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Internist and Yale University Medical School professor Mary Tinetti, MD, a 2009 MacArthur Fellow, sees the grant as a "wonderful opportunity" to continue her focus on health care for older people. [Photo courtesy of the MacArthur Foundation]

Mary Tinetti, MD, was one of two physicians to get an "out of the blue" phone call from the MacArthur foundation in late September informing her that she would receive $500,000, no strings attached.

"I was asked if I was sitting down, and I got a little suspicious," Dr. Tinetti said. "I didn't believe it, and it still doesn't seem completely real."

But it is real.

Dr. Tinetti, a professor of medicine, epidemiology and public health at the Yale University School of Medicine in Connecticut, was named a MacArthur fellow for her work on the widely recognized, but little-investigated, problem of injuries due to falls among elderly people. She has championed the idea that the increased risk of falling faced by older people be incorporated into the diagnosis and treatment of other diseases, such as diabetes, depression, arthritis, insomnia and low blood pressure.

For nearly three decades, the John D. and Catherine T. MacArthur Foundation has been awarding $500,000 fellowships to creative people who work in medicine, science and other fields. Winners are selected for the originality of their work and their potential to make important contributions in the future.

Although Dr. Tinetti has a few months to decide how to use the money, she may tackle the complexity of medical decision-making in treating older people who often have many diseases. A balance must be struck between treating one disease without making another worse, she said.

"What's the best strategy to maximize benefits and minimize harms?" she asked. "Right now we don't really have a good, feasible way to do that in practice. I will likely do something about that with the award."

The second physician among this year's recipients of the five-year grants is Jill Seaman, MD, an infectious diseases specialist who provides care in remote areas of Sudan in Africa and in Yup'ik Eskimo communities in Alaska.

She began working in Africa in 1989 for Doctors Without Borders. After the group left Sudan in the late 1990s, Dr. Seaman established her own medical organization to continue her work in Africa.

"I feel very fortunate to have found a place where what I have been trained to do can be put to good use," Dr. Seaman said in a video on the MacArthur foundation's Web site.

Rebecca Onie

Beth Shapiro, DPhil

Lin He, PhD

Also among grant recipients was Rebecca Onie, co-founder and CEO of Project HEALTH in Boston. Onie built a low-cost, public health model of care that links college students with physician mentors to assist patients in overcoming obstacles to health care.

Students provide transportation, child care, food, education and legal advice to low-income people. Project HEALTH has hundreds of volunteers and operates in several cities, providing help to thousands of families each year.

Other winners included Beth Shapiro, DPhil, an assistant professor of biology at Pennsylvania State University, who uses gene sequencing to study fast-evolving RNA viruses; and Lin He, PhD, an assistant professor of molecular and cell biology at the University of California, Berkeley, whose research has contributed to a new avenue of cell biology that is centered on the role of microRNAs in the development of cancer.

Winners of "America's Nobels"

Also in September, the 2009 Lasker-DeBakey Clinical Medical Research Award was given to a team whose work on chronic myeloid leukemia led to the disease's transformation from a fatal cancer to a manageable condition. The Lasker awards are often called "America's Nobels," and many Lasker winners go on to receive Nobel Prizes.

Brian J. Druker, MD, director of Oregon Health & Science University's Cancer Institute, and Nicholas B. Lydon, PhD, head of consulting company Granite Biopharma LLC in Wyoming, were honored for research that led to the development of imatinib for treating CML and other cancers. Charles L. Sawyers, MD, chair of Memorial Sloan-Kettering Cancer Center's Human Oncology and Pathogenesis Program, was cited for his efforts toward combating resistance to the drug, marketed by Novartis as Gleevec, that arises in some patients.

The trio's discoveries also revolutionized cancer drug development by demonstrating the effectiveness of treatments that target a cancer-causing molecule and avoid damage to normal cells.

"One of the really fun things since the announcement was to get phone calls and e-mails from patients, some of whom were part of the original phase I study [on Gleevec]. It's amazing to hear from them," Dr. Sawyers said.

Although "it's extremely gratifying to be recognized by your peers," Dr. Druker said, it's hard to beat congratulatory messages from patients who are still alive because of Gleevec. "One woman showed me pictures of her grandchildren. Another said her daughter is graduating from college. That's what it's all about."

Dr. Druker continues to study CML and search for targets for other cancer drugs. "We know we have patients with manageable CML, and now we want to cure it," he said.

The print version of this content appeared in the Oct 12, 2009 issue of American Medical News.

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