Handprints - Summer 2007 - Children`s Hospital Oakland

Transcription

S U M M E R 20 07
A LS O I N S I D E :
Hevanne is the
Never-Give-Up
Kid
A little boy with a big heart
problem beats the odds
When meds can’t control
epilepsy, maybe
the ketogenic diet can
intractable
Elliott
Vichinsky, MD
A physician’s path to becoming
Hem/Onc medical director was
inspired by ‘60s idealism
2
C H I L D RE N ’ S H A N D P RI NTS
table of contents
17 The diet that cures
When medications can’t stop seizures,
sometimes the ketogenic diet can. At
left, Niko, in orange, is now seizure free
thanks to the ketogenic diet.
3
DEAR READER
Letter from the president
4
THIS AND THAT
Little People, Big World comes to Children’s Cable TV show
features a Children’s orthopedic physician.
James Betts, MD, wins Bronze Bambino “He’s the best trained
anything I know in surgery,” said C. Everett Koop, MD, former surgeon
general of the United States, about Dr. Betts.
The nevergive-up kid
Children’s doctors on tour When Children’s specialists talk at
area CME lectures, other physicians listen and take notes.
Physician liaison joins Children’s family Malia Hansen reaches
out to help community doctors feel at home at Children’s.
10
Born with a major heart
defect and placed for adoption,
there was little reason to believe
Hevanne would make it.
Running
again
25 Competitive youth
soccer player Andrés Jankowski
survived a car accident that
nearly cost him a leg. Now he’s
back on the field and playing
better than ever.
7
IN THEIR OWN WORDS: JAMIE NUTILE
Becoming a butterfly A mom writes about her daughter Alicia’s
journey to recovery after severe bites from the family dog. Her daughter’s grace and spirit teach all who meet her the meaning of courage.
14
FEATURE: NEURO-ONCOLOGY
The bounce-backer Janessa’s adventurous spirit and positive attitude see her through a knock-down, drag-out battle with brain cancer.
21
PHYSICIAN PROFILE: ELLIOTT VICHINSKY
From Brooklyn to bedside Elliott Vichinsky, MD, found a way
to combine a love of science and a desire to serve people through
medicine. He’s excelled at both, learning and applying ways to help
children with blood diseases.
28
CHILDREN’S HOSPITAL & RESEARCH
CENTER FOUNDATION
Click here to support Children’s Hospital Donating via the
Web has never been easier. Save time and stamps by giving to
Children’s Hospital’s foundation at www.chofoundation.org/donate.
On the cover Charlie Cleberg joins his
parents in a thumbs- and “toes-up” for the
ketogenic diet that helped him become seizure
free. Brain bleeds after Charlie’s premature birth
left his arms paralyzed; now he does everything
with his feet. Photo by Tom Levy.
Discover treasures at The Bambino Search for undiscovered
treasures at a thrift shop run by Branches volunteers that raised more
than $100,000 for Children’s Hospital last year.
From fear to financial freedom After a difficult childhood, Marge
Hayden found freedom from agoraphobia through self-sufficiency as a
dog groomer. To help other struggling children, she gave a generous
gift to Children’s Hospital when she retired.
S U M M E R 20 07
3
Children’s HandPrints is a publication of Children’s
Hospital & Research Center Oakland, 747 52nd Street,
Oakland, CA 94609; 510-428-3000.
Written, designed and produced by:
Communications Dept.
Children’s Hospital & Research Center Oakland
665 53rd Street, Oakland, CA 94609
Phone: 510-428-3367
Fax: 510-601-3907
Dear Reader:
The first months of the year usually bring rain to northern California
and more patients than usual to Children’s Hospital. This winter was
different though, bringing little rain to the region, but a flood of patients
to Children’s and our busiest January ever.
We’re never happy to see a sick child; but when kids need great
healthcare, the team at Children’s is proud to provide it. Our combination
of state-of-the-art facilities, unwavering focus on pediatrics and
extraordinary caregivers makes Children’s second to none in northern
California.
One such caregiver is Elliott Vichinsky, MD, medical director of
Children’s Hematology/Oncology team. In this issue we profile his
exemplary work as clinician, researcher, leader and mentor.
Other stories in this issue illustrate not only our excellence and range
of services, but the wide sweep of geography we serve.
Hevanne, who underwent several surgeries to repair a congenital
heart defect, is back home in Manteca. Janessa, a two-time cancer
survivor, is again adding pictures to her photo album in Benicia. And in
Berkeley, Andrés is back on the soccer field, helping his team score goals
after recovering from two severely broken legs.
Pursuing excellence at Children’s includes the search for better
treatments. Our page 17 story looks at the ketogenic diet, an unconventional treatment for intractable epilepsy that helped Children’s patients
Niko and Charlie become seizure free. Their parents did their part too,
working with experienced Children’s caregivers to help the boys recover.
To all those in the community supporting Children’s Hospital—
especially our generous donors—thank you.
Frank Tiedemann
President and Chief Executive Officer
Mary L. Dean
Senior Vice President, External Affairs
Tina Amey
Receptionist
Debbie Dare
Senior Graphic Designer
Susan Foxall
Project Manager
Tom Levy
Senior Writer
Venita Robinson
Director, Media and Community Relations
Gary Turchin
Writer
Diana Yee
Media Relations Specialist
Board of Directors
Harold Davis, Chair
Jeffrey Cheung
Arthur D’Harlingue, MD
Arnold Grisham
James Keefe
Watson Laetsch, PhD
Michael LeNoir, MD
Barbara May
Melba Muscarolas
Howard Pien
Lloyd Takao, MD
Frank Tiedemann
Gene Upshaw
Harold C. Warner, PhD
Frank Tiedemann
President and Chief Executive Officer
Children’s Hospital & Research Center Oakland
Story requests, comments or suggestions for Children’s
HandPrints may be emailed to [email protected] or
sent to 747 52nd Street, Oakland, CA 94609.
4
this
this
this
this
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that ANDthat ANDthat ANDthat AND
AND
that
this
this
this
this
ON LOCATION: [Left] Amy Roloff (center), Zach’s mom, consults with orthopedic nurse clinician Michael Syberg, RN, (left)
while the Little People, Big World cameras roll. [Right] Dr. Hoffinger and his TV-star patient meet in the Outpatient Center.
T V S H OW
Little People,
Big World
comes to
Children’s
Cable TV show features a
Children’s orthopedic
physician.
When Scott Hoffinger, MD, first
consulted with the Roloff family about
their son Zachary’s bowed legs, the
teenager fell asleep in the middle of
the exam. Fortunately, the trials and
tribulations of Zach and his family,
stars of TLC TV’s reality show Little
People, Big World, have kept lots of TV
w w w. c h i ld re n s h o s p i ta lo a k l a n d . o rg
this
that ANDthat ANDthat ANDthat ANDthat
AND
viewers awake and interested.
The Roloffs, many of whom
are short of stature, were concerned
that Zach’s legs were affecting the
16-year-old’s soccer game. Orthopedic
complications are not unusual in
people with disproportionate
dwarfism. The exam, which took
place in a hotel room at the Little
People’s Annual Convention, was
followed by a journey from the
Roloffs’ Oregon ranch to Children’s
Hospital & Research Center Oakland,
to see Dr. Hoffinger again. A camera
crew traveled with them.
Dr. Hoffinger, chief of Children’s
Orthopedics department, recommended straightening Zach’s right leg. He
performed the surgery in December.
In February, Zach’s cast was removed.
Everything looks great.
All is being revealed in a series of
episodes on this season’s Little People,
Big World, on Monday nights at 8 p.m.
Stay tuned. #
AWA RD
James Betts,
MD, wins
Bronze
Bambino
Longtime Children’s
physician is honored.
In 1989, James Betts, MD, made
national news when he performed surgery on a patient under the collapsed
Cypress Freeway following the Loma
S U M M E R 20 07
this
this
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this
AND
that
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5
this
L EC T U R E S E R I ES
Children’s
doctors on tour
Children’s physicians are
reaching out to community
physicians with a year-long
lecture series.
RECOGNIZING AN AMAZING DOCTOR: Dr. James Betts was chosen by his peers
to receive the 51st Bronze Bambino award.
Prieta earthquake. It was no surprise to
those who know him. Dr. Betts has
devoted much of his career at
Children’s Hospital & Research Center
Oakland to trauma and trauma
patients.
For a lifetime of dedicated service
to the well-being of children and an
unselfish devotion to Children’s
Hospital, Dr. Betts was given the 51st
Bronze Bambino award at March’s
annual Medical Staff Dinner.
Dr. Betts—a surgeon, urologist
and director of Trauma Services at
Children’s—joined the hospital staff in
1983. In 1986, he was instrumental in
helping Children’s join the elite group
of level 1 pediatric trauma centers.
Dr. Betts graduated from the
University of Vermont College of
Medicine in 1973. A native
this
AND
Vermonter, Dr. Betts has maintained a
close connection to his alma mater. In
2003 he received the College of
Medicine’s A. Bradley Soule Award for
loyalty and dedication to the School of
Medicine, and in 2004, he was named
to a six-year term on the university’s
board of trustees.
After receiving his medical degree
he completed residencies in urology
and surgery at Case Western Reserve in
Ohio, and Children’s Hospital of
Philadelphia, where he met his mentor
C. Everett Koop, MD, former surgeon
general of the United States.
“I had the pleasure of training Jim
Betts,” Dr. Koop said in a videotaped
message played at the awards ceremony, “and he’s the best trained anything
I know in surgery.” #
When Jenny Thomas took her son
Lucas for a check-up, the pediatrician
noticed a subtle abnormality in the
boy’s gluteal fold (buttocks crease).
The doctor recalled seeing a picture
like it in a class, and knew it needed to
be examined by a specialist. He
referred Lucas to Peter Sun, MD,
Neurosurgery director at Children’s,
where an MRI revealed a tethered
spinal cord.
Dr. Sun repaired the cord, and
Lucas, 4, is fine. But it’s a good example of why physicians need to stay upto-date and informed.
