Groundbreaking signals start of much-anticipated Family Lodge
Breaking ground for 'quiet seclusion and supportive fellowship'
Breaking ground for The Edmond J. Safra Family Lodge are (l-r):
Dr. Michael Gottesman, Deputy Director for Intramural Research, NIH; Dr.
Elias Zerhouni, Director, NIH; Dr. John Gallin, Director, Clinical Center,
NIH; Jeffrey Keil, President, Ellesse LLC; Amy McGuire, Executive Director,
Foundation for NIH; and Susan Lowell Butler, member, Clinical Center Patient
Advisory Group. The groundbreaking ceremony was held indoors due to inclement weather.
A groundbreaking ceremony was held on Oct. 29, for The Edmond J. Safra Family Lodge,
a home-away-from-home for the families and caretakers of NIH Clinical Center patients.
The event, which occurred at the future Lodge location near the corner of Center and
Convent Drives, formally signals the project's start.
The rain-soaked day did not deter a large crowd, which included patient partners
and NIH management and staff, from attending. Clinical Center Director Dr.
John Gallin served as master of ceremonies. Program remarks were given by
NIH Director Dr. Elias Zerhouni; Jeffrey Keil, President of Ellesse, LLC,
representing The Edmond J. Safra Philanthropic Foundation; Dr. Michael
Gottesman, Deputy Director for Intramural Research, NIH; Amy McGuire,
Executive Director, Foundation for NIH; and Susan Lowell Butler, member,
Clinical Center Patient Advisory Group.
Dr. Gallin welcomed attendees stating that the Family Lodge has been much
anticipated. "The concept for such a facility started in the early 1990s
when volunteers from the Clinical Center's nursing, housekeeping and
social work departments launched this idea purely on a voluntary basis
because they recognized the deep need to provide patients' families with a
place of respite," he said.
Lodge rendering is now on display in the Clinical Center.
The Clinical Center is the largest hospital in the world totally dedicated
to clinical research. "The Lodge will complement the work we do by providing
quiet seclusion and supportive fellowship to families and patients participating
in our research protocols. I predict the Lodge will become a model for
other institutions that conduct clinical research," said Dr. Gallin.
Dr. Gallin introduced Dr. Elias Zerhouni highlighting the NIH Director's
commitment to clinical research as a top priority. Dr. Zerhouni said
that the Lodge "embodies the connection of humanity and science and the
connection of government and enlightened citizenry."
Dr. Zerhouni expressed how impressed he was that a federal agency such as
NIH was receiving the highest mark of recognition from philanthropy. "It
is because of the ground breaking research that the Clinical Center has
done over the years that we're now able to be at such a groundbreaking
ceremony. Would you ever imagine a foundation funding something for the
IRS? I think only NIH can attract that sort of recognition because
philanthropy by definition is the concept of loving another," he said.
Foundation for NIH Executive Director Amy McGuire echoed Dr. Zerhouni's
sentiment. "The Foundation has learned a great deal by conducting this project.
We feel the Safra Lodge is really a symbola symbol of what Congress intended
the Foundation to do when they authorized and created us. The Safra Lodge
is a public/private partnership that will help the whole NIH family,
the patients, their families, and ultimately the American public," she said.
Noting that the first cancer treatment using chemotherapy took place
at the Clinical Center, Dr. Michael Gottesman, deputy director for Intramural Research at NIH, spoke poignantly of the courageous acts of patients. "Think about the very first patient who had serious cancer who was asked to be part of this clinical trial. He was asked to take a toxic chemical at risk of life to find out whether this would be a treatment that would help other patients in the future. In no way is this different from the bravery shown by firemen who run into a burning building, or John Glenn in his first orbital maneuver, or Neal Armstrong when he stepped out on the surface of the moon. These patients and many, many others have come to NIH to put their lives on the line to advance human knowledge, to improve public health." The Family Lodge, said Dr. Gottesman, is a very small payback to these "amazing patients."
Susan Lowell Butler, member, Patient Advisory Group, Clinical Center,
shares her thoughts on being an NIH patient.
Susan Lowell Butler, an NIH patient and member of the Clinical Center's
Patient Advisory Group, has intimate knowledge about such courage. "I was
treated for simultaneous breast and ovarian cancer here in 1995 on a
clinical trial. When I tell you I'm glad to be here, I'm not just using a
tired old phrase," she said.
