1. < Message from the Chair

In honor of Women’s History Month, I spotlight some of the outstanding women faculty within the UCLA Department of Medicine (DoM) who are at the forefront of groundbreaking research, delivering humanistic, compassionate patient care, are shaping the future of medicine through mentorship, and advocating for equitable healthcare access in our broader community. These highlights are but a small snapshot of the women leaders in our department, whose impactful contributions are evident throughout the year. Stay tuned for additional highlights throughout the month.

Healthcare for People Experiencing Homelessness Expands at the VA

Within the US healthcare system, processes are typically set up in a way that requires individuals to bring themselves to care. Taking time off work to get a screening, getting stuck in a clinic waiting area, and trying to decide if taking two hours to get to an appointment is worth it, are all common experiences for patients in the US. However, for some patients, those steps serve as less of an annoyance and more as a significant barrier. This dynamic is especially true for people most at the margins of our healthcare system – for instance, those without insurance, people who can’t afford the cost of transit, and people without reliable internet connection; and at the intersection of these risk factors is housing. If one doesn’t have housing, these seemingly small barriers can quickly add up, making it nearly impossible for some to get care. Data backs this up, showing us that we’re in a real crisis in which most people experiencing homelessness only have sporadic access to care, if they have care at all. Data also shows that a high percentage of these individuals are veterans.

UCLA has been working to respond to this crisis, which is especially stark in LA, in several ways. The VA Greater LA Healthcare System (VA GLA) runs the Homeless Patient Aligned Care Teams (HPACT). The UCLA Homeless Healthcare Collaborative was started in 2022; and the Mental Health Intensive Case Management (MHICM) team at the VA, led by Emily Defraites MD, cares for a specific patient population – many of whom are set up in encampments outside the facility. These efforts have served many unhoused community members with the goal of improving healthcare for people experiencing these significant barriers, who are also most in need of high-quality care. Still, these programs are primarily clinic-based, and unable to reach everyone in need. In an effort to supplement these amazing ongoing efforts, MHICM and the substance use disorder team at the VA began street outreach through a new integrated medical education rotation called the “Integrated Dual Diagnosis Outreach” (IDDO).

“The idea was that we’d go to transitional housing sites to engage with patients who were harder to reach, not making it into appointments, and were very unstable,” Isabella Morton, MD, a psychiatrist on the IDDO team explained.” By just going to them, we've been able to reach a lot of veterans who were either not at all connected to healthcare or poorly connected.”

Elizabeth Ranson, MD, assistant professor of infectious diseases at UCLA, joined HPACT downtown a few months ago, and instantly became interested in the IDDO outreach. Most HPACT care takes place in-clinic; yet, Dr. Ranson knew, in large part due to the prior work of her mentor, Brianna Cowan, MD, the IDDO team, and her HPACT West Side colleague Layla Parks, that there were many veterans on the streets and in transitional housing still falling through the cracks. In response, Dr. Ranson and Dr. Cowan set out to build a direct outreach program, under the model and partnership of IDDO.

At first, Dr. Ranson would go out with the IDDO team, to meet their partners and supplement their addiction and mental health work with primary care. Typically, they set up their clinic in makeshift settings, such as a utility closet of Single Room Occupancy settings where patients would come with medical questions. Recently, however, the team secured access to a van and rolled out a mobile clinic once a month, an operation replete with Dr. Ranson, a nurse, a social worker, and even an awning and chairs. The goal of the mobile clinic is to reach more veterans on the street who may not specifically be staying in an SRO. Their hope now is to push access even further by rolling out walking outreach to reach people who are in tents; in essence, bringing care even more directly to them. This expansion is aimed for March. In the meantime, Dr. Ranson and Dr. Cowan are proud of the strides they are making to improve healthcare for unhoused veterans and the many collaborators who have paved the way for this crucial work.

She makes clear that each action, regardless of scale, can make a significant difference in someone's life.

