In Remembrance: Dr. Ernest Cole Brock, Jr.

Dr. Ernest Cole Brock, Jr., a longtime physician for the Alabama Crimson Tide and the creator of a sports medicine lecture series for the College of Community Health Sciences, passed away on Nov. 5 at his home in Tuscaloosa. He was 91.

Dr. Ernest Cole Brock, Jr., with his wife, Hannah Brock

Dr. Ernest Cole Brock, Jr., with his wife, Hannah Brock

Brock was an orthopedic surgeon who practiced in Tuscaloosa for many years, in addition to serving as a physician for the Alabama football team.

He and his wife, Hannah Brock, created The Ernest Cole Brock III Endowment for Continuing Medical Education at the College to support a lecture series on treating concussions and other athletic injuries. They created the fund to honor the memory of their son Ernest Cole Brock III who died in 1999 at the age of 36. The inaugural lecture was held in January 2013.

Brock grew up in Fairfield, Alabama. In 1943, at age 18, he entered the United States Air Force and fought as a gunner in 32 combat missions in Guam and Japan. After he returned to the US, he accepted a scholarship to play football at Wake Forest University in North Carolina.

Brock had plans to be a football coach and a science teacher, but after he suffered a career-ending leg injury during his second year of college, he decided to pursue medical school. He received his medical degree from Wake Forest University and then completed his residency in orthopedic surgery at University Hospital in Birmingham (now UAB Hospital).

After residency, he joined the hospital’s staff and served as the physician for high school football players at Legion Field.

“[Orthopedic surgery] is a good field to be in,” Brock said to the College in a 2014 interview. “Most of the patients are young and can heal.”

Brock later formed an orthopedic surgery and sports medicine practice in Tuscaloosa and began traveling as a surgeon with the Crimson Tide and head coach Paul “Bear” Bryant.

“I enjoyed working for the team, and Coach Bryant was nice to work for,” Brock said.

For 25 years, Brock was the team orthopedist for Alabama. He also served as an orthopedic preceptor for the College, training residents and medical students on the diagnosis and treatment of musculoskeletal conditions. He practiced in Tuscaloosa until he retired in 1992.

Dr. James Robinson, chair of Sports Medicine, team physician for Alabama and an alumnus of the College’s Residency, said Brock was a mentor to him when he was training.

“Dr. Brock’s legacy to CCHS will be maintained by the annual lecture series that bears his name and by the continuation of the physician care of the athletic department through the deShazo Sports Medicine Clinic,” he said.

Brock’s funeral was held Nov. 9 at Calvary Baptist Church in Tuscaloosa.

Scholarships awarded to medical students, Rural Medical Scholars

Scholarships were recently awarded to four medical students receiving their clinical education at The University of Alabama College of Community Health Sciences. Rural Medical Scholars also received awards.

UA News: UA’s Rural Medical Scholars Program Adds 10 New Students

Ten students from rural Alabama have been accepted into The University of Alabama’s Rural Medical Scholars Program this year.

The Rural Medical Scholars Program, which is part of UA’s College of Community Health Sciences and has been cited nationally as a model program for educating rural physicians, is a five-year medical education program for rural Alabama students leading to the M.D. degree.

The program provides specialized training and field experiences, as well as a peer network between the students and rural doctors who serve as preceptors and mentors, and former students who graduated from the program and have entered practice.

CCHS hosts two Cuban physicians, discusses health care topics as part of UA Cuba Week

October Mini Med School Topics: Women’s Health, Injury Prevention and Telemedicine

Breast cancer is the second leading cause of death among women, so prevention and screening are important, not only for breast cancer but also for other gynecologic cancers, according to Dr. Kristie Graettinger, associate professor and chair of the College’s Department of Obstetrics and Gynecology.

Graettinger provided a presentation, “Women’s Health Update: Cancer Prevention,” at the Oct. 20 Mini Medical School program conducted in collaboration with UA’s OLLI program.

In addition to her presentation, three other faculty members presented during the month of October. Dr. Ray Stewart, assistant professor of Sports Medicine, talked about “Preventing Injury” on Oct. 6, and Dr. Karen Burgess, chair of Pediatrics, gave a presentation on “Telemedicine” on Oct. 13.

Mini Medical School lets adults and community learners explore trends in medicine and health, and the lectures by CCHS faculty and residents provide information about issues and advances in medicine and research. OLLI, short for Osher Lifelong Learning Institute, is a member-led program catering to those aged 50 years and older and offers education courses as well as field trips, socials, special events and travel.

In her presentation, Graettinger said to think of cancer prevention as three tiers: “prevention, screening and treatment.” Prevention is interventions to reduce the risk of cancer, including maintaining a healthy weight, being physically active, having a diet high in fruits, vegetables and whole grains and low in processed foods and red meats, and receiving vaccinations that can protect against cancer, such as the HPV vaccine for cervical cancer. Examples of screening include mammograms for breast cancer and pap smears for cervical cancer.