She spoke about the caregivers' burden. "I'm blessed with a magnificent
husband. He supported me when I had been given a death sentence. One
night he was with a group of other caregivers and I heard him say, 'In seven
months, no one ever spoke to me without starting
with the question 'How's Susan?'" That's what the caregiver role
really feels like. It is loneliness, isolation and fear."
"Anything that helps ease the caregiver's suffering and distress is
quite a miracle," she said. And The Edmond J. Safra Family Lodge
may be just that.
Actual construction should begin early next year with completion
in the summer of 2004. For more information contact Jan Weymouth,
Program Manager, at 301-496-2925.
by Dianne Needham
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HHS mandate restructures Human Resources
The Department of Health and Human Services mandated that Human Resources
activities throughout HHS be centralized. The November 2001 decision cited a
need for department-wide consistency. Officials felt many individuals hoping
to work for HHS found it difficult to navigate through the myriad of departmental
personnel offices. At NIH alone there were more than 25 different HR offices.
HHS' goal was to decrease the number of personnel offices in HHS from 40 to 4 by
October 2003. Thus, NIH had to restructure the individual institute and center HR
offices into a central Office of Human Resources.
As part of the restructuring, the Clinical Center's HR office was reassigned
to the NIH, Office of the Director, Office of Human Resources, Division of
Human Resources Operations and became the Clinical Center HR Operations Branch.
Several staff members moved to other NIH OHR offices. At the same time four
more personnel specialists from other institute and center HR offices joined
the Clinical Center Branch. Two significant changes occurredTom Reed, formerly Clinical Center HR Director, now serves as HR Program Advisor to the Clinical Center senior management, and Barbara Lang, formerly Associate Personnel Officer under Tom Reed, is now Chief, Clinical Center Human Resources Operations Branch.
Reed and Lang both agree that for the Clinical Center the restructuring is
seamless to the vast majority of employees.
"The change is transparent to managers and staff. The federal personnel process
did not change," said Reed. "We know that the Clinical Center HR Operations
Branch understands the Clinical Center's mission and is committed to its
biomedical research patient care environment."
The HR centralization creates greater consistency, improves timeliness of
hiring and brings global identification of compensation problems throughout NIH.
"Our goal is to provide timely and effective HR support and advice to the Clinical
Center," said Lang.
The Clinical Center HR Operations Branch is located at 6100 Executive
Boulevard, Room 3E01. The telephone number is 301-496-6924.
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Eclipsys to build core system of CRIS project
A contract to build the largest component of the NIH Clinical Research Information System has been awarded to the Eclipsys Corporation.
The Clinical Research Information System-CRIS-is a $60 million
project that will link and support patient care, research and management
at the Clinical Center.
Under the contract announced Nov.14, Eclipsys Corporation will develop
and implement the components of CRIS that comprise the patient-care aspects
of clinical research. Included in this core system is the electronic medical
record, which houses information such as lab results, pharmacy orders and
multidisciplinary care documentation.
The Clinical Center developed and has used an electronic medical information
system for more than a quarter century. The system was one of the nation's first.
"This phase of the CRIS project replaces and expands the original system,"
explained Dr. Stephen Rosenfeld, CRIS project manager and chief of the Department
of Clinical Research Informatics. "It's a critical component to complete before
the new Clinical Research Center opens in 2004. As CRIS evolves, we will be
building an information technology foundation to support future clinical research at NIH."
Dr. Rosenfeld will discuss CRIS project next steps during Clinical Center
Grand Rounds Dec. 18 at noon in Masur Auditorium.
"The Clinical Research Information System will be a valuable resource
for both patient care and clinical research," said Clinical Center Director
Dr. John Gallin. "It will provide innovations in managing, analyzing and
using valuable information surrounding clinical research."
More information about the CRIS project is available on
the web: http://cris.cc.nih.gov.
by Sara Byars
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Training Programs in Clinical Research
Applications for the 2003-2004 NIH-Duke Training Program in Clinical Research
and the University of Pittsburgh Training in Clinical Research Program are
available in Building 10, Room B1L403.
Duke Training Program in Clinical Research
The NIH-Duke Training Program in Clinical Research, implemented in 1998,
is designed primarily for physicians and dentists who desire formal training
in the quantitative and methodological principles of clinical research.
The program, offered via videoconference at the Clinical Center, allows
the integration of a student's academic coursework with his or her clinical training.
