From the Offices of Jeffrey A. Flaks and Jeffry Nestler, MD

Dec. 23, 2012 Edition

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HH Facts:

1987 - First replacement of the pulmonary valve and pulmonary artery with a pulmonary homograft performed at Hartford Hospital by Dr. Lee Ellison.


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In This Issue...
Top News



Happy Holidays From President Jeffrey A. Flaks

The holiday season is a magical time of year – a time when people seem to treat one another with more kindness. At Hartford Hospital, that kindness and caring occur around the clock, every day of the year, as we extend our hands to everyone who walks through our doors, including one another.

I want to thank every member of the Hartford Hospital team for making our hospital such a special place – especially those of you sacrificing your time with family and friends to care for our patients during the holidays. You all make this organization special in innumerable ways – in your work through H3W that has improved countless processes and greatly enhanced the patient experience and in the way you live our values, which are the core of our culture of excellence.

Hartford Hospital truly stands apart from other institutions, and our reputation continues to grow, not only in our state, but also throughout the country, thanks to our commitment to providing state-of-the art care in the most compassionate way.

In light of that compassion and dedication to the people who need us, I ask you to consider participating in our work with Donate Life New England to register at least 1,000 new organ donors by the end of January. We need your help and caring and the help of all of our families and friends to accomplish this goal for the good of our community members and people throughout our region.

Anyone can join the Donate Life New England Donor Registry and become part of a data base of organ donors by signing up at If you decide to register, please select “Hartford Hospital” from the “How did you hear about” drop-down menu to acknowledge our hospital’s commitment to this program.

More than 110,000 men, women and children currently are on the national organ waiting list; about 3,400 of these patients live in New England. We can make an impact on these statistics by registering more donors who may give more patients the opportunity to live their lives and realize their dreams.

Once again, thank you for everything you do every day, all year. I look forward to working with you in the New Year, and I wish you and your family joyful holidays and a safe and healthy 2013.

With warmest holiday wishes,

Jeffrey A. Flaks
President & CEO


Cancer Physician Directory Being Distributed

Hartford HealthCare recently launched its first Hartford HealthCare Cancer Network Directory, which highlights disease-specific teams from across the system. Nearly 4,000 copies of this powerful referral tool are in the process of being distributed to the region.


Drs. Escalon and Lowe Perform First Thoroscopic VATS Segmentectomy

Drs. Robert Lowe, peripheral vascular and thoracic surgeon, and Juan Escalon, our newest minimally invasive thoracic surgeon, performed the first totally thoroscopic VATS anatomic lingular segmentectomy of the left upper lobe at Hartford Hospital Dec. 12. This is an operation the doctors believe has not been previously performed at HH, even as an open procedure.

The patient had a solitary metastasis from remote breast cancer. The metastasis was removed with maximal preservation of functional lung. The surgery went very smoothly with minimal blood loss.



Drs. Sadiq, Azemi and Underhill Perform First Percutaneous EVAR

A young man with a large Abdominal Aortic Aneurysm underwent percutaneous EVAR (endovascular triple A repair) on Dec. 6, the first done at Hartford Hospital. Drs. Immad Sadiq, invasive cardiology, Talhat Azemi, invasive cardiology, and David Underhill, cardiothoracic surgery, were co-operators.

The procedure was performed with total percutaneous technique using only Fentanyl and local anesthesia.

The cath lab staff did a fantastic job of doing yet another complicated procedure on a very sick patient. The patient has an EF of < 10% and is being considered for LVAD/transplant.



Our Goal: Register 1,000 New Organ Donors

Hartford Hospital has launched a campaign to register 1,000 new organ donors, in cooperation with the Donate Life New England Donor Registry .

You can join the Donate Life New England Donor Registry by going to On the registration page, please be sure to select “Hartford Hospital” from the “How did you hear about…” drop-down menu.

This year's Black & Red gala, scheduled for Jan. 5, 2013, will benefit the Transplant Program.


Finances Strong For November

Inpatient discharges for November were 3.9% above the budget and greater than the prior year by 4.1%.

Outpatient revenues exceeded budget by 5%. Radiation/Oncology and Cardiology were the areas with significant favorable variances for the month.