"We can't fix most of what we see, but we can make seemingly small changes that make a big difference -- bringing insulin, getting someone a wheelchair, cleaning wounds, providing compressions socks, connecting someone to methadone -- each step goes a long way and makes our care more patient-centered, rather than health system-centered."

Special thanks to Dr. Brianna Cowan, Dr. Elizabeth Ranson, Dr. Isabella Morton, Dr. Sonya Shadravan, Dr. Emily Defraites, Dr. David Lawrence, and Dr. Maria Aquilera Nunez for your commitment to improving healthcare for housing-unstable populations.

Thanh H. Neville, MD Awarded the J. Randall Curtis Humanism Award from the American Thoracic Society

In 2017, Dr. Neville launched the 3 Wishes Program at UCLA, introducing humanism and compassion to the intensive care unit. She emphasizes that, "although tasks like decorating a dying patient’s room, coordinating a date night, or creating a keepsake for a grieving family are not typically thought of as 'medical' care, I have witnessed how these acts of kindness have made lasting, powerful impacts on patients, families, and healthcare workers."

Dr. Neville’s commitment to humanism in medicine is also evident in her work as a clinician educator. She encourages trainees to pursue unique career paths aligned with their passions, challenging the norms of traditional academic medicine. Reflecting on her mentor, Dr. Curtis, Dr. Neville shares, "he told me not to give up, despite 3 failures, on trying to get an NIH R01 grant to expand the 3 Wishes Project to safety-net hospitals. I received the grant on my 4th submission, 6 months after his death. I always think that he would have been proud of me."

Receiving the J. Randall Curtis Humanism Award represents a special moment for Dr. Neville, as she shares,

"getting this award in his namesake means the world to me. I was a refugee from Vietnam and was raised by parents who barely had an elementary school education. I learned English in the first grade, grew up on food stamps, worked at my parents’ food business throughout childhood, and went to school on grants, scholarships, and loans. I am now an NIH-funded physician-scientist at UCLA!"

Dr. Neville's journey, marked by resilience, compassion, and mentorship, serves as an inspiring testament to the transformative power of humanism in healthcare.

Tisha Wang, MD Awarded the 2024 American Thoracic Society’s Outstanding Educator Award

While she is known for teaching UCLA residents and fellows ICU concepts (e.g. acid-base), she shares that,

“the most important teaching I can provide the trainees is the depth of the impact they have on patients and families in the ICU. Oftentimes, you are engaging in end-of-life discussions or implementing palliative care on an almost daily basis…but I always remind the trainees that this family will remember you and this day for the rest of their lives. We must lead with compassion, humanism, and patience.”

One poignant example underscores Dr. Wang’s emphasis on the human connection in medicine. A chance encounter in an elevator in CHS led to a heartwarming reunion with a patient from 2006, who vividly remembered her as the compassionate ICU fellow who eased her fears while experiencing a life-threatening condition 17 years ago! In this patient’s moment of fear and loneliness, Dr. Wang showed up at her bedside, held her hand, and alleviated her concerns by explaining at length what was going to happen in the ICU. This encounter motivated this patient to become a volunteer with UCLA so that she could be of service to others in similar situations. Dr. Wang adds, “medicine is one of the few careers where you can have that much impact in such a short period of time. Because of that, I never take for granted how amazingly powerful and meaningful our careers are.”

While reflecting on this achievement, Dr. Wang encapsulates her leadership philosophy in two quotes:

"A leader’s job is to take care of people, it is that simple and that complicated," and "Leadership is a transfer of belief. It starts by believing in others more than you believe in yourself."

These principles guided her through leading the pandemic response team and ICU teams and her leadership in training the future generation of physicians.

