Synapse ursday, May 22, 2014 synapse.ucsf.edu Volume 58, Number 32 The UCSF Student Newspaper IN THIS ISSUE News Briefs » PAGE 3 Journal Club » PAGE 5 Puzzles » PAGE 11 ARTS&CULTURE Charlie Varnon in Feisty Old Jew Storytelling from the stage » PAGE 11 NEWS IDEA to IPO Class Training the new science entrepreneur » PAGE 8 SUTRO STEWARDS » PAGE 8 Photo courtesy of Tina Tran/P2014 GENETIC TESTING KITS » PAGE 4 NEWS Regulating Direct-to- Consumer Genetic Testing vs. The Right to Know By Benjamin Cohn and Dalga Surofchy Staff Writers F or about $100, customers can have DNA from their saliva analyzed by the genetic testing company 23and- Me for hundreds of gene variants thought to be linked to traits ranging from ancestry and earwax type to warfarin sensitivity and Al- zheimer’s disease. While 23andMe gives customers access to their raw genetic data, some would say the real value of their product lies in the inter- pretation packaged with these data. For gene variants linked to health and disease traits, however, , the U.S. Food and Drug Adminis- tration has taken notice as 23andMe has yet to provide them with premarket assurance that these interpretations are clinically vali- dated and accurate. e FDA argues that using 23andMe’s ser- vice this way qualifies it as a medical device, and ordered the company to cease marketing their kit as a health management tool until these assurances were met. How should the direct-to-consumer (DTC) genetic testing industry respond to the FDA? Last month, the San Francisco Bay Area chapter of Oxbridge Biotech Roundtable (OBR) convened experts at UCSF to debate the FDA’s recent decision to bring DTC genet- ic testing under its regulatory authority. is decision marks the most recent chapter in five years of largely unproductive communica- tions between the federal agency and 23and- Me, culminating in December, when the FDA ordered the company to “immediately discon- tinue marketing the Personal Genome Service (PGS) kits until such time as it receives FDA marketing authorization for the device.” Arguing in favor of the FDA’s actions were Gianfranco de Feo, VP of Marketing at the Redwood City-based computational genet- ics company Bina Technologies, and Patri- cia Zettler, a fellow at the Stanford University Law School Center for Law and the Biosci- ences. In opposition were Andro Hsu, Di- rector of Product Marketing at Syapse, Inc., a Palo Alto-based data management soft- ware company, and Paul Billings, Chief Med- ical Officer for Life Technologies. ey were joined by Glenda Anderson, CEO and co- founder of the healthcare IT company Far- sight Genome Systems. A medical device? If a medical device calls to mind imag- es of heart stents and CT scanners, it might seem surprising that the FDA wants to regu- late 23andMe’s DNA testing service under this classification. e distinction is worth think- ing about, however, because it relates to the type of service 23andMe claims to be offering. Here’s an excerpt from the official FDA defini- tion for a medical device: “An instrument, apparatus, implement, machine, contrivance, implant, in vitro re- agent, or other similar or related article, in- cluding a component part, or accessory which is intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease.” (http:// www.fda.gov/MedicalDevices/DeviceRegula- tionandGuidance/Overview/ClassifyYourDe- vice/ucm051512.htm) Patricia Zettler argued that 23andMe’s test unambiguously satisfies the FDA definition because it was marketed as a way to prevent and diagnose disease. Last year, 23andMe ran a television spot which promised—or at least strongly insin- NEWS Paying it Forward: Sutro Stewards Volunteers Keep Our Mountain Accessible By T. Booth Haley Staff Writer M t. Sutro is the most amazing back- yard any urban university could ever want. Right in the middle of San Francisco, students and neighbors can en- joy 61 acres of eucalyptus forest, replete with rocky outcrops, a summit meadow, miles of trails and even a seasonal creek. e moun- tain has experienced many changes through- out the last 150 years, including being owned by two different San Francisco majors, but only recently has it truly become the spar- kling emerald of the San Francisco park sys- tem. e current set of trails that hikers and bikers enjoy today has been greatly improved in the last seven years, almost entirely due NEWS Congratulations to the School of Pharmacy Graduates By Tina N. Tran Contributing Writer L ast Thursday, beloved families, friends and fac- ulty joined 123 Doctor of Pharmacy (PharmD) graduates at Davies Symphony Hall in an event we had all been anxiously waiting for—the UCSF School of Pharmacy Commencement Cer- emony. Dean B. Joseph Guglielmo, PharmD, known to the Class of 2014 as “Dean Joe,” opened the ceremony with a warm wel- come speech. As he read aloud a few ex- cerpts from our entrance essays, those written just four years ago about our chal- lenges, hopes, dreams and the kind of phar- macists we were all inspired to become, we couldn’t help but think to ourselves: “Four years have flown by in the blink of an eye! It is hard to believe, but we finally did it!” Ryan Beechinor and Gary Lau, our elect- ed student speakers, delivered two person- al reflection speeches on their experiences PHARMACY GRADUATES » PAGE 3 as student pharmacists at UCSF as well as their perspectives on the future of pharma- cy. ese reflections highlighted the qualities that make up the unique student body at the UCSF School of Pharmacy: diverse, authentic, caring, compassionate, innovative, resource- Tina Tran is a member of the the School of Phar- macy, Class of 2014. Photo by Mason Tran/D4 The Sutro Stewards help maintain the hiking trails of Mt. Sutro.
Transcript
SynapseThursday, May 22, 2014 synapse.ucsf.edu Volume 58, Number 32
The UCSF Student Newspaper
IN THIS ISSUENews Briefs » PAGE 3Journal Club » PAGE 5Puzzles » PAGE 11
ARTS&CULTURECharlie Varnon in Feisty Old JewStorytelling from the stage » PAGE 11
NEWSIDEA to IPO Class Training the new science entrepreneur » PAGE 8
SUTRO STEWARDS » PAGE 8
Photo courtesy of Tina Tran/P2014
GENETIC TESTING KITS » PAGE 4
NEWS
Regulating Direct-to- Consumer Genetic Testing vs. The Right to KnowBy Benjamin Cohn and Dalga SurofchyStaff Writers
For about $100, customers can have DNA from their saliva analyzed by the genetic testing company 23and-
Me for hundreds of gene variants thought to be linked to traits ranging from ancestry and earwax type to warfarin sensitivity and Al-zheimer’s disease.
While 23andMe gives customers access to their raw genetic data, some would say the real value of their product lies in the inter-pretation packaged with these data. For gene variants linked to health and disease traits, however, , the U.S. Food and Drug Adminis-tration has taken notice as 23andMe has yet to provide them with premarket assurance that these interpretations are clinically vali-dated and accurate.
The FDA argues that using 23andMe’s ser-vice this way qualifies it as a medical device, and ordered the company to cease marketing their kit as a health management tool until these assurances were met.
How should the direct-to-consumer (DTC) genetic testing industry respond to the FDA?
Last month, the San Francisco Bay Area chapter of Oxbridge Biotech Roundtable (OBR) convened experts at UCSF to debate the FDA’s recent decision to bring DTC genet-ic testing under its regulatory authority. This decision marks the most recent chapter in five years of largely unproductive communica-tions between the federal agency and 23and-Me, culminating in December, when the FDA ordered the company to “immediately discon-tinue marketing the Personal Genome Service (PGS) kits until such time as it receives FDA marketing authorization for the device.”
