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Hard Call podcast explores tough ethical decisions in health care

Some of the toughest ethical challenges in life play out in health care. The Hard Call podcast series, launched over the summer by the CU Center for Bioethics and Humanities, explores heart-wrenching choices confronting real patients, families and care teams. And in a novel, creative twist for a podcast, it also asks listeners to vote on what they would do if they were facing the same decisions.

Hard Call: Derailed” was the first story launched. It tracks a patient with emerging bipolar disorder through five episodes. The story was funded by the Colorado Health Foundation and the Community First Foundation, and it has been championed by mental health organizations such as the National Behavioral Health Innovation Center. Derailed quickly garnered listeners from across the US and in Australia, Canada, England and Ireland.

Wynia Matthew, MD
Matthew Wynia, MD, MPH, director of the CU Center for Bioethics and Humanities, collaborates with Elaine Appleton Grant, a journalist and radio producer, on the new podcast series, “Hard Call.”

The second story is “Hard Call: The Electronic Heart.” This four-part podcast series follows a patient, nicknamed “Max” to protect his privacy, through a set of critical decisions about a very risky and expensive treatment toward the end of life.

Hard Call collaborators Matthew Wynia, MD, MPH, director of the CU Center for Bioethics and Humanities at the Anschutz Medical Campus, and Elaine Appleton Grant, an experienced journalist and public radio producer, say the two storylines have brought different listeners to the program. “The first Hard Call story, about a patient with bipolar disorder, has drawn a large number of listeners particularly interested in mental wellness and the care of patients with mental illness,” Grant said. “The second patient’s story is of interest to anyone who’s lived through difficult decisions around end of life care, or people interested in heart disease and how it’s being treated these days.”

Listen to a Colorado Public Radio interview with Wynia about the ‘Hard Call’ series and the story about a Denver man suffering from bipolar disorder here.

Each Hard Call episode ends with a difficult choice facing one person in the story and the provocative question, “What would you do?” Listeners are asked to vote on the Hard Call website. They can also see how others voted and join the discussion online.

Hard Call is a collaboration between creative minds in health care, radio and theater. Episodes are available in iTunes, Google Play, other podcast platforms and on the web.  It is made possible by the CU Center for Bioethics and Humanities, with support from the Colorado Health Foundation and the Community First Foundation.

The CU Center for Bioethics and Humanities, located on the University of Colorado Anschutz Medical Campus, engages today’s and tomorrow’s health professionals and the community in substantive, interdisciplinary dialogue about ethical issues confronting patients, professionals and society.

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Jankowski awarded NIH funding for bone density study

Approximately 46 percent (21 million) of older women in the United States have low bone mass, a condition that increases the risk of fracture, disability, and death, but may also be reversible. Exercise is recommended to maintain bone health in women, but the benefits of exercise may be limited by low levels of sex hormones after menopause.

Kathy Jankowski of CU College of Nursing
Kathy Jankowski, PhD, FACSM

A new R01 (a type of research project funded by the National Institutes of Health) study, “DHEA Augmentation of Musculoskeletal Adaptations to Exercise in Older Women,” led by CU College of Nursing Associate Professor Kathy Jankowski, PhD, FACSM, will attempt to show whether dehydroepiandrosterone (DHEA) will provide estrogenic and androgenic hormonal responses that will enhance the benefits of exercise on bone and muscle in postmenopausal women.

High-impact research

“This research has high impact and importance for women, who have a longer life expectancy than men, and are more prone to health issues arising from lower bone mineral density,” Jankowski says. The project is federally funded for a five-year period of study at $600,000 per year.

Exercise is recommended for postmenopausal women to maintain or increase areal bone mineral density, to improve muscular fitness and balance, and ultimately to prevent fractures. During exercise, joint-reaction and ground-reaction forces contribute to strain signals that are transduced via a mechanostat to osteocytes, causing region-specific adaptations in bone tissue.

However, age-related declines in anabolic adrenal, gonadal, and somatotropic hormones may blunt this and other musculoskeletal adaptations. DHEA is the major source of estrogen and testosterone in postmenopausal women, but adrenal DHEA production declines with age.

