“We have a unique opportunity to partner our pediatric research programs with rapidly expanding basic and translational research programs in China,” said Brad Keller, M.D., vice chair for pediatric research and Kosair Charities chair for pediatric heart research. Keller traveled last fall with Lu Cai, MD, PhD, , who heads up the department’s research institute, to meet with researchers and administrative leadership at Wenzhou Medical University, Jiangxi Provincial Children’s Hospital and Jilin University to launch the formal collaborative relationships.

“These agreements substantially expand collaborative pediatric clinical and research programs, facilitate the exchange of research trainees, and create opportunities for new global health rotations and telehealth programs,” said Pediatrics chairman Gerard Rabalais, MD. Rabalais joined Cai and a delegation of UofL pediatric faculty on a recent trip to China to execute the completed agreements.

More than 20 Chinese trainees and scientists have worked in Cai’s basic science diabetes research lab over the past several years. These collaborations have significantly increased UofL department of pediatrics’ scientific research activity, publications and funded grant proposals. For example, in May 2014, the collaborative teams published articles in three high profile journals: The American Journal of Physiology – Endocrinology and Metabolism, the Diabetes Journal and the Journal of Molecular and Cellular Cardiology.

“Through the performance of the mutually interesting projects by students, the research capacity and diversity in my lab has been significantly strengthened,” said Cai, who directs Department of Defense and National Institutes of Health�� grants derived from these collaborative projects.��

KCHRI’s current research is focused in three major areas: diabetes, sleep and respiratory neurobiology, and tumor biology and cellular therapies. KCHRI researchers are actively pursuing research into the causes and complications of diabetes, focusing primarily on diabetes’ effect on the kidney and heart.

With these new agreements, researchers from the three institutions will begin collaborating with the rest of the UofL delegation — Janice Sullivan, MD, director of the Kosair Charities Pediatric Clinical Research Unit (KCPCRU), Kupper Wintergerst, MD, the Wendy L. Novak Endowed Chair of Pediatric Diabetes Care and Clinical Research, and Brad Keller, MD, Kosair Charities Pediatric Heart Research Program in the Cardiovascular Innovation Institute — as well as other department of pediatrics faculty.

The KCPCRU conducts inpatient and outpatient pediatric clinical pharmacology, device and quality improvement studies and works with about one-third of the UofL pediatric faculty conducting research.����

Utilizing the expertise of the KCPCRU, the KCHRI, and the Wendy L. Novak Diabetes Care Center clinical research team, Wintergerst conducts a variety of translational and clinical research trials, ranging from the study of new therapies for diabetes care and complications to diabetes prevention and cure.��

Over the next three years, up to five senior physicians from each Chinese institution will come as visiting faculty to UofL for up to six months. In addition, as many as 15 junior clinician-investigators or basic scientists from each institution will spend one to two years working with UofL researchers in their clinical research facilities or laboratories during the three year period.

Funding, including stipend, mentorship and laboratory expense for each visiting researcher, will be paid by the sponsoring institutions in China.

“Research is a critical part of the UofL department of pediatrics’ mission but finding dollars to support our research mission has become increasingly challenging. We must find new partners and pursue nontraditional approaches to funding in order to maintain and expand our research enterprise,” Rabalais said. “Dr. Cai’s resourcefulness has enabled him to pursue his own research and has greatly benefited our department and our university.”

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Medals4Mettle is an Indianapolis-based international charity that connects athletes from all walks of life with critically ill patients. The Louisville chapter, which is based at the UofL School of Medicine, has a unique approach to the program. The med students don’t just give their Kentucky Derby Festival Marathon medals to strangers; they meet their running buddies and learn more about the up-close-and-personal side of critical illness.

��This year, 75 med students were paired with children being treated by UofL pediatric specialists. The patients range in age from 18 months to young adult and have been diagnosed with conditions such as brain cancer, bone cancer, hemophilia, leukemia and sickle cell disease.