Arguing in favor of the FDA’s actions were Gianfranco de Feo, VP of Marketing at the Redwood City-based computational genet-ics company Bina Technologies, and Patri-cia Zettler, a fellow at the Stanford University Law School Center for Law and the Biosci-ences. In opposition were Andro Hsu, Di-rector of Product Marketing at Syapse, Inc., a Palo Alto-based data management soft-ware company, and Paul Billings, Chief Med-ical Officer for Life Technologies. They were joined by Glenda Anderson, CEO and co-founder of the healthcare IT company Far-sight Genome Systems.
A medical device?
If a medical device calls to mind imag-es of heart stents and CT scanners, it might seem surprising that the FDA wants to regu-late 23andMe’s DNA testing service under this classification. The distinction is worth think-ing about, however, because it relates to the type of service 23andMe claims to be offering. Here’s an excerpt from the official FDA defini-tion for a medical device:
“An instrument, apparatus, implement, machine, contrivance, implant, in vitro re-agent, or other similar or related article, in-cluding a component part, or accessory which is intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation, treatment, or prevention of disease.” (http://www.fda.gov/MedicalDevices/DeviceRegula-tionandGuidance/Overview/ClassifyYourDe-vice/ucm051512.htm)
Patricia Zettler argued that 23andMe’s test unambiguously satisfies the FDA definition because it was marketed as a way to prevent and diagnose disease.
Last year, 23andMe ran a television spot which promised—or at least strongly insin-
NEWSPaying it Forward: Sutro Stewards Volunteers Keep Our Mountain AccessibleBy T. Booth HaleyStaff Writer
Mt. Sutro is the most amazing back-yard any urban university could ever want. Right in the middle of
San Francisco, students and neighbors can en-joy 61 acres of eucalyptus forest, replete with rocky outcrops, a summit meadow, miles of trails and even a seasonal creek. The moun-tain has experienced many changes through-out the last 150 years, including being owned by two different San Francisco majors, but only recently has it truly become the spar-kling emerald of the San Francisco park sys-tem.
The current set of trails that hikers and bikers enjoy today has been greatly improved in the last seven years, almost entirely due
NEWS
Congratulations to the School of Pharmacy GraduatesBy Tina N. TranContributing Writer
Last Thursday, beloved families, friends and fac-ulty joined 123 Doctor of
Pharmacy (PharmD) graduates at Davies Symphony Hall in an event we had all been anxiously waiting for—the UCSF School of Pharmacy Commencement Cer-emony.
Dean B. Joseph Guglielmo, PharmD, known to the Class of 2014 as “Dean Joe,” opened the ceremony with a warm wel-come speech. As he read aloud a few ex-cerpts from our entrance essays, those written just four years ago about our chal-lenges, hopes, dreams and the kind of phar-macists we were all inspired to become, we couldn’t help but think to ourselves: “Four years have flown by in the blink of an eye! It is hard to believe, but we finally did it!” Ryan Beechinor and Gary Lau, our elect-ed student speakers, delivered two person-al reflection speeches on their experiences PHARMACY GRADUATES » PAGE 3
as student pharmacists at UCSF as well as their perspectives on the future of pharma-cy. These reflections highlighted the qualities that make up the unique student body at the UCSF School of Pharmacy: diverse, authentic, caring, compassionate, innovative, resource-
Tina Tran is a member of the the School of Phar-macy, Class of 2014.
Photo by Mason Tran/D4The Sutro Stewards help maintain the hiking trails of Mt. Sutro.
2 | May 22, 2014 | synapse.ucsf.edu
EVENTS
Journal Club
MISSION BAY EVENTSFOOD TRUCK THURSDAYS AT MISSION BAY Thursday, May 22, 11 a.m.-2 p.m., 4th Street & Nelson Rising Lane, Mission Bay Join the food truck lunch party every Thursday at Mission Bay and explore the tasty culinary options to break up your routine. Each week will feature two different vendors, so there will always be something new. Grab some friends, get some food and take your lunch experience up a notch.
SYNAPSE NEWSPAPER Friday, May 23, noon-1 p.m., Graduate Division, CC-310, Mission Bay Synapse is looking for Mission Bay and Parnassus writers, bloggers, photographers and designers. Come to the lunch meeting, share your story ideas and enjoy a free lunch. RSVP to Steven Chin, [email protected].
MUSLIM FRIDAY PRAYER SERVICES Friday, May 23, 1-2:30 p.m., Helen Diller, 160, Mission Bay The Muslim Community at UCSF holds regular Friday prayer services (Jum’a) for the UCSF Muslim community every week. Come join your fellow brothers and sisters for prayer, lunch and socializing. All are welcome.
MISSION BAY RIPSFriday, May 23, 4-5 p.m., Genentech Hall Auditorium, Mission BayResearch In Progress Seminar is a seminar series at which one student and one postdoc present their current research. Talks are 15 minutes in length and are preceded by a 20-minute social. Snacks and beverages are provided.
ALTERNATIVE SOURCES OF FUNDING TALKTuesday, May 27, 5:30-7:30 p.m., Rock Hall, 102, Mission BayLearn about sources of funding for your venture that are less well known than angels and venture capital. We will explore the range of investment possibilities, including corporate venture groups, foundations, crowdsourcing, online markets and other alternative sources. A senior representative of AngelList will join us for part of the evening. Cost: $5. ita.ucsf.edu/news-and-events/alternative-sources-funding-and-crowdsourcing-workshop
THE SEASON FINALE OF THE VOCAL CHORDSTuesday, May 27, 7 p.m., Genentech Hall Auditorium, Mission BayJoin us for an exciting evening of UCSF's a cappella group singing jazz and contemporary pop hits! Free food and drinks.
MISSION BAY FARMERS’ MARKETWednesday, May 28, 10 a.m.-2 p.m., Gene Friend Way Plaza, Mission BayShop healthy, shop fresh, shop California-grown at the UCSF Farmers' Market, every Wednesday (rain or shine). Sponsor: Pacific Coast Farmers' Market Association.
PARNASSUS EVENTS
CHANCELLOR’S CONCERT SERIES Thursday, May 22, noon-12:45 p.m., Cole Hall, Parnassus
Looking for a place to study or relax between classes? CLS Arts & Events has got just what you need. The Chancellor's Concert Series on Thursdays is a great place to set up your laptop and study or just take a break from classes while listening to classical music. Seating begins at noon. If you are unable to come, you can now listen to the music through live stream.
J-1 ORIENTATION Thursday, May 22, noon-2 p.m., Medical Sciences, 20 , Parnassus J-1 immigration regulations mandate that all new J-1 visa holders who have started their appointment at UCSF must attend one orientation. At orientation, you will learn about traveling during your program, employment and reimbursement policies, extending your program, and other helpful information about living in San Francisco and doing research at UCSF. Bring your passport and your DS-2019.
GRANTS IN CONTEXT: INSIGHTS AND STRATEGIES FOR FUNDING YOUR RESEARCH Thursday, May 22, 5-7 p.m., Nursing, 225, Parnassus The GSA Social Science Programs Committee is hosting an interdisciplinary panel on grants and funding. Dean Watkins will provide opening remarks. The panel will be followed by a networking reception with food and drinks.