Jankowski’s research project proposes that DHEA therapy, by providing androgenic and estrogenic hormonal support, will augment the effects of bone-loading exercise on areal bone mineral density and fat free mass in women with low areal bone mineral density (i.e., osteopenia). This population is the focus because low area bone mineral density, an indicator of fracture risk, could be corrected with hormonal treatment.

Measuring changes to bone architecture

“There only a few anabolic hormonal therapies approved to increase bone density in women, and these are typically prescribed only for women with osteoporosis,” Jankowski says. “DHEA has the advantage of providing anabolic effects on bone, and is well-tolerated in postmenopausal women. Exercise is the only therapy that provides benefits to muscle and bone. I am looking forward to discovering whether combining exercise with DHEA provides benefits to muscle and bone that exceed that of either DHEA or exercise alone.”

Jankowski’s study will measure changes in bone architecture in addition to bone density. “Small changes in bone architecture can have profound effects on bone strength,” she says. “It is currently not known if DHEA has beneficial effects on bone architecture.”

To learn more about research projects at the CU College of Nursing Office of Research and Scholarship, contact CON.ORS@ucdenver.edu .

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ECHO Colorado receives grant renewal

The University of Colorado Anschutz Medical Campus is honored to announce a $3.3 million gift in renewal funding from the Colorado Health Foundation (TCHF) in support of the continued success of ECHO Colorado (Extensions for Community Health Outcomes) and to recognize the positive impact of the program center located here on campus.

“This funding allows ECHO Colorado to continue changing the way Coloradans receive healthcare with an innovative approach to the well-known model,” said CU Anschutz Chancellor Don Elliman. “I am proud to stand behind and beside the work of ECHO Colorado and hope you will join me in celebrating their extended program efforts.”   

The ECHO Model

John F. "Fred" Thomas
John F. “Fred” Thomas, PhD, Primary Investigator for the grant and Executive Director of ECHO Colorado

The ECHO model bridges specialty and primary care by linking expert specialist with providers in local communities. Together they participate in ongoing learning sessions, which operate like virtual grand rounds combining didactic presentations, mentoring and peer-presented case review.

ECHO brings ongoing learning and specialty knowledge to rural providers and their patients at no cost. They create ongoing learning communities where providers receive support and develop the skills they need to provide comprehensive, best-practice care to patients with complex health conditions, in their own neighborhood.

“What is often needed to help patients facing barriers to care is an efficient mechanism to share data and knowledge as opposed to hours of driving and the many inefficiencies of our current health care delivery model,” said Duane Pearson, MD, Medical Director of ECHO Colorado.

ECHO Colorado redefines Project ECHO

ECHO Colorado is responding to a statewide crisis: across Colorado, health care outcomes continue to be heavily influenced by zip code as an undeniable reflection of the accessibility to quality health care and specialty care. By focusing on building a virtual center to support ongoing learning, community, connection, and peer collaboration, ECHO provides the infrastructure to democratize knowledge, reduce professional isolation and improve health outcomes.

“We believe in continuously expanding our opportunities for collaboration and believe our partnerships are the pulse of what we do,” said Kory Thomas, Assistant Director of ECHO Colorado. “Working toward a common goal for health equity allows us to reduce redundancies, maximize impact, and act as a force multiplier connecting resources to those that need it most. Together, we pave a more practical pathway to achieve our goals.”

Duane Pearson, MD
Duane Pearson, MD, Medical Director of ECHO Colorado

ECHO Colorado continues to grow and innovate and is part of a larger national discussion about re-envisioning and reshaping health care delivery. “We are extremely proud of what we have accomplished over these two years and, in light of the ECHO Act and the national spotlight that has been placed on the ECHO model for the next couple of years, we are well-positioned to continue to demonstrate the effectiveness and efficiency of ECHO Colorado,” said John F. “Fred” Thomas, Ph.D., Primary Investigator of the grant and Executive Director of ECHO Colorado. “We truly appreciate the support of Chancellor Elliman, and we cannot begin to thank the Colorado Health Foundation enough for their continued commitment to our efforts.”

