On the road with Dr. Khan

College of Public Health Dean Ali S. Khan, M.D., M.P.H., near Chimney Rock.

College of Public Health Dean Ali S. Khan, M.D., M.P.H., near Chimney Rock.

By Elizabeth Kumru, UNMC public relations

The new dean of UNMC’s College of Public Health is in love with Nebraska and Nebraska seems to be in love with him.

Just one month into his new position, Ali S. Khan, M.D., M.P.H., began a six-week listening tour of all 24 local and tribal public health departments in the state.

Brandon Grimm, Ph.D., director of public health practice, wasted no time in planning the trip Dr. Khan had envisioned while still in the interview process. The four of us — myself, Drs. Khan & Grimm (who handled most of the driving) and the University of Nebraska Foundation’s Karen Levin, director of development for the Colleges of Medicine and Public Health – were excited as we left. Never before had a dean from the College of Public Health taken a tour of the state like this one. Dr. Grimm, a Nebraska native, often seemed proud to be displaying the beauty of his state to his college’s new dean.

Our “most excellent journey” to western and central Nebraska started with an eight-hour trek to Alliance, punctuated by a drive through the University of Nebraska-Kearney campus and a brief stop at Carhenge, Nebraska’s answer to Stonehenge, built with 38 vintage cars.

In all, Dr. Khan visited eight departments, one critical care hospital and one federally qualified health center, stopping in the communities of Hemingford, Scottsbluff, Gering, North Platte, York, McCook, Holdrege and Burwell. He met with directors, staff, board members and a hospital CEO. He dined with UNMC donors and one prospective student in the unincorporated town of Lisco, population 64, and in a Broken Bow hotel that features the culinary art of a Lebanese chef.

From left, Karen Levin, Dr. Khan and Brandon Grimm, Ph.D., at Carhenge.

From left, Karen Levin, Dr. Khan and Brandon Grimm, Ph.D., at Carhenge.

His easy-going, sincere and energetic style charmed them all.

Dr. Khan spread the message that he was inspired by UNMC Chancellor Jeffrey P. Gold, M.D., and one of his strategic goals of making Nebraska the healthiest state in the nation.

“I call this the ‘Goldilocks state’ because it’s just the right size to get big things done,” he told his hosts. “It’s a microcosm of the country. We have the opportunity to be a model for the nation and the world. It will take a strong public health system partnered with education, business and community. We’re already 11th, so we don’t have far to go.”

See the World-Herald interview with Dr. Khan here.

“America’s Health Rankings,” compiled by the United Health Foundation, places Nebraska 11th on the list of states. Several factors, including the states’ immunization rates, infectious disease numbers, preventable hospitalizations and infant mortality rates, are considered.

Dr. Khan listened to the successes and health challenges each district faced and learned how the College of Public Health faculty, staff and students could collaborate to impact these priorities.

At the first stop, the Panhandle Public Health District in Hemingford, director Kim Engel and her 15-member staff are responsible for the public health of 50,380 people in 10 counties that cover 14,000 square miles. Engel chose Hemingford, population 830, as a base of operation because the “small town makes us think regionally.”

The Panhandle PHD is one of 18 public health districts covering 86 sparsely populated counties that were formed by the Nebraska Health Care Funding Act (LB 692) of 2001 and funded by tobacco settlement funds. All but four districts cover more than one county and three districts do not qualify for state funding.

Engel and her staff spoke about immunizations, clean water, worksite wellness, tobacco-free zones at schools and hospital campuses, health and nutrition education and a myriad of other programs they administer.

Her list of public health challenges foreshadowed those we’d hear across the state:
• Health care access
• Chronic disease management and prevention – diabetes, heart disease and cancer
• Domestic violence/child abuse
• Healthy pregnancy/teen pregnancy prevention

Of course, disease surveillance is constant. Outbreaks of pertussis, or whooping cough, have cropped up in pockets across the state where vaccine rates have dropped. West Nile virus is ever present and mosquito and bird testing is continuous.

The public health professionals we met face another challenge, as well — people generally don’t understand what they do, because the definition of “public health” is so broad. From the first meeting, officials were exploring avenues to better explain the concept of public health. The difficulty of defining public health became clearer after each visit as the team saw the diversity of public health activities at each location.

“Public health is unsustainable as it is set up now and will be unrecognizable in a decade,” Dr. Khan said. “These changes are being driven by the Affordable Care Act (which will fundamentally change health care) coupled with new technology, changes in demographics and populations, and globalization.

“In the U.S., we spend $3.1 trillion on health care. That’s one-sixth of the economy. It’s our version of the cookie monster gobbling up one out of every four state dollars and the crumbs symbolize waste,” he said. “Our health care cost is so much higher than other leading countries in the world, yet we don’t have better public health as a result of that. We can use public health and a community-based approach to make the state and nation healthier.”

The trip allowed Dr. Khan to meeti with some of the state's top public health professionals.

The trip allowed Dr. Khan to meet with some of the state’s top public health professionals.

Prevention is the most efficient and effective way to be healthy, he said. And the public health officials across the state can have a huge impact there, Dr. Khan said, showing people how to “be healthful in your life — with great choices, the ability to exercise and experience positive mental health. “Who doesn’t want to be healthy?”

Officials expressed a desire to collaborate with the College of Public Health to help train health care practitioners, expand research capacity and look for ways to provide field experiences for students.

Dr. Khan announced that this year he is forming the first student outbreak response team, which will provide assistance in an emergency. He also said that adjustments are underway in the master’s program so that students are able to complete the degree in two years.

“I’m out here because I learned a long time ago that public health happens on the local level,” he said. “The best practices and innovations happen here.

“We’re all in this together,” he said. “If we’re going to be the healthiest state in the nation, we have to work together.”

Dr. Wolfensberger kept everything, gave even more

The McGoogan Library's Cameron Boettcher is tasked with unpacking, archiving, organizing, digitizing and otherwise curating the massive collection of Wolf Wolfensberger, Ph.D. (Photos by Rich Watson, UNMC Public Relations)

The McGoogan Library’s Cameron Boettcher is tasked with unpacking, archiving, organizing, digitizing and otherwise curating the massive collection of Wolf Wolfensberger, Ph.D. (Photos by Rich Watson, UNMC Public Relations)

When young Wolf Wolfensberger escaped Nazi Germany for Denmark, then later immigrated to the United States, he took a few things with him.

For the rest of his life, he kept them.

Turns out, he kept everything.

Turns out, he gave everything.

Wolf Wolfsensberger, Ph.D., was an extraordinary man. He came to America. He educated himself. He was a researcher at the former Nebraska Psychiatric Institute from 1964 to 1971, and a faculty member in the Department of Psychiatry, of what would become UNMC, during his time here. Over the course of his career, he became a world-renowned advocate for and expert on the care of the developmentally disabled.

“He revolutionized services for people with disabilities,” Mike Leibowitz, Ph.D., director of Munroe-Meyer Institute, said.

Said a UNMC release: In 1999, he was selected by representatives of seven major mental retardation organizations as one of 35 individuals worldwide who had the greatest impact on mental retardation in the 20th century.

During a period when the developmentally disabled were routinely shifted off to institutions, literally cast off from society, he recognized their humanity. He insisted they be treated as citizens, as people. He realized that not only could they benefit from living in regular society, they could contribute to that society.

When he founded ENCOR, the Eastern Nebraska Community Office on Retardation and Developmental Disabilities, “those were the first community based programs in this country,” Dr. Leibowitz said.

To say that he fought for these people is not an understatement. There were debates with other “experts” in his field, he once said, “which almost digressed to physical violence.”

He gave everything.

Check out the walls and walls of files. The collection itself takes up 1,584 square feet.

Check out the walls and walls of files. The collection itself takes up 1,584 square feet.

We know he gave everything because he kept everything. All of it, just about anything he ever read, wrote, said or thought. He saved it all. Dr. Wolfensberger was a person who made your everyday pack rat look like a piker. He didn’t just keep notes to himself scribbled on scratch paper. He kept notes – sometimes unrelated to one another – he’d scribbled on both sides of scratch paper. On napkins. Everything. A publication celebrating his career noted his collection even included “a history of institutions through postcards.”

The sheer volume of it all is staggering.

Dr. Wolfensberger had worked at a number of places. After he died in 2011, most of these places looked at his collection and wanted some of it. But only one of them wanted all of it.

The UNMC McGoogan Library of Medicine stepped forward: Munroe-Meyer Institute, the Nebraska Developmental Disabilities Council and UNMC collaborated to make possible taking it all. All the scratch paper. All the boxes. All the books. All the items and trinkets. A lifetime’s worth of stuff.

Among the collection, the passion of a man’s life’s work is palpable.

Now, it is 2014, and another man is combing through it. Another man is starting to feel that passion seeping into his bones. Another man may be finding his life’s work.

Of all the rarities within Dr. Wolfensberger’s collection, Cameron Boettcher believes he has found the rarest of them all.

“A history major with a job,” Boettcher said, and grinned. That would be him.

This is his job. This collection. All this stuff. Wolf Wolfensberger. Boettcher spreads his arms and smiles, the wonder of it all washing over him. He is home. He ducks his head and gets back to work.

Boettcher has put his own stamp on the collection. One needs to keep his sense of humor when taking on a job this big.

Boettcher has put his own stamp on the collection. One needs to keep his sense of humor when taking on a job this big.

Boettcher, a library assistant in the McGoogan Library of Medicine, tackles his task with a young man’s enthusiasm and a novice’s wide eyes and bursting heart. This is new to him. All of it. Wolf Wolfensberger? Never heard of him. Is that even a real person?

The treatment of the developmentally disabled. A few short months ago, he knew next to nothing. Now?

“Did you know …?!” he will begin, before launching into indignities from decades past.

The passion is seeping into Boettcher’s bones.

It’s all here. Over there, half a small library’s worth of bookshelves. Their contents? Some, seem obvious. Others … a Danielle Steele romance novel? A Dungeons and Dragons adventure fantasy? Each book has tucked within it a sheet of paper, neatly typewritten. Dr. Wolfensberger’s thoughts on what he’d read. His own synopsis, what it meant to him. What a word on page 236 might have meant to those for whom he spent a lifetime working. Every book has a summary; why he kept it.

Why he kept everything.

There were 35 filing cabinets. Hundreds of boxes; 450 boxes, in fact, containing books, monographs, papers, artifacts, recording tapes, CDs, journals and photographs. There were 4,550 books and monographs, 598 journal volumes, and thousands of file folders.

The collection itself takes up 1,584 square feet. “The size of a house!” McGoogan Library head of special collections John Schleicher said.

Among Dr. Wolfensberger's rarities, a series on Nazi atrocities.

Among Dr. Wolfensberger’s rarities, a series on Nazi atrocities.

Over here there’s a shelf filled with what Boettcher calls “a Ph.D. in a box.” Dr. Wolfensberger had done all the research on a certain topic, written it up, and then, just filed it away. Never published it. Never did anything with it. Just, a Ph.D.’s worth of work, here. In a box. There are several of them.

Boettcher has met with members of Dr. Wolfensberger’s family, great people. Grateful people. Grateful that all of this has found a home, a home that will treat it like the treasure it is. Grateful that home isn’t theirs. Dr. Wolfensberger would send his kids to garage sales, when they were younger, armed with lists of rare things he was on the lookout for. His daughter remembers, when she was a girl, her nightstand piled high with her father’s books, so full was their house with all this stuff.

Why save it? Was the man just a hoarder? No, Boettcher said, going through it all now, it’s clear it was more than that.

“I think he knew he was important,” he said. Dr. Wolfensberger knew what he was doing mattered, would matter. Still matters today.

Boettcher hooked on to the McGoogan Library as an intern. Then, he was a temporary worker. He liked the work. He was a history major with a job. Then, as the acquisition of the Wolfensberger collection came together, they asked him. Would he like to work here, at UNMC? Would he like to do this?

He would. He absolutely would.

Now, this is what he does. Wolf Wolfensberger. UNMC has sent him to archivists’ training. He’s in this stuff every day, waist-deep. The goal is to wade through it, to move and organize and digitize, to sift this vast collection into something the public can appreciate. To go through these books and boxes and napkins and postcards and scraps of paper and make the genius within available. So the world can see who Wolf Wolfensberger was, what he did and what his work meant.

Combing through it all, Boettcher finds himself living a Bob Seger lyric: What to leave in/what to leave out …

“I get to decide what the world gets to see,” he said. “Right now it’s all in a back room, 50 years of advances for the developmentally disabled.”

Boettcher began knowing nothing about Dr. Wolfensberger or his work, but in going through it has discovered a new passion.

Boettcher began knowing nothing about Dr. Wolfensberger or his work, but in going through the collection, has discovered a newfound passion.

Here comes the passion again. Because of Dr. Wolfensberger’s efforts, Boettcher said, people who otherwise would have been shipped to institutions are now in classrooms, working, living lives.

The collection, “a unique, one-of-a-kind resource without parallel in the academic world,” retired library director Nancy Woelfl, Ph.D., said.

“Having that collection provides an amazing opportunity for students across all of our colleges,” Dr. Leibowitz said.

Boettcher looked out over the collection again. He shook his head and grinned. It’s amazing. Wolf Wolfensberger. That man kept everything.

He gave even more.

Is there a sexpert in the house?

Drs. Irwin and Jawed-Wesel interacted with the public at a July 8 Science Cafe.

Drs. Irwin and Jawed-Wessel interacted with the public at a July 8 Science Cafe.

Sexpert. “It’s a funny word,” said Jay Irwin, Ph.D., associate director of the Midlands Sexual Health Research Collaborative (MSHRC), housed in the Department of Health Promotion, Social & Behavioral Health in the College of Public Health.

It is a funny word. Nevertheless, Dr. Irwin has agreed to take it on as a mantle. At least that’s the way he and his fellow panelists are billed at periodic Science Cafes that tackle the subjects of sex, sexuality, gender issues and sexual health. They’re the sexperts.

Dr. Jawed-Wessel listened as a member of the audience contributed to the discussion.

Dr. Jawed-Wessel listened as a member of the audience contributed to the discussion.

How does one achieve the rank of sexpert?

“I would say at least some basic training in human sexuality and being comfortable with the title,” Dr. Irwin said. So, it’s an honorary title, but not just an honorary title. There should be academic/scientific training involved. That schmoozy guy at a party going around calling himself a sexpert?

“I’d ask to see some credentials,” Dr. Irwin said.

That guy’s probably a pervert.

But being a sexpert is not all glamour – writing academic papers, conducting research surveys and headlining Science Cafes.

Anyone with a profession – doctor, plumber, author of incredibly compelling Lookin’ at U profiles – can sometimes want to unplug and think about something else. Lawyers, for example, sometimes complain about getting bugged at parties for free legal advice. Do sexperts ever want to just talk about something other than sex?

Christopher Fisher, Ph.D.

Christopher Fisher, Ph.D.

“I was at a gas station,” said Christopher Fisher, Ph.D., UNMC assistant professor of public health and director of the MSHRC. He was minding his own business, looking for some beef jerky or some chips, when a woman yelled out: “Hey, you’re the guy from that thing!”

(It’s rarely good to be the guy from that thing.)

And the woman started enthusiastically asking him about sexually transmitted infections (STI).

Now THAT’S a full-service gas station.

“I did stop and talk to her,” Dr. Fisher said. “But I was just there to buy snacks!”

And physicians complain about being on call. Sexpert: it’s not just a job, but a mission to serve.

Dr. Irwin addressed a full house at the sexperts' recent Science Cafe.

Dr. Irwin addressed a full house at the sexperts’ recent Science Cafe.

I went to a recent Science Café to see sexperts in (ahem) action. This time the panelists were Dr. Irwin and Sofia Jawed-Wessel, Ph.D., another MSHRC assistant director. Dr. Irwin’s research interest is in health status and health care of LGBT individuals and in sexual and gender identity. Dr. Jawed-Wessel studies the sex lives of pregnant and postpartum couples.

“I come from a very pleasure-focused, sex-positive point of view,” she said.

Hi-yo!

They threw the floor open to questions. One young man raised his hand immediately. Then, question answered, we waited a minute or so for the ice to break and someone else to step forward. The same guy immediately raised his hand again.

It turns out, we need sexperts. There’s a lot of misinformation out there. As Dr. Jawed-Wessel said at one point, “There’s misinformation even at the doctor level.”

But the sexperts are helping there, too. They give presentations to UNMC students. These students master a tremendous amount of information, Dr. Irwin said. “But most of it is very clinical. Not so much on how to talk to people.”

A patient’s level of “outness,” for example, may be important. (That’s a scientific term, “outness.”)

Sexperts in action: important, but not quite as exciting as it sounds.

Sexperts in action: important, but not quite as exciting as it sounds.

The questions kept coming. One silver-haired gentleman seized the microphone. He emphatically stated that young people should not think it’s icky that their grandparents have sex. Old people have sex! And it’s beautiful!

It was unclear whether he was actually there for Science Café night at the Slowdown or if this was just his latest stop as he made this announcement at every bar in town. Either way, the sexperts nodded appreciatively.

Afterward, more people came up to them. Asked more questions, delivered more declarative statements. They were surrounded by people. People who wanted to talk to them about gender identity, or sexual health. This is the life of a sexpert. It’s rewarding. But not as sexy as you’d think.

Listen to the podcast of the July 8 Science Cafe featuring the sexperts, below.