��“The M4M program adds a different type of learning to the medical school experience,” said Meagan Holtgrave, a third-year medical student and UofL Medals4Mettle president. “We get to witness firsthand how the diseases we read about affect families in the real world. Building long-lasting relationships with these brave and spirited kids is a life-changing experience and we will be better people and physicians because of it.”

“UofL has lead the way with Medals4Mettle medical school chapters around the country and some of their graduates have gone on to become Medals4Mettle leaders as they advance into their careers,” said Steve Isenberg, M.D., founder of the charity said.

Four-year-old DustiRae Dean collected her second Kentucky Derby Festival Marathon medal at Saturday’s medal ceremony on the UofL Health Sciences Center campus. It was her third marathon medal from second-year medical student Lee Richardson. He also gave her the medal earned at the Walt Disney World Marathon this past January. She likes to wear her medals while racing through the house yelling, “I’m a champion!”

DustiRae was diagnosed with leukemia in 2011. She was treated with chemotherapy for two and one-half years and will soon be six months post treatment.

Richardson and the Dean family stay in touch in and out of race season, following each other on Facebook and exchanging messages and texts about DustiRae’s latest exploits. It’s a friendship that helps them both.

“Spending an afternoon with the Deans in a nonprofessional setting helps me realize the impact I can have as a physician,” Richardson said.

“Medals4Mettle is a life-enhancing journey for the child and the medical student,” said her mother Vonny Dean, who spoke at the ceremony.

Dean is confident Richardson will excel in whatever medical specialty he chooses and is glad to be able to help with his medical training. “He will be the kind of doctor I would take my daughter to see,” she said.

The award was presented at this year’s Celebration of Teaching and Learning Feb. 7.

This teaching award was established in 2005 in memory of Paul Weber, a distinguished UofL teacher, scholar and mentor, and recognizes departments that demonstrate excellence in teaching.

“We are honored to be the first university department to receive this important teaching award,” said Gerard Rabalais, MD, MHA, chairman, Department of Pediatrics. “As pediatricians, we are trained to observe subtle growth and change in our patients.�� As educators, we remain attuned to this same process in our community of learners.”

Experiential learning underpins all of the Department of Pediatrics’ medical education programming.

“Our faculty teach new medical students as well as senior residents, all the while maintaining our own lifelong learning profiles as we strive to keep pace with evolving technology, generational changes in learners and evolution of the country’s health care system,” said Kimberly Boland, MD, vice chair for pediatric medical education. “Our philosophy is to engage our learners by investing them in the educational process and integrating real-life applications of knowledge.”

Pediatrics has incorporated numerous innovative programs into its curriculum.

Each year, 20-26 rising second-year med students take a break from the classroom to participate in the Pediatric Summer Externship program. This four-week clinical experience provides a preview of pediatric medicine in private and academic offices and hospital settings.

A new procedure rotation gives pediatric residents the opportunity to hone their skills on 26 pediatric procedures, ranging from stitching up a wound to performing a spinal tap. This new rotation corrects a training shortcoming posed by duty hour limitations and the use of specialized hospital teams.

Trainees get to walk in the shoes of their patients through the Poverty and Social Justice in Child Health rotation. They must learn to negotiate a clinic trip on public transportation and to shop healthfully using food stamps. Time spent working with refugees and in community health centers broadens their understanding of the unique challenges of impoverished children and families.

Residents practice communications skills with patient actors. They also learn to advocate for children at the community and state level through the resident advocacy organization PUSH (Pediatricians Urging Safety and Health).

Faculty development is a priority. The department has developed a curriculum of more than 50 topics focused on improving teaching skills, mentoring, career development and research.

“We strive daily to prepare the complete pediatrician of tomorrow and enrich the practicing pediatrician of today by engaging them as learners, listening to their needs and integrating new knowledge with real-time experiences,” Boland said.

The department will receive a monetary award of $30,000 to support efforts to enhance critical thinking through faculty-generated projects.

“We plan to use the $30,000 award to integrate innovative technology into our core curriculum,” Boland said.