Changing the future of health in Colorado and beyond

ECHO Colorado was established in 2015 with the belief that it would change how health care is accessed and delivered, and it is doing just that. “This initiative will not only improve the health and quality of life for countless citizens of Colorado, but it enables the university to expand and elevate its educational outreach to medical professionals across the state by leveraging our partnerships with state and regional health offices,” said John J. Reilly, MD, Vice Chancellor for Health Affairs and Dean of the School of Medicine.

This grant allows ECHO Colorado to continue program center operations, partner on efforts prioritized with collaborating organizations across the state, and examine the reach and impact of ECHO in light of the ECHO Act passed by Congress in late 2016.

The ECHO Act was approved following the Senate’s unanimous vote and signed into law by President Obama. Congratulations to the ECHO Colorado team!

For information on becoming an ECHO Colorado partner, click here to contact Kory Thomas, Assistant Director.

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Canto-Soler brings visionary aspirations to Gates Center for Regenerative Medicine

Valeria Canto-Soler at CU Anschutz
Valeria Canto-Soler at work in the lab at the Gates Center for Regenerative Medicine.

When Valeria Canto-Soler, Ph.D., was a biology student in Argentina, she dreamed of a career studying elephants and other African wildlife in their natural habitat.

But life took her on a different journey. In July, Canto-Soler joined the Department of Ophthalmology and the Gates Center for Regenerative Medicine as the Doni Solich Family Endowed Chair in Ocular Stem Cell Research.

“I like to joke about it,” she says. “Instead of spending my life studying animals in the wilds of Africa, I’m in a dark room sitting in front of a microscope.”

After an international search, Canto-Soler also was named director of CellSight, the Ocular Stem Cell and Regeneration Research Program, in partnership with the Gates Center and the Department of Ophthalmology. She also will be an Associate Professor of Ophthalmology at the CU Anschutz School of Medicine.

Valeria Canto-Soler, Ph.D.
Valeria Canto-Soler, Ph.D.

This $10 million ocular stem cell and regeneration program initiative began with a $5 million grant from the Gates Frontier Fund to research the potential for stem cells to treat age-related macular degeneration, the leading cause of blindness in people ages 50 and older.

“I dreamed of launching a stem cell research program like this for years,” she says. “The leadership at both the Gates Center and the Department of Ophthalmology has the same vision that I have. Working together, we can make it happen.”

Growing up in Argentina

Canto-Soler grew up in Mendoza, Argentina, a city on the eastern side of the Andes Mountains. Similar to Denver in that it’s nestled in the foothills, Mendoza’s close proximity to the mountains gave her the opportunity to hike, explore and marvel at the natural wildlife she encountered.

But when it came to a career choice, it was more difficult for her to decide how to direct her love of nature and biology. In contrast to the U.S., students in Argentina have to decide on a career early.

“It’s a very important decision and there are very few chances for you to change your mind after that,” she says.

As a young biology student, Canto-Soler found herself drawn to the study of the human nervous system and how the sense organs work.

“Year by year, I felt more and more fascinated by the biology of the human body,” she says. “In the last two years of biology school, I started to work in a lab studying the nervous system. That defined my future.”

Canto-Soler earned a B.S. in Biology from the University of Cordoba School of Natural Sciences, Cordoba, Argentina in 1996. In 2002, she completed a Ph.D. in Biomedical Sciences at the Austral University School of Medicine in Buenos Aires.

A Johns Hopkins Fellowship

After she earned her Ph.D., Canto-Soler had the opportunity to explore new vistas. She was accepted as a Fellow with the Retinal Degenerations Research Center in the Department of Ophthalmology at Johns Hopkins University School of Medicine in Baltimore. She worked with renowned scientist Ruben Adler, MD, at the Wilmer Eye Institute.

“I was so excited – the focus of his research was the development of the eye,” Canto-Soler says. “It was perfect for me.”

She thought her fellowship would provide her the knowledge and experience she could take back to Argentina, but she found new challenges to keep her in the U.S. When her mentor, Dr. Adler, died in 2007, she took over his role at Wilmer to continue their work.