Through the first two months of the fiscal year inpatient discharges are 1.4% greater than budget and 2.0% greater than last year. Outpatient revenues are approximately 4.9% greater than budget through year to date November 2012.



Make Your Gift to the Annual Campaign Before December 31st

As you prepare to ring in the New Year, please consider making your gift to Hartford Hospital’s 2013 Annual Campaign. Your financial support, as well as your medical expertise is important to our patients and can make a significant difference in their lives.

To best serve our patients, we need new technology, advanced training for physicians, and enhanced programs and facilities. We recognize these needs and are committed to providing the best resources for physicians and staff.

You may make a tax-deductible donation to the Medical Staff campaign online at, or by mailing a check to Hartford Hospital Attn: Fund Development, 80 Seymour Street, Hartford CT 06102. To qualify for a 2012 tax deduction, envelopes must be postmarked by 12/31/12.


Dr. Jay McIsaac Awarded Certificate in Terrorism Studies in Scotland

Dr. Joseph (Jay) McIsaac, chief of trauma anesthesia and urologic anesthesia, has been awarded a Graduate Certificate in Terrorism Studies from The Centre for the Study of Terrorism and Political Violence at the University of St. Andrews in Scotland, UK.

The course is recognized as the world leader in terrorism studies. It covers theory and practice, as well as counter-terrorism strategies and techniques.

Dr. McIsaac currently serves as the chair of the Disaster and Preparedness Task Force for the American Society of Anesthesiologists Committee on Trauma and Emergency Preparedness, and is also a member of the CBRN Committee of the World Association for Disaster and Emergency Medicine. He is a member of the National Disaster Medical System and was deployed during the Democratic National Convention in September.


Drs. D'Avella and Laut Present at American Society of Nephrology Annual Meeting in San Diego

Drs. John D'Avella and Jeffrey Laut, nephrologists, both had poster presentations at the annual meeting of the American Society of Nephrology last month in San Diego.

Dr D'Avella made two presentations: "The Incidence Of False Positive Rapid  PEF 4  Antibody Screen For Heparin Induced Thrombocytopenia In Hemodialysis Patient's /  And  A Unconventional Cause Of Thrombocytopenia In Hemodialysis Patients;" and " The Incidence Of Missed / Shortened Hemodialysis Treatments And There  Effect On Mortality / Hospitalization Rates And Economics In A Urban Hemodialysis Unit.  The Positive Effect Of A QAPI Derived Protocol On These Outcomes."

Dr. Laut made a presentation on "Peritoneal Dialysis In The Elderly : A Comparison Of Outcomes With Younger Patients."

Innovative and Complex Care

Dr. Jinnah Phillips Conducts International Webinar on Automated Breast Ultrasound

Dr. Jinnah Phillips, director of Women's Imaging and Mammography, conducted an international webinar on automated breast ultrasound in conjunction with Professor Marc Inciardi of Kansas University.

The live event had a global audience with close to 1,200 registrants from North America, Europe and Australia. Dr. Phillips oversees ongoing research programs on screening breast ultrasound and she is actively lecturing and publishing in this field.

Research and Academics

Dr. Orlando Kirton Serves as Examiner for Surgery Residency Exams at UWest Indies Medical School

Dr. Orlando Kirton, the Ludwig J. Pyrtek chairman of Surgery, participated as an external examiner for the DM (postgraduate) general surgery residency exit examinations and the MBBS (undergraduate medical school) exit examinations for the University of the West Indies Medical School and Surgical Residency training programs.

Dr. Kirton participated and certified both the general surgery DM and MBBS examinations in Jamaica on December 3 and the MBBS examinations in the Republic of Trinidad and Tobago on December 5.

He also provided a lecture presentation to a combined Caribbean surgical faculty on the status of the burgeoning specialty of acute care surgery in the United States.


Dr. Robert Siegel on Planning Committee for National Clinical Oncology Quality Symposium

Dr. Robert Siegel, medical director of Cancer Clinical Research and chair of the Institutional Review Board, was on the Planning Committee for the inaugural American Society of Clinical Oncology Quality of Care Symposium held in San Diego on November 30 and December 1.

He moderated a general session entitled "Re-engineering Your Practice to Deliver Quality and Value" and presented a poster entitled "Utilizing QOPI in the Quality Improvement Efforts of the NCI Community Cancer Centers Program (NCCCP).