“The goal is first to try and prevent cancer, and also to identify people at risk for the disease,” Graettinger said.

Breast cancer is the second leading cause of death among women, right behind lung cancer, and will affect 1 in 8 women in their lifetimes. Approximately 250,000 cases of breast cancer are diagnosed every year.

Having a first-degree relative, such as a mother or sister, with breast cancer doubles the risk, but that amounts to only 15 percent of women diagnosed. Breast cancer screening includes mammograms, clinical exams performed by a physician or health professional, breast self-exams and genetic testing.

A mammogram is an x-ray of the breast. Currently there is not a consensus among organizations about the age a woman without a family history of breast cancer should be – ranging from 40 to 50 – to begin receiving annual mammograms.

There is recent evidence that clinical breast exams might not be helpful for women without symptoms of breast cancer, “but have that discussion with your doctor,” Graettinger said. She added that the concept of breast self-exams has shifted to “being aware of your breasts.”

For women with the inherited BRCA gene mutation, “this is serious business and increases the risk of breast cancer from 1 in 8 to 1 in 2, or by 50 percent, and the risk of ovarian cancer is 10 times greater,” Graettinger said. Having the BRCA gene is “not extremely common, but it’s not rare,” she said, adding that women with a personal history of breast cancer should consult with their physicians about this genetic testing.

Other gynecologic cancers include cervical, ovarian and uterine cancer. Of those, only cervical cancer has a screening test – pap smears, which detect precancerous changes on the cervix. Pap smears are now recommended every three years for women ages 21 to 65.

Ovarian and uterine cancers are detected by signs and symptoms, “which is scary because sometimes these are found in the later stages,” Graettinger said. Symptoms of ovarian cancer are vague and include pelvic and abdominal pain and pressure, bloating and feeling full quickly, and irregular bleeding. Approximately 20,000 cases of ovarian cancer are diagnosed annually. Pressure, pain and bleeding after menopause are common symptoms of uterine cancer, which primarily strikes women over the age of 50.
In Stewart’s presentation, he said that “sprains and strains are where the vast majority of injuries are occurring.” The most common sports injury is an ankle sprain, followed by a groin sprain and a hamstring sprain.

Stewart said the goal is to introduce preventive measures to avoid the injury. A warm up is a good way to do that. A warm up should get the body moving, introduce a light sweat and “literally warm up the muscles,” he said.

Stretching is a good way to prevent injuries, too. There is dynamic stretching, which are bouncing, jerking movements, static stretching, which are slow, deliberate movements that are held for about 20 seconds, and then proprioceptive neuromuscular facilitation, or PNF stretching, which combines static stretching with isometric movements to increase flexibility.

To prevent an ankle sprain, Stewart suggested wearing an ankle support to reduce the risk and to conduct balance training: stand on one leg in order to train muscles to support the ankle.

To prevent a hamstring sprain, Nordic hamstring exercises are best, Stewart said.

There is a higher injury rate of the ACL in women, and prevention requires regular exercises. Plyometrics, known as “jump training” help may reduce an ACL injury, but must be performed throughout the athlete’s season. After the participant stops performing the training exercises, he or she becomes at risk for injury again.
Burgess introduced many of participants in the Mini Medical School series to the concept of telemedicine for the first time.

Telemedicine is any medical information exchanged from one site to another through the use of technology. It could be a phone or computer.

“We use it to improve access to care,” said Burgess.

Many parts of Alabama are rural and are underserved in primary care and specialty care providers. Unfortunately, many of the underserved areas in Alabama are also areas with limited connectivity, which makes it difficult to access telemedicine, Burgess said.

Burgess spoke about CCHS Telemedicine and Telehealth efforts, including the asthma education program that she and Beth Smith, a nurse practitioner in pediatrics at University Medical Center, have led. Students at Greensboro Elementary School in Hale County and their parents are taught through telemedicine about asthma symptoms, medication and treatment. The program teaches  students how to use a spacer with their asthma inhaler for more effective usage of their medicine.

The program so far has revealed that students and parents are learning more about asthma and how to treat it.

One participant said: “Until today I had no idea what telemedicine was. Thank you for coming here and telling us about that today.”


Faculty members, Pediatrics department honored at Argus Awards ceremony

Two faculty from The University of Alabama’s College of Community Health Sciences were honored at the annual Argus Awards ceremony on Friday, Oct. 7. The awards are given by medical students to faculty and mentors for outstanding service to medical education.