A New Discovery

In 2014, Canto-Soler and her team created a miniature human retina in a petri dish, using human stem cells. The mini retinas had functioning photoreceptor cells capable of sensing light. This cutting-edge research opened up the potential to take cells from a patient who suffers from a particular retinal disease, such as macular degeneration, and use them to generate mini retinas that would recapitulate the disease of the patient; this allows studying the disease on a human context directly, rather than depending on animal models.

Canto-Soler at CU Anschutz
Valeria Canto-Soler, Ph.D., hopes her research will someday result in cell-based treatments for vision patients.

This research could lead to personalized medicine and drug treatments for specific patient needs. At CellSight, Canto-Soler will work with clinicians and members of the Gates Center to create patient registries and cell banking. She hopes her research will someday result in cell-based treatments; retinal patches, for example, which could be transplanted into a patient’s eye, possibly curing blindness.

“Once you transplant a retinal patch, the cells have to establish all the right connections with the patient’s own retinal cells in order to process the information and produce a visual image,” she says. “No one really knows how to do that yet.”

But she’s confident the clinicians from the Department of Ophthalmology, and the researchers at CellSight and the Gates Center, will work together to make the dream a reality.

“I’m definitely a dreamer,” Canto-Soler says. “I never imagined we could generate human mini retinas in a petri dish. And to see that happen made me a believer. I believe our scientific dreams can come true if we pursue them in the right way.”

The letters and emails she receives from those who have family members or friends suffering from sight problems or blindness inspire her. They’re also looking for answers.

“It’s what gets me motivated to come to work every day,” she says. “I’m excited to think about how we could help people and the impact that would make in their lives.”

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Small cash incentives can encourage primary care visits

An economic experiment to inform policymakers considering Medicaid expansion shows small cash incentives to low-income people with new health care coverage can promote primary care visits that may significantly reduce costs overall. The study, by Cathy Bradley, professor of health systems management and policy at the Colorado School of Public Health at CU Anschutz, published today in the August issue of Health Affairs.

“This shows a potential for cost savings for a very small amount of money,” Bradley said. “Access to primary care does not necessarily mean a visit will occur. Establishing a primary care relationship with an initial visit helps prevent chronic conditions, avoids hospitalizations and use of emergency departments and provides better care to the patient.”

Some employers use cash incentives to encourage healthy behaviors among workers and the Affordable Care Act expanded the use of such incentives to public insurance programs.

“At the time this experiment began, Medicaid expansions were happening across the US,” Bradley said.

Previous studies reported that low-income patients could be especially responsive to financial incentives like cost-sharing responsibility for emergency department use.

“An emergency room visit would treat the patient’s immediate acute need and discharge them,” Bradley said. “A primary care doctor will do all the things that improve their well-being and prevent a medical crisis.”

In a randomized controlled trial with subjects in Virginia living 100 percent below the federal poverty level, researchers studied low-income adults newly covered by a primary care program to determine if a cash incentive could encourage them to make an initial visit to a primary care provider. Among four total participant groups, three were given a baseline survey by telephone and then either $50, $25 or $0 to visit their provider within six months. A control group received no incentive or contact from the researchers.

The findings also suggest that interaction with a health care program coordinator who shows low-income enrollees through the system may also encourage primary care visits without further cash incentives. In the $0 incentive group, more people sought and received care than the unpaid control group.

“It shows that for a small amount of money and a conversation you can get a person to obtain primary care,” Bradley said.

Subjects in the $50 and $25 incentive groups were more likely to see a primary care provider (77 percent and 74 percent, respectively) compared to the $0 group (68 percent). In the control group, 61 percent received care.

Study subjects were identified and enrolled through a community-based primary care program from a safety-net health care provider in Virginia serving low-income patients. All were newly enrolled in a health care program and had not seen a primary care provider or specialist in the previous nine months.

Overall, 1,228 participants were included in the three incentive groups and completed the baseline interview. There were 414 in the control group.