MUSLIM FRIDAY PRAYER SERVICES Friday, May 23, 1:30-2 p.m., Medical Sciences, 178, Parnassus The Muslim Community at UCSF holds regular Friday prayer services (Jum’a) for the UCSF Muslim community every week. Come join your fellow brothers and sisters for prayer, lunch and socializing. All are welcome.
CAMPUS EVANGELISTIC FELLOWSHIPFriday, May 23, 7-10:30 p.m., Nursing, 517, ParnassusJoin the Campus Evangelistic Fellowship for its weekly meeting, with Bible study, hymn singing and fellowship.
CARRY THE ONE RADIOTuesday, May 27, 5-7 p.m., Student Resource Center, Mission BayCarry the One Radio is a biweekly science podcast produced entirely by UCSF students. The show has featured some of the country's top scientists and it covers a myriad of science topics. If you are interested in community outreach or science communication come to a weekly meeting. No radio experience necessary. Visit our site to learn more: www.ctoradio.org or find us on twitter: @ctoradio.
UCSF MEMORIAL DAY CELEBRATIONTuesday, May 27, noon-1 p.m., Saunders Court, ParnassusJoin the Student Veterans at UCSF in honoring the members of the UCSF community who have served in the Armed Forces. Light refreshments will be provided.
PARNASSUS FARMERS’ MARKET Wednesday, May 28, 10 a.m.-3 p.m., ACC, 400 Parnassus Ave. Shop the Farmers’ Markets on Wednesdays to pick up locally grown produce and more. Sponsor: Pacific Coast Farmers’ Market Association.
SYNAPSE NEWSPAPER Wednesday, May 28, noon-1 p.m., Millberry Union 123W, ParnassusSynapse is looking for Mission Bay and Parnassus writers, bloggers, photographers and designers. Come to the lunch meeting, share your story ideas and enjoy a free lunch. Email [email protected] to RSVP.
UCSF RUN CLUB Wednesday, May 28, 5:30-6:30 p.m., Millberry Union Central Desk, ParnassusPlease drop by and join UCSF Fit & Rec for a run. Each Wednesday night, the Run Club runs various distances (from 3-6 miles) at 9 to 11 minutes per mile.
IMN MIDWEEK MEDITATION HOURWednesday, May 28, 5:30-6:30 p.m., Library, CL 211, ParnassusThe Integrative Medicine Network invites everyone in the UCSF community to experience a weekly guided meditation. All are welcome, whether you are looking to combat day-to-day stress using meditation or you'd like to uncover subtle layers of your self by diving deep. No experience in meditation is necessary. Both regular meditators as well as amateurs are welcome.
ENTREPRENEUR'S CLUB: THE LIFE OF A PHYSICIAN-DEVICE INVENTORWednesday, May 28, 5:30-7:30 p.m., Library, CL-221, ParnassusAl Chin, MD, Co-founder, Pavilion Medical Innovations. Al is a prolific inventor of medical devices, drawing on his background in engineering and UCSF Medical School. During his 36 year history, he has invented products generating $3.2 billion in revenue and holds 182 U.S. patents. Learn about Al’s approach to entrepreneurship and why he can’t stop inventing. Cost: $5. ucsf.edu/news-and-events/entrepreneurs-club-life-physician-medical-device-inventor
ENGLISH CORNERWednesday, May 28, 6-8:30 p.m., Clinical Sciences, 130, ParnassusEnglish Corner is an informal conversational English class given as a free community service and provided on a voluntary basis by both people born and raised in the United States as well as many people who have, at one time in their lives, experienced life as a new immigrant to the United States.
UCSF FAMILY DAY AT THE SAN FRANCISCO ZOO: TICKETS ON SALE Saturday, June 7, 11 a.m.-2 p.m., 1 Zoo Road, SF Campus Life Services invites you to come and enjoy UCSF Family day at the San Francisco Zoo. Discounted admission ticket includes: attractions, lunch, and musical entertainment! Cost: $12/adults and $8/children (4-14yrs), clsonlinestore.ucsf.edu/.
THE SEASON FINALE OF THE VOCAL CHORDSTuesday, May 31, 7 p.m., Health Sciences West, 302. ParnassusJoin us for an exciting evening of UCSF's a cappella group singing jazz and contemporary pop hits! Free food and drinks.
UCSF BOOK DRIVEBring your donations of textbooks, study guides, workbooks, and novels in clean, legible condition to any UCSF Library. The UCSF Library and its affiliates are hosting a book drive with Better World Books. A portion of every donated book sold will help support The National Center for Families Learning. library.ucsf.edu/content/donate-used-books-support-family-literacy-1
ANNOUNCEMENTS
OFF-CAMPUSCALIFORNIA ACADEMY OF SCIENCES: SKULL NIGHTLIFE Thursday, May 22, 6-10 p.m., Cal Academy, Golden Gate Park, SF You’ve seen them in tattoos, in processions down Mission Street, and on high-fashion runways. Now, take a closer look at the roles that skulls play in popular culture. http://bit.ly/NightLifeTickets, http://bit.ly/CLSDiscounts.
FRIDAY NIGHTS AT THE DE YOUNGFriday, May 23, 5-8:45 p.m., de Young Museum, 50 Hagiwara Tea Garden Dr., Golden Gate ParkFriday Nights at the de Young offers a variety of arts programs. Programs are free and open to the public, but do not include admission to the museum's galleries.http://deyoung.famsf.org/programs.
U.C.S.F. ARAG Plan Members are entitled to a comprehensive Trust & Estate Plan (including an Advance Health Care Directive) at a ZERO out of pocket cost! Consultations provided at any U.C.S.F. campus or 1795 Union St., 3rd Fl., S.F.
About Synapse is the UCSF student-run weekly newspaper, which runs on Thursdays during the academic year and monthly during the summer. Synapse seeks to serve as a forum for the campus community. Articles and columns represent the views of the authors and not necessarily those of the Board of Publications or the University of California.
Submissions Announcements and letters should be submitted six days before publication. All submissions can be either emailed or mailed. All material is subject to editing. Letters to the Editor must be signed by the author.Subscriptions Subscriptions cost $20/year ($40/outside US).
Advertising Paid advertisements do not necessarily reflect the views of Synapse. Synapse and its editorial board reserve the right to decline advertisements promoting false or misleading claims, known health risks, or content deemed by the editors to be antithetical to the interests of UCSF students or the UCSF community. Synapse does not accept advertisements from tobacco or alcohol manufacturers, or sexually oriented personal ads. Synapse reserves the right to run any ad with a disclaimer.
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NEWS BRIEFSGraduate Students Recognized for Community Service
Two UCSF graduate students received awards for their outstanding community ser-vice. Charlie Morgan, a sixth-year student in the Graduate Division’s pharmaceutical chemistry PhD program, won the Chancel-lor’s Award for Public Service. And Carolyn Sufrin, MD, a student in the medical anthro-pology PhD program—won the Edison T. Uno Award for Public Service in the faculty category.
Morgan, who works at the Wells Lab un-der the guidance ofJames Wells, PhD, has also served as a volunteer with the UCSF Sci-ence and Health Education Partnership (SEP) program almost since he first began his de-gree program in 2008. Since then, Morgan has taught science as a volunteer teacher at Miraloma and Bessie Carmichael elementa-ry schools and at Lowell and Mission high schools, igniting an interest in science among many San Francisco students.