Dr. Gualberto Ruaño Invited To Present at the Yale Interdisciplinary Center for Bioethics in January

Dr. Gualberto Ruaño, director of Genetics Research, will deliver an invited lecture entitled "Personalizing Public Health: The Ethical Practice of Personalized Medicine" at the Yale Interdisciplinary Center for Bioethics on Jan. 23, 2013 from 4:15-6:15 p.m.

The event, which is open to all, will take place at the Institute for Social and Policy Studies, 77 Trumbull St. (corner of Prospect Street - entrance on Prospect) in New Haven, in basement- tiered classroom A002. The Yale parking lots will be open for the use of guests at 4 p.m.

For more information, please contact Yale’s Technology and Ethics chairperson Wendell Wallach at

Care Coordination

Call For Abstracts on Improving Patient Experience

How did you or your area improve the patient experience? You are invited to submit an abstract about it for a tabletop poster display on "The Patient Experience - Connecting With Purpose" for the First Annual HHC Patient Experience Event on April 12, 2013. The event, to be held at Heublein Hall, is designed to showcase best practices and innovation across HHC.

Staff can submit an abstract in one of three categories: Improved Transitions of Care, Innovation, or Enhanced Patient and Family Centered Care. A winner and runner-up will be chosen in each category. The winner will be asked to present a brief presentation.

The deadline for submission is January 11, 2013. We encourage you to take advantage of this exciting opportunity and share with other health care practitioners how you or your area improved the patient experience. Download the rules and application form here.

Operational Update

"Help Wanted Ads" in Seymour Street Journal

Looking for a clinician? Why not check with your colleagues at Hartford Hospital?

Upcoming issues of Seymour Street Journal will feature free "ads" for physicians and other clinicians that could make your talent search easier.

Send the job description to Dr. Jeffry Nestler, editor of the Seymour Street Journal, at


N-95 Respirator Fit Testing Reminder/Schedule

Dec. 27 & 28

N-95 Respirator Fit Testing will be offered Thursday, December 27, 10 a.m.-2 p.m., ERD 4th Floor, and Friday, December 28, 1-5 p.m., ERD 4th Floor.

Just a reminder that this is an annual requirement and should be completed near the anniversary of your previous Fit Test. Complete your HealthStream module prior to getting the Fit Test portion. If there are any changes to your cardiac or pulmonary health, or if you are a new employee, you must be medically cleared by Occupational Health prior to being Fit Tested. Also, Federal Law prohibits testing of anyone with facial hair that interferes with the mask seal. Please ensure you meet all of these requirements before getting Fit Tested.

HH In the News

Lots of Kids are Loners, But When Does Social Disconnection Signal Danger?

Hartford Courant, Dec. 19

Many people who knew Adam Lanza said he was awkward, withdrawn and socially isolated. It's a common description of mass shooters, but it also describes countless numbers of young people, most of whom grow out of their shyness and go on to lead normal lives. The challenge for mental health experts is identifying — out of the sea of awkward youths — when a social disconnection signals danger. How do you identify the potential mass murderer?

"Here, we're out at the leading edge of information, where nobody knows," said Dr. Harold Schwartz, psychiatrist-in-chief at The Institute of Living, a mental health center in Hartford. "When you think of the number of kids who have committed acts like this and have survived to tell us about them, there have been really very few. I don't think anyone can say what happens in their minds."


Mental Illness and Mass Shootings

CT Mirror, Dec. 19

Investigators have not yet disclosed whether Adam Lanza had a mental illness. The distinction might sound academic -- after all, don't his actions answer the question? But experts say that not all people who commit horrific crimes like mass shootings necessarily have a major psychiatric diagnosis.

"Some people would say, 'Well yeah, but wait a minute, if you are capable of picking up a gun and killing 20 children, you are obviously mentally ill,'" said Dr. Harold "Hank" Schwartz, psychiatrist-in-chief at the Institute of Living in Hartford. "To which I can only say, 'OK, if you want to make that the definition of mental illness you can, but it's not the definition that currently is in use.'"

Of the mass shootings that took place in the past three decades, about half of the perpetrators would be considered to have a major psychiatric disorder, Schwartz said.