That’s why Children’s launched its
2007 Physician Lecture Series in
January. The year-long series of talks,
20 in all, rotate through Modesto,
Stockton, Tracy, Pleasanton, Walnut
Creek and Fairfield. They are designed
to provide community physicians
updates on each specialist’s area of
expertise, and they offer practical guidance in diagnoses and treatments.
Dr. Sun launched the series in
Modesto. Fourteen physicians spent
their lunch hour with him—leaving
with practical tips on how to recognize
normal head and spinal cord development.
6
this
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LECTURING: Children’s Hospital’s first annual CME lecture series launched Jan. 19 in
Modesto with Peter Sun, MD, Neurosurgery division director, delivering a talk titled From
Head to Tail: Evaluation of head size/shape, spinal dysraphism and the tethered spinal cord.
Dr. Sun is speaking again July 12
in Walnut Creek. Other Children’s
physicians scheduled to join the tour
include neurologist Daniel Birnbaum,
MD, speaking in Modesto in
November, and neuro-oncologist
Joseph Torkildson, MD—(see story on
page 14)—speaking in Pleasanton in
September.
If you’re a physician and would
like to learn more about the lecture
series or attend one of the lectures,
please call Susan Foxall at 510-4283367, or go to www.childrenshospitaloakland.org/upcoming_eventsprovider.asp. #
this
this
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AND
STA F F N EWS
Physician
liaison joins
Children’s
family
Malia Hansen connects with
NorCal community docs.
Many of the 14 physicians who
came to hear Dr. Sun’s Modesto
lecture were met with a warm smile
and a handshake or hug from Malia
Hansen.
Malia is Children’s Hospital &
Research Center Oakland’s first-ever
physician liaison. The warm greetings
LIAISON: Malia Hansen helps Children’s
Hospital stay in close touch with valued
community physicians.
were a reflection of the three years
Malia spent as a Pfizer pharmaceutical
representative in the Modesto area.
“These doctors were like my
family when I worked out there,”
Malia said.
Now Malia is part of the
Children’s family. As physician liaison,
Malia’s goal is to help Children’s
communicate more effectively with its
valued community physicians.
“I’m learning all I can about our
referring physicians’ practices, so I
can help connect them with the
Children’s specialist their patients need
in a timely manner,” Malia said.
If you are a referring physician and
would like to hear from Malia, she
can be reached at 510-207-4040 or
[email protected]. #
S U M M E R 20 07
7
Severe dog bites put Alicia Nutile in the hospital. Her mother Jamie tells the story
of Alicia’s remarkable attitude, and her recovery at Children’s Hospital & Research
Center Oakland, with help from clinicians like plastic surgeon John Griffin, MD.
IN THEIR
Own
WO RDS
B Y J AM I E
NUTILE
Photographs by Tom Levy.
O
ur family’s chocolate Labrador
Retriever, Bo, attacked my 9-yearold daughter Alicia on Dec. 13,
2005. He had never bitten anyone before,
and we all loved him—most of all Alicia.
She has always been a complete dog lover.
If you asked anyone who knows her to
describe her, the first thing said would be
how much Alicia loves dogs. Incredibly, she
still does.
“I’m almost glad it happened. If it
hadn’t, I would never have met Dr.
Griffin,” said Alicia to my husband Chris
and me, six months after her first surgery at
Children’s Hospital Oakland. She had just
had her fourth surgery and had grown very
fond of Dr. Griffin.
I found this amazing, but was not surprised; Alicia has had a phenomenal outlook since the attack. Soon afterwards, I
was explaining the series of surgeries Dr.
Griffin would perform to help her. Her
response: “Oh I get it. It’s like the caterpillar to the cocoon to the chrysalis to the
butterfly! He will make me the butterfly.”
* * *
The night of the attack, Chris and our
oldest daughter Heather, 21, were standing
8
[Previous page] Alicia and her parents,
Jamie and John, visited Children’s to
distribute gifts to patients.
[Right] Dr. John Griffin and Alicia during
a routine follow-up appointment.
[Next page] Alicia brought quilts and
books donated by family friends to give
to Children’s patients.
next to Alicia in our family room in
Vacaville. Then it happened. Seeing the
horrific damage to her cheek, Chris
picked her up and put her face to his
chest, and the three of us drove to the
local hospital emergency room. Heather
stayed behind to wake up our son
Christopher, 15. They met us at the hospital.
Before seeing the doctor we noticed
Alicia also had several head wounds.
Emergency room staff immediately started an IV containing pain medication and
antibiotics. As soon as the emergency
room doctor saw her, he said she would
have to be transported to one of two
other hospitals. One was Children’s
Hospital Oakland. Staff were on the
phone with both, but they weren’t sure
where Alicia would go.
We immediately knew we wanted her
to go to Children’s Oakland. Chris and I
grew up in the East Bay, and I had been
with an organization that visited
Children’s to pass out gifts to patients.
We were familiar with Children’s impeccable reputation.
Within the hour we were in an
ambulance on our way to Oakland. I felt
such relief to be going to Children’s.
Heather and Christopher were there
with other family members when we
arrived. Heather, knowing we would be
there awhile, had already packed bags for
Chris and me.
Soon we met Dr. Griffin for the first
time. Right away we felt we liked him.
Alicia, lying on a gurney ready to go
“I’m almost glad it
happened; if it
into surgery, couldn’t speak very easily.
But even so, she whispered to Chris and
me, “Don’t worry about me. Is Bo okay?
Is he warm?”
A nurse gave her a cute little teddy
bear wearing scrubs to take with her. I
knew Alicia liked that, and I asked her if
she wanted to name the bear. She said
“Faith.” Trying desperately to hold it
together, we kissed her and told her we
loved her and would see her soon—that
Dr. Griffin would take care of her. We
had to put our faith in a man we had
just met.
* * *
Alicia’s cheek, including its muscles
and nerves, was gone, but there was no
bone damage. Her surgery went well. Dr.
Griffin closed the open wound from the
inside of her mouth. We were very fortunate that her nose, mouth, eyes and
hadn’t, I would
never have met
Dr. Griffin,” said Alicia.
jugular vein were untouched.
Dr. Griffin explained that Alicia
would need several reconstructive surgeries over the next several months and possibly years.
Alicia was awake off and on for visits
from all the family members and friends
who rushed to Oakland to be with her.
She received cards from her school and
so many stuffed animals, we could barely
see her in the bed.
Dr. Griffin came to examine her
every day; he was concerned about infection caused by bacteria dogs carry in
their mouths. She didn’t have an infection then, or in the days that followed.
The fear and depth of the pain we
were feeling for our little girl is indescrib-
S U M M E R 20 07
able. But the comfort of knowing she
was where we would choose her to be,
Children’s Hospital, helped us cope.
I can’t imagine wishing my child in a
different hospital. The nurses and other
staff members were wonderful.
The next day Sister Bernice visited
us. What a special moment. She helped
us get through every single day that followed. Several other staff members came
to support us, and we appreciated it.
One day a resident physician came to
see us. She had heard about Alicia and
wanted to meet us. She looked me in the
eye and said she had been bitten in the
face when she was young. She thought
we might want to see how in time, scars
can heal. She looked fantastic. My heart
swelled, and as I cried, I again felt grateful to be in this special hospital.
Alicia continued to have a positive
attitude. She didn’t sleep through the
night, so I would push her downstairs to
see the beautiful Christmas tree and dollhouse in the lobby.
On her third day at Children’s,
Alicia’s best friend’s mother visited again,
this time bringing huge Christmas stockings filled with blankets and toys. We
pushed Alicia in her wheelchair down
hospital hallways while she and a few
close friends gave Christmas gifts to
other patients.
It really made Alicia sad to see some
children without family or friends by
their sides. I know she felt like a very
lucky little girl. She started talking about
wanting to write a children’s book, so
kids would know they could be beautiful
butterflies too—that it’s the inside that
counts, not the outside.
Soon Dr. Griffin said she could go
home. But I feared our return home to
where this had all begun.
Alicia didn’t want to go because she
really liked the hospital. Everyone at
Children’s made her feel comfortable,
even during the worst time of her life.
She was able to find a peace with what
was happening to her that I don’t feel she
would have found anywhere else. I’m
also pretty sure she liked having visitors
and a call button for nurses.
When we arrived home, it went
easier then I thought. Heather and
Christopher had cleaned up the mess
from the attack. Heather strung
Christmas lights in Alicia’s room and had
all of her new stuffed animals arranged
on her bed.
Friends had come to clean, and we
could smell cookies baking in the oven.
We saw the tree lights on and heard
Christmas carols playing. They made a
very difficult moment perfect for us,
especially for Alicia. Her transition back
into our home went smoothly. That
week, Heather even interviewed for a job
and got it.
Alicia had many visits with Dr.
Griffin, and always liked to see him and
his nurse, Amber. Her head wounds
healed well.
In January, Dr. Griffin took skin
from her body and grafted it to cover the
open wound in her cheek.
In February, during her third surgery,
Dr. Griffin put a tissue expander into
her cheek. For weeks afterward she
went in for saline injections to help
the expander work.
9
On May 5, 2006, it was time to
remove the expander. I couldn’t believe
it. It was incredible. Dr. Griffin had
actually made a cheek for Alicia!
Alicia had a full and active summer
and went back to school to start fifth
grade.
On Nov. 30 she had another
expander put in, with more saline injections. It took through January. This time
she wanted to go to school while wearing
the expander. Dr. Griffin agreed, as long
as she promised to be careful. I knew her
friends wouldn’t let her get too active!
Alicia misses Bo very much. That has
actually been the hardest part for her.
Before Alicia left the hospital, Heather
arranged for Bo to be picked up and
euthanized. Professionals said he had a
brain tumor.
Alicia forgives Bo. She says he didn’t
mean to hurt her; he was sick. She has
hung a picture of him in her room that
says “Miss you” on it. She still wants to
be a veterinarian when she grows up.