Academic credit earned by participating in this program may be applied
toward satisfying the degree requirement for a Master of Health Sciences in
Clinical Research from Duke University School of Medicine.
queries regarding the program may be addressed to firstname.lastname@example.org.
The deadline for applying is March 1, 2003. Applicants who have
been accepted into the program will be notified by July 1, 2003.
Pitt Training Program
The University of Pittsburgh Training in Clinical Research Program, designed
for Ph.D. and allied health professionals (i.e. pharmacists and nurses),
allows trainees to gain the knowledge and skills required for the conduct of
clinical investigation, as well as more extensive knowledge relative to a
specific area of concentration.
Participants in this program have the option of receiving a
Certificate in Clinical Research (15 credits) or a Master of
Science in Clinical Research (30 credits) from the University of Pittsburgh.
The deadline for applying is March 1, 2003. Successful applicants will be notified by May 29, 2003.
Physicians and dentists are also eligible to matriculate in this program.
Enrollment in these programs is limited. Prospective participants should
consult with their institute or center regarding the official training nomination procedure.
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Saving life and limb
Doctors give life back to woman with nearly fatal blood clot
Pictured are (l to r): Denise McLaughlin, R.N., 7E charge nurse; Rebecca McDonald; 3-month-old Jordan; Robert McDonald; Dr. McDonald Horne and Dr. Richard Chang.
Three months ago Rebecca McDonald gave birth to her third child, Jordan.
A couple of weeks later, a blood clot had formed in her pelvic area and stretched
its way down to her calf. The swelling from her leg became crippling. Her life began
to revolve around a wheelchair, her bed and doses of morphine for the pain.
"The scary part was not knowing what the future was going to be," said Rebecca,
a stay-at-home-mother of three from Boise, Id. "How was I going to parent my
children from a bed?"
And how was her husband Robert going to care for her, a newborn, two daughters,
ages five and seven, and still hold down his job as a dentist?
They were unsure; but, more than 2,300 miles away, Clinical Center
Doctors Richard Chang and McDonald Horne were searching for patients like Rebecca.
"She's very healthy and runs every day," said Robert McDonald. "She was
running before she became pregnant and started running again after the baby was born."
It was then that she began to have pain in her left calf area. "We thought
that maybe she just stretched the muscle. She took Ibuprofen, but it got worse,"
said Robert. "So we went on a Saturday to a clinic just to get it checked out."
The clinic sent them to the emergency room at St. Luke's Hospital in Boise.
"After they ran some tests, the nurse came in with tears in her eyes and said
she was happy that we came in when we did because she had a pulmonary embolism
and it was life threatening."
A pulmonary embolism is a blocked artery in the lungs that is generally caused
when a blood clot or a portion of a clot from another part of the body travels
to the lungs.
Rebecca was placed on anticoagulants, medications used to dissolve and prevent
blood clots. After a week in the hospital she was sent home. "The treatment wasn't
working. Her leg was getting bigger and becoming worse. It was twice the size of
her other leg." said Robert. "I rented a hospital bed because she couldn't go up
and down the stairs. The pain pills were like TicTacs. . . they just weren't working . . .
so we went back to the emergency room and they put her on morphine."
As a dentist, Robert said he was familiar with clinical trials. So he went
to his computer and began looking for websites that could give him information
about clinical trials for severe blood clots.
"NIH was the first website I found. I called them the next day at six o'clock
in the morning and they said Rebecca would be the perfect candidate," said Robert.
"We took a flight out that same night."
According to Dr. Chang, chief, Special Procedures Section, Department of
Radiology, Imaging Sciences Program, nearly 200,000 people suffer annually
from deep venous thrombosis or DVT, a blood clot in the lower part of the body.
"Most of these cases will be treated with anticoagulation drugs alone.
This would be great if anticoagulation was perfectly effective," said Dr. Chang.
"Anticoagulation is extremely effective in the prevention of pulmonary embolisms,
and it is also fairly good at preventing DVT in the first place. Where it fails,
is in clearing the clot in the leg and preserving the function of the veins
in the legs."
In Rebecca's case, anticoagulation wasn't working. As her uterus expanded
during the pregnancy, it pressed against the veins in her pelvic area,
narrowing the vein channel. This reduced blood flow and allowed the blood to clot.
According to Dr. Horne, senior clinical investigator, Hematology Services,
Department of Laboratory Medicine, even if the anticoagulants worked in
clearing the blockage, the vein would still be narrow, increasing the chance of
developing another blood clot.