Sufrin will graduate from the Graduate Division’s Medical Anthropology PhD pro-gram this spring. She also works at San Fran-cisco General Hospital and Trauma Center as an assistant professor in the Department of Obstetrics, Gynecology and Reproductive Sciences.
E-Cigarettes Expose People to More than ‘Harmless’ Water Vapor
In a major scientific review of research on e-cigarettes, UCSF scientists found that in-dustry claims about the devices are unsup-ported by the evidence to date, including claims that e-cigarettes help smokers quit.
The review marks the first comprehen-sive assessment of peer-reviewed published research into the relatively new phenomenon of electronic cigarettes. The devices, which are rapidly gaining a foothold in popular culture particularly among youth, are marketed as a healthier alternative to tobacco smoking, as an effective tool to stop smoking and as a way to circumvent smoke-free laws by allowing users to “smoke anywhere
But in their analysis of the marketing, health and behavioral effects of the products, which are unregulated, the scientists found that e-cigarette use is associated with signifi-cantly lower odds of quitting cigarettes. They also found that while the data are still limited, e-cigarette emissions “are not merely ‘harm-less water vapor,’ as is frequently claimed, and can be a source of indoor air pollution.
The authors concluded that e-cigarettes should be prohibited wherever tobacco cig-arettes are prohibited and should be subject to the same marketing restrictions as conven-tional cigarettes. The paper is published May 12, 2014 in the American Heart Association’s journal Circulation.
Harvey V. Fineberg Named UCSF Presidential Chair
Harvey V. Fineberg, MD, PhD, MPP, the president of the Institute of Medicine(IOM), will come to UCSF for a yearlong appoint-ment as a Presidential Chair beginning in September.
Fineberg is a public health expert with a particular interest in health policy and medi-cal decision making. He has been head of the IOM, which is the health arm of the Nation-al Academy of Sciences, for two full terms, and will step down at the end of June. Before that, Fineberg spent many years at Harvard University; first as a college and medical stu-dent, and later as a faculty member, dean of the School of Public Health and provost of the University.
At UCSF, Fineberg will write and lecture about global health policy and analysis.
» FROM HOME PAGE
ful, talented, hard working and always “think-outside-the-box!”
People outside of the field of pharma-cy may not know that for years, the UCSF School of Pharmacy has been considered the top-ranked Doctor of Pharmacy pro-gram in the nation. And since there have not been any alien-pharmacists identified up to today, we may safely assume that we are the #1 pharmacy school in the entire Universe. In 1872, the school was the first to be established in the western part of the United States and became the first Doctor of Pharma-cy program to train pharmacists to become specialized clinical pharmacists. Since then, our program has been committed to provid-ing a high quality education, innovative re-search and excellent patient care.
So, you might wonder: “What have the Class of 2014 PharmD graduates accom-plished in the past four years to live up to this reputation?”
We are proud to say that not only have we been able to serve and make an impact on the UCSF campus, we have also expanded the scope of our experiences to the local, nation-al and global levels.
Since our first year being student pharma-cists, we have assumed the roles of medicine specialists through a wide variety of activities. Through several health projects, we spent our weekends in the community educating our pediatric, adult and geriatric patients about the appropriate use of medications and their associated side effects.
Furthermore, we provided vaccinations, disease and lifestyle information and ad-vice on how to save costs on medications to the public. We served as mentors to high school, undergraduate and post-baccalaure-ate students because we believe it is our re-sponsibility to prepare the next generation of pharmacists.
We traveled internationally to learn and participate in advanced pharmacy practice experiences in countries around the world: Honduras, Switzerland, England, Korea, Tai-wan, Kenya, Uganda, Haiti and India.
Academically, at UCSF, we conduct-ed research projects that spanned the field of pharmaceutical sciences, health ser-vices and policy and direct patient care. We were also firm believers in shar-
ing our drug expertise with health profes-sionals outside of the School of Pharmacy. We did so by collaborating with medi-cal, nursing, physical therapy, dentistry and biomedical graduate students in interpro-fessional education activities, projects and seminars. Of course, these are just a few high-
lights on the tremendous accomplishments our graduates have been able to achieve. In the final commencement address of the ceremony, Dr. Michael L. Lim, PharmD, MBA, Class of 1999, urged this year’s PharmD graduates to never stop learning and always attempt to break down silos.
Doing exactly that, many graduates from the Class of 2014 will become practicing pharmacists in the community settings, while a majority of others will pursue post-graduate training programs around the nation in the following areas: advanced pharmacy practice in acute, ambulatory, and managed care set-tings, research fellowships, as well as commer-cial fellowships.
We could not be more proud of the Phar-mD Graduates, Class of 2014 and cannot wait to see what the future of pharmacy will be in the hands of these graduates.
My dearest pharmacist, mentor and edu-cator Dr. Tina Brock used to quote the Amer-ican writer Flanner O’Connor: “When you can assume that your audience holds the same beliefs you do, you can relax a little and use more normal means of talking to it; when you have to assume that it does not, then you have to make your vision apparent by shock—to the hard of hearing you shout, and for the almost-blind you draw large and startling fig-ures.”
These 123 pharmacists are ready to shock, shout, and draw large and starling figures wherever we may be practicing… so watch out world!
This article is dedicated to the PharmD grad-uates from the Class of 2014, our Families, Friends, Faculties, Mentors and most of all, our patients.
Tina is a recent graduate from the UCSF School of Pharmacy, Class of 2014.
Pharmacy Graduates
Photo by Elisabeth FallThe UCSF School of Pharmacy, Class of 2014, celebrate.
4 | May 22, 2014 | synapse.ucsf.edu
uated—that they could tell customers “hun-dreds of things” about their health, including their risk for heart disease, arthritis, gall-stones and hemochromatosis. (http://www.ispot.tv/ad/7qoF/23-and-me)
“Know more about your health,” the san-guine narration goes. “Change what you can, [and] manage what you can’t.” While the FDA doesn’t object to providing customers access to their raw genetic data, they drew the line when 23andMe started marketing the test as a way to manage disease risk.
Andro Hsu saw things differently. Despite 23andMe’s agressive marketing, he said that their product can’t be classified as a medi-cal device because the interpretation provid-ed with raw test results gives only a statistical risk for health-related conditions, not a strict diagnosis.
As a former writer and early employee of 23andMe, he recalled obsessing over the wording of their online content as they tried to communicate this distinction to customers. They tried, he said, to relay that genetic risk accounts for only a portion—usually a small portion—of the overall risk of developing a certain disease. Other non-genetic factors, like environment and lifestyle, are important too.
Even conceding that people may effective-ly use 23andMe’s test to manage disease, Hsu said that this definition of a medical device “is too broad to be useful.” He argued that gyms and bathroom scales can also be used to pre-vent and manage disease, but are obviously unregulated by the FDA. Fitbits, and other wearable, fitness-oriented technology are also unregulated.
Other services, such as WebMD.com’s symptom checker—a tool which allows us-ers to input symptoms to see a list of possible medical conditions—carry a familiar “for in-formational use only” disclaimer, and are un-regulated by the FDA.
Paul Billings said that calling 23andMe’s DNA test a medical device promotes a “vague definition of [the FDA’s] authority and of what a device is.” Given the lack of regulation over other similar entities, he called its action against 23andMe “unusual and capricious.”