She had nightmares for a long time,
but during the day, made it her goal to
have a good day. A family friend called
the week she came home and said,
“Sweetie, did you have a good day?” Alicia
answered, “Every day is a good day.”
On Feb. 1, Dr. Griffin removed the
second expander, inserting tissue underneath to raise her cheek, balancing it with
the other side. He also revised the scar.
We are forever grateful to Children’s
Hospital and Dr. Griffin.
Alicia may need more surgeries down
the line as she grows and her face
changes, but when we look at her now,
we know she is truly a beautiful butterfly.
Children’s clinicians see
more than 100 dog-bite victims a year. For more information
about Children’s Plastic Surgery
department, call 510-428-3024.
10
Hevanne’s survival
was a long shot.
His heart lacked a left ventricle and
his family placed him for adoption.
But Children’s cardiologists and a
loving new family intervened,
and now he’s…
H
evanne Brown, 3, plays peek-aboo with “Poppy” from his
fifth-floor bed at Children’s
Hospital & Research Center Oakland.
Poppy, Samuel Sterling, pokes his head
here and there, eliciting giggles and
screeches of joy. In the room cooing over
Hevanne’s fun is “Nanna,” Catherine
Sterling, and “Momma,” Henrietta
Brown. It’s an all-in-the-family affair. But
this isn’t a typical family, and Hevanne
isn’t a typical 3-year old.
Hevanne was born with hypoplastic
left heart syndrome. Even among congenital heart defects, it’s a tough diagnosis. His
heart has virtually no left ventricle, the
organ’s main pumping chamber. In many
parts of the world, he wouldn’t have survived three days. Even in our advanced
medical culture, one treatment option,
according to Children’s cardiologist Ziad
Saba, MD, was “to do nothing.”
But Children’s cardiothoracic surgeons
Olaf Reinhartz, MD, and John Lamberti,
Written and photographed
by Gary Turchin.
S U M M E R 20 07
MD, did something. They performed
life-saving surgery on Hevanne when
he was a week old, beginning the
process of rerouting his blood so the
weaker right ventricle could do the job
of the missing left ventricle.
They operated again when he was 3
months old; all told, he had five major
heart surgeries by the time he was
9-months, with more to come. (See
sidebar on page 13 for a surgery
description.)
But Hevanne’s challenges weren’t
just medical. At 4 months, his birth
mom placed him for adoption. Then
his first foster family was quickly overwhelmed by the demands of his medical condition. With a series of major
surgeries ahead, and his life on the line,
little Hevanne had no one to hold his
hand.
In stepped Sam and Catherine,
Poppy and Nanna, a retired Fairfield,
Calif., couple who had fostered many
children. A call from the county foster
care program brought them to
Children’s, where they thought they
were only going to give relief to the
struggling new foster family.
“They asked us to take him for a
few days to give the couple a break,”
Catherine recalled. Once they arrived,
Dr. Saba asked a little more of them.
“We’d never seen Dr. Saba before,
but he was observing us through a
door,” Catherine said. “And he comes
in, and he looks at Sam and me, and he
says, ‘Will you take this baby and bring
him back in two weeks for surgery?’
We’d never seen Hevanne before, but
we happen to believe in God, and Sam
looked at me, and I looked at Sam and
said, ‘Which way do we go now?’”
“We were trying to get someone to
take care of him, and they were the
sweetest people,” Dr. Saba recalled.
11
ALL SMILES: [Previous page] Cardiothoracic surgeon, Olaf Reinhartz, MD, beams like a
proud papa while looking over his playful young patient’s shoulders.
[Above] “Poppy” Sam gets a big giggle from Hevanne while visiting him at the hospital.
Accepting the challenge
The Sterlings accepted the challenge. They took Hevanne home, but
were back in a week for surgery prep.
Children’s clinical social worker Leslie
Cohen, MSW, helped get them a room
in Children’s Family House so they
could stay near Hevanne. They took
shifts remaining at his side as the
months and the surgeries went by,
Hevanne clinging precariously to life.
They became fixtures at Children’s,
standing by a child they had only just
met, but had grown to love dearly.
Besides the lack of a left ventricle,
Hevanne’s condition was complicated
by a leaky heart valve as the right ventricle’s tricuspid valve isn’t built to handle the workload it was now assigned.
When a couple of surgical valve repairs
weren’t sufficient, Children’s surgeons
replaced the valve with a mechanical
St. Jude valve. If you stand close to
Hevanne, you can hear it clicking.
Despite the complications—he suf-
fered infections, hemorrhages and liver
and kidney problems, and couldn’t eat
on his own—the temperamentally
sweet Hevanne pulled through.
“We prayed he would hang in there
and get through all the surgeries until
he was adoptable,” Catherine said. She
hoped a younger family, with more
energy, would step forward and raise
him.
Enter Henrietta
Enter Henrietta Brown. Ten years
earlier, she had adopted a special needs
child, Amontay, now 12. She had a gift
for managing him. A social worker at
her church sought her out and told her
about Hevanne. It was May 2005.
Henrietta called the Sterlings. “We
talked on the phone for hours and
hours,” Catherine recalled. “We
clicked.” Henrietta came to Children’s
to meet Hevanne.
“I’m a pushover,” Henrietta said.
“I see those big ol’ eyes looking at me,
12
HEVANNE’S GAMES: [Right] When Hevanne comes to visit,
everyone wants to get down and play, including Hitu Patel, MD,
medical director, Cardiology.
[Below] Hevanne happily rests in Sam’s arms, while (l to r)
Henrietta and Catherine look on.
and I went, ‘Oh God, that’s him!’” She
counted on her husband Lee for a
“reality check.”
“I thought I had an ace in the hole,”
Henrietta said. “I mean I’m weak, but
my husband is strong. My husband
came a few days later and said, ‘Well, I
guess God wants us to take him.’”
First, Henrietta and Lee had to get
foster care training and get back in the
county’s foster care system. A couple of
months after first meeting Hevanne,
they become his legal foster parents. The
Sterlings agreed to be “grandparents.”
Meanwhile, there was another
surgery that Team Brown/Sterling
needed to see Hevanne through.
Catherine remembered it this way:
“Sam would hold his hand and sing to
him, and Hevanne would just hang
onto his hand, even though he was
sedated. It was like he was saying ‘I can’t
see you, but I know you are there…’”
“At the end, we were going to a
reunion, and we wanted to stay till the
surgery was done. I cried and prayed
and cried. We had to leave that night, it
was almost midnight, and he was hem-
orrhaging. I called Henrietta and said:
‘We gotta go.’ And she said, ‘I’ll be right
there.’ And two hours later she was
there. We just changed hands. We left
and she took over, and here he is today.”
“A miracle baby,” Henrietta said.
Home
On Aug. 8, 2005, Henrietta took
Hevanne home to Manteca, Calif.
Other than a couple of brief stints, it
was the first time Hevanne had left
Children’s since he was brought in after
birth. A year later, the Browns adopted
him. The Sterlings, including their
daughter and grandkids, have made
Hevanne a member of their family, too.
“He’s a never-give-up story,” said
“He’s a thriving little boy,”
Henrietta said. “Very strong willed.
He has a heart condition and if something
happens, we deal with it. Otherwise
he’s an everyday kid,
a little daredevil.”
Dr. Reinhartz. “So many times we
looked at his numbers and we thought,
‘My God, we’re never going to get this
kid out of here,’ but we kept trying.
And now, to see him walk in here, like a
normal kid…”
“He’s a thriving little boy,”
Henrietta said. “Very strong willed. I
just let him be a kid. He has a heart
condition and if something happens, we
deal with it. Otherwise he’s an everyday
S U M M E R 20 07
13
How Hevanne’s heart works
kid, a little daredevil. ‘I like to run into
walls, and jump off couches and beds and
play with trucks,’ he says. We’re trying to
get him into preschool, get him potty
trained. Regular boy things.”
First time back
“This is his first hospital visit since I
took him home in September 2005,”
Henrietta explained, while Poppy and
Hevanne play their little game of hideand-seek. An RSV virus brought him back
to Children’s for observation. He went
home a couple of days later.
Hevanne still has a rough road. He
needs another major surgery to complete
the blood stream rerouting process. He
has to be bigger and stronger for doctors
to consider it. Someday, he might need a
larger valve, or even a heart transplant.
“With the type of social support he’s
getting, he’s a candidate for the other
procedures,” Dr. Reinhartz suggested.
Meanwhile, he has a life and two
families that love him, and something no
one thought he’d ever have: a chance.
And when things get a little rough for
Henrietta?
“She has no trouble dialing a telephone,” Catherine said.
“I call the grandparents,” Henrietta
agreed.
All in the family.
To learn more about
Children’s Cardiology and
Cardiothoracic Surgery department, call 510-428-3380. Or
visit their Web pages inside
www.childrenshospitaloakland.org.
In a normal heart, the right side pumps oxygen-poor, blue blood into
the lungs, where it picks up oxygen. The oxygen-rich, red blood is then
returned to the heart’s left side, where the stronger left ventricle pumps it
through the body. A two-pump system.
With hypoplastic left heart syndrome, the left ventricle is undeveloped, so doctors must reroute the blood stream so the right ventricle can
do all the work. That usually requires three surgeries, done over time.
Stage one
Stage one, called the Norwood operation, was performed when
Hevanne was a week old. A shunt was inserted to connect his aorta—
which sends red blood to the body—to his pulmonary artery—which sends
blood to his lungs.
This allows the
right ventricle to
pump blood to
both his body and
his lungs.
Stage two
Stage two,
called the
Hemifontan
procedure, done
a few months
later, connects the
vein (superior vena
cava) carrying blue
blood from the
upper body
directly to the
lungs, bypassing the heart and
reducing the workload on the
right ventricle.
Stage three
Stage three of the surgery,
called the Fontan procedure—not yet
performed on Hevanne—diverts blood
from the lower body to the lungs.
Illustration
courtesy of
The Modesto Bee/
Brian Harris.
The end result is the weaker right ventricle pumps all the blood to the
body, and the blood flows to the lungs “passively,” as part of the natural
route it must follow. A one-pump heart.