Dr. Heather Taylor, an associate professor ­­­in the Department of Pediatrics, received an Argus Award in the Clinical Awards category for Best Clinical Educator, and Dr. Quinton Matthews, an associate professor in the Department of Surgery and a physician with University Surgical Associates, received an award in the Excellence in Education category for Best Community-Based Physician.

The Department of Pediatrics also received an Argus Award in the category of Best Clinical Department at the Tuscaloosa Campus. Other departments nominated were Obstetrics and Gynecology and Surgery.

“It’s always an honor to be recognized by the students,” says Taylor. “That’s why we have the jobs that we have so that we can work with students and do something valuable that gives back to them.”

Those who received nominations were: Dr. Bradley Bilton, associate professor in the Department of Surgery; Dr. Ashley Evans, associate professor in the Department of Pediatrics; and Dr. Robert Slaughter, hospitalist in the Department of Neurology.

One of the College’s functions is to serve as the Tuscaloosa Regional Campus for the University of Alabama’s School of Medicine, which is headquartered in Birmingham. A cohort of third- and fourth-year medical students receive their clinical education at the College.

The Argus Awards were created in 1996 to recognize faculty members and allow medical students to honor faculty and mentors for their service and dedication to medical education. Faculty are­ nominated based on their course evaluations and students vote to select winners in each category.

—Kimberly Florence

Southeast Sun: New medical school program brings Birmingham native to Enterprise

Lissa Handley Tyson is a Birmingham native, but she says she has come to love the smaller city of Enterprise.

Tyson came to Enterprise to work with Dr. Beverly Jordan and others with Professional Medical Associates. She is a third-year medical student at the University of Alabama Birmingham’s Tuscaloosa campus and is one of nine medical students taking part in the Tuscaloosa Longitudinal Community Curriculum offered through the University of Alabama School of Medicine. This is the third “pilot” year of the program.

Parkinsonism, ADHD in Grandchildren and Geriatric Depression topics in fall semester of Mini Med School

Mini Medical School is back in session this fall semester. The University of Alabama College of Community Health Sciences kicked off its second semester of the lecture series for UA’s OLLI program that has been put on by faculty and resident physicians at CCHS.

Mini Medical School lets adults and community  learners explore trends in medicine and health, and the lectures by CCHS faculty and residents provide information about issues and advances in medicine and research. OLLI, short for Osher Lifelong Learning Institute, is a member-led program catering to those aged 50 years and older and offers education courses as well as field trips, socials, special events and travel.

Parkinsonism — Dr. Catherine Ikard

Many people think of Parkinson’s disease as a single disorder, but it is actually more complicated than that, said Dr. Catherine Ikard, a neurologist at University Medical Center and assistant professor of Internal Medicine and Psychiatry and Behavioral Health for the College.

Parkinsonism is a syndrome characterized by decreased movement and is associated with tremors and a loss of balance, Ikard said at her lecture, titled “Parkinsonism and Parkinson’s Disease,” which she presented as part of the Mini Medical School series on Sept. 15.

Parkinsonism can appear in an array of disorders, some even as a result of repeated head trauma or medication, but the most common one—the one most people refer to when they think of Parkinson’s Disease—is Idiopathic Parkinson’s Disease.

Idiopathic Parkinson’s Disease is the progressive loss of dopamine-producing cells in the brain. The disease is slow and degenerative. “We don’t know why this happens,” Ikard said.

There are motor symptoms, which include shaking, smaller and slower movements, becoming stiff and losing balance more easily. Motor symptoms usually start on one side of the body. Tremors can worsen when the patient is at rest, and they are suppressible by concentration.

Non-motor symptoms include affective disorders, such as depression, orthostatic hypotension (when blood pressure falls significantly when standing up too quickly), memory impairment, fatigue, constipation and sleep disturbances.

There is no test for Idiopathic Parkinson’s Disease, Ikard said. The diagnosis is clinical. “We often have to watch a tremor over time—months, sometimes years,” Ikard said.

Medication and therapy can help treat symptoms, Ikard said. The most common medication is Levodopa, and physical and speech therapy can help improve lifestyle. “I cannot emphasize enough how important therapy is for patients with Parkinsonism,” said Ikard. Exercise improves symptoms, too, she said.

There are clues that the disorder might not be traditional Idiopathic Parkinson’s Disease, Ikard said.

Some of these include: rapid progression of the disease, absence of tremors, frequent falls early in the disease, abnormal eye movement and poor response to Levodopa. If that is the case, the Parkinsonism could be tied to another disorder.

Grandchildren and ADHD — Dr. Brian Gannon

Children are very active from the ages of 2 to 5, but that busyness should decrease over time, said Dr. Brian Gannon, a pediatrician at University Medical Center and an assistant professor of Pediatrics for the College.