Pediatrics has received the Weber Award several times in previous years. In 2011, the award went to pediatric critical care specialists Aaron Calhoun, MD, and Katherine Potter, MD, and their pediatric simulation program. Amy Holthouser, MD, who has joint appointments in the Departments of Medicine and Pediatrics, received the Weber Award in 2008.

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Bingham marked the anniversary with a continuing medical education session for healthcare providers, a birthday dinner and a community forum about children’s mental health care.

“These were special moments for our faculty and staff to be able to spend time with our former trainees and referring physicians�� as well as our long-time supporters—people like Congressman John Yarmuth, who served on Bingham’s board of directors, and Edie Bingham, whose family has been a friend to the clinic since the 1930s. As we plan our next 100 years, it’s important to remember how we got here,” said Allan Josephson, MD, chief of the Division of Child & Adolescent Psychiatry and Psychology in the Department of Pediatrics.

Fourth child guidance center in the nation

The Commonwealth Fund of New York established a start-up fund for child guidance centers at the beginning of the 20th century. After New York City, Boston and Chicago, they turned to Louisville, where the school system’s Psychological Laboratory was already assessing intellectually disadvantaged and gifted children for grade placement and curriculum development. With support from the Commonwealth Fund, the Louisville center began working with truant and delinquent children and continued to evolve as the need for children’s mental health services changed.

“Once, there were only two recognized diagnoses: Hyperkinetic Reaction of Childhood, which we now know as ADHD, and Runaway Reaction of Childhood. Today, we have identified more than 30 mental health diagnoses of childhood,” Josephson explained. ��“Our knowledge about children’s mental health issues has grown dramatically over the past 100 years and the clinic has responded accordingly.”

After the school district withdrew from managing the center in the 1930s, it affiliated with the University of Louisville School of Medicine. Spafford Ackerly, MD, one of the first child psychiatrists in the country, was tapped to redevelop the clinic and lead the UofL Department of Psychiatry. For the next 25 years, Ackerly ran the UofL Department of Psychiatry from the Louisville Mental Hygiene Clinic.

Ackerly also partnered with Barry Bingham, Sr., editor and publisher of The Courier-Journal and the Louisville Times. They worked together to raise awareness of the plight of Louisville’s mentally ill and to improve their care. Bingham’s ongoing mental health advocacy, which began in the 1930s, was recognized in 1974 when the Louisville Mental Hygiene Clinic’s new office was named the Bingham Child Guidance Clinic.

The modern era

Today the Bingham Clinic has a dual focus. It’s faculty serve the local community, treating the most challenging problems and families in need. They also are educators and have trained many of the community’s mental health leaders.

Bingham Clinic’s current roster of eleven psychiatrists and psychologists have a wide range of pediatric mental and behavioral health expertise, including family treatment, chronic pain management, sports psychiatry, children who start fires, minority youth, obesity, autism and inpatient psychiatry.

“Like Dr. Ackerly, who was known as the father of psychiatry in the state of Kentucky, our faculty are national leaders in the fields of child and adolescent psychiatry and psychology,” Josephson said. “For example, in the last two years our faculty have lectured at four of the eight Ivy League universities. They also serve on numerous national committees.”

The Clinic oversees several training programs. It offers a two-year child and adolescent psychiatry residency training program, a one-year child and adolescent psychology internship and a one-year post-doctoral child and adolescent psychology�� fellowship.

“We are educators, as well as clinicians and researchers,” Josephson said.

The more things change, the more they stay the same

Even as the field of psychiatry and the Bingham Clinic has evolved, the need for children’s psychiatric services has expanded over the past 100 years.

A recent CDC study found that 20 percent of children have mental disorders. Yet, children face modern versions of many of the same barriers to care that kept children from getting needed treatment 100 years ago: a shortage of pediatric psychiatry/psychology specialists, long waiting periods and inadequate insurance coverage top the list.