Medical maternalism or consumer advoca-cy?
The FDA’s decision to regulate 23andMe’s DNA testing kit could be interpreted as an extension of its mandate to “protect and pro-mote the public health.” Specifically, it wor-ries that patients might make hasty medical decisions without consulting their primary care doctor, and of the “potential health con-sequences that could result from false posi-tive or false negative assessments for high-risk indications.” (http://www.fda.gov/iceci/en-forcementactions/warningletters/2013/ucm376296.htm)
Examples might include a patient inap-propriately adjusting his or her medication dose or seeking unnecessary prophylactic surgery.
Billings said that this concern is over-drawn, and cited published studies which failed to show significant harm in providing customers with their genetic test results. In one study, Stanford geneticist Dr. Uta Francke surveyed women who had tested positive for variants of the gene BRCA1, which is asso-ciated with increased risk for breast cancer. She found that all the women surveyed acted appropriately with the information, seeking more information and re-testing.
Furthermore, family members who were unaware of their risk were also informed. (https://peerj.com/articles/8.pdf) In anoth-er study from Boston University, researchers found that disclosure of APOE genotype (a risk factor for Alzheimer’s disease) to adult children of patients with the disease produced no significant short-term psychological risks. (http://www.bu.edu/alzresearch/files/pdf/
Green_NEJMREVEALIpaper_final6.pdf ) Gianfranco de Feo argued that just be-cause knowing test results doesn’t seem to hurt people, it doesn’t obviate the need for these results to be accurate and clinically meaningful.
He alluded to studies conducted by re-searchers at the University of North Carolina at Chapel Hill (http://www.ncmedicaljour-nal.com/wp-content/uploads/2013/11/74608.pdf) as well as by the U.S. Government Ac-countability Office (http://www.gao.gov/assets/130/125079.pdf), which reported dis-crepancies between test results for the same samples from different leading personal ge-nomics companies, including 23andMe.
Furthermore, some of these companies were unable to provide good clinical inter-pretations for African American and Asian customers, a limitation which they did not communicate well when the kits were sold.
Consumer misdirection aside, de Feo emphasized that the science behind genetic testing is not easy. Interpreting raw test re-sults depends on many factors, such as which markers are assayed, which algorithms are used to process the data, and how the clin-ical trials were designed in which the gene variants were first identified. Many of these original trials were conducted in very small cohorts, many years ago.
Since the current model of conducting large clinical trials or genome-wide associa-tion studies (GWAS) for each genetic vari-ant might be unfeasible given the quantity of targets, de Feo advocated for using the tech-nology provided by the personal genomics in-dustry to create large translational databases that could link phenotypes to specific gene variants. With enough participation, this ap-proach could streamline better and more clin-ically relevant test results.
Zettler reminded us that the FDA’s regula-tory powers have historically been added after public health disasters. Since the agency was formed in the early 1900s, lawmakers added premarket requirements that drugs be shown safe (1938) and effective (1962), following, re-spectively, hundreds of deaths in the United States due to diethylene glycol-contaminated sulphanilamide and thousands of birth defects in Europe caused by thalidomide.
Medical devices were brought under the same umbrella in 1976 after defective intra-uterine devices (IUDs) injured thousands of women in the United States. de Feo cautioned
that only one salient public health disaster, even among a small group of individuals, could set back the consumer genetics industry decades, along with any potential benefits for genomics research. In that light, he thought it was worth it to preventatively regulate the in-dustry and ensure that tests are high quality and clinically validated.
The right to know, the right not to know
Gianfranco de Feo recognized that the issue of genome ownership evokes a strong emotional reaction, and many people feel that access to their genetic information is a basic right. California and Oregon both extend civil or property rights guaranteeing residents ac-cess to their available genetic information.
Even so, some patients may not actually want to know their genetic status, especially for untreatable diseases. Economist Emily Os-ter studied the behavior of at-risk individu-als for serious diseases. Among people at high risk for Huntington’s Disease (i.e. one parent has or had the disease), she found that only five percent sought genetic testing, despite the near 100 percent predictive power of the test (http://faculty.chicagobooth.edu/emily.oster/papers/hdbeliefs.pdf).
Similarly low rates of voluntary testing are reported for breast, ovarian and colon cancer and Alzheimer’s disease, for which predictive
genetic tests also exist, albeit with less predic-tive certainty. When the course of medical treatment is the same in either case, some ar-gue that knowing one’s genetic status adds no value. On the contrary, it could diminish the quality of life for these individuals as well as that of close family members, who may share the same gene variants but may not have sought testing themselves.
For most customers, however, the central issue may be one of packaging how the infor-mation is presented. Glenda Anderson called 23andMe “recreational genomics,” highlight-ing the fact that the technology’s ability to predict and manage disease remains in its in-fancy.
While 23andMe encourages customers to share their test results with their doctor before making any medical decisions, most doctors are not trained to interpret this information. Building the requisite databases to improve the technology will take time. Meanwhile, companies like 23andMe must help consum-ers and their doctors understand how well the science supports the clinical interpretation.
Benjamin Cohn is a fifth-year student in Biomedical Sciences at UCSF/Gladstone Institutes and Dalga Surofchy is a first-year pharmacy student. They are correspondents for the Oxbridge-Bay chapter.
Genetic Testing Kits » FROM HOME PAGE
The FDA argues that 23andMe’s interpretation of a customers' data qualitfies it as a medical device, and ordered the company to cease marketing their kit as a health management tool.
synapse.ucsf.edu | May 22, 2014 | 5
UCSF JOURNAL CLUBRecent research by UCSF scientistsBy Taylor LaFlamStaff Writer
IMMUNOLOGY: Host cell polarity proteins participate in innate immunity to Pseudo-monas aeruginosa infection. Tran, C.S., Eran, Y., et al. (Engel). Cell Host Microbe. 2014. 15(5):636-43.
Skin and mucosal surfaces form a critical first barrier to infection. They serve not simply as a passive wall but as a sentry, often detecting impinging pathogens and calling for help from immune cells.
The opportunistic bacterium Pseudomonas aeruginosa is a frequent and potentially le-thal cause of hospital-acquired infections. Previous research has shown that bacterial aggregate binding to the apical surface of epithelium causes it to change to resemble basolateral mem-brane.
In this paper, Tran and colleagues reported the mechanism underlying this change. They found that the flagellum and type III secretion system needed to be present in the bacteria. They further discovered that binding led to recruitment to the membrane of Par6, Par3, Rac1 and aPKC and that PI3K signaling is required for membrane transformation.
CELL BIOLOGY: The kinase regulator mob1 acts as a patterning protein for Stentor morphogenesis. Slabodnick, M.M. et al. (Marshall). PLoS Biol. 2014. 12(5):e1001861.
Polarization of cells is essential to life—consider the long axons of neurons, the flagella of sperm, or the apical secretion of goblet cells.
Most research on this topic has focused on multicellular organisms, in which both signals from inside and outside the cell control its polarization. Here, however, the authors focused on the extremely large unicellular ciliate Stentor coeruleus, which has a consistent, complex shape.
They first demonstrated that they could effectively use RNA interference to manipulate Stentor.