Anticoagulants will dissolve a clot within several weeks or several months.
However, it leaves behind damage to the vein. Within each vein are delicate valves
that allows blood to flow up the leg. Without the valves, or with damaged valves,
pressure builds up in the veins, leading to swelling, and potentially reclotting,
and possibly skin ulcers.
"But if we move the clot out quickly, the venous valves remain functional,"
said Dr. Horne.
And that was the theory behind their research. In 1998, Dr. Chang and Dr.
Horne began recruiting patients for a clinical trial for treatment of acute
deep vein thrombosis.
For almost 15 years, Dr. Chang treated cancer patients who developed blood
clots in the neck and arms caused by catheters used during chemotherapy. "We
studied and tried different ways of dissolving the clots, but we weren't quite
happy with the results from techniques used in the general medical community,"
said Dr. Chang.
By 1994, Dr. Chang and Dr. Horne decided to test rtPA, a natural protein that
was generally used for patients who have had heart attacks. By using a catheter
to spray the enzyme directly into the clot, the doctors hoped to dissolve the
clot within days, if not hours after treatment. Unlike the other alternative
choices of clot dissolving enzymes, rtPA sticks directly to the clot, allowing
prolonged enzymatic action, dissolving the clot to restore a channel for blood to
flow again. Anticoagulants themselves do not dissolve clots and when patients are
placed on anticoagulant therapy alone, their physicians are relying on natural
clot-dissolving enzymes to penetrate the clot and dissolve the clot. This is a
very slow process when the clot is large and blocks flow of enzyme reaching the area.
"Ideally, patients should get rtPA treatment within two weeks of diagnosis.
Referring doctors should not delay if the patient has extensive DVT," said
Dr. Chang. "Thrombolytic therapy is very effective when the clot is fresh.
Doctors and their patients should not adopt a wait-a-month-and-see approach,
because they will miss the period when thrombolytic therapy is most effective."
However, many doctors have been reluctant to support what Dr. Chang and
Dr. Horne have found to be successful among patients they have treated with DVT.
"We received limited patient referrals from other physicians," said Dr.
Chang. "They said it wasn't proven, it doesn't work, it's too dangerous; all
information from older studies over 10 years ago. I think this is no longer
true and thrombolytic therapy deserves a fresh reevaluation."
And the results are starting to prove him right.
Of the 14 people who have participated in the study, all have had successful
resultsincluding Rebecca. Within three days Rebecca was walking. Within six
weeks she was running regularly.
"It's not a coincidence that this clotting occurred after Rebecca's pregnancy.
We were surprised that it didn't happen during the pregnancy," said Dr. Horne.
"However this case was unique because of the severity of it. This is a young, active
individual who had pain and swelling in her leg that was not improving with
anticoagulants. Eventually, she would have been severely debilitated and crippled."
Blood clots can develop from pregnancy, birth control pills, hormone
replacement, cancer, and several other rare situations, according to Dr.
Chang. "Many people who are athletic or have an active lifestyle are at a
higher risk, especially if they become sedentary or confined to a chair or
a bed for a period of time," he said.
That's exactly what happened to Dr. Ryszard Pluta, clinical staff
physician, Surgical Neurology, NINDS. After returning from a 17-hour
flight from China, Dr. Pluta felt a pain in his right calf. He decided
to have an ultrasound and found that he was suffering from economy class syndrome.
This condition results from long hours of minimal movement on
an airplane when passengers are crammed into small quarters.
"Nearly ten percent of travelers develop DVT, but less than one
percent are actually diagnosed," said Pluta. "Many fly in business
class or first class, but the same percentage get DVT."
Pluta was accepted into the clinical study and within a week
returned to his regular activities of running, tennis, swimming, and golfing.
"This is a blessing," said Pluta, who now flies more European
airlines that remind passengers to stretch and move around every hour to
avoid the risk of blood clotting. "The fact that this is giving people a
real chance to go back to their normal life is great."
by Tanya Brown
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2002 Medicine for the Public Lecture Series premiers on Research Channel
The Medicine for the Public lecture series helps people understand the latest developments in medicine. Topics of current relevance are presented by NIH physicians who can relate
stories of science to the lay pugblic. The 2002 lecture series is being videocast/webcast weekly on the Research Channel.