The Bingham Clinic continues to seek creative solutions to these problems. The clinic has adopted a family focus rather than working solely with the children and adolescents in treatment. The psychologists and psychiatrists recently joined the UofL Department of Pediatrics, which has increased their ability to work with children as they come to their pediatrician’s office. Several Bingham psychiatrists are now engaging in telepsychiatry, counseling children across the state via the internet.

“There is nothing quite so distressing as a child in emotional pain and nothing so heartening as seeing joy return to a child. We at the Bingham Clinic are constantly looking for new ways to help families move their kids from the former condition to the latter. We think that attitude will sustain us through another 100 years of caring for children,” Josephson said.

“In 2011 we opened the UofL Autism Center here on the Kosair Charities campus. Now their clients will have easy access to pediatricians and pediatric dentists practicing in offices designed for children with sensory problems and physical challenges,” said UofL President James Ramsey. “We are so grateful to Kosair Charities for helping us create a medical/dental home that is welcoming to all children—from the toddler whose autism makes dental care a challenge, to the teen who needs a sports physical to play volleyball at a neighborhood school.”

Kosair Charities has donated the $1.2 million rent amount over a five-year period, providing a combined 12,500 square feet of renovated space in the Kosair Charities headquarters building for the two clinics: and University of Louisville School of Dentistry at Kosair Charities. The university may opt to renew the lease for two additional five-year terms, bringing the estimated value of this agreement to $3.7 million over 15 years.

“This year Kosair Charities celebrates 90 years of caring for children. Since 1923, the University of Louisville has been a primary partner in meeting the health and wellness needs of Kosair Kids®. This new collaborative project builds on 90 years of working together and positions UofL and Kosair Charities for decades of service to future generations of Kosair Kids®,” said Jerry Ward, chairman of the board for Kosair Charities.

The patient mix for both practices will include children receiving services elsewhere on the Kosair Charities campus, children from surrounding neighborhoods, children whose families participate in the Family Scholar House program and children who are uninsured or under-insured.

The UofL Department of Pediatrics at Kosair Charities office has nine exam rooms, a laboratory and separate sick- and well-child reception areas. Pediatrician Erica Labar began seeing patients in the Eastern Parkway office on July 1. A second physician will join Labar in 2014. Medical students and pediatric residents will also rotate through the clinic.

“What could be more fitting than to provide a medical/dental home on the grounds of the former Kosair Crippled Children Hospital, where thousands of children were once treated for disabling diseases such as polio and smallpox,” said Gerard Rabalais, chairman, UofL Department of Pediatrics. “I’m confident that Dr. Labar and her team will continue the tradition of compassion and excellence long associated with this historic location.”

The UofL School of Dentistry at Kosair Charities pediatric office will open in the fall, under the leadership of Ann Greenwell, pediatric dentist. The clinical space will be outfitted with six dental chairs and equipped to meet the special needs of autistic and physically challenged children.

“We know good oral health is integral to overall health and wellness. Coordination of care is the future of health care in this country, and we are removing many of the logistical barriers for the children of the community,” said John Sauk, dean of the UofL School of Dentistry.

The dental clinic will provide comprehensive dental care–including routine exams, fillings, treatment for trauma, mouth guards for athletes and orthodontic care.

The Sam Swope Kosair Charities Centre is at 982 Eastern Parkway in Louisville.

Medals4Mettle is an Indianapolis-based program that connects athletes and critically ill patients. The Louisville chapter is based at the UofL School of Medicine. Runners participate in Medals4Mettle to extend their knowledge about critical illnesses beyond the classroom. This year, 52 med students were paired with children with cancer and serious blood disorders. As part of their training for the race, many students exchanged emails and phone calls with their patient partners and kept vigil through doctor visits.

“Medals4Mettle is so rewarding. Medical students tend to live inside textbooks and in the classroom. Medals4Mettle gives us a chance to put faces to life-threatening illnesses and an opportunity to dedicate our time to the courage and mettle of these amazing families,” said Meagan Holtgrave, a second-year medical student and UofL Medals4Mettle president.