"It is true that in the small number of people who ever are going to commit an act like this, there is a disproportionately large number of people who do carry a psychiatric diagnosis," Schwartz said. "But we're talking about a very, very low base rate event" -- too low to extrapolate about mental illness in general, he added.


Welcoming, and wary of, a focus on mental health

CT Mirror, Dec. 19

The calls to improve the mental health care system in the wake of last week's elementary-school shooting are welcome, and worrisome, for some people. "All of the evidence that we have suggests that people with mental illness are essentially not more dangerous on average than ordinary people," said Dr. Harold "Hank" Schwartz, psychiatrist-in-chief at the Institute of Living in Hartford. "If you combine mental illness with substance abuse, the risks go up, but if you combine the range of people with impulsive personalities with alcohol and drug abuse, the danger of violence goes up."

Earlier this year, advocates turned out in force to oppose a proposal to allow people with mental illnesses who are not hospitalized to be medicated, even if they object, if remaining unmedicated would leave them or others at risk of harm. The concept could be revisited in the wake of the Newtown shooting.

The way discussions about the mental health system are framed risks further stigmatizing people with mental illness, Schwartz said.


Holiday Season Difficult For Shopping Addicts

Hartford Courant, Dec. 11

Individuals with oniomania, better known as shopping addicts or compulsive buyers, tend to spend like it's Christmas throughout the year and their obsessive drive to acquire can lead to financial and personal disaster.

"For them, the winter shopping season is one of the most difficult times of the year — the equivalent of St. Patrick's Day or New Year's Eve for individuals with alcohol problems," says psychologist Dr. David Tolin, director of the Anxiety Disorders Center and director of Cognitive Behavioral Therapy at the Institute of Living in Hartford, who treats shopping addicts at his clinics.

“At this time of year, retailers are bombarding us with advertisements and enticements to shop and spend," says Tolin. "Everyone's on a shopping high. For someone who can't control their spending, it's irresistible. Being able to log on to your computer and purchase things with a few clicks is like a crack delivery system for the shopaholic," notes Tolin, who is featured on "My Shopping Addiction," a reality show on the Oxygen Network.


Westfarms Mall and Hartford HealthCare Open Wellness Lounge for Holidays

West Hartford Patch, Dec. 17

Hartford HealthCare has become the exclusive health and wellness partner for Westfarms Mall and has opened a wellness lounge there for the holidays. Located on the town line between West Hartford and Farmington, Westfarms is a 1.3 million square foot regional shopping center that features more than 160 shops. According to James Blazar, chief strategy officer and senior vice president for Hartford HealthCare, the wellness lounge is the first component of what will become a long-term partnership between the two organizations.


Hartford Hospital to open LEED facility

Hartford Business Journal, Dec. 5

Hartford Hospital is preparing to open a facility in central Connecticut built to green standards. Branford-based O,R&L Construction completed work on the Hartford Hospital Family Health Center in South Windsor. The 16,000-square-foot medical office building is designed to achieve the silver level of the Leadership in Energy & Environmental Design, or LEED program from the U.S. Green Building Council.

The South Windsor facility is the first Hartford Hospital building to achieve LEED Silver status. The sustainable features include recycled and regional building materials, extensive insulation, and energy efficient mechanical, electrical, and plumbing systems.


Dr. Jean Wells: Feminist and Medical Trailblazer

Hartford Courant, Dec. 10

Dr. Jean Wells was a strong individualist, a feminist path breaker and a strong-willed pediatrician at a time when women physicians were rare and not always held in high esteem. Wells practiced for 50 years, then worked part time at Hartford Hospital's pediatric emergency room. A longtime resident of West Hartford, she died on July 27 at the age of 101.

During World War II, there was a need for doctors because so many male doctors had joined the armed services, and Wells was asked if she would take a courtesy staff position at Hartford Hospital. She refused, saying she would work only if she were given the same salary and benefits as a male doctor. With no recourse, the hospital offered her the job, and Wells became the first full-time female physician at the hospital. She also worked at Newington Children's Hospital in an unpaid position.

At Hartford Hospital, Wells took phone calls early in the morning from worried patients, and made house calls to children who were seriously ill in the morning, then visited her hospital patients. She also made an effort to educate the mothers of her patients so they could distinguish harmless symptoms from those that indicated something more serious, and encouraged them to nurse their babies — not a popular practice at the time.