Bradley said the biggest limitation to the study was recruitment. A significant amount of potential subjects did not have stable phone connectivity, were homeless or incarcerated, making study enrollment a challenge.

The study was co-authored by David Neumark, professor of economics at the University of California, Irvine.

 

 

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Center for Women’s Health Research holds career day for high school girls

Participants of the ‘Exploring Healthcare Careers for High School-Aged Girls’ event, hosted by the CWHR, practice suturing techniques at the Center for Surgical Innovation
Participants in the ‘Exploring Healthcare Careers for High School-Aged Girls’ event, hosted by the CWHR, practice suturing techniques at the Center for Surgical Innovation

On June 8, the Center for Women’s Health Research (CWHR) and UCHealth partnered to host the third annual “Exploring Healthcare Careers for High School-Aged Girls,” an interactive learning opportunity for high school girls interested in exploring healthcare and science careers. The day-long program offered 60 young women the chance to visit the CU Anschutz Medical Campus, attend lectures and Q&A sessions and participate in hands-on learning experiences to gain insight into the working lives of scientists and healthcare professionals.

After a mother-daughter breakfast and welcoming remarks by CWHR Director Judy Regensteiner, the participants spent their morning visiting the Gates Biomanufacturing Facility and the Center for Surgical Innovation (CSI). At the Gates Biomanufacturing Facility, they observed how lab discoveries translate into cell therapies; at CSI, they experimented with suturing techniques on a variety of tissues. Various researchers and surgical residents explained their different roles at Gates and CSI, and described the diverse and sometimes unpredictable paths they took to get there.

At lunch, the participants were treated to an insightful lecture by Dr. Anne Libby, Vice Chair for Academic Affairs, who discussed the five indicators of talent that can lead to thoughtful, satisfying career choices: yearning, satisfaction, rapid learning, glimpses of excellence, and flow. “In choosing a career path,” she told the girls, “don’t ask yourselves what you want to be. Ask yourselves who you are, and how you can become more you.” A psychiatrist and nurse practitioner from the Johnson Depression Center also spoke to the girls about careers in behavioral health.

The afternoon’s activities included a visit to the Cardiac and Vascular Center’s heart catheter lab, where the girls saw simulated demonstrations of heart catheterization and expanded their knowledge of the various options for professions in cardiology.

The day ended with presentations by athletic trainers from the Sports Medicine Department at Children’s Hospital Colorado, who discussed the options for individuals interested in sports medicine careers. When the day’s activities came to a close, many of the girls expressed their gratitude and excitement at the insights they had gained after exposure to so many career options on campus.

“It opened my mind to a health-centered career,” one participant said. “Before, I simply wanted to do engineering, but now medical school seems interesting too.”

Another, reiterating Dr. Libby’s message, came to the following conclusion: “The best part about the day was realizing that there is no ideal way to get anywhere – you just have to be yourself and follow your heart and it will lead you to where you need to be.”

The CWHR is looking forward to hosting the event again next year.

Guest Contributor:  Andrew Weaver, Public Relations and Community Education Coordinator, Center for Women’s Health Research

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Immune system may keep body from neutralizing HIV-1 virus

Researchers at the University of  Colorado Anschutz Medical Campus have discovered that a process protecting the body from autoimmune disease appears to prevent it from creating antibodies that can neutralize the HIV-1 virus, a finding that could possibly help lead to a vaccine that stimulates production of these antibodies.

Dr. Raul Torres, professor of immunology and microbiology at CU Anschutz
Raul Torres, PhD, professor of immunology and microbiology at the University of Colorado School of Medicine.

The study, led by Raul M. Torres, PhD, professor of immunology and microbiology at the University of Colorado School of Medicine, was published Tuesday in The Journal of Experimental Medicine.

Torres and his team sought to better understand how the body’s own immune system might be getting in the way of neutralizing the HIV-1 virus.

They knew that some patients infected with HIV-1 developed what are known as ‘broadly neutralizing antibodies,’ or bnAbs, that can protect against a wide variety of HIV-1 strains by recognizing a protein on the surface of the virus called Env. But the patients only develop these antibodies after many years of infection.

