form friendships and
provide a lot of support for each
For a list of support groups, go to
www.mdanderson.org/departments/socialwork
or call Place … of wellness at (713) 794-4700.
This story idea came from
Mary Fitzgerald, coordinator of
the clinical research program
in Gynecologic Oncology.
other outside our meetings,” says
Fitzgerald, coordinator of the clinical research program in Gynecologic Oncology.
So the group now serves primarily as an educational resource, with
each meeting including a speaker
and a question-and-answer session.
“When the members wanted to
change the format, we did. It’s their
group; we just guide it,” Hughes
says.
When asked why she spends time
outside her regular work schedule
as a facilitator, Fitzgerald responds,
“Alycia and I both have training
in this area and are grateful for the
chance to use it to create a unique
source of support for our patients.”
A neglected population
Phyddy Tacchi is an advanced
practice nurse in Psychiatry. She
has been a full-time caregiver and
knows firsthand that the needs of
caregivers frequently are overlooked.
That’s why she started “Caregivers: I’ve Got Feelings, Too!” five
years ago.
Tacchi facilitates this weekly
psycho-therapeutic group to give
caregivers a safe place to talk
about issues they’re facing. She has
developed a caregivers’ video in
both English and Spanish, makes
frequent caregiving presentations
and created an annual Caregivers’
Week.
“This has become my passion,”
she says. “Caregiving is perhaps
the most stressful job one will ever
have. It also can be the most honorable.”
Virtual support
While support groups typically
involve face-to-face meetings, online
groups are growing in popularity.
For the past six years, our
Bladder Cancer Support Team
has sponsored an Internet site to
promote better understanding and
awareness of the fifth most common
cancer in the United States. The
team is part of M. D. Anderson’s
Specialized Program of Research
Excellence in bladder cancer, a
National Cancer Institute program
that funds translational research
projects.
Unlike most support groups, this
one began without any members.
“Our support team started going
to health fairs and other community events to get the word out
about our site and activities. It was
a trickle-down effect instead of the
usual trickle up,” explains Jane Dinney, the support team’s volunteer
coordinator.
Today team members regularly
correspond with 250-300 patients
through www.mdanderson.org/departments/bladdercansup. A bladder
cancer survivor who’s undergoing treatment at M. D. Anderson
recently has stepped forward to
organize a patient group.
“We’ll answer every person who
contacts us and direct their questions to the right people,” Dinney
says. The team also sponsors Bladder Cancer Awareness Week every
November and continues to give
presentations and attend community events.
Whatever their structure, support groups can help their members
feel less isolated.
“These groups put people in
touch with others who really have
been there, and their facilitators
can help demystify the cancer experience,” Baynham-Fletcher says. M
by
Jonathan
Lowe
Lighten up
Finding the humor in Making Cancer History®
T
reating cancer is no laughing
matter. And being sensitive to
the concerns of our patients
and co-workers is at the heart of our
core value of caring. Yet far from
being inappropriate, a healthy sense of
humor is an essential survival skill for
employees under pressure.
As with other disciplines, a sense
of humor is a viewpoint that needs
to be practiced. Once it’s developed,
employees can put difficult situations
in perspective and take themselves
lightly while facing challenges at work
seriously.
Karen Mooney proudly displays her kindergarten diploma, which
states she has “satisfactorily completed the requirements of work and
play.” She says that cultivating a humorous outlook on life at work has
helped her stay sane through busy schedules and tough times.
16
Perfect timing
Joking around, like performing delicate surgery or disarming a bomb, requires
expert timing. “It’s harder to do that when
you don’t have much shared history,” says
Thomas Burke, M.D., executive vice president and physician-in-chief. “Think about
who you joke with the most: It’s usually your
family, your school buddies, people you’ve
known for a long time.
