CTSA Crowns Verbalis’ Collaborations
Not long into a conversation with Joe Verbalis, MD, a clear picture of his crisp, building-block logic and solution-oriented thinking emerges, reflecting the bygone teenager who dreamed of becoming an engineer. Yet Verbalis found at Princeton University that his characteristic curiosity drew him instead to chemistry, and then, at the University of Pittsburgh, to medicine, both as a clinician and a researcher.
Along the way he developed a love of collaboration between white coated-scientists who labor at the laboratory bench and those often similarly-clad physicians at the patient bedside. He calls their teamwork a “thing of beauty. My dual role as physician and scientist taught me early on not just the importance of, but the beauty of, collaboration. We can accomplish so much more by working together than separately, in all aspects of life.”
Now Verbalis has the opportunity to spread widely that perspective through his leadership as Georgetown University Medical Center’s co-Director of the new $38.2 million National Institutes of Health (NIH) Clinical and Translational Science Award (CTSA) to establish the Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS). Howard University College of Medicine’s Associate Dean for Clinical and Translational Research, Dr. Tom Mellman, is the other co-Director of the center, whose funding was announced in mid-July. Washington’s Veterans Affairs Medical Center, the MedStar Health Research Institute in Hyattsville and the Department of Energy’s Oak Ridge National Laboratory in Tennessee also will have important roles in GHUCCTS.
Teams of physicians and scientists from an array of disciplines are more likely than those “siloed” inside discrete areas of expertise to galvanize much-needed advances in health care to better serve the public. For example, biochemists, not cardiologists, developed cholesterol reducing drugs that effectively pioneered a new era in the treatment of cardiovascular diseases.
And by using these new therapies, physicians are responsible for decreasing morbidity and mortality from cardiovascular disease. Neither group could have accomplished this without the other’s contribution, underscoring the importance of collaboration between basic science and clinical medicine.
Howard J. Federoff, MD, PhD, Executive Vice-President for Health Sciences and Executive Dean of the School of Medicine, long has pushed physicians and scientists to pool their knowledge and resources across disciplinary lines and work together in what he calls “ensemble science.” Such team work will propel the medicine of the future, Federoff says, because traditional academic and hospital barriers can hinder the translation of laboratory advances into new patient therapies.
Verbalis long has practiced ensemble science. In the lab he developed an animal model of hyponatremia, or low sodium concentrations, so that he could investigate the role of body endocrine, or hormone-producing gland, systems to maintain water balance in humans. “I first saw the problem at the bedside, from patients I treated, and then took it to the lab to find answers to what I observed in the clinic,” he says.
That work garnered him a reputation in sports medicine as a go-to expert on exercise-associated hyponatremia (EAH) or water intoxication, which can cause death during endurance exercise events. Verbalis has worked from that lab model to help athletes to reduce their risk of death with his doctor’s orders to “respect the thirst meter. Thirst is a good indicator of your body's need for fluids,” he says.
Verbalis is a Professor of Medicine and Physiology, Chief of the Division of Endocrinology and Metabolism, and the Clinical Research Director of the Center for the Study of Sex Differences (CSD) at Georgetown University. As an endocrinologist and internist, his clinical interests include pituitary diseases and disorders of water metabolism. His research interests include pituitary function, particularly the posterior pituitary hormones vasopressin and oxytocin, and the role of sex differences in producing various clinical disorders.
Both physician and scientist are apparent at a weekly Friday afternoon endocrinology rounds discussion that Verbalis hosts in his second-floor Building D offices. About a dozen doctors at various stages of their careers present their assessments of the endocrine health of patients they’ve examined at Georgetown University Hospital that week.
Verbalis listens intently to the results of myriad tests, including of blood sugar and peptide levels, and lengthy discussion of whether a 51-year-old schizophrenic man who has survived numerous suicide attempts is insulin dependent. Verbalis suggests that the man needs more care than he already is receiving and that he cannot really be trusted to take his life-saving medications.
“If he were truly a Type 1 diabetic, he’d be dead by now,” he says. “His compliance with schizophrenia medications has not been very good, so why would we think his compliancy with his diabetes medications is any better?” he asks the other doctors.
In an interview, Vebalis pointed to the man’s access to medications but inability to take them regularly as illustrative of some of the current limits on medical practice, which he is confident the national CTSA network will help address.
“Translational research comprises not only discovering new therapies to help patients (called T1 research), but also research into more effective ways to deliver it to patients, both as populations and individually (called T2 translational research),” Verbalis explains. “Only by addressing both of these areas will we truly improve the health of our communities.”
By Victoria Churchville, GUMC Communications