The students’ running buddies also received Medals4Mettle ribbons from Steve Isenberg MD, founder of the charity, who attended this year’s ribbon ceremony.

“I am so proud of the medical students involved with Medals4Mettle at the University of Louisville. For several years they have donated their time and hard-earned medals to those who are in a much more difficult race. A physician myself, I am particularly impressed by the dedication of these outstanding medical students. As Hippocrates said, ‘Where there is love for humanity, there also is a love for the art of medicine’,” Isenberg said.

The children who received the Derby Marathon medals range in age from 1 to 16 years and are being treated by UofL pediatric hematologist/oncologists for conditions such as brain cancer, bone cancer, hemophilia, leukemia and sickle cell disease.

Seven-year-old Dawson Barr collected his fifth Medals4Mettle Derby medal this year. He and his mother, Aimee Barr, addressed the crowd assembled in the Belknap Student Activities Center for the ceremony.

“I do this for Dawson, to lighten his day,” Aimee Barr explained. “He thinks it’s neat to get to participate. If med students can run 13 or 26 miles and end up with nothing to show for it, then I can take time out of my day to go thank them.”

Dawson was diagnosed with brain cancer at 6 months old. The first mass was found April 26, 2006. Since then, he has had multiple brain and spinal tumors. He was been treated for five years on several protocols of chemotherapy. He’s been out of treatment since February, 2012. One tumor remains on his brain.

“Dawson and his family have a lot to teach us all about mettle,” said UofL pediatric oncologist Salvatore Bertolone, MD, who has treated Dawson since he was first diagnosed. “He and his family have put their lives on hold. This is not one little boy with cancer but a family affair. They live with the unknown and deal with ongoing changes in schedules and unexpected trips to our clinic or the hospital. Try getting through a week never knowing what you will need to do tomorrow until tomorrow comes. Dawson and his family are always smiling and gracious, intently focused on what is important.”

This center was established March 6 with a $5 million gift from the Lift a Life Foundation to create a comprehensive center that will offer care, education and clinical research focused on improving the lives of children with Type 1 diabetes, previously known as juvenile diabetes.

The Lift a Life Foundation gift provides support to hire a physician, educator and nurse practitioner specialists; enhance medical, technological and educational resources and programs available to families; and improve inpatient and outpatient care facilities.

“This is a great opportunity to do something that can give children with Type 1 diabetes in our region a chance at a healthier future,” said David Novak, founder of the Lift a Life Foundation and chairman and chief executive officer of Yum! Brands, headquartered in Louisville. “Our family has been affected by Type 1 diabetes, and we felt this was an opportunity to build one of the best diabetes care centers in the country.”

“This generous gift provides the University of Louisville Department of Pediatrics and Kosair Children’s Hospital an incredible opportunity to work in unison to provide vital services to children with diabetes throughout the community and the state,” said Gerard Rabalais, MHA, chairman, UofL Department of Pediatrics. “Dr. Wintergerst is a superb physician and dedicated clinical researcher. I’m so proud to see him take the lead on this important initiative.”

“For kids with diabetes, it’s not just about living; it’s about living full, healthy, happy lives and reducing the negative impact that diabetes has on each child’s daily life,” Wintergerst said. “The Wendy L. Novak Diabetes Care Center will provide a personalized, integrative approach that will link the services we provide at Kosair Children’s Hospital to our Diabetes Center sites throughout the state. This amazing gift from the Lift a Life Foundation has truly given me and our families with type 1 diabetes new hope for the future.”

UofL specialists and Kosair Children’s Hospital are treating more than 1,200 children for Type 1 diabetes. Approximately 150 children are diagnosed each year; nearly half of these children require hospitalization.

“Type 1 diabetes has been on the rise for the past 50 years and is growing annually, especially in younger age groups. We’ve seen a 20 percent increase in hospital admissions due to Type 1 diabetes since 2008,” Wintergerst said. “The incidence of Type 1 diabetes is showing no sign of slowing here or across the world.”