“I’m more cautious and less freewheeling
with patients I’m meeting for the first time
or don’t know as intimately as someone I’ve
treated for years,” he continues. “However,
with patients I’ve treated for years, I’ve built
close, long-standing relationships. We’ve
been through surgeries, chemotherapy and
some pretty tough times together. That’s
where I can use humor and a looser interaction, because we have that bond.”
“It’s not about always trying to be
funny; it’s about being comfortable
and genuine.”
— Thomas Burke, M.D.
When it comes to funny business with
his co-workers, Burke says he uses wit as a
way to diffuse stress for his team. “It’s not
about always trying to be funny; it’s about
being comfortable and genuine. It’s trying
to acknowledge that others have stresses
that need to be removed,” he says. “It’s a tool
to keep people focused and relaxed, keeping your team functional instead of bogged
down in daily frustrations.”
Comic relief
Karen Mooney agrees that the best managers encourage employees to have fun at
work. The project manager in Research and
Education Facilities Management says that
when the going gets tough, the tough need
to lighten up.
“It’s preventive maintenance,” she says.
“If you don’t let your group blow off steam
now and then, you’re going to lose efficiency.”
In her office, Mooney’s framed diploma
from kindergarten states that she “met the
requirements in fun and play.” She retains
those early lessons and helps her team keep
things light by periodically organizing voluntary holiday decorating contests, coming
up with computer-generated backgrounds for
department portraits, and offering her “two
cents” during lunchtime soap opera discussions.
“I think it’s important that employees
have the opportunity to release tension at
the workplace rather than at home,” she
adds. “Many people hesitate to suggest fun
activities at work, but if you don’t see some-
E
one stepping up to propose these things, you
need to suggest them yourself.”
Halloween costumes and skits that
poke good-natured fun at faculty at annual
training retreats help build camaraderie in
Biochemistry and Molecular Biology.
“Anything I can do as a leader to promote collaboration in the department is
great,” Chair William Klein, Ph.D., says.
“Humor can be a wonderful bridge to
achieving that.”
Thomas Burke,
M.D., and Senior
Administrative
Assistant Victoria
Watson share a
laugh in Burke’s
island retreatthemed office.
Developing optimism
After pondering the genetic lineage of
hilarity in human nature, Klein admits that
not everyone grows up learning to appreciate a life of laughter. “Whether it’s scientists or even professional comedians, some
people are just naturally more solemn.”
That tendency toward seriousness is not
one Duke Rohe accepts. The improvement
adviser with Performance Improvement
believes that having a humorous, upbeat
perspective is a matter of conscious choice.
“You choose what you want to dwell on,”
he says. “Why not choose the fun option?
Fun can be anything that builds learning.
When I enjoy what I’m doing, it doesn’t
seem like work anymore.”
Rohe encourages those he meets to assume responsibility for their own entertainment. “If you have a difficult job in front of
you, make a game out of it,” he says. “Having a positive spin on things will benefit
your life, and that can’t help but spill over
into the lives of those around you.” M
I.V.
by Jay Edwards
(inside view)
Technology Architecture relentlessly designs
better ways to work
When you need expert advice on the best and latest computer innovations,
call the Technology Architecture team.
I
magine you want to build a 70story tower in the middle of the
Texas Medical Center. You have
plenty of money to finance the project, and you’ve hired the best construction crew in town. You have
everything to build your skyscraper.
But you don’t have an architect.
No matter how much hard work
you and your team put into the
building, without an experienced
architect to ensure the stability of
its infrastructure, it likely will end
up a large pile of rubble on the
street.
The new Technology Architecture team in Information Ser-
18
vices isn’t constructing any 70-story
towers. But it does ensure that our
technological infrastructure holds
up, no matter what the conditions.
Multiple roles
Technology Architecture team
members ensure that technology
you use every day to do your job,
such as PC and Macintosh workstations, printers, servers, video conferencing equipment and BlackBerrys,
is current and functioning properly.