When they used this technique to deplete the kinase Mob1, which is located at the poste-rior of the cell, they found it led to major defects in cell shape. They also noted that Mob1 was required for the cell to regenerate normally from a small fragment.
CANCER BIOLOGY: Mechanistic rationale for targeting the unfolded protein response in pre-B acute lymphoblastic leukemia. Kharabi Masouleh, B. et al. (Müschen). PNAS. 2014 May 12. Epub ahead of print.
Acute lymphoblastic leukemia (ALL) is one of the most common childhood cancers. It usu-ally develops from cells in the B cell lineage, frequently from the pre-B cell stage.
Recently, a clinical trial found an endoplasmic reticulum (ER) stress-inducing drug had a strong anti-ALL effect. The UPR was not previously known to be important in pre-B cells, but here the researchers found that ablation of this pathway led to the death of normal pre-B cells.
The authors investigated the role of the UPR pathway in pre-B ALL. They found that an in-hibitor of XBP1, which is associated with the UPR, killed pre-B ALL cells in vitro and length-ened survival of mice transplanted with pre-B ALL cells.
This research further suggests that the UPR pathway may be a useful target for pre-B ALL treatment.
NEUROSCIENCE: Krüppel mediates the selective rebalancing of ion channel expression. Parrish, J.Z., et al. (Davis). Neuron. 2014. 82(3):537-44.
Neurons use multiple ion channels to achieve very particular action potential firing char-acteristics and receptiveness. Disruption of one ion channel gene generally does not disrupt this state, as the expression of other ion channels adjust to compensate.
The mechanism by which the cells are able to respond to restore normal neural firing prop-erties is not well understood. In this paper, Parrish and colleagues reported their study of this phenomenon in fruit flies.
They showed that loss of the potassium channel Sha1 led to increased expression of the channels Shaker and slowpoke. They found that the transcription factor Krüppel was essen-tial for this response.
Moreover, this response was specific in that Krüppel was induced by loss of Sha1 but not in five other potassium channel mutants.
Taylor LaFlam is a fifth-year MSTP student.THE STRENGTH TO HEAL
To learn more, call (650)347-3967 or visitSan Mateo Medical Recruiting Center400 S. El Camino Real, STE 450San Mateo, CA 94402Email: [email protected]
You can begin training for the career you’ve always dreamed of withfinancial assistance from the U.S. Army. Through the Health ProfessionsScholarship Program (HPSP)*, you could be eligible to receive a fulltuition scholarship for an accredited medical program.
The HPSP provides reimbursement for books, laboratory equipmentand academic fees. You’ll also receive a sign-on bonus of $20,000 and amonthly stipend of $2,157. During breaks, you’ll have the opportunity totrain alongside other members of our health care organization.
Capt. Ana Morgan, M.D., HPSP Medical RecipientBrooke Army Medical Center, Texas
6 | May 22, 2014 | synapse.ucsf.edu
UC San Francisco Family Dayat the SF Zoo
Saturday, June 7, 2014UCSF Reserved Area: Patas Lawn1 Zoo Rd, San Francisco11:00 am-2:00 pmDiscounted tickets: Adults, $12; Children $8 (4-14 years of age) Children 3 & under are free*
✦ Catered Lunch ✦ Live Entertainment ✦ Playground ✦ Nature & Animal Exhibits ✦ Giveaways ✦ Meet & Mingle with UCSF Friends & Family
Discounted tickets are limited and available to UCSF affiliates only.**
Order yours now:http://clsonlinestore.ucsf.edu/
Deadline to purchase tickets is Friday, May 30, 2014
For details visit: campuslifeservices.ucsf.edu/artsevents
*Children 3 and under are not eligible for a meal ticket
**You must use a UCSF campus computer or have VPN to access our campus online store. Computer kiosks are available at both UCSF Fitness Center lobbies.
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8 | May 22, 2014 | synapse.ucsf.edu
» FROM HOME PAGEto an industrious volunteer group called the Sutro Stewards, founded in 2006. Their latest efforts include a new Stanyan Street trailhead, which leads up to the Historic Trail traversing high on the west slopes, and the lovely sum-mit meadow, an urban paradise filled with sunshine and birdsong.
While this tireless group certainly has sponsors—the Rotary Club, UCSF and oth-ers—thousands of hours of labor are all pro-vided by volunteers. Students are often too busy to hike up the Sutro trails let alone to help build one, so the assemblage of volun-teers is mostly comprised of residents.
However, one can’t study ALL the time, and helping build trails or propagate plants is a perfect break for busy pre-professionals. With the Sutro Stewards, a student can do three great things—spend time in nature, get some exercise and give back to one’s commu-nity—all in a single morning.
Joining the work parties doesn’t require any experience or even an RVSP. Every first and third Saturday of the month volunteers meet at 9 a.m. at the Woods Lot, halfway up Medical Center Way. Craig Dawson, long-time local resident, hiker and leader of the Stewards, greets everyone and then divides the workers into teams.
A nursery full of everything from native columbines to coast redwoods has been built to supply the planting projects. A truck full of trail building tools is unloaded at various sites around the mountain for trail projects. The work is fun, the folks are friendly and the session is always followed by good pizza and even better beer (recently Lagunitas IPA and Redhook Audible Ale) at the Aldea Center.
Third-year dental students Max Jensen and Ramon Gutierrez joined last month. Their group removed weeds from the sum-mit meadow and then improved water drainage on the North Ridge Trail. “I had
Sutro Stewardsa great time, got outside and got a work-out. I’m going to come again,” said Max. Dawson says he would love to see more participation from UCSF students. The long-range plan for the forest includes more trails and the need for plant stewardship is as great as ever, so there will always be plenty of work for spirited volunteers.
Damon Lew, from the Office UCSF Com-munity Relationships, reports on one fu-ture project: “a new trailhead to Sutro from the western side of campus . . . is in the early stages of planning. In fact, this new stairway/trailhead is mentioned in the upcoming Long Range Development Plan (LRDP) . . . So keep an eye out, it should be happening soon.”
Recently a small trail was built on the west slope of the mountain which was not approved by either UCSF or the Sutro Stew-ards. While perhaps well intended, renegade projects like this do not ultimately help im-prove access because they are not up to the safety standards required for an urban trail, said Dawson. Hikers eager to see more trails on Mt. Sutro should let the Office of Commu-nity Relations know that they support plans for better access and then channel their zeal for trail building into Sutro Steward volun-teer events.
Yet while some may be overly enthusiastic, it is astounding how many folks have never felt the joy of exploring our backyard forest. You may think you’re not a hiker, but expe-rience just once the afternoon light filtering through the silvery tree trunks, listen for a moment to the wind in the leaves, close your eyes and hear the birds, smell the earth. Soon you’ll be walking up the mountain more of-ten. And then before you know it, you may even want to join the Stewards and help to maintain our beautiful and unique preserve.
For more information on Mt. Sutro, visit sutrostewards.org.
T. Booth Haley is a fourth-year dental student.
Photo by Mason Tran/D4Sutro Stewards meet every first and third Saturday of the month at 9 a.m. at the Woods Lot, halfway up Medical Center Way.
NEWS
IDEA to IPO Class Incubates Science EntrepreneursBy Rosa ChanStaff Writer
Are you interested learning more about science and business? “IDEA to IPO” is an experiential, team-based entre-
preneurship class. This course teaches faculty researchers, clinicians, residents, PhD stu-dents, Masters and medical students how to move an idea from the lab/clinic/digital world to the business world.