Type 1 diabetes usually is diagnosed in children and young adults. It occurs when cells in the pancreas that have been damaged by the immune system produce little or no insulin. Insulin is necessary for moving blood sugar into cells for storage and use as energy. When the body does not make enough insulin, the blood sugar builds up and cannot turn into energy. While no one knows the exact cause, this autoimmune disorder can be fatal if not properly treated.

People with Type 1 diabetes must test their blood sugar five or more times per day. Treatment includes taking multiple insulin injections or using an insulin pump every day, along with maintaining proper diet and exercise. There is no cure, although advances have been made.

“The lifespan of children with Type 1 diabetes is no longer just a few weeks or a few years,” Wintergerst said. “The important thing we need to work on now is better blood sugar control to reduce the severe complications of diabetes, such as blindness, kidney damage, and cardiovascular and nerve disease.”

Established in 1999 through a charitable trust by David and Wendy Novak, the Lift a Life Foundation provides innovative grants to nonprofit partners serving Kentucky.

“The Lift a Life Foundation exists to provide individuals in need the opportunity to reach their full potential,” said Ashley Novak Butler, director, Lift a Life Foundation. “Helping children manage their diabetes and avoid the devastating complications of the disease will help them meet, and hopefully exceed, their expectations for a full and healthy life. We can’t think of a better result from an investment.”

The use of home remedies like chamomile and star anise teas is common in many Hispanic cultures but it can cause life-threatening complications for a young infant. A pediatrician who isn’t savvy to Hispanic traditions would never think to ask whether a parent were dosing a crying baby with tea and the parent might not mention such a routine practice.

This single example illustrates the need for culturally sensitive health care for Louisville’s Hispanic community—now 3 percent of Kentucky’s population—according to University of Louisville Children & Youth Project pediatrician Fernanda Nota, MD. Nota has made that goal her personal mission and has worked to achieve it since beginning her pediatric residency at UofL in 2003.

“I was moved by the needs of my Hispanic patients who don’t know our medicines or understand our pharmacy and health care systems and often don’t have insurance. It seemed language barriers and lack of cultural awareness kept them from getting optimal care,” said Nota, a native of Argentina.

Nota recently received a competitive one-year fellowship that she hopes will prepare her to advance her goal. The National Hispanic Medical Association Leadership Fellowship provides seasoned Hispanic physicians the skills necessary to take a leadership role at local, state and national levels in health policy development and advocacy related to the health of the Hispanic community.

“I want to receive the education and knowledge I need to lead and implement programs that will benefit our Hispanics in Louisville as well as network with other Hispanic physicians in the country so I can learn how to get federal or state support needed to organize and create a culturally sensitive medical home for this underserved population,” she said.

Nota believes any federal or state dollars would pay off universally, improving patient care, reducing long-term complications and minimizing patients’ need to access more expensive emergency and specialty services that could be avoided with preventive care.

She already has thought through many of the details and envisions a medical practice specifically for Hispanic families that offers primary care for adults and children and possibly obstetrical and gynecology services, as well. Nota knows from experience that Hispanic families expect to spend more time with their doctors so she would like to handle scheduling differently than it is in traditional primary care offices. She also wants interpretive services available, as well as bilingual health care providers, nurses and front desk personnel.

“If patients feel the doctor understands and respects their perspective, beliefs and culture, they will be more likely to follow their medical advice,” she noted.

A study done in collaboration with UofL’s J.B. Speed School of Engineering has shown that the optimal location for the clinic is near the Gene Snyder Freeway, which provides easy access to Churchill Downs and Shelbyville, Ky., where many Hispanic families have settled.

Nota also sees this as an opportunity to expose students and doctors-in-training to Hispanic culture, which will someday�� make them better able to serve their own patients with Latin heritage.

“Many of our medical students are aware of this increasing need. Frequently I get emails from students asking for opportunities to practice and improve their Spanish language skills in a direct patient encounter setting” she said.

UofL Department of Pediatrics Chairman Gerard Rabalais, MD, MHA, thinks Nota’s concept is a wise one.