“Technology architects perform
three major roles at M. D. Anderson:
internal information technology support, daily operations and technol-
ogy project consultation,” explains
Erin Adkins, project manager.
As internal IT support, technology architects step in whenever an
IT support group needs help. Technology architects work with vendors
or other teams to get the problem
resolved.
Additionally, team members
ensure that technology throughout
the institution operates at peak performance each day. They monitor
computer workstations and install
software patches to keep computers
up to date. They manage enhancements to servers, networking
devices and databases.
Setting the standard
Team members also set institutional standards for preferred
software and hardware, including
desktop operating systems (such as
Microsoft Windows XP for PCs),
application software (such as Adobe
Photoshop for image editing), and
computer hardware (such as HP
LaserJet for personal printers). A list
of preferred software is available on
the Preferred Software Program site,
http://4info.mdanderson.org/preferredsoftware.
Finally, team members serve as
consultants for special technology projects. “Like conventional
architects, we’re consultants,” says
Team Manager John Ferro. “We
thoroughly investigate the technology needs of our clients, determine
the best potential solutions, perform
thorough testing and document
the entire process. That way, we
can be sure that we’re recommending a solution that will function as
intended, and that any potential
problems are known in advance.”
The team has played an important role in designing and implementing a number of high-profile
new technologies at M. D. Anderson. These include adding Vocera
badge communicators (hands-free,
wireless radio-phone devices) in
clinics, developing a system for
Clinical Nutrition to speed up
meal ordering for patients, making
chemotherapy order sets available
through ClinicStation, and designing a system to connect microscopes
to PCs in Veterinary Medicine.
Call the architects first
In this age of innovation, we
all want the latest device to make
our jobs more efficient. Technology companies have countless new
programs and gadgets that promise
to revolutionize how we do our jobs,
and vendors who work for these
companies are more than willing to
sell them to you.
“If your department wants to
purchase some new piece of technology, we recommend you call us
first,” says Wesley Fielder, systems
analyst. “We can test to make sure
it does what you want it to and that
it works with other systems in the
institution.”
From their testing lab in the
Fannin Bank Building, technology
architects can evaluate just about
any type of software or hardware
before it’s purchased. Most companies will provide software and
equipment for evaluation for up to
90 days, Fielder says.
“Vendors sometimes can be
notorious for making exaggerated
claims about their products. Many
employees have bought something
for work solely on the advice of
vendors, only to find that it isn’t
compatible with M. D. Anderson
systems,” says Nathan McKaskle,
support services analyst. “Then they
bring it to us and hope we can make
it work. We’ll offer our recommendations, but it sometimes requires
buying additional products, which
end up costing more.”
McKaskle says there are several things to consider before you
purchase new technology, including
whether it’s compatible with our
current systems, how it compares
with similar products and if it has
all the required features. In some
cases, another department might
use the same application, so there’s
no need for it to be bought again.
“It’s best that you contact us
before making any new technology
purchases for your department,”
McKaskle says. M
Technology Architecture team
members include, from left: Nathan
McKaskle, Erin Adkins and Chris
Schroeder.
From left: Ramiro Ibarra, John Ferro
and John Blackwell.
Top row, from left: Eric Bilodeau and
Jeff Davis. Bottom row, from left:
Mark Sellers and Wesley Fielder.
In the eye of the beholder
by Carol
Bryce
and Jay
Edwards
Meeting the challenges of ‘rare’ cancers
G
erm cell tumors … cancer
of the bile duct … ocular
cancer.
Uncommon cancers such as
these often don’t have celebrity advocates or fund-raising campaigns.
If you’re a patient who’s seeking
treatment information, educational
material or even a support group,
you may be disappointed by the lack
of resources for rare cancers.
Maurie Markman, M.D., vice
president for clinical research,
questions the use of the term “rare,”
however, when it comes to cancer.
“To some extent, it’s in the eye of
the beholder,” he says.