Because of shared features found in a number of HIV-1 bnAbs, researchers suspected the inability or delayed ability to make these type of protective antibodies against HIV was due to the immune system suppressing production of the antibodies to prevent the body from creating self-reactive antibodies that could cause autoimmune diseases like systemic lupus erythematosus.

At the same time, patients with lupus showed slower rates of HIV-1 infection. Scientists believe that’s because these autoimmune patients produce self-reactive antibodies that recognize and neutralize HIV-1.

The process by which the body prevents the creation of antibodies that can cause autoimmune disease is known as immunological tolerance.

Torres wanted to break through that tolerance and stimulate the production of antibodies that could neutralize HIV-1.

“We wanted to see if people could make a protective response to HIV-1 without the normal restraint imposed by the immune system to prevent autoimmunity,” Torres said.

The researchers first tested mice with genetic defects that caused lupus-like symptoms. They found that many of them produced antibodies that could neutralize HIV-1 after being injected with alum, a chemical that promotes antibody secretion and is often used in vaccinations.

Next, they treated normal mice with a drug that impairs immunological tolerance and found that they began producing antibodies capable of neutralizing HIV-1. The production of these antibodies was increased by alum injections. And if the mice were also injected with the HIV-1 protein Env, they produced potent broadly neutralizing antibodies capable of neutralizing a range of HIV-1 strains.

In every case, the production of these HIV-neutralizing antibodies correlated with the levels of a self-reactive antibody that recognizes a chromosomal protein called Histone H2A. The researchers confirmed these antibodies could neutralize HIV-1.

“We think this may reflect an example of molecular mimicry where the virus has evolved to mimic or look like a self protein,” Torres said.

Torres suggested that the difficulty in developing a vaccine against HIV-1 may be because of the ability of the virus to camouflage itself as a normal part of the body.

“But breaching peripheral immunological tolerance permits the production of cross-reactive antibodies able to neutralize HIV-1,” Torres said.

Since the research was done on animals, scientists must still determine its relevance for HIV-1 immunity in humans.

“The primary consideration will be determining whether immunological tolerance can be temporarily relaxed without leading to detrimental autoimmune manifestations and as a means to possibly elicit HIV-1 bnAbs with vaccination,” he said.

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Dr. Jonathan Samet is new dean of Colorado School of Public Health

Following an extensive national search, the chancellor of the University of Colorado Anschutz Medical Campus, Don Elliman, announced Tuesday the hiring of Dr. Jonathan Samet, MD, MS, as the new dean of the Colorado School of Public Health.

Dr. Samet, an accomplished medical professional and administrator, has occupied top positions in leading universities around the country.

Dr. Jonathan Samet, new dean of the Colorado School of Public Health
Dr. Jonathan Samet is the new dean of the Colorado School of Public Health

He is currently distinguished professor and chair of the Department of Preventive Medicine at the Keck School of Medicine at the University of Southern California. He also directs both the USC Institute for Global Health and the Workforce Development and KL2 Program of the Southern California Clinical and Translational Science Institute.

“I am honored by being selected as the third dean of the Colorado School of Public Health,” Dr. Samet said.  “A key goal will be to enhance the school’s impact on public health in the state and region through our research and training activities.”

Previously, he chaired the department of epidemiology at the Johns Hopkins Bloomberg School of Public Health and was clinical division chief for Pulmonary and Critical Care Medicine at the University of New Mexico.

Chancellor Elliman said the new dean will strengthen and deepen the impact of the Colorado School of Public Health (ColoradoSPH).

“Since its establishment just nine years ago, the ColoradoSPH – a partnership of CU Anschutz, Colorado State University and the University of Northern Colorado – has made remarkable strides toward becoming one of the country’s premier institutions of public health,” Elliman said. “As its third dean, Dr. Samet, who brings the experience of a long and distinguished career in academic medicine and public health, is uniquely qualified to take the ColoradoSPH to new heights.”

Dr. Samet comes to ColoradoSPH with nearly 40 years of experience in education, health care and research.