DoM Research LEADERS: Meet Andrea Hevener, PhD

Dr. Hevener's commitment to advancing women's health research is evident in her leadership within the NIH Office of Research on Women’s Health (ORWH). Recognizing the disparities in funding for studies focused on women’s health, she actively advocates for resources to support investigations in female rodents and women. She is currently a project PI of an NIH U54 Specialized Center of Research Excellence (SCORE), studying sex difference and women’s health. Additionally, her decade-long membership on the Iris Cantor-UCLA Women’s Health Center Research Executive Committee reflects her commitment to fostering success for early career investigators as well as supporting the work of senior research investigators. She has a passion for scientific discovery, team science, and mentoring the next generation was recently validated when she celebrated a career milestone, with the appointment of her first UCLA undergraduate trainee to the DoM faculty.

As Dr. Hevener looks towards the future, she is excited about the positive impact promised by the White House Initiative on Women’s Health. She looks forward to continuing to promote the well-being of women nationwide through mentorship of the next generation of physician-scientists and continuing to advance scientific knowledge.

Cantor-UCLA Women’s Health Center Executive Advisory Board- CTSI Pilot Project Awards:  Promoting Research in Women’s Health and Sex and Gender Based Medicine

In “Exploring the Biological Contributions to Human Health: Does Sex Matter?” the Institute of Medicine (now the National Academy of Medicine) found that scientific research has shown that sex (being male or female, according to reproductive hormones and chromosomes) and gender (one’s sense of self as a man or woman in society) profoundly impact health. For over 30 years, analyses have repeatedly shown that research on sex and gender differences is underfunded, and, that research on conditions that affect primarily females and women has been systematically given less priority in scientific investigation.

In 2023, Applied Mathematician Arthur Mirin, PhD was quoted in an editorial in the journal Nature entitled, “Women’s Health: Ending the Disparity in Funding”. His analyses, published in 2021, showed that of 15 diseases and conditions which were most underfunded in terms of the relationship of research funding to public health impact, 14 primarily affect women, including cervical and ovarian cancer, multiple sclerosis, inflammatory bowel disease, and rheumatoid arthritis.

In 2012, the UCLA Clinical Translational Institute (CTSI) joined this effort as a co-funder. This program, which invites annual submissions from DGSOM/CTSI faculty, has awarded $1.5 million to over 70 investigators from clinical and basic science departments. This group of investigators has reported over $50 million in funding that was secured with data generated by pilot work. Tomas Ganz, MD, PhD, professor of medicine, Andrea Hevener, PhD, professor of medicine, Carolyn Crandall, MD, MS, HS clinical professor of medicine, and Kimberly Narain, MD, MPH, PhD, associate professor of medicine, form the Scientific Committee with Dr. Greendale, and oversee selection of projects.

Recent DoM awardees include post-doctoral researcher Kelsey Jarrett, PhD, from the division of cardiology, whose work on sex differences in bile acid composition and atherosclerosis contributed to a $1.9 million NIH R01 grant to the lab of her mentors, Thomas Vallim, PhD and Elizabeth Tarling, PhD;  Richard Pietras, MD and Diana Marquez-Garban, PhD, from the division of hematology and oncology whose work combining estrogen receptor down regulators and immune checkpoint inhibitors in breast cancer immunotherapy provided the data for a $2.3 million grant from the California Institute for Regenerative Medicine, and Kortney James PhD, whose pilot work during her fellowship in the division of general internal medicine and health services research with Joann Elmore, MD, MPH, on racism-based stress and postpartum depression received $200,000 in follow up funding from the American Nurses Association.

Join me in honoring the tremendous contributions of women to our department. What I have summarized here is a small sample of the outstanding work, legacy and contributions of our women colleagues, trainees and staff to the future of  the DoM.

Dale

P.S.

We have had a lot of rain recently, causing disruption for many of us. I want to share my mother’s perspective on rain, which she shared with me when we were in Kingston last November. We were driving back to her home when the skies opened, with a tropical downpour. My  mother said two words: “Car Wash”. The rain stopped by the time that we got home, and she sprang into action, taking advantage of the “sky wash”. Total water conservation!

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