“For a person with a particular
cancer, ‘rare’ or ‘common’ aren’t
words that have any meaning. If I
have it, or my child, or my friend,
then I want answers. I want to
know what’s the best treatment,
what research is being done, has
this new wonder drug been looked
at in my cancer?” Markman says.
There often are no simple
answers. But a lack of research or
treatment options for a particular
type of cancer doesn’t signify a lack
of interest among the medical community.
“It’s not that these cancers are
less important or that we don’t care
about them. It’s just that it’s more
difficult to answer a scientifically
valid question in a rigorous manner,” Markman emphasizes.
Numbers matter
Researchers who’ve developed a
new treatment strategy for a more
20
It’s more difficult for researchers to answer scientific questions about cancers that occur infrequently, such as gastrointestinal cancer. So there often
are fewer resource materials available for such cancers than for more common ones, such as breast cancer.
common disease such as breast cancer can conduct early development
trials and then randomized national
and international clinical trials over
a relatively short time period.
“We can go from the theory to
the demonstration of benefits or
lack of benefits because of the commonness of the malignancy. So we
can get answers quickly,” Markman
explains.
But with a less common cancer,
it’s more difficult to conduct such
investigations because of the smaller
number of patients available to
participate in trials.
“You can finish a 400-patient trial on lung cancer in several months.
But it could take you 10 years to do
a 400-patient trial in some other
cancer,” he says.
A ‘home run’ discovery
Answering scientific questions
can be more difficult with uncommon cancers, but it’s not impossible.
“Sometimes you can come up
with an answer that’s definitive with
a relatively small number of patients
and hit the proverbial ‘home run,’ ”
Markman says.
He cites gastrointestinal stromal
tumors, a relatively rare cancer
that develops within the stomach
or intestinal tract, as an example.
GIST is diagnosed in some 4,0006,000 people a year in the United
States, according to Jonathan Trent,
M.D., Ph.D., assistant professor of
Sarcoma Medical Oncology.
“Pathologists and clinical investigators have studied GISTs for the
past 60 years. But there were no
major advances in patient care until
the late 1990s,” Trent says.
At that time, GISTs were found
to have the same molecular abnormality as chronic myeloid leukemia,
a more common disease. Research-
ers discovered that GISTs responded favorably to the drug Gleevec,
and the drug was approved for use
against the disease in 2002.
“Today, the flurry of clinical advances in GIST makes the outlook
for these patients very bright,” Trent
adds.
“Our GIST patients are treated
in the Sarcoma Center by a multidisciplinary team whose members
ensure that patients receive appropriate diagnosis, therapy, assessment
of response and side effects management. The majority of our GIST patients also participate in our clinical
trials.”
But the GIST example is unusual, Markman says.
“Cancer is really several hundred
different diseases. So just because a
drug works in cancer A, that doesn’t
mean it’s going to work in cancer
B.”
The value of familiarity
Markman understands the frustrations felt by those who’ve been
diagnosed with uncommon cancers.
“American society has been
told, very appropriately, that we’re
making major efforts to understand
the biology of cancer and improve
cancer survival and quality of life,”
he says. “But then someone says,
‘I have this rare tumor, and I just
don’t see much work going on in
this area. How come?’ ”
Such patients often travel to
M. D. Anderson for treatment.
“A patient whose doctor says,
‘I’ve only seen one of these in my
entire career,’ should come here,”
Markman says. “We may not have
seen hundreds of cases, but we may
have seen several dozen. And that
several dozen may be incredibly
helpful.” M
Common but
uncommon
Despite the fact that
cancer is the most common cause of death
by disease for children
in the United States,
its occurrence is relatively rare, says Eugenie
Kleinerman, M.D., division head of Pediatrics.
About 12,500 new
cases are reported each
year across the country.
“Because new drugs are
expensive to develop,
pharmaceutical companies tend to invest in
more common types
of cancer,” Kleinerman
says. “Finding funds for
pediatric research can
be difficult.”