14
Treating cancer is
never pretty. Treating a
relapse of brain cancer,
even less so. But saving
a child’s life is the most
beautiful thing of all.
W
hen Janessa came to see Joseph Torkildson, MD, in
March of 2005, the situation was already grave. The
then 12-year-old had just been through six months of treatments—including surgery, chemotherapy and radiation—at
another hospital. But the germinoma, a cancer that had grown
in her brain, grew back. Dr. Torkildson, director of Children’s
Written and photographed by
Gary Turchin.
Neuro-oncology program, understood the implications.
“The treatments she received are
normally very effective,” he explained.
“When germinoma relapses, you have to
go after it full-force.”
Dr. Torkildson outlined the treatment plan for Janessa and her mom,
Lorraine Sales. It would have to be
aggressive. It would include high-dose
chemotherapy and a bone marrow stem
cell transplant. Janessa’s own stem cells
would have to be harvested first for use
in the transplant. There were significant
risks of side effects from the treatments;
a rough road lay ahead.
But they had a chance.
The spirit of adventure
The last of the human freedoms, it’s
said, is to choose one’s attitude in any
given circumstance. Janessa and Lorraine
chose theirs: “Remember all the scary
times when we were stuck in a strange
place and didn’t know where to go?”
Lorraine asked Janessa. They’d traveled
the world together, flying standby.
“Well, look at this as a strange place: We
don’t know where we’re going to go, but
we’re going to get through it.”
They would make the best of it,
together. “An adventure,” Janessa called it.
“Everything that made it intense
and miserable,” Lorraine now says, “we
would turn that around and make it
memorable and fun. I focused on that,
focused on that really hard…”
Treatment
Janessa’s treatment began with
chemotherapy under the supervision of
Dr. Torkildson and the Children’s Blood
and Marrow Transplant (BMT) team,
led by Mark Walters, MD. Five days of
chemotherapy to attack the cancer, followed by a booster to stimulate production of stem cells in the blood. When
the cell count rose, a couple of weeks
after the chemo, Janessa was brought to
Children’s Day Hospital where her
blood was circulated out of her body,
her stem cells harvested, and her blood
returned. It was a full day’s work, four
days straight.
Janessa and Lorraine did what they
do best: have fun; tell jokes; watch
celebrity chef Rachel Ray—“I’m her
number-one fan!” Janessa
said; take pictures—they
have pictures of everything,
even the “salmon-colored”
stem cells; and play lots of
bad poker.
“I don’t have a good
poker face,” Janessa confessed. “I get
good hands and I go, ‘Yea!’”
Her smile is a full house.
When the first harvest didn’t collect
enough stem cells, another cycle of
chemo was needed. More days attached
to IVs and pumps. More days harvesting. More days trying to laugh in the
face of adversity.
The worst part for Janessa: Wearing
a mask. “It made me look like a duck.”
The side effects Dr. Torkildson had
warned about appeared: Her kidneys,
endocrine system and organs were under
stress. Stomach growling. Appetite gone.
Some hearing was lost. Hair gone a long
time ago.
And the hardest was yet to come.
Full force
This is where the body weakens and
the spirit carries the fight.
In most chemotherapy treatments,
oncologists limit the potency of the
chemotherapy to preserve the bone marrow stem cells, which maintain the
body’s blood and immune system. But
with a relapse case like Janessa’s, Dr.
Torkildson had to be sure there was no
residual cancer. Not a single cell. He
prescribed high-dose chemotherapy, five
to ten times more potent than “normal.”
The knock-out punch. This
“Well, look at this as a strange place:
should not only kill any vestige
We don’t know where we’re going to go, of the cancer, but it would
destroy her bone marrow stem
but we’re going to get through it,”
cells as well. That’s why the
said Lorraine. They would make the best of BMT team had harvested as
it, together.
many of her stem cells as possi-
“An adventure,”
Janessa called it.
ble, to restore them after this treatment.
The new cells would re-boot her body’s
immune system and help her heal from
the treatment. They would give Janessa
her life back.
The chemo is potent because it has
to be.
When her failing kidneys couldn’t
filter one of the chemo drugs—carboplatin—out of her blood, the hair follicles in her inner ear were damaged. A
lot of her hearing was lost.
It was her lowest point.
Watching closely
Doctors, nurses, specialists, care
team associates—everyone in Children’s
5 South oncology unit—was watching
Janessa closely. Most of all Lorraine, her
biggest advocate. “I may not be an
expert on any of these other children,”
she explained, “but I am an expert on
Janessa.”
A mother’s prerogative at Children’s
Hospital Oakland.
Lorraine wouldn’t leave the room. “If
she woke up, she needed to know I was
there.”
Janessa’s body dove into the storm of
high-dose chemotherapy. Nonstop sleep.
Systems failing. Several times, her kidneys almost stopped, and she was readied
for dialysis. Somehow her levels, like her
spirits, bounced back at the last
moment.
A real bounce-backer.
Two, three, four, five days of “full
force.”
“It was killing her,” Lorraine
remembered.
16
Finally, her doctors stopped. It was
all she could take. She needed her stem
cells restored. She needed to heal.
Happy Transplant Day?
Another complication arose. Some
of the chemotherapy drugs were still in
her system. They could destroy any new
stem cells given to her. She was too
weak to harvest more. How long could
they wait?
“It was really touch-and-go,” Dr.
Torkildson said.
Scenes in the shower: Lorraine washing the chemo off Janessa’s flaking skin,
trying to clear the drugs out of her system.
A few days to recover. But in the
end, they had to give her the transplant.
“I remember seeing these signs at
the hospital: ‘Happy Transplant Day.’
What’s happy about it?” Lorraine said.
“It was the most scary thing,
that day. I was so emotional.
Then I realized what ‘happy
transplant day’ meant. You
have to live through it to know what it
meant. It’s deeper…It’s almost like a
birth, a new life starting; these little
baby stem cells are going to become
mature and help her stay alive.”
On July 1, 2005, the BMT team
gave her only half her stem cells, in case
the chemo was still toxic.
Everything okay. Two days later,
they gave her the rest.
Too weak to stand and see the July 4
fireworks through her hospital window,
Janessa watched from her bed. She
called to others in the unit: “C’mon and
watch the fireworks!”
Long, slow climb. Recovery. Janessa
bounced back—for good.
A memory
“We were playing cards with my
nurse,” Janessa said. “My mom, she likes
to watch the sunset…This one particular day, she was watching the sunset,
and the sun hit perfectly, and an angel
appeared in the clouds, with the halo
and all—it was perfect. My mom said,
‘Oh my God, there was an angel!’ The
nurse and I both saw it ourselves, and
the nurse said, ‘Oh my God, if I never
saw this with my own eyes, I would never
have believed it.’ And she looked at me
and said, ‘Do you always attract angels?’”
Home
In October, Janessa and Lorraine
were able to move into a nearby hotel,
to be close to Children’s. It was back
and forth to the hospital for a while, but
by Thanksgiving, 2005, Janessa was
strong enough to go home.
And stay there.
“Don’t think the worst,” Janessa
said, when asked what she’d tell other
kids in her shoes. “You should always
think you’re going to get better.”
Future
“I want to be a teacher and a
writer,” Janessa says about her future. “I
want to write about me, but in a fiction
way, so I can exaggerate!”
Lorraine wants to write about their
adventure, too. They have the pictures.
If you’d like to contact
Dr. Torkildson or learn
more about Children’s
Neuro-oncology department, please call 510-428-3308.
JANESSA’S PICTURES:
[On page 14] Janessa flashes sign language and a big smile while mom Lorraine looks on.
[On page 15] Celebrity chef Rachel Ray signs her book, then offers Janessa a hug.
[Above left] Barry Zito, then a star pitcher for the Oakland A’s, visits Janessa in the hospital.
[Above center] Janessa with Children’s Val Parker, RN.
[Above right] Janessa mugging for her niece Calena and mom.
[Left] Janessa with one of the many photo albums chronicling her journey back to good
health.
S U M M E R 20 07
17
When meds can’t control intractable
epilepsy, maybe the ketogenic diet can.
Written and photographed by Tom Levy.
N
iko Cortessis used to have
up to 20 seizures a day,
sometimes more than five in
a half hour. He was 2 when they
began. When it wasn’t a head-drop
seizure, leaving him limp as a dishrag,
it might be one more violent, making
him roll around the floor.
Now 5, Niko and his older brother are busily building toys out of plastic Lincoln Log pieces in their family’s
playroom in Lafayette.
Charlie Cleberg used to have a
seizure nearly every day—frequently
between 11 and 11:30 a.m. Five years
later, Charlie, 8, is glued to his Xbox
video game console in Pinole, playing
Need for Speed. “He never finishes the
race because he’s so busy flying off the
road getting ‘air,’” said his mom,
Kathy.
For these two boys, and others
with intractable epilepsy, anti-epileptic
medications haven’t helped. But
thanks to a remarkable treatment
option called the ketogenic diet, both
boys—and many other children—are
now seizure free. In northern
California, Children’s Hospital &
Research Center Oakland is one of
only three Neurology departments
Niko
Charlie
offering the treatment.
At Children’s, the ketogenic diet
begins with a brief hospital stay and
continues at home. The diet’s four
main characteristics are:
• Extremely high fat content: 85
to 90 percent of food energy comes
from fat.
• Calories precisely controlled:
Every food item in a meal is measured
with a gram scale.
• Very low in carbohydrates.
• Supplements and protein must
be adequate to maintain growth and
development.
In 12 years, neurologist Robin
Shanahan, MD, and Clinical
Nutrition manager Karen Spalding,
MS, RD, CSP, veteran Children’s
clinicians, have treated more than 125
children with the diet—including
Niko and Charlie. “(The diet’s) been a
godsend for us,” said Niko’s mother,
Kirstin.
Charlie’s mom, Kathy, is also
enthusiastic. “His seizures stopped
while he was in the hospital beginning
the diet,” she said. “He hasn’t had one
since; it was dramatic.”