“Dr. Nota’s plan puts patients’ needs first, which must be our first concern. In this instance, serving the patients’ needs also serves the community at large by helping to reduce health care costs,” he said. “We’re lucky to have Dr. Nota to lead us on this journey, especially since our Hispanic population continues to grow.”

Nota’s experience as a pediatric resident, Children & Youth Project physician, and member of Louisville’s Hispanic community, has informed her vision. She has taken charge of overseeing the care of C&Y’s Hispanic patients, who make up 13 percent of the total patient population. When she was a pediatric resident, the total was just 5 percent.

She consulted a University of Arkansas pediatrician who created a successful Latino pediatric clinic and a medical home for Hispanic children with special needs in Little Rock. She visited free-clinics in Utah and Indiana. In 2011, she helped open a Family Community Clinic in Louisville’s Butchertown neighborhood that’s modeled on those clinics. Located in the basement of St. Joseph Catholic Church, the free-clinic provides intermediate health care services to adults and children without insurance. In its first year, the Saturday morning clinic served 360 patients, of whom 58 percent were Hispanic.

“I like to think of the Family Community Clinic as a pilot for my larger vision,” Nota said. “I look forward to learning the leadership skills necessary to pursue this dream.”

As a part of the one-year fellowship, Nota will spend a week at New York University studying federal and state policy development strategy. She will attend the Congressional Hispanic Caucus Institute in Washington, D.C., and meet with leaders of the executive branch, the White House and national organizations with interest in health policy.

Shelley has been competing with cancer—Hodgkin’s lymphoma—since her diagnosis in 2007 at age 15. While she has had setbacks over the last five years, Shelley hasn’t let the disease get the best of her. Despite 15 rounds of chemotherapy, a course of radiation therapy and a bone marrow transplant, Shelley was chosen a Governor’s Scholar in her junior year and a Mayor’s Outstanding Senior in 2010. She graduated high school with a 4.0 grade point average and is maintaining her perfect GPA at UofL as she works her way toward her goal of becoming a physical therapist.

For the past four years, UofL medical students have paid tribute to the grit and determination of Shelley and other UofL Pediatrics cancer and blood disorders patients by running the Kentucky Derby Marathon in their honor as part of the Medals4Mettle program based in Indianapolis.

Pediatric oncologist Alexa Cheerva, MD, considers it a positive experience for patients and students alike.

“This program celebrates mettle, or courage, a character trait that sustains a marathon runner, a medical student and all of our patients and their families,” she said.

The doctors-in-training give their medals to their patient partners and spend time with them online and in person. The students believe the experience helps them reach beyond the classroom to learn about critical illness. Many of the runners find that it also helps them be more accepting of the rigors of medical school.

“It’s an opportunity for the students to see what it’s like from the perspective of the patient and it’s good for the patients to know there are people thinking about them,” Shelley said.

A three-year program participant, each of Shelley’s Derby Marathon medals marks a leg of her journey. The petite brunette received her first medal in the hospital. Chemotherapy made her too weak and vulnerable to other peoples’ germs to attend the 2010 awards ceremony so her medical student runner brought the prize to her later.

She received her second Derby Marathon medal last year. She was able to attend the award ceremony but, because her cancer had relapsed, she had a bone marrow transplant a few weeks later.

This year’s Kentucky Derby Marathon marks the close of her recovery from the transplant. Her cancer is in remission. She is slowly regaining energy and is back to her UofL classes full time. Shelley joined nearly 100 other patients at the Medals4Mettle award ceremony Sunday, April 29, on Belknap Campus, receiving her 2012 medal from first-year medical student Megan Bedolla.

“Erica is really a driven person,” Bedolla said. “There’s obviously a lot more to her than a diagnosis or statistics. She has aspirations and goals and is really driven to accomplish them.”