In the HHC System

Network hospitals like Meriden's MidState pursue new model for patient care

My Record Journal, Dec. 17

Hartford HealthCare officials intend to consolidate the psychiatric services of two network hospitals, but say the move represents an exception to their goal of adding services to member hospitals.

Dr. Rocco Orlando, Hartford HealthCare chief medical officer, said the addition of a surgical robot to MidState three years ago illustrated the benefits of being in the network. Vascular surgery is another service planned for MidState.

“Our vision is not to consolidate services, but to coordinate and integrate services,” Orlando said. “Generally, our approach is not consolidation.”


Hospitals Take Precautions During Flu Season

Norwich Bulletin, Dec. 19

Hospitals around the state are taking precautions against the flu, but none has gone as far as The William W. Backus Hospital here, which last week announced it would limit visitors to adults only.

“There is no flu outbreak at Backus. This is just our way of being proactive and keeping patients safe,” Backus spokesman Shawn Mawhiney said Friday, adding that the hospital is asking visitors who are feeling sick to avoid the facility as well. “It’s not out of the ordinary — in fact we do this most flu seasons when we start seeing flu in the community.”

Mawhiney said nine people tested positive for the flu in the week before restrictions went into effect. The restrictions could be lifted if the spread of the flu slows, or may continue until the end of the flu season next spring.

At Backus, Windham and Lawrence and Memorial hospitals, spokesmen said mandatory vaccines and masks for staff have them prepared.


$1.5M microgrid proposed for Backus Hospital

Norwich Bulletin, Dec. 19

Norwich leaders and The William W. Backus Hospital are calling on the state to finance a multimillion venture that would provide a constant flow of electricity to the region’s only trauma center and LIFE STAR facility.

The roughly $1.5 million investment would allow for the creation of a 10-megawatt microgrid to be installed on hospital-owned property at Matlack Drive. One megawatt is enough energy to power about 1,000 homes.

“This has been a dream of ours for a very, very long time. It’s been years in the talking,” said Keith Fontaine, Backus’s vice president and chief administrative officer. “It provides critical redundancy to us and essentially means there will never be a power failure at the hospital.”

Officials hope to tap into a newly created $15 million Microgrid Grant and Loan Program to pay for the plan. The funding stream was included in Senate Bill 23, a measure approved last year by the General Assembly to enhance emergency preparedness and response statewide.



Health Care News In the Region

Connecticut is Sixth Healthiest State in the Union

America's Health Rankings, Dec. 11

Connecticut ranked sixth healthiest state in America’s Health Rankings®–2012 Edition. Vermont, which was at the top of the list, steadily rose in the rankings over the last 14 years from 17th in 1998 to first, where it has remained for 4 consecutive years. Hawaii is ranked second this year, and has ranked in the top 6 states every year of the index. New Hampshire is third, followed by Massachusetts and Minnesota.

Mississippi and Louisiana tie for 49th as the least healthy states. Arkansas, West Virginia, and South Carolina complete the bottom 5 states.

The ratings are based on a list of health determinants, which includes a high rate of high school graduation, a low violent crime rate, a low incidence of infectious disease, a low prevalence of low birth weight infants, high per capita public health funding, a low rate of uninsured population, and ready availability of primary care physicians.



Legislature OKs Budget Cuts That Mostly Eliminate $365 Million Deficit

Hartford Courant, Dec. 19

Connecticut lawmakers on Wednesday approved a measure that nearly eliminates the state's $365 million deficit by cutting funding for hospitals and education, among a myriad of other programs.

The proposal reduced state spending in the current fiscal year by $252.3 million, and comes on the heels of about $108 million in cuts made by Gov. Dannel P. Malloy last month.

Several senators expressed concern over cuts to hospitals, which total close to $90 million. State officials say some of those cuts will be offset by increases in federal reimbursements, but the Connecticut Hospital Association said the reductions will result in job losses and service reductions.

Lawmakers were called into a special session to deal with the deficit. The House of Representatives moved swiftly to approve the measure; it cleared the chamber on a vote of 140-3. In the Senate, debate was more vigorous, but it ultimately passed, 31-3.