While the diet doesn’t work for
every child with epilepsy, about one in
three children treated with the diet
experience a 90 percent or greater
reduction in seizures. Niko and Charlie
are among the lucky ones in that third
who become seizure free, about 5 to 10
percent of all those treated.
A second third experiences a 50 to
90 percent reduction in seizures, while
the others experience up to a 50 percent reduction in seizures.
Throughout recorded history it’s
been known that fasting can reduce or
eliminate seizures. Even the Bible mentions the phenomenon. Yet today, how
and why the ketogenic diet works
remains a mystery.
This seizure treatment option has
had its ups and downs in the United
States since the early 1900s, when
physicians at several institutions,
including ketogenic diet pioneer Johns
Hopkins University, began studying it.
As more anti-epileptic medications
became available, the diet fell out of
favor.
In the 1990s, the ketogenic diet was
catapulted out of obscurity—first in
1994, when NBC broadcast a Dateline
story about it, and again in 1997, with
the broadcast of First Do No Harm, a
made-for-TV movie that starred Meryl
Streep and Fred Ward.
The movie’s fictional neurologist,
like many real ones practicing at the
time, didn’t consider the ketogenic diet
a legitimate treatment and didn’t offer
it as an option.
But after the Dateline program
aired, the phone was ringing off the
hook at Children’s Neurology department. Within weeks, Karen and
Dr. Shanahan were on a plane to
Baltimore for training at Johns
Hopkins. By February 1995 they
had admitted their first patient.
As key members of Children’s ketogenic diet team—which includes other
neurologists, a nurse practitioner
and social workers—Karen and Dr.
Shanahan have strict guidelines for
choosing patients. They
begin with eligibility.
To be considered for the diet at
Children’s, patients must have
intractable epilepsy that can’t be
controlled with medication. Each
patient needs to have tried at least three
medications without seizure reduction
before being considered.
Once everyone agrees the child is
ready—parents, child, treating neurologist and Karen—a date is set to begin.
Children’s Hospital’s
Neurology
department is
one of only four in
northern California
offering the
ketogenic diet as a
treatment option for intractable
epilepsy. To learn more about the
diet, or to make a Neurology
appointment, call 510-428-3590.
S U M M E R 20 07
Children’s patients begin their ketogenic
diet treatment with a 24- to 72-hour
medically supervised inpatient stay.
Starting the diet shifts the body’s
principal energy source from carbohydrates to fats. Ketones, a byproduct of
fat metabolism, are excreted in urine
and signal that the body has shifted into
ketosis.
Maintaining ketosis is apparently the
key to the diet’s ability to reduce or
eliminate seizures. Whether ketones
themselves are therapeutic or are simply
a marker of some other process is not
known.
After their inpatient stays, Charlie
and Niko, like other patients, returned
home to continue the rigidly controlled
diet. Karen calculates menus designed to
help parents keep their children healthy,
yet burning mostly ketone-producing
fats for energy.
AT HOME: [Previous page] From inside a large Pottery Barn box, Charlie puts on a
puppet show for his mom, Kathy.
[Below] Niko’s parents, Kirstin and John, sit beneath family photos while Niko plays
with plastic Lincoln Logs in their Lafayette home’s family room.
19
Maintaining ketosis is tricky.
Anything from misreading a food label
to eating a single piece of candy, to having a routine childhood illness or drinking extra water can throw it off. There
may also be complications, including
dehydration, nausea or lethargy. But
nearly all families find the challenge
worth the effort.
During their first few days on the
diet, both boys stopped having seizures.
In time, perhaps after two years in
ketosis, it’s possible for some treated
children to stay seizure free without the
diet. Clinicians and parents work this
out case by case.
Their brain chemistry seemingly
altered permanently, many seizure-free
children may be able to “wean” off the
diet, just as Niko and Charlie are now
doing.
During the weaning process, the
calorie ratio between fats, and carbohydrates and proteins is gradually shifted.
It starts in a range from 3:1 to 4:1—
meaning for every gram of carb or protein in the diet, three to four grams will
come from fats. During weaning, fewer
calories will come from fats and more
from carbs and proteins, shifting slowly
to a more conventional diet. The actual
process is slow, precisely calculated and
carefully monitored.
The boys also illustrate the spectrum
of children with seizures. While seizures
were Niko’s main serious health concern, for most children with intractable
epilepsy, including Charlie, brain dysfunctions, including developmental
delay, are associated with seizures.
Charlie has faced a host of serious
medical conditions since he was born six
weeks prematurely. He spent his first
five months on a ventilator in Children’s
Hospital’s Neonatal Intensive Care Unit
20
and wasn’t expected to live until his first
birthday. Brain bleeds led to brain damage, cerebral palsy and paralysis of his
arms.
Because Charlie can’t swallow and
required surgery that removed much of
his intestines, he gets all his nourishment through a tube straight into his
stomach. When he was 3, the seizures
started.
But Charlie has been blessed with
wonderful adoptive parents, Kathy and
Joe. “Charlie’s done great,” said Kathy.
“He’s almost 8 and is fully included in a
regular second-grade class at Castro
School, a full-inclusion elementary
school.”
Seizures, and the medications neurologists use to try to control them, also
put a crimp in children’s ability to learn
and develop, especially during crucial
early years. “A year of his life in development was just gone from the drugs he
was taking,” said Niko’s mom, Kirstin.
With the help of 2½ days a week at
a local intervention program and another 2½ days at a preschool, Niko is now
developing at a more normal pace.
When Charlie became seizure free,
his development, also slowed, came
back strong. “Once he stopped having
seizures, he was able to start thriving
even more,” said Kathy. “It seems like
his brain was able to be more receptive
to learning.”
All four parents appreciate not only
the diet, but Children’s treatment team,
including Neurology medical director,
Daniel Birnbaum, MD. “We love Karen
and Dr. Birnbaum, and Charlie loves
them,” said Kathy. “Dr. Birnbaum is the
only doctor at Children’s Hospital who
actually gets on the floor to play with
and examine Charlie. And I think that
says a lot about the man’s character.”
Niko’s father agrees. “Dr. Birnbaum
was just great,” said John. “He was
always attentive.”
For most families, the hardest part
of the diet, once they see it working, is
staying on it. Building menus that follow prescribed dietary calculations is
one of Karen’s areas of expertise. Her
goal is controlling calories and carbohydrates, while providing a high-fat diet
containing adequate protein for growth
and development. “We calculate their
diets down to the gram,” said Karen.
Food allergies and preferences, and
each child’s oral–motor abilities, must
also be considered. The diet can be
taken by mouth or by feeding tube, the
way Charlie does.
“The most exciting thing about the
ketogenic diet is you have someone who
has poorly controlled seizures, that
potentially, on the diet, can be 100-percent seizure free and off medication,”
said Dr. Shanahan. “The diet can be
stopped after a couple of years, and the
kids stay seizure free. That’s such an
exciting prospect.”
Menu planning for the ketogenic diet
The recipe for maintaining a child on the ketogenic diet combines art and
science. Karen Spalding, MS, RD, CSP, Children’s Clinical Nutrition manager,
13 grams
calculates each child’s customized dietary prescription of calories, protein, fat,
raw
carbohydrates and supplements to control seizures while promoting growth
strawberries
and development. The art is in creating a variety of palatable,
11 grams
age-appropriate menus.
61 grams
egg
lettuce
Karen
understands
the
visceral
connection
38 grams
cream, 30%
between parents, children and food. “Since feeding is the most
down-to-earth thing you do as a parent, if you can control your
child’s horrible disease by modifying their diet and being in charge
of it, it really leads to a lot of satisfaction,” she said. “I see that
25 grams over and over again. If it works, they hold on tight.”
raw
Creative parents come up with food ideas within dietary
tomato
restrictions, sharing them with each other and with Karen. It’s all
about letting go of traditional meal combinations. A meal of
19 grams
24 grams
popcorn, butter and a small portion of bacon may fit the
raw apple
cheese
with skin
prescription, provide needed nutrients and keep a kid
25 grams
24 grams
beef frank
mayonnaise
excited about eating.
21 grams
cream, 40%
11 grams
butter
5 grams
bacon
15 grams
broccoli
40 grams
cream,
40%
Elliott Vichinsky, MD
From
A physician’s
path to
becoming
Hem/Onc
medical director
was inspired by
‘60s idealism.
Brooklyn
to bedside
Written and
photographed by
Tom Levy.
Elliott P. Vichinsky, MD’s voice still carries the sound of Brooklyn, NY, where he was raised in a
four-story apartment building belonging to his grandfather. He fondly remembers the 16
apartments in the building, all filled with members of the tight-knit Vichinsky clan. His father
was one of five brothers who worked together in the shipping business.
His father was also a poet, sculptor and inventor, and Dr. Vichinsky absorbed his intensity, work
ethic and passion for creativity. His mother made
sure those in need were helped in their home, teaching Dr. Vichinsky never to ignore the suffering of
others.
Soon his family of five moved to East Meadow,
where, even in kindergarten, Dr. Vichinsky
impressed his teachers. “He is alert and eager to
learn,” read a line on his report card from East
Meadow School. “His work is interesting and original in its content.”
Today, as medical director of the Hematology/
Oncology program and Comprehensive Sickle Cell
Center at Children’s Hospital & Research Center
Oakland, Dr. Vichinsky, 59, continues doing
impressive work as a researcher and physician.
He sees the healing arts as a higher calling.
“The gift of being a physician is an enormous
responsibility,” Dr. Vichinsky told fellow physicians
when honored in 2005 with Children’s Hospital’s
49th Bronze Bambino award. “I’ve always seen it as
an extreme honor, a spiritual experience.”
He backs his words with action.
Dr. Vichinsky is an expert on genetic blood disorders, primarily thalassemia, sickle cell disease and
hemophilia. He has authored and co-authored more
than 300 articles in peer-reviewed journals and is
22
editor-in-chief of The Journal of Pediatric Hematology/Oncology.