The UofL Medals4Mettle program began four years ago with 13 medical students. It was the brain child of first-year medical student Riley Jones, who is about to graduate and begin a surgery residency. He’s grown the program to nearly 100 student runners and now is turning the reigns over to Meagan Holtgrave, a rising second-year medical student who expects Medals4Mettle to be a formative experience for another generation of doctors-in-training.

“A good percentage of this year’s runners are finishing their first-year of medical school like me. Many had never done a marathon before. We were moved by the idea of running in the name of a child and a patient and wanted to give it a try,” she said.

“If you don’t have firsthand knowledge of childhood cancer, it doesn’t have a name, it doesn’t cry, it doesn’t have a family. Medals4Mettle takes diseases like cancer out of the textbook and makes them real for these students. That’s why this program has grown so dramatically,” said Salvatore Bertolone, MD, chief of the UofL Division of Pediatric Hematology/Oncology and Blood and Marrow Transplant.

For them, it is about more than running a race or doing a good deed. It’s about showing the youngest cancer patients that there’s a team of doctors and medical students in the fight with them.

The students — plus one seminary student — are participating in Medals4Mettle, a program that connects athletes and critically ill patients.

“I feel the need to be a personal advocate for patients. Medical students and doctors really do care about patients but often we’re too busy to say, ‘I’m rooting for you and I’m running this race with you,’” said Marc Ettensohn, a medical student and cancer survivor. “This is an opportunity to practice a different type of medicine. I can be a healer instead of letting the drugs do all the work.”

UofL’s participation in Medals4Mettle started three years ago when Riley Jones, a first-year medical student and developing tri-athlete, conceived of a way to marry these two passions in his life. He recruited 13 classmates to run in the Kentucky Derby Festival Marathon on behalf of pediatric cancer patients and the UofL Medals4Mettle team was born.

Since then, Jones has matured as a student and an athlete and Medals4Mettle has grown along with him. Now in his third year of med school, Jones is close to settling on a career in general surgery and has two Iron Man competitions under his belt.

The Louisville team is not only bigger than it originally was, its approach goes well beyond the original Medals4Mettle’s concept of distributing donated medals through the mail.

The students met their running buddies at a ceremony on Tuesday, April 12.

By the time the race comes around this weekend, many of the UofL students will have exchanged e-mails and phone calls with their patient partners and kept vigil during doctor visits and grueling chemotherapy treatments. On race day, the runners will wear friendship bracelets made by their young friends. The next day, they will give their hard-earned marathon medals to their patients in a special ceremony.

The experience is good for patients and students alike.

Five-year-old Samuel Adams, who has acute lymphocytic leukemia, participated in Medals4Mettle last year with Sarah Todd, now a fourth year medical student. She’s running for him again this year.

“It’s a really wonderful program,” said Samuel’s mother, Chrystal Brigman, explaining that it helps both the patient and student connect on a closer level than is typical of doctor-patient relationships.

“Sarah came to many of his appointments. She’s special and really stuck with it. I have her in my phone and talk to her a lot. He sees her more as a friend. She came to his birthday party!”

All the running buddies are cancer or blood disorders patients of Pediatric Hematology/Oncology Specialists, a practice operated by UofL Pediatrics faculty members. This year, they range in age from 2 to 20 years and are being treated for such conditions as brain cancer, acute lymphocytic leukemia and sickle cell disease.

Jones’ 14-year-old partner Andrew Holland, who has cancer of the spine, is very enthusiastic about Medals4Mettle.

“I think it’s great!” he said.

His mother added that she appreciates the support from students and other Medals4Mettle families that the program affords.

“You wouldn’t believe how comforting it is to talk to people who know what you’re going through,” Regina Hensley said.

Salvatore Bertolone, MD, chief of the UofL Division of Pediatric Hematology/Oncology and Blood and Marrow Transplant, considers Medals4Mettle an excellent opportunity for patients and students alike.

“This program celebrates mettle, which is a fancy word for courage or determination. It’s the kind of character trait that gets a marathon runner through the long race. It’s the pluck that gets a medical school student through years and years of training. And it’s the spirit that we see in all of our patients and their families,” he said.