Coming Events

January 5, 2013 (Saturday):

Black & Red Gala


Hartford Hospital's 22nd annual Black & Red Gala will take place on Jan. 5, 2013 at the Bushnell. Headliner is Earth, Wind, & Fire. The event is sold out. More than 1,000 medical, business, and community leaders will come together to raise money for Hartford Hospital's Transplant Program, with a goal of $1 Million. For more information, visit


January 12, 2013

STABLE Program - A LIFE STAR Educational Opportunity

There will be a LIFE STAR S.T.A.B.L.E. program session on Jan. 12, 2013 from 8 a.m.-4:30 p.m. in JB-118. S.T.A.B.L.E. is an educational tool developed for maternal/child health care providers to organize care during the post-resuscitation/pre-transport stabilization period.

S.T.A.B.L.E. is the most widely distributed and implemented neonatal education program to focus exclusively on this care for sick infants. It stands for the six assessment and care modules in the program: sugar, temperature, airway, blood pressure, lab work and emotional support. Instructors will be Jason Doonan, RN, and Michael Frakes, APRN.

Registration is $25, and includes continental breakfast, lunch and afternoon snack. For more information, contact Patrick Dowd at 860-545-4369 or


March 9-16, 2013

28th Annual Winter Medical Meeting, "Trends in Medicine and Surgery"

Vail Cascade Resort and Spa

Trends in Medicine and Surgery (TMS), the 28th annual winter medical meeting sponsored by the Department of Medical Education at Hartford Hospital, will be held at the Vail Cascade Resort and Spa, from March 9-16, 2013.

The meeting is open to all medical, nursing and allied health staff. CME credits will be awarded. For further information, please contact Val Riccio, Department of Medical Education, at, or Mary Moretti, Huntington-Hay Travel, at 860-678-1407 (


For more coming events, click here.

Hot Topics in Healthcare

Social Media Used Frequently By 1 in 4 Physicians

Medical News Today, Dec. 12

A new survey shows that about one in four physicians uses social media daily or multiple times a day to scan or explore medical information, and 14 percent use social media each day to contribute new information, according to an oncologist at the Johns Hopkins Kimmel Cancer Center.

The survey of 485 oncologists and primary care physicians, also found that on a weekly basis or more, 61 percent of physicians scan for information and 46 percent contribute new information. More than half said they use online physician-only communities but only 7 percent said they use Twitter.

The work was published recently in the Journal of Medical Internet Research. Oncologists are more likely to use social media to keep up with innovation, while primary care physicians are more likely to use social media to get in touch with peers and learn from them, the survey found.

Voices Of Our Patients

A Patient's Family Thanks All The Caregivers

Dear Friends,

The Bouchard Family and I thank you all for the love and professionalism you shared with my sister Michelle Cullen before she died Sept. 24 in her room at the Conklin Building.

Michelle’s last weeks, last days, hours, and even minutes were made more comfortable by each of you. The job you chose is tough. To care for people who may soon die means risking your own feelings.

To the doctors who extended Michelle’s life at a level worth living; to the caregivers who hugged her when she cried; to the staff who tip-toed into her room so she would not wake up; to the people who made her sheets neater so the wrinkles would not cause her pain; to the employees who bought her Spanish food during their own lunch break, or who sought the right “color” popsicle or the right flavor drink she would like at that moment – and to all who smiled and said hello to her each day – we are deeply indebted.

Please share this letter with your friends and family so they better appreciate the work you do; especially when you come home from a “tough” day at work.

At Michelle’s funeral, the priest and the deacon played Michelle’s favorite song: “It’s a Wonderful World” by Louis Armstrong. I hope you hear it sometime.

Many people die without warning. No last good-byes to their friends. No more hugs or kisses to family members. Nothing. Losing Michelle broke our hearts; but we were given extra time with her because of you. Please do not forget the gift that you gave us.

We never will.

Paul Bouchard

The Seymour Street Journal is published every two weeks to communicate key messages pertinent to our hospital's physicians, and to promote alignment between the medical staff and administration. It will keep you informed on hospital news in a concise, convenient format. SSJ will be sent to your preferred email address every other Sunday.


Back issues can be viewed here.

For any questions or suggestions, please contact Dr. Jeffry Nestler, Medical Staff President, at (860) 836-7313.