He’s been principal investigator on more than 40 major
research projects and has given countless presentations around
the world about blood disorders.
He diagnoses and treats children with cancer and tumors,
helped create the Blood and Marrow Transplant program at
Children’s and led the first multi-center studies showing there
could be positive outcomes for children with sickle cell anemia.
“I was a product of the ‘60s and I really believed in social
justice and change, that society needed to do more, to give
back,” said Dr. V, as he’s widely known at Children’s, during a
recent interview in his small, cluttered, book-lined office. “I
really believe it’s the moral responsibility of members of society
to help those in need, to never ignore those less fortunate than
yourself. Medicine to me was that opportunity to help others.
It was a way to make a difference in the world.”
He attended State University of New York Downstate’s
medical school in Brooklyn and, early on, had an interest in the
scientific rigors of internal medicine. But then he met Maria
Falter, MD, a pediatric hematologist and professor at his medical school.
“Dr. Falter had such a rapport with the children with fatal
diseases,” said Dr. V. “She got down and played with them. She
changed my life.”
He changed career plans immediately, upsetting his advisor
by switching his goal to pediatric hematology. He also accepted
Dr. Falter’s invitation to help with her research on sickle cell disease. They became close friends.
“(Dr. Vichinsky) was so compassionate; he didn’t go after the
material things a medical career could offer,” said Dr. Falter. “He
was very bright; he had an outstanding personality; and he was
interested in helping others.”
After Dr. V graduated from medical school, they stayed in
touch. When he delivered a research paper in the late ‘70s at a
San Francisco meeting of the American Society of Hematology,
Dr. Falter flew out from New York to be there.
It was quite a night after the meeting. Because Dr. Vichinsky’s mother was
also visiting, he took them both to dinner.
After medical school, Dr. Vichinsky
and his wife, Diane, a public interest
lawyer, moved to Seattle. He completed
his residency at Seattle’s Children’s
Hospital & Regional Medical Center,
staying on to do a fellowship in Pediatric Hematology/Oncology
and later becoming a senior research fellow at the University of
Washington.
In 1979, Bertram H. Lubin, MD, now Children’s senior vice
president, research, recruited Dr. Vichinsky. Dr. V, in turn,
brought in James Feusner, MD, a friend with whom he’d trained
in Seattle. Together they built up Children’s Hematology/
Oncology department; it now has 17 clinicians and scientists.
“Children’s offered me the opportunity to serve a diverse
community that was really a microcosm of the world,” said Dr.
V. “Working here enabled me to make a difference in a community, to integrate state-of-the-art research and academic inquiry
into a complicated community that had social and medical
needs.”
As Dr. V took on new roles, he went from mentored to
mentoring. He recruited Mark Walters, MD, another Seattle
alum, who now heads up the Blood and Marrow Transplant
“I’ve learned a lot about life from patients,”
said Dr. Vichinsky. “I’ve always found
patients and parents to be much smarter
than people give them credit for.”
S U M M E R 20 07
23
DR. V:
[Top left] Patients: Dr. Vichinsky gave
thalassemia patient Christian Dato a
hug the day Christian went home after a
long hospital stay.
[Above] Mentoring: Dr. Vichinsky talked
with Robert Raphael, MD, a
Hematology/Oncology fellow at
Children’s. “It’s thanks to Dr. V that
Children’s has the reputation it has,”
said Dr. Raphael. “Everybody knows his
name.”
[Left] Colleagues: Dr. Vichinsky shares a
laugh with nurse Violetta Borjez, RN,
while making rounds on 5 South.
24
program. Dr. Walters said Dr. Vichinsky
taught him how to be a mentor.
“One way to assure that the patients
you serve get the care they need is to
teach someone else how to do it, or
teach people how to do studies that will
discover new treatments,” said Dr.
Walters. “Elliott’s kind of a model mentor: he’s done all those things. Over the
years he’s trained a number of really
productive hematologists.”
It’s hard to be a mentor. “You have
to selflessly devote your vision to promote the individual who’s in training,”
said Dr. Walters. “Dr. Vichinsky puts
people first, he puts the mentee’s agenda
first.”
Dr. Vichinsky adds a twist.
“Mentoring is a two-way street,” he
said. “There are a lot of people here
who are a lot smarter than I am. I’ve
learned a lot from the junior people; it’s
enabled me to stay enriched, to learn
and continue to grow.”
Dr. V is proud of the fellows he’s
helped train: “They’re now experts in
their respective fields of
hematology/oncology,” he said. Many
have joined the staff at Children’s.
Dr. V also praises what he’s learned
from the many non-MD clinicians he’s
worked with over the years. A nurse
practitioner named Judy was one in a
long line of nurses and nurse practitioners who taught him. In 1973, Dr. V
worked a stint with the New England
native, who’d been transplanted to a
Papago/Pima Indian reservation in
Arizona. Judy asked Dr. V to give the
shots because many older Indians she
served didn’t want a woman giving
them injections.
“They can do most of what you (the
physician) can do, and most of the time
they can do it better,” said Dr. V. “I
didn’t know how to give shots; she had
“The gift of being a physician is an enormous responsibility,” said Dr. Vichinsky.
“I’ve always seen it as an extreme honor, a spiritual experience.”
to instruct me.” They bounced around
her 100,000-acre territory in a beat-up
jeep, her laughter in his ear.
But patients have been his best
teachers. “I’ve learned a lot about life
from patients,” said Dr. Vichinsky. “I’ve
always found patients and parents to be
much smarter than people give them
credit for.”
Dr. Vichinsky tells a story to illustrate his point: Ten years ago, when
bone marrow transplantation was considered controversial therapy for many
diseases, many physicians would not
offer it to families. Dr. V asked his advisory group of patient family members
whether physicians were right to do
that.
“‘Look, Dr. V. Your job (as medical
experts) is to give us the information,’”
he recalled them saying. “‘We can make
our own decisions. We just need you to
give us the facts. We’re capable of making our own decisions.’”
Dr. Vichinsky agreed. “I’ve always
felt that was true. Given the truth and
the facts behind it, families have the
skills to make the right decisions.”
He said patients have also taught
him about living and dying. “I’ve
learned that people can adapt to serious
illness and handicaps and still maintain
joy in life,” said Dr. Vichinsky. “The
important thing about a Hem/Onc doctor is to maintain quality of life.”
To help maintain his own quality of
life, Dr. V began running marathons 17
years ago. He recently ran the Napa
Valley Marathon. It was his slowest
marathon, but the most fun.
While his two children aren’t running marathons, they are following in
his footsteps, with careers combining
healthcare and a passion for service. His
daughter coordinates anti-tobacco policy for New York City’s public health
department. His son, a senior at Tufts
University near Boston, is focusing on
education for children with special
needs.
His kids and his patients, he said,
have taught him that there are more
important things than one’s personal
goals. Quietly he said, “My family is the
most important thing.”
S U M M E R 20 07
F
A Berkeley teen
plays competitive
soccer again after
recovering from two
broken legs.
Written and photographed
by Tom Levy.
25
lying across soccer practice fields
in the northwest corner of
Berkeley, Andrés Jankowski darts
among his teammates as precisely as a
hummingbird. He tickles the soccer
ball with his feet like a magician doing
sleight of hand. The sphere is here, it’s
there, and then, with a kick, Andrés
makes it take flight.
You’d never know that two years
before, the 14-year-old at Berkeley’s
School of the Madeleine had two broken legs, one with a compound fracture.
In December 2005, while visiting
friends in Concord, Andrés borrowed a
Razor scooter. Chased by another boy,
and unfamiliar with the roads, Andrés
accidentally shot out into traffic on the
scooter. A surprised motorist on
Clayton Valley Road hit him.
By chance, a Concord police officer
was there. She stopped traffic, and
soon the unconscious Andrés was being
airlifted to Children’s Hospital &
Research Center
Oakland.
Andrés’ mother
Carmen quickly heard
about the accident, first
after calls from his
friend’s mom, and then
with a call from Concord police. “Why
Children’s?” Carmen asked the officer.
“That’s where he needs to be,” was the
reply. Carmen feared the worst.
She arrived at Children’s from her
north Berkeley home just in time to see
Andrés on his way to the operating
room. His face looked puffy. “I knew it
was bad,” Carmen said.
It was.
* * *
Growing up with two older brothers in
Berkeley, Andrés played a lot of sports,
mostly basketball. Then, for six months
26
before he started kindergarten, his family lived near a soccer field in Florence,
Italy. Watching the matches and hearing
the cheering crowds, Andrés fell in love
with “the beautiful game.”
He played some of his first soccer
matches with Italian boys in the neighborhood. He took to the sport like a
natural, scoring 18 goals in his first official match.
After moving back to the East Bay
and starting at Madeleine, Andrés and
several other boys were recruited for a
first grade soccer team. Volunteer coach
Miguel Jara, a former semi-pro and state
team player in Mexico, built the team
around his son and several other boys,
including Andrés.
He recognized talent when he saw it.
“(Andrés) has been gifted as an athlete,”
said Miguel, owner of a meat distribution company. “He basically won the
games. He did everything. We called
him ‘Mr. Offense’ and ‘Mr. Defense.’
He’s been my best player all these years.
When he was injured it was hard for me
to coach.”
* * *
With help from x-rays, James Policy,
MD, a veteran pediatric orthopedic surgeon at Children’s, quickly sized up
Andrés’ situation.
Andrés had a broken left tibia, the
larger of the two lower leg bones, and
he had lost three teeth. But the worst
damage was to his right leg.
Andrés’ right femur, the big bone in
his thigh, had broken in two places,
piercing the skin. The small middle
piece, about an inch long, had flipped
around 90 degrees, and the leg’s main
artery was injured.
Dr. Policy couldn’t detect a pulse in
the leg. He knew any delay in treatment
Glad to have Andrés
back on the team,
Coach Miguel said,
“If you look at our
team play, there’s a
lot of talent; but
above all,
the number
one quality is
the fight, the
heart—that’s
Andrés.”
could cost the boy his leg. But for
a kid Andrés’ age, he knew exactly
which technique would work best.