But as children get older and if they are easily distracted, can’t stick with a task for a reasonable amount of time and their activity level is not appropriate for their age, they could suffer from ADHD, or attention deficit hyperactivity disorder.

“ADHD is defined as an activity level that is inappropriate for age, that interferes with school work, that causes trouble in dealing with adults,” Gannon said during a lecture on Sept. 22, titled “Grandparents and ADHD.”

Gannon said about 5 percent of the general population in the US qualifies for an ADHD diagnosis. He said sometimes the markers of what appears to be ADHD are actually caused by other medical issues. He said hearing, vision and speech problems can cause some of the same symptoms of ADHD, as can developmental delays, autism and sensory processing disorder.

“We want to look at medical issues because they may cause similar issues to ADHD,” Gannon said.

A child’s living situation – unstable home environment, varying and inconsistent rules and food insecurity – is also a factor. “My job as a physician is to advocate for the child and help parents problem solve. We don’t want to just throw medicine at a child.”

Gannon said medication can help and should be part of efforts to manage ADHD, but is only part of the answer. “Children still need to follow the rules, and do their work. With medication, they can do it without your help.”

Geriatric Depression — Dr. John Burkhardt

Older adults are at risk for depression. One reason: The more medical burdens one has, the higher the risk of depression, said Dr. John Burkhardt, a clinical psychologist with University Medical Center-Northport.

“Chronic pain conditions can be managed, but you never get a break from them. Heart problems can precipitate depressive episodes, and then you have to eat differently, go to physical therapy and deal with a chronic condition. What does that do to your mood?” said Burkhardt, also an assistant professor of Psychiatry and Behavioral medicine for UA’s College of Community Health Sciences, which operates UMC-Northport.

His remarks came in a lecture titled “Geriatric Depression” that he provided on Sept. 29 as part of the Mini Medical School lecture series.

Burkhardt said changes in previous functioning, pain and sleep disruption, significant weight gain or loss, a loss of interest in activities, a sad and depressed mood, a feeling of being a burden – and if those conditions and feelings go on for two weeks or more – could signal possible depression. “A lot of people go through sad times. But when it starts to impact your functioning, that could be depression.”

With older couples, depression can also be “contagious,” Burkhardt said. “If one spouse is depressed, the other spouse is at an increased risk of depression.”

Late-life depression, which happens after the age of 60, can carry added risk because it can transition to dementia, Burkhardt said.

He stressed that depression needs to be treated, particularly in the elderly, who might not seek care because of an associated perceived stigma. He noted that suicide is the 17th leading cause of death in those aged 65 and older.

“When you’re depressed, you’re not good at coping with your physical conditions. Depression impacts the person who is experiencing it, and their families. Who wants to visit people when they aren’t happy? Then they’re alone.”

Burkhardt recommended that people watch for changes in behavior, thoughts, appetite, sleep and whether they lose interest in activities once important to them. “See a provider if you suspect depression. Don’t let stigma keep you from getting help. Don’t isolate yourself. Be social, stay active and have a daily structure.”


Four medical students selected to Alpha Omega Alpha Honor Society

Four medical students at the UA College of Community Health Sciences were selected to the Alpha Omega Alpha Honor Medical Society.

The students, all in their fourth year of medical school, are Reaves Crabtree, Maria Gulas, Julia (Massey) Steigler and Chelsea Turgeon. 

Alpha Omega Alpha is a professional medical organization that recognizes excellence in scholarship as well as an outstanding commitment and dedication to caring for others. The top 25 percent of a medical school class is eligible for nomination to the honor society, and up to 16 percent may be selected.

About 3,000 students, alumni and faculty are elected to Alpha Omega Alpha each year. The society has 120 chapters in medical schools throughout the United States and has elected more than 150,000 members since its founding in 1902.

In its role as a regional campus of the University of Alabama School of Medicine, the College provides clinical education to a subset of third- and fourth-year medical students. The students complete the first two years of basic science courses at the School of Medicine’s main campus in Birmingham, and then complete clinical rotations on the Tuscaloosa Regional Campus in the departments of Family Medicine, Pediatrics, Internal Medicine, Obstetrics and Gynecology, Neurology, Psychiatry and Surgery.

“Congratulations Reaves, Maria, Julia and Chelsea on your accomplishments and for this recognition,” says Brook Hubner, director of Medical Student Affairs at the College.

Kamal awarded second Sara Crews Finley, M.D. Endowed Leadership Scholarship

Salmaan Zaki Kamal, a medical student at the College of Community Health Sciences, has been selected as the 2016 recipient of the Sara Crews Finley, M.D., Endowed Leadership Scholarship. The University of Alabama School of Medicine scholarship, which supports students who demonstrate exceptional academic and leadership abilities, includes full tuition for the third year of medical school and is renewable for the fourth year.