Charles Craik, UCSF professor and en-trepreneur, teaches the intensive, 12-week course, which is offered every winter quarter. Craik is the director of the Quantitative Bio-sciences Consortium (QB3) and the Chemis-try and Chemical Biology Graduate Program.
Anthony O’Donoghue took Craik's class in 2010 and has since started his own compa-ny, Alaunus Biosciences. He developed a tech-nique to simultaneously assay all proteases in a biological sample at exquisitely low concen-trations. This global identification of protease specificity allowed him to determine the pro-teolytic signatures of cancer cells and parasit-ic organisms and to subsequently identify the major proteolytic enzymes involved. For in-dustrial applications he is using the method to characterize native or recombinant proteases and to screen microbial strains for proteases with desirable characteristics.
Synapse: Can you tell me how the IDEA to IPO course initially started?
Craik: The class initially started with the support of QB3. QB3 was created to make sure that ideas in the laboratory get into the real world. Now this course has expanded. Synapse: Do I need to have an idea or team
prior to enrolling in the course?
Craik: No, you don’t need to have an idea or a team.
Synapse: How big is your class? How difficult it is for UCSF students to enroll? Craik: We had 110 applicants this year and we had room for about 60-70 people. There is a preference for people at UCSF.Synapse: What makes this course different than a business class at UC Berkeley or Stan-ford?
Craik: Classes in business school very sel-dom talk about science. These students are already aware they just need to know how to start a business. This course is designed to people who want to do health related re-search and have great ideas.
Synapse: Is this a good time for startups?
Craik: Steve Burrill, CEO of Burrill & Com-pany, a leading life sciences investment talk-ed about how 52 companies went IPO last year and that is a huge number compared to previous years.
Synapse: How does this class work?
Craik: Topics cover the full range of life sci-ence/healthcare entrepreneurship subjects for therapeutics, devices, diagnostics, tools, and digital health ventures. Participants ap-ply classroom learning as they form a team to focus on an idea, assess market poten-tial, create a business model and learn about market assessment, the FDA, reimburse-ment, IP, basic finance, legal structures, capi-
tal sources and pitching investors. In the end 10 teams present to a jury of individuals that represent top tier Silicon Valley investors.
Synapse: Why did you decide to take this class?
O’Donoghue: It's been four years since I took the class. As a scientist you spend all this time doing science and along the way you think, “Oh, wow! I think I could com-mercialize this. Someone in industry might find this useful. But to go from the lab to having a product to sell—nobody teaches that. It's not high on any mentors' agenda. When I heard about this course, I remem-bered there were a few things from my PhD work that I felt if I could commercialize.
There are two kinds of people who take the course. One group has a pretty advanced idea and is looking to build a team, sort of on the cheap, because you can’t hire someone with no money. They might need someone to help develop a business plan. They want to see if as a team they can go from an idea to some-thing that they can pitch to investors.
And then there are people like me who are just enthusiastic about understanding the pro-cess of going from an idea to a product. So when I started on day one, the people with the ideas pitched their ideas to the group to see if anyone wanted to join their team.
There were 15 pitches that day and the rest of the class wrote their order of prefer-ence which team they would be most inter-ested in joining. And essentially for the rest of two months, you joined that team and you had different assignments: one person looks at all the IP, another person at financial strat-egy, the other looks at the science. My job for my team was to understand the IP landscape.
With patents, you may have an idea, but you need to protect a bubble of ideas around that central idea because it is not worth patenting if someone comes and makes a tiny tweak and has a new product.
Synapse: Did you see science differently after you took the course?
O’Donoghue: Absolutely. In fact the group I joined had pretty advanced ideas. Two guys came in with an idea from their PhD work, a biofuel-related project. No matter what, those two guys were going to start a compa-ny and essentially they were just looking for extra hands to move it forward. At the end of class there was a pitch in front of investors. The investors weren’t actually going to in-vest, but we got the highest score. The inves-tors gave $50,000 as really early seed money to get it to the next stage.
Synapse: Are you still involved in this? How did you apply this knowledge?
O’Donoghue: No, I was always in the pe-riphery of this project. A year later, I started my own company based on my own tech-nology that I developed. A protease Lab. Charlie and I developed a technology that can globally characterize all protease activ-ity from any biological sample—human tis-sue, secreted material from bacterial, fungal culture. We are a protease lab and a partic-ular disease. The company exists. We have a client lined up, source of revenue. Fee for service, and we will process them and give them the data.
Rosa Chan is a second-year PSPG graduate student.
synapse.ucsf.edu | May 22, 2014 | 9
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ARTS&CULTURE
Charlie Varnon: Storytelling from the StageBy Akshay GovindAssociate Editor
Bernie Schein lives in a Jewish retire-ment home in San Francisco. He hates yoga, boutique shops, $6 cups of cof-
fee and the people who drink them. Bernie, at 83 years young, has just hitched a ride from a trio of Tesla-driving 20-somethings and bet them $400,000 he can catch a wave his first time surfing.
Writer and actor Charlie Varon gives us an engaging blend of humor and social commen-tary through Bernie’s colorful story, Feisty Old Jew, which he performs as a solo stage work at The Marsh Theater (1062 Valencia St.) in the
Photo courtesy of Charlie Varon
Charie Varon performs in Feisty Old Jew, playing at The Marsh Theater through July 13.
Mission. It runs on weekends between now and July 13 and is well worth the $25-$35 ticket prices, available at www.themarsh.org.
Varon and his work have been featured on KQED's Forum with Michael Krasny and in the SFGate. In short, Feisty Old Jew is a joy to watch, and Varon is a master at using the physical space of the stage, the dynamics of his voice, and beautifully chosen language to paint vibrant images of his characters and their predicaments.
Bernie is one of several imaginary elderly folks living in the same retirement home, and Varon has recently found himself writing vol-umes about their eccentric views and life ex-periences, which he refers to as a love letter to his parents’ generation.
When I spoke with Varon, we discussed what makes the theater-going experience so unique. After all, why should anyone bother changing out of their pajamas, battling crowds and buying tickets to a play when they can access a nearly unlimited supply of movies, television shows and other entertainment vir-tually for free these days? Vigorish
Vigorish. The word was used several times during the performance. It sounds strong, hardy, bold. At the end of his performance, Varon asked the audience how many peo-ple thought it was a real word. I snickered as nearly half the audience raised their hands. He followed with who would be willing to de-fine it, and majority of the hands dropped. A few stayed up in the air, and I braced myself as I expected someone to be humiliated.
“The vigorish, or the vig, is the cut taken by the bookie during a bet,” said a man. I got what he was doing—saying something com-
pletely unrelated to draw attention away from the minor embarrassment of having pretended earlier that he knew the word.
“That’s exactly right,” replied Varon. I was stunned. There was no script to how Varon, the audience, or the man would react. Some laughed, some offered their gambling habits as reasons they had heard the word, but everyone did something—all to-gether.
It is this real time interaction among hu-mans all in a room to-gether that makes the experience of live the-ater so magical. In our discussion, Varon quot-ed Mark Kenward, also a Marsh writer and per-former, “our audience is going to leave with more energy than they walked in with.” I know I did. Writers’ Workshop at UCSF?