It was dramatically different from
that used for an adult’s injury.
“We treat a lot of children with
complex long-bone traumatic injuries,”
said Dr. Policy. “This is the type of surgery we do frequently. Femur fractures
require a certain degree of expertise; it’s
one of the things that makes a pediatric
trauma center necessary.”
Adult treatment of a femur fracture
is straightforward: Insert a metal rod
through the central core of the femur
and attach two screws, one at either
end, to prevent twisting.
But in growing kids, this procedure
won’t work. It can actually cause
irreparable damage to the ball-and-socket hip joint.
For then–12-year-old Andrés, Dr.
Policy used an external fixator. It’s a
steel rod running outside and parallel to
the leg. He inserted smaller rods into
the two main femur sections and then
attached them to the fixator rod, holding the leg bones in place. In a second
surgery, the small piece of orphan bone
between femur sections was removed.
The external fixator worked well. It
installed quickly, enabling Dr. Policy
and his team to minimize how long
Andrés was in surgery. It was also the
best way to get his femur out to its normal length. A second fixator secured the
broken tibia in his left leg.
* * *
The surgeries were successful, and
the next day Dr. Policy detected a pulse
in Andrés’ right leg. After six days in the
hospital, Andrés went home, where a
hospital-style bed had been delivered.
His mother slept in the same room with
him for months, ready to help.
“This is the kind of injury when
S U M M E R 20 07
27
GOOOOOAAAALLLL:
[Previous page top] Miguel Jara has been Andrés’ coach for eight years.
[Previous page bottom] Physical therapist Robin Bousquet, MPT, worked with
Andrés at Children’s sports medicine center to help straighten his right leg.
[Left] Heading the ball takes great skill and concentration; during practice Andrés
passed the ball to a teammate in scoring position.
you’re happy if you can walk again,” said
Dr. Policy. “It’s just amazing, the recovery he has had. All the credit goes to
Andrés. He did all the work.”
Of course, some credit must go to
the body’s miraculous healing ability. It
took several months, but Andrés grew
new bone to fill in the gap, making his
right femur whole.
At first, the new bone was an
ungainly lump twice as wide as the original femur. This was normal. Getting
up, moving around, doing physical therapy and working the leg helped Andrés’
body sculpt the new bone into the lightweight, honeycombed, cylindrical shape
of a whole and healthy femur.
Credit also goes to Andrés’ coach
and teammates. Miguel took Andrés,
and his wheelchair when necessary, to
every soccer practice and match for the
entire season. Andrés remembers what
Miguel said: “‘Just because you’re
injured doesn’t mean you’re not part of
the team.’”
At Children’s, Andrés also got help
from Caryn Lesko, PT, in the Pediatric
Rehabilitation department. She did
physical therapy with Andrés until he
could get out of his wheelchair and use
crutches.
Then Sports Medicine physical
therapist Robin Bousquet, MPT, took
over. Because sports med PTs at
Children’s work very closely with the
orthopedic surgeons, she had already
met Andrés, joining Dr. Policy at each
clinic session. “It was definitely a
worst-case scenario,” she said. “Andrés
was the most severely injured kid I’ve
had so far.”
He was also one of the first to go
through rehab at the sports medicine
center’s new building on Children’s
Hospital’s main campus. “He stood
there with three teeth missing and said,
‘I want to play soccer,’” recalled Robin.
“He had this drive—in his soul.”
His work with Caryn and Robin
took about seven months. Andrés had to
do exercises: with Caryn at Children’s, at
the sports med center with Robin and
also at home. Robin worked hard to
help him straighten his right leg, bent
from contracture caused by months of
less-than-full use.
Sometimes the pushing, pulling and
stretching hurt, but he never gave up.
“You set goals they can reach, so they
have success,” said Robin. She praised
Andrés’ parents too: “They didn’t set
any limitations for his goals.”
Finally the day came they’d all been
waiting for. “When we first saw him run
(again), we all cried,” said Robin. “It
was a beautiful sight.”
* * *
The day Andrés came home from
physical therapy without his crutches,
Carmen knew he’d be OK. She was so
excited, she got on the phone and called
the driver of the car that hit Andrés.
The driver’s wife answered. Carmen
told her how well Andrés was doing.
“You don’t know what this means to
me,” said the wife. “My husband has
been so concerned, so worried.” When
the driver finally got on the phone and
heard about Andrés’ recovery, there were
tears at both ends of the phone call.
* * *
The post-accident Andrés, once the
fastest kid in school, is now second
fastest. That speed helps at his favorite
position on the soccer field: center midfield. “You can go anywhere you want,”
said Andrés. “You run a lot more. You
pass a lot, but I get some goals too. I
don’t like to stand. I’d rather run.”
Miguel is glad to have him back on
the team. “If you look at our team play,
there’s a lot of talent, but above all, the
number-one quality is the fight, the
heart—that’s Andrés,” said Miguel.
“Now I also have other players with the
desire to win; they learned that from
Andrés.”
Andrés is running again—fierce—
and free as a hummingbird.
To find out more about
Orthopedics, call 510-428-3238;
for the Sports Medicine Center for
Young Athletes, call 510-428-4120.
Or visit their Web pages inside
www.childrenshospitaloakland.org.
28
Click here to support Children’s Hospital
By Ken McKinney
Go to www.chofoundation.org/donate
Since the dot-com boom of the
and see how easy it can be to support
‘90s, the Bay Area has been widely
Email alerts: Online donors
Children’s Hospital.
regarded as the hub of high techreceive periodic email alerts
nology development, particularly
containing the latest Children’s news, new funding opportuInternet development. Research shows Bay Area residents
nities and upcoming community events benefiting
are significantly more likely than other Americans to
Children’s.
regularly use the Internet—as a communications tool,
and to effectively and efficiently do business.
Convenient and fast: It takes only a few minutes and a
As more people become comfortable spending and
few keystrokes to make a significant difference in the lives
sending money via the Internet, Children’s Hospital &
of the thousands of children served at Children’s. You don’t
Research Center Oakland encourages those wishing to
need to wait for a piece of mail or a phone call to give a gift.
make a gift to Children’s to enjoy the ease and costWhen you’re inspired to support Children’s, you can give
effectiveness of making gifts online; visit www.chofoundaonline—anytime, anywhere.
tion.org/donate.
Easy tributes: Giving online also makes it easy to honor
Making an online gift to Children’s has many benefits,
or memorialize a friend, family member or colleague.
both for the donor and the hospital.
The online donation form lets you make a gift to honor or
No stamps, no paper: When donors make online gifts,
remember a loved one’s life, or a birthday, anniversary or
they don’t need to fill out a paper form or mail anything in a
other special occasion. You may request that we also notify
stamped envelope. This means more of the donor’s gift can
the honoree’s family or friends.
be used for hospital programs and services. And because
E-philanthropy is no longer the wave of the future;
online gifts automatically generate printable “thank you”
it’s becoming today’s way for more and more donors to
letters, Children’s saves money on paper, postage and staff
support Children’s. And because online gifts go to the
time.
Children’s foundation immediately, your donation is available right away to support Children’s most pressing needs.
Discover treasures at The Bambino
For those who aren’t familiar with it, The
Bambino is a full-service thrift store that
sells “gently used” and new merchandise to
a loyal clientele. It is owned and operated
by the Chinquapin/Foothill Branch of
Children’s Hospital Branches, but it is
supported and cared for by members of
other branches as well.
A friendly competition exists to see
which of the branches’ donations and
labors contribute the most each month.
“But we’re still nice to each other,” joked
branch volunteer Sharon Levaggi.
The Bambino has been at its present
location, 5290 College Ave., near the intersection of College and Broadway, since
1994. The store donates 100 percent of its
net profits to Children’s Hospital; last year
that amounted to more than $100,000.
The Bambino is a volunteer-based
enterprise, and volunteers do everything to
w w w. c h o fo u n d a ti o n . o rg
make the store a success—including taking
donations home to be laundered or
cleaned. The only paid staff member is
manager Lani Rumbaoa.
The Bambino, Lani reminded us, is
always interested in good, gently used or
newer items, from clothes to household
items to furniture to jewelry. They can turn
your junk—’er, treasure—into cash for the
hospital.
Lani invites everyone to come over and
do a little rummaging themselves. There’s
new merchandise every day. In November,
The Bambino displays its prime donations
at a boutique sale for holiday shoppers.
Bambino Thrift Shop
5290 College Ave., Oakland, CA 94618
Phone: 510-658-7473
Open Tuesday to Friday, 10 a.m. to 3 p.m.;
Saturday, noon to 4 p.m.
Three loyal Bambino volunteers, Jeanette
Kattelmann (seated), Sharon Levaggi (l)
and Gerry Hillis (r) gather in the tagging
room in the back of the store.
S U M M E R 20 07
29
By Ken McKinney
Anhel Amezcua and her cardiologist, Howard Rosenfeld, MD.
W
hen Gabriela Amezcua gave
birth to her daughter,
Anhel, all seemed right
with the world. Her doctors declared
Anhel healthy, and mother and father
couldn’t have been happier. They were
looking forward to taking their new
baby girl home.
But during a routine check-up at 7
months, Anhel’s doctor gave her parents some unexpected and devastating
news. He had detected signs that she
had an atrial septal defect—a hole in
her heart. After a heart scan, their fears
were confirmed. But Anhel’s doctor
recommended a wait-and-see
approach, telling her parents it was
possible the hole might resolve itself.
For years following the diagnosis,
Anhel experienced periodic bouts of
tiredness and fatigue, but it wasn’t until
she was 6 that her heart condition
reached a critical point. She had just
gotten off an amusement park ride
when she was slammed with severe
chest pain and shortness of breath.
Aware that this sudden onset of symptoms might be related to Anhel’s
underlying heart condition, her mother
rushed her to a Union City community clinic, where the attending physician
ordered an x-ray and told them,
“Something is definitely wrong.”