Tune in to the Research Channel video and webcasts each week on Tuesdays at (Eastern Standard Time) 6 a.m., 11 a.m., 4 p.m., 9 p.m., and Wednesdays at 1 a.m.
Specific programs premier on the following dates:
Dec. 3 Nutritional Therapies for Age-related Eye Diseases
Dec. 10 Coping with Anxiety and Depression in Uncertain Times
Jan. 7 The Teen Brain
Jan. 14 Endometriosis: Scrambled Eggs and Killer Cramps
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Beating the odds:
Dickinson given life-saving treatments for 25 years
Diane Dickenson, pictured with her husband Neil, undergoes LDL apheresis at the Clinical Center's Department of Transfusion Medicine, a process she must do every two weeks.
You could say Diane Dickinson is "one-in-a-million," and you'd be right in a
number of ways. She's feisty, outgoing, yet laid back, has a good sense of humor
and is, if anything, persistent. But she's also one in about every million
Americans with homozygous familial hypercholesterolemia (FH) type IIa, a
genetic disorder that causes too much LDL (the "bad" cholesterol) to
accumulate in her body.
By all counts, she said, she should never have made it this far.
"Thanks to the attention I've received at NIH, I've had the chance to
raise a family and have grandchildren. It's all so phenomenal because I wasn't
supposed to live beyond my teens."
Mrs. Dickinson, who was diagnosed when she was 2, is one of the lucky pioneers
who blazed a trail from research to realitya trail that's led her through 25
years of varying treatments including drugs and blood-cleansing techniques.
Now, at 63 years of age, she's the longest living patient with FH.
"She's very unique," said Dr. Robert Shamburek, a staff physician
researcher with the Molecular Disease Branch, NHLBI, who spent a decade
following Mrs. Dickinson through her ongoing journey. "When she came to us
in 1976, she had perhaps six months to live. She was picked up under one of
our protocols, and, as so often happens, an investigational process leads to a
number of proven treatments. You could say that Mrs. Dickinson is a milestone
in modern cholesterol treatment."
Dickinson grandchildren (l-r) Morgan, Mitch and Sidney, with baby Haley,
sport t-shirts proclaiming "Thank you NIH."
Because of two defective genes, low density lipoprotein cholesterol (LDL)
in FH patients cannot be metabolized by liver cells into useful nutritional
components. As a result, LDL continues to circulate in the blood stream,
where it accumulates in dangerous levels along arterial walls, creating obstructions.
"There's no housekeeping function to get rid of it," explained Dr.
Susan Leitman, chief, Blood Services, Department of Transfusion Medicine.
"The excess LDL becomes oxidized, which makes it even more dangerous. It
enters the walls of blood vessels, causing inflammation and forming deposits
known as arteriosclerotic plaques. These plaques block blood flow in the
coronary arteries, causing severe, life-threatening and lethal heart disease."
To illustrate her point, Dr. Leitman pointed to figures devised by the Adult
Treatment Panel of the National Cholesterol Educational Program. For normal,
healthy people, the panel recommends an LDL level of less than 160. For victims of
coronary heart disease, the recommended level is less than 100. "In patients like
Mrs. Dickinson," she added, "LDL levels are characteristically between 600 and 800."
Mrs. Dickinson's condition was so precarious that when she first arrived at NIH,
she had to undergo coronary artery bypass surgery, using saphenous vein grafts from
her legs. Although the use of arteries was later standardized, increasing the
efficiency of the bypass, Mrs. Dickinson's graft has survived without blockage
well beyond the 10-year range expected-and at 25 years shows no sign of atherosclerotic disease.
"It was research that evolved through many treatments," Dr. Shamburek said. The
late and renowned researcher and physician Dr. Jeffrey Hoeg, who now has an award
lecture series in his honor by the American Heart Association, was a leading player.
And though Mrs. Dickinson herself credits her success to "being in the right place at
the right time," the focus on her rare condition led to treatments and knowledge that
would benefit large numbers of Americans at risk from high cholesterol.
One achievement was drugs called statins, which increase the liver's ability to
metabolize LDL. Others included plasma exchange or plasma clearance, and more
recently, LDL apheresis, which physically deletes, or adsorbs, LDL from the circulating blood.
"In Mrs. Dickinson's case, statins were only marginally effective," Dr. Leitman
said. "Drug therapy lowered her LDL levels from 800 to 600, which wasn't adequate.