This got me thinking about the stories we are privileged enough to hear about or to be a part of in healthcare, and how great a medium the stage would be to tell them.
I discussed the idea with Varon, who would be open to holding a workshop for writers to adapt their stories to be read on stage.
The project would culminate in a night of medical theater, either at UCSF or at The Marsh, depending on availability and inter-est. We would require some sort of finan-cial support as well as enough interest from writers, performers, and theater-goers. If you would like to be part of this in any capacity, please send me an email at [email protected], and in the meantime, get thee to a theater.
Akshay Govind is a third-year resident in the Department of Oral and Maxillofacial Surgery.
10 | May 22, 2014 | synapse.ucsf.edu
FOODA Frozen Section of Holy Gelato!
The Scoop
Holy Gelato! offers 12 non-dairy options in addition to 18 gelato flavors.
It’s strange how we tend to overlook gems in our own backyard, so for this installment of The Scoop, we brought one of UCSF’s finest pathologists along to a nearby gelato shop, so that we wouldn’t miss even the most microscopic of details.
Holy Gelato! is located just blocks away from UCSF’s Parnassus campus, and it was only recently that the Scoop team realized that we had never given it a hard-hitting, newsworthy review. We were accompanied by guest reviewer Dr. Raga Ramachan-
dran, a pathologist beloved amongst UCSF medical students, to help us analyze a sweeter va-riety of frozen sections.
A storefront sign on 9th Street announces that in addition to 18 regular gelatos to choose from—with flavors like Tiramisu, Vanilla Bean and Chocolate Hazelnut—the store features 12 vegan flavors including Mango Sorbet, Thai Tea and the soy-based Charlie Brown’s Night-
mare (Chocolate, Peanut Butter & Cookies). We walked in and were greeted by a cooler filled with heaping mounds of gelato, neatly separated into vegan and non-vegan halves.
The Scoop team ordered a total of nine flavors, including Cinnamon Sin, Dark Chocolate, Vanilla Bean, Fresh Strawberry, Caramelo Chocolate Crunch, White Pista-
chio, Sea Salted Caramel, White Raspberry Chocolate,and Honey Lavender.Run-away favorites were the White Raspberry Chocolate which team members described
as “a perfect combination of flavors” and the Caramelo Chocolate Crunch, chocolate ice cream with caramel and friable toffee pieces distributed throughout. The White Pistachio was also a crowd-pleaser with its large, satisfying nut pieces. The team was more divided in its opinion of the Fresh Strawberry, which had a remarkable strawberry flavor but too icy a texture for some.
Dr. Ramachandran described the Sea Salted Caramel as having “more salt than caramel—and I like it the other way around... I’d pick Bi-Rite’s Salted Caramel over this one.” In addi-tion, she noted that the flecks of spice in the Cinnamon flavor bore the appearance of “highly
stippled chromatin,” while the Dark Chocolate remained “largely acellular.” Just goes to show that you can take the pathologist out of the lab, but she’ll still be on call.
The actual scooping and arranging of the flavors was notable, as Dr. Ramachandran point-ed to how in her four-flavor medium size order ($4.99) the chocolate was packed into the bot-tom, with her other three flavors triangularly scooped atop. Even in a “mini” size ($2.99) you could request up to two flavors—a nice option for those of us who are less decisive. Despite
the overall satisfying taste and great variety of flavors, you might have noticed that this gus-tatory delight doesn’t come cheap, as a small (one to three flavors) will set you back $3.99.
While enjoying our gelato, the team took careful note of the eclectic surroundings. In addition to frozen treats, patrons are able to purchase a variety of curious items including mugs shaped like ducks, loose-leaf tea, su-perhero lunchboxes, a perplexing variety of T-shirts and a travel pet carrier ($34.95).
Dr. Ramachandran concluded that she was ”confused by their business model.” She also noted that if she lived in the neighbor-hood and showed up to a birthday party for one of her daughter’s friends with a Hello Kit-ty lunchbox as a gift, everyone would know that it was likely picked up on the way over.
Final report? Holy Gelato! delivers a pret-ty good gelato if you’re willing to pay top dol-lar. And if you ever need an Elvis cookie jar, you know where to find one.
Theresa Poulos and Dawn Maxey are fourth-year medical students.
Dark Chocolate packed at the bottom with White Pistachio, Honey Lavender and Salted Caramel triangulated on top.
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20 Is in the past?21 Philanthropic gift22 Boastful person24 In theory only28 Concerning the
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English word 70 Like spoiled 12 Laudatory verse 44 Earth-shaking43 Something to tie meat 13 Headed up 46 Slammer
up 71 Tiny bit 19 Storage spot 49 "Lose Yourself"45 Small-dog sound 21 Water down rapper47 Eye DOWN 23 Paving material 51 Slowly, in music48 Turn red, maybe 1 "Psycho" scene 25 Sulky look 52 Fairly new50 Mountain goat setting 26 Make an 53 Dig (up), as
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by Margie E. BurkeThe Weekly Crossword
Copyright 2014 by The Puzzle Syndicate
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28 29 30 31
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Week of 5/19/14 - 5/25/14
Edited by Margie E. Burke
HOW TO SOLVE:
(Answer appears elsewhere
in this issue)
Solution to Sudoku
Copyright 2014 by The Puzzle Syndicate
Difficulty : Easy
Piled Higher and Deeper by Jorge Cham www.phdcomics.com
title: "Check it" - originally published 3/31/2014
SPRING A CAPPELLA SHOW
THE SEASON FINALEVOCAL CHORDSAT UCSFTHE
ARTS&CULTURE
Contemplating a Good Death REVIEW: Knocking on Heaven’s Door: The Path to a Better Way of Death, by Katy Butler
By Hannah PatzkeAssociate Editor
An old man lies prostrate in bed, his lips ringed in blue. His chest rises and falls erratically and his eyes flut-
ter occasionally. His daughter holds his hand as he takes his last few breaths. She kisses his forehead and draws the sheet over his face. Is this a good death? Would slipping away dur-ing sleep with no warning be better?
As medical professionals we spend years learning how to preserve life. But how does one learn when it is time to die? Journalist Katy Butler discusses this question and oth-ers in her book Knocking on Heaven’s Door: The Path to a Better Way of Death.
Butler’s parents both want “a good death” but are prevented by the very medical advanc-es that save lives in the short term. Should families be allowed to turn off the pacemaker keeping a demented parent alive?
Butler illustrates the pain that comes with watching her father die the slow death of de-mentia following a massive stroke, coupled
with her and her mother’s inability to ease his passing. A pacemaker keeps his heart beating strongly as his mind fades away.
She discusses the spiritual and legal ram-ifications of helping a loved one die in the United States. It is estimated that roughly 25 percent of our healthcare dollars are spent in the last six months of life. Billions of dollars are poured into desperately keeping bodies alive as they try to shut down.
I do not disagree with the right to choose to fight for life, but what about those who are ready to die? Should we force them to keep fighting as well? Too often our fears keep us from discussing and notating these important issues until it is too late. Knocking on Heaven’s Door is a thought-provoking book for medi-cals professionals, for people whose parents are aging, and for those who wish to consider how they themselves would like to die. What is a good death? How do you want to die?
Hannah Patzke is a first-year Master’s student in Health Policy.
12 | May 22, 2014 | synapse.ucsf.edu
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