The physician at the clinic told
Gabriela that a visit to the Cardiology
department at Children’s Hospital &
Research Center Oakland was Anhel’s
best chance to repair her damaged
heart.
At Children’s, cardiologist Howard
Rosenfeld, MD, evaluated her; he discovered Anhel had not one, but two
holes in her heart. He advised immediate surgery to seal them, to avoid longterm damage to her heart, kidneys and
liver. Dr. Rosenfeld was Anhel’s primary cardiologist, and Nilas Young,
MD, performed the procedure to
repair her heart.
For many years following her successful heart surgery, Anhel didn’t want
to talk about her experience. She was
always careful to keep her surgery scar
covered, concerned about what people
might ask or say. “I didn’t want anyone
to see my scar because I thought it was
ugly,” she explained.
But now 17 and a senior at
Irvington High School in Fremont,
Anhel has a new perspective, thanks to
a year-long school project she is doing
for her class. Each student focuses on
one “essential question,” researching
and writing a report for a year-end
presentation to a panel of teachers.
Anhel chose a question close to her
surgically-repaired heart: How have
advancements in modern cardiology
Anhel hopes to raise awareness
about cardiac birth defects and new
treatments for them. “It’s really
important to share my
story and help other kids
and families,” said Anhel.
procedures improved the quality of life
for heart patients with birth defects
and other heart diseases?
Anhel hopes her answer will help
her raise awareness about cardiac birth
defects and new treatments for them.
“It’s really important to share my story
and help other kids and families,” said
Anhel.
Telling her story through her class
project isn’t the only way Anhel is
giving back. She recently helped raise
money for the hospital’s programs by
volunteering during the Children's
Hospital & Research Center
Foundation’s annual Radiothon for
Kids, hosted this year by 107.7FM The
Bone and sponsored by Foresters.
“I wanted to do something that
counts, instead of just something to
pass a few hours because it is a requirement,” Anhel explained. She also plans
to do volunteer work at the foundation
on other fundraising projects.
If you have a story to tell or would
like to contribute to Children’s, please
call Ken McKinney at 510-428-3885,
ext. 2846, or send an email to [email protected]. To donate online, go
to www.chofoundation.org/donate.
30
From fear
to financial freedom
A dog groomer’s journey to self-sufficiency
By Lynn Sagramoso
F
or many years, Marge Hayden suffered from agoraphobia and was
afraid to leave her own house.
“Sometimes I couldn’t go to my mailbox,
or step out on the front lawn,” Marge
recalls, shaking her head. She remembers
the debilitating panic attacks—but they
don’t rule her life now. After years of living in fear, Marge was able to create a
safe haven through sheer determination
and her love of animals.
This wise and vivacious woman has
become a confident world traveler. In
planning for her active retirement, she
has also given to Children’s Hospital a
generous gift that will ease the lives of
generations of sick children.
Marge’s own childhood was very
unstable. Her early years were spent in a
fatherless home with an alcoholic mother. When she was 8, Marge’s mother
dumped her in a convent boarding
school and never looked back. “The
school was very Dickensian—there were
about 30 of us children, and the nuns
expected us to live as they did,” Marge
says. “We slept in tiny, doorless alcoves
adjacent to the nuns’ cells, and arose at
5:30 each morning.”
Silence was enforced most of the
time, including during meals. “The nuns
didn’t praise or comfort us the way a
w w w. le ga c y fo rc h i ld re n s c a re . o rg
child needs in order to feel loved. I began
to feel as if I were invisible, or didn’t
even exist. It was terribly hard for us kids
to grow up like that.”
Despite the lack of encouragement,
Marge excelled at music, especially piano
and voice. A determined young woman,
she graduated from the convent high
school and went on to San Francisco
State University, majoring in music.
During an opera workshop, she
recalls helping a soft-spoken fellow student rehearse for a duet, and she remembers thinking, “Wow, this kid doesn’t
have what it takes to be in opera.”
Smiling, she brings out a picture of the
workshop students, and points out a
young Johnny Mathis. Marge was offered
a spot in the San Francisco Opera, but,
unable to support herself on the seasonal
salary, she took a job as a receptionist at
Standard Oil instead—and met her
future husband there.
When she was 24, she had her first
panic attack. “My heart began to pound,
I couldn’t breathe, my legs started shaking, my vision got blurry—I wanted to
faint, just to stop it,”
Marge says. Soon she
was having so many
attacks that she had
to stop working. For
the next 18 years,
Marge was so terrified of the panic
attacks that she became housebound.
“It impairs your life,” Marge says.
“You live in fear, and your world narrows
to limit the possibility of another
episode.” Realizing she was not alone,
she reached out to other agoraphobics by
establishing a telephone support group.
Her husband supported her efforts,
too, but after 10 years, their marriage
broke up.
One day Marge noticed that her
poodle needed a trim, which gave her an
idea. Because she felt completely comfortable around animals, she realized she
could manage her panic attacks and her
growing need for money by running her
own dog grooming business. She set up
Marge’s Groomerie a half-block from her
home, but she had to drive the short distance to avoid an attack. “As a ‘safe’ environment, my car was a security blanket,”
Marge explains.
She learned all the American Kennel
Club grooming requirements, and she
found satisfaction in transforming “a
S U M M E R 20 07
scruffy SOS pad” of a dog into a powder
puff. “It was a total joy,” Marge says.
“Dogs are so trusting—they helped me
feel secure—and I loved the challenge of
enhancing each dog’s features.”
During the three decades that Marge
ran her successful groomerie, her panic
attacks gradually disappeared. “I found
myself focusing on other things besides
the fear,” Marge says. She was able to go
out with friends, and she served on the
board of directors of the Alameda
Humane Society for 10 years.
Throughout her dog-grooming years,
Marge lived frugally, saving for her two
favorite things: opera and travel. When
she decided to retire, she consulted a tax
attorney about how she might accomplish this financially. She owned the
building that had housed her groomerie,
and was renting it out. “The rental property was becoming a money pit. I had
heard about charitable gift annuities
(CGA) as a possible solution, but didn’t
really know how they worked,” Marge
says.
With thoughts of her own childhood
and history of panic attacks, she felt
strongly that children’s health was very
important. “It breaks my heart to think
of a 3-year-old child battling cancer or
other serious illness. If you have good
health, you’ll have a decent chance at
happiness,” Marge says. “I called up
Children’s Hospital Foundation, and they
explained how an annuity could optimize
my finances. The staff at Children’s
foundation made it so clear and easy—
I just had to sign my name.”
Because she used the rental property
to set up the CGA, Marge was able to
reduce the capital gains taxes she would
have to pay. She also received a significant charitable tax deduction, as well as
guaranteed annual payments for the rest
of her life. “The CGA afforded me a
retirement lifestyle I never thought possible,” Marge says. “I now receive over two
and a half times the income I got from
my tenants.”
Marge now enjoys box seats at the
opera, and she is planning her 14th trip
to her favorite travel destination—China.
“I am proud that my gift will help make
children’s lives easier. Life is hard enough
sometimes,” Marge says.
Thank you, Marge, for your compassionate legacy. And have a wonderful trip!
[Previous page] Marge with a client at her groomerie; Marge today.
[Above] San Francisco State University’s opera group, 1955. Marge is third from the left and
Johnny Mathis is on the far right.
31
What is a Charitable Gift
Annuity, and how will it
help me give wisely?
A Charitable Gift Annuity allows you
to make a substantial gift to Children’s
Hospital & Research Center Oakland and
receive guaranteed fixed annual payments
(they can never go down) for the rest of
your life. If you, like Marge, use a rental
property to fund the gift annuity, you will
have the added freedom of enjoying your
retirement years unburdened by property
management.
In addition to secure payments, a charitable gift annuity provides other benefits,
including:
• A significant charitable income tax
deduction
• An annuity rate that’s often much
higher than other fixed investments like
CDs
• Partially tax-free payments
• Flexibility to fund your annuity with
cash, mutual funds, stocks or real estate
• Capital gains tax savings when you
use appreciated real estate or stocks to
fund the CGA
• Income payments that can be made
to couples, with payments continuing at
the same level to the survivor
• Security that your annuity payments
are backed by the assets of Children’s
Hospital & Research Center Foundation
• Satisfaction of assisting generations
of children to come, with no probate fees
or estate taxes.
The Children’s Hospital & Research
Center Foundation can work with you or
your financial advisor to establish a framework for charitable giving that meets your
philanthropic and financial goals. For more
information on charitable gift annuities, or
for other estate planning, call the foundation at 510-428-3360, or visit us online at
www.legacyforchildrenscare.org.
This is not legal advice. Any prospective donor
should seek the advice of a qualified legal, estate
and/or tax professional to determine the consequences of his or her gift.
We’re closer than you think.
When Children’s Hospital & Research Center Oakland was born 95 years ago, we served
babies in our local community.
Now we serve kids of all ages, and our service area spans all of northern California,
Nevada and beyond. Janessa came from Benicia, Hevanne from Manteca, Dylan from
Tracy, Bailey from Turlock, Gracie from Santa Rosa, Adrianna from Fremont, and on and
on. Kids are brought to Children’s because their parents know that, as an independent
children’s hospital, we focus all our resources on kids and only kids.
Now we have physicians’ offices in
Larkspur, Walnut Creek, Pleasanton
and Brentwood to make serving you
more convenient than ever.
Children’s Hospital & Research Center
Oakland: We’re closer than you think.
Santa Rosa
Fairfield
Vallejo
Benicia
101
Stockton
Larkspur
Physicians’
Offices
Orinda
980
Walnut Creek
Physicians’
Offices
Brentwood
Physicians’
Offices
Manteca
Summit
Unit
Tracy
San
Lorenzo
Pleasanton
Physicians’
Offices
Modesto
Turlock
Fremont
Non-Profit Org.
U.S. Postage
PAID
Oakland, CA
Permit No. 3
747 52nd Street
Oakland, CA 94609-1809
Undivided attention. Unsurpassed care.
SM

Handprints - Summer 2007 - Children`s Hospital Oakland

Transcription

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