Throughout his career, he’s fostered and mentored faculty members, created new lines of research, initiated curricular advances and maintained fiscal stability.

Along with teaching everyone from undergraduate to postdoctoral students, Dr. Samet has conducted a wide array of research into health issues.  In many cases, he’s translated that research into action. His work led to advancing tobacco controls nationally and around the world, tightening air quality regulations and winning compensation for underground uranium miners suffering health problems.

The new dean is past-president of the American College of Epidemiology and the Society of Epidemiologic Research. He was elected to the National Academy of Medicine, one of the highest honors in medicine, and holds a bachelor’s degree from Harvard College, an MD from the University of Rochester and a master’s degree from the Harvard School of Public Health.

“We are fortunate to have someone as accomplished and versatile as Dr. Samet taking the helm of the Colorado School of Public Health at this critical juncture in its growth,” Chancellor Elliman said. “I am grateful to Dr. Elaine Morrato who, as interim dean since December, has helped the school continue to build on its momentum while ensuring we are set up for a smooth handoff to new leadership.”

Dr. Morrato, DrPH, MPH, will continue as interim dean until Dr. Samet assumes his new post in October.

 

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CU Anschutz Spring Commencement 2017

More than 1,300 graduates from a wide range of health care disciplines celebrated their achievement with friends and family at CU Anschutz Commencement on May 26. The ceremonies included the graduation of the 10,000th student from the CU Anschutz Medical Campus in its current location, reflecting the campus’s tremendous growth since relocating from the location at 9th Avenue and Colorado Boulevard.

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The hero and the dental student: A tale of friendship

Willie Peterson is an Army veteran who has lived through his share of hard times. He has learned to cherish small blessings and pay attention to positive role models. One such role model sat across from him over a string of dental appointments which saw Willie’s once-shy smile transform into a mouth of pearly whites.

That person is Bill Berguin, a recent graduate of the CU School of Dental Medicine. Bill has been the architect of Willie’s new dentures and a close witness to the inspired and ever-upward trajectory of Willie’s life.

Willie and Bill at the Heroes Clinic at CU Anschutz
Army veteran Willie Peterson, left, proudly shows off his new teeth, which were created by Bill Berguin, his Heroes Clinic caregiver.

At a recent dental appointment, Willie was all smiles. Besides gaining his stellar teeth, the soldier was excited to fill in Bill about yet another achievement. “Check out my credit score,” he said with a beaming grin. “Also, I’ve got a job. I haven’t had a good job in a long time.”

‘He’s a good man’

Willie met Bill about a year ago when he became the first Pathway 1 patient in the dental school’s Heroes Clinic, a Delta Dental of Colorado-sponsored program which provides free and discounted dental care to military veterans. Pathway 1 provides dental care to veterans served through the Bill Daniels Veteran Services Center, which helps link homeless veterans to jobs.

They come from different backgrounds – Willie is from Wisconsin and Bill hails from the Western Slope – but they bonded during Willie’s many visits to the dental chair. “I got to sit and talk with him about life – where he’s from and what he’s doing and how he was trying to go back to school,” Bill said. A few good-natured jabs also found their way into the conversations. Bill likes to razz Willie about being a Green Bay Packers fan, while Willie dishes it right back on the Broncos.

Kidding aside, Willie once confided to Bill, who was in the fourth year of dental school, that he had planted in the soldier’s mind the notion of returning to school. “I thought that was really neat,” Bill said. “I told him he might want to see a graduation, so he’s going to come to my graduation.”

Sure enough, early last Friday morning, Willie boarded a bus near his Denver apartment and rode to the CU Anschutz Medical Campus to attend Bill’s graduation. He hadn’t been to a graduation since his own from high school some 40 years ago. When Bill said he was looking forward to having his new friend meet his family, Willie smiled, extended a hand for a firm shake and said, “I want Bill to come to my graduation, too.”

Willie Peterson and Bill Berguin at CU Dental School graduation
Willie Peterson shakes hands with Bill Berguin at Bill’s graduation on May 26.

Willie has his sights on becoming a technician in heating, ventilation and air conditioning (HