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.”

Answered prayers

Lisa Spellman and her nephew, Jeffery

Lisa Spellman and her nephew, Jeffery

By Lisa Spellman

My nephew has a new kidney!

Jeffery Spellman, the young man I told you about earlier this year, has a beautiful new, fully functioning kidney as of June 2.

We are grateful and indebted to the incredible generosity of an unknown donor and their family and will always be praying for them.

They will never know the magnitude of this gift.

But we do. I do. And so do total strangers to whom I have spontaneously blurted out the good news.

“My nephew just got a kidney transplant and it’s working perfectly!”

The looks of surprise quickly turn into smiles and hearty congratulations.

Happiness is definitely infectious.

We have a lot to be happy about. And the transplant team couldn’t be happier with how perfectly matched the donor kidney is to Jeffery. You can’t get better than 100 percent, with zero antigens.

Jeffery had 99 out of 100 antigens and finding that one person whom he would be compatible with, well, it took two years. For others, the wait is much longer.

This transplant was definitely orchestrated by a higher power.

Jeffery should have waited 10 years for a kidney, his transplant surgeon, Alexander Maskin, M.D., told us.

The best part was when he said the kidney began producing urine immediately. It’s as if it woke up the moment it touched Jeffery’s body.

As for the surgery, which we were sure would last well into the night, it only lasted two hours and 39 minutes.

We were amazed by how quickly things went.

Dr. Maskin seemed to think it took longer than the usual hour procedure.

“He was a very difficult transplant,” he said explaining the length of time to Jeffery’s wife Ashleigh and other family members in the waiting room that night.

As Dr. Maskin explained the surgery he spoke of a potentially fatal infection that he discovered in Jeffery’s bladder that would have destroyed the new kidney.

Someone was definitely looking out for Jeffery and his precious new kidney.

Jeffery will be just fine.

And I can breathe again.

The beginning

The practice ice rink looks like the graduation area.

DSC_0312There are rows of chairs for the graduates. There is a podium. There are even seats on one side, though not nearly enough to seat all the friends and family who are expected.

Still, the room looks official enough that one graduate, gown draped over her arm and a cap in one hand, asks “Is this where the ceremony is?”

It’s not.

UNMC’s official commencement ceremony was held May 10 at the Ralston Arena, on the main floor, where the Lancers hockey and UNO basketball games take place. This room, a practice area located just below and behind the arena gift shop, was the staging area, where, a half-hour before the ceremony starts, Barbara Breazeale and Janet McLaughlin are trying to wrangle more than 450 graduates.

“It’s our second year at the Ralston Arena,” Breazeale said. “We’re still trying to tweak things.”

Right from the start, some tweaking is needed. The seats have been sectioned into areas A and B, but the signs have been switched, so the students who have actually taken their seats – by college and in alphabetical order – are all in the wrong place.

“We always have interesting things pop up,” Breazeale said.

As the two consult lists – who is here, and who isn’t coming, and who’s supposed to be coming but hasn’t yet? – the students gather in groups, pose for photos and adjust their caps and gowns. The clear fiberglass that would serve as protection for the audience during hockey practice doubles nicely as a reflective surface, where hair can be checked or makeup fine-tuned.

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Kate Weidemann and William Warner

Nursing graduate Kate Weidemann is adjusting classmate William Warner’s tassel as the two wait in their seats.

“I’m a non-traditional student,” Warner said. “I’m 41-years-old, and this is the completion of my first bachelor’s degree. Getting that degree in my hand means everything.”

Rob Bowen is getting his M.D.

“Graduation is a good opportunity for our family to come and see us,” he said. “It’s the end of something, but it’s the beginning of a lot.”

Ernie Sigler, D.D.S., and John Reinhardt, D.D.S., are lined up in a hallway behind the arena floor, academically garbed and waiting to make the walk into the main arena. The two are smiling as they talk to each other, obviously happy to be part of the Omaha ceremony, as well.

“They work so hard, it’s almost like they can’t believe it’s over,” said Dr. Reinhardt, “It’s great to assure them that they’re ready to face the world, and it’s great because we get to see their parents again – to have them come for a special celebration like this is really nice.”

By 9 a.m., everyone in the practice rink is ready. McLaughlin and other Student Services staff have the students seated in the proper sections and in alphabetical order by school. No-shows have been identified. It’s go time.

At the signal, the graduates rise and, behind two red-garbed marshalls, they troop out of the practice rink.

From the arena floor – from the real graduation area – the music starts.

It’s the beginning.

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Entering the arena for the ceremony.