Since 1977, Mrs. Dickinson has come to the Clinical Center every two weeks, first
for the plasma exchange, which was replaced in 1989 by LDL apheresis. Both
processes take between 4 to 6 hours."
"She's a real trooper," said her husband, Neil. "The changes in treatments
over the years have been remarkable. We're both very thankful for the help we've
received from NIH. Before we came here, we felt more like we were a research project."
"It's been very successful," Mrs. Dickinson said. "It's what's kept me alive
for 25 years." She marvels that the apheresis clinic she visits so often is named
after Regina Dowling, one of her original nurses.
"The people here could not be kinder or nicer and, of course, we've established
many enduring friendships," she said. On June 1, she celebrated her
25-year mark by throwing a dinner party and inviting the people at the Clinical
Center she has come to know and love.
"I've been on the pioneer's edge the entire time," she said. "And I've been
very fortunate. I was able to go into nursing, so I have a medical understanding
to follow my condition. But everyone's been so supportive and has taken very
good care of me."
Even so, nothing's perfect. But the Dickinsons do enjoy life and their
families, especially their grandchildren. Once a year, they visit Florida,
where Diane receives treatment at a medical facility in Tampa. And though
there are some adverse effects to the apheresis, including headaches and
nausea, these, too, are being systematically addressed along the way by an
unrelenting sciencea science with a very human touch.
by John Iler
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Quality of Worklife Initiative and Diversity Council
Holidays bring joy, happiness and the blues
The holiday season can be one of the most stressful and
emotionally difficult times of the year. Despite the joys and
happiness of being surrounded by family and friends, this particular
holiday season may prove difficult for many individuals. In addition
to the stresses of the holiday season, military families may be
celebrating the holidays away from home, the slowing economy may place
financial burdens on some and the loss of loved ones to illness or even
violence may cause people to feel isolated from those who are enjoying the holiday.
During this holiday season remember that many are coping with anxiety,
trauma and depression. Instead of feeling joy, many people may experience
the holiday blues and not feel like celebrating.
Tips for Coping
- Try to set realistic goals for the holidays. Keep expectations simple
for yourself and others.
- Make a budget and stick to it. Spend what you can afford.
- Try not to overeat or drink excessively to escape stressful feelings.
Eat healthy foods and get plenty of exercise.
- Remember that the holidays are more than one day; they are part of a whole season.
Pace yourself. Spread enjoyable activities throughout the entire season.
- Helping others can also help you feel better. Volunteer at a homeless shelter,
buy a present for a child in need or visit people in nursing homes.
- If you do not have friends or family to visit with, reach out. Contact local clubs,
religious groups or community centers to see if they are holding activities that
may interest you.
- Nurture yourself. Take some time out each day to care for and celebrate yourself.
- Try to stay in the present. Look forward to the future. Life is full of changes.
Consider what is important in your life and good about these times.
Signs to Seek Help
Some people may experience the holiday blues, but others may have profound
feelings of sadness or depression that do not go away over time. Symptoms may include:
- Persistent sad, anxious or empty mood
- Sleeping too much or too little; middle-of-the night or early morning waking
- Reduced appetite and weight loss or increased appetite and weight gain
- Loss of interest or pleasure in activities, including sex
- Irritability or restlessness
- Difficulty thinking, concentrating, remembering, or making decisions
- Fatigue or loss of energy
- Thoughts of death or suicide
- Feeling inappropriate guilt, hopelessness or worthlessness
For help with issues of depression, anxiety or stress that may be
affecting work and family life, contact the NIH Employee Assistance
Program at 301-496-3164. All information is confidential.
Source: National Mental Health Association
The QWI and Diversity Council bids farewell to one of its co-facilitators,
Sue Fishbein. Fishbein helped establish the council in 1996 and is credited
with much of its success. "Through boundless energy and a genuine interest in
employees' welfare, she was the main protagonist in promoting quality of worklife
and diversity at the Clinical Center," said co-facilitator Jacques Bolle. Her
planning and organizing a two-day retreat for council members; developing a
regular column for Clinical Center News; stewarding a QWI/Diversity library;
developing a QWI/Diversity web page and drafting a new diversity award as
part of the Clinical Center Director's award. She supported the expansion
of the 14th floor exercise room for employee use, and was an advocate for
child care issues. Fishbein is succeeded by Deborah Dozier-Hall who will
serve as co-facilitator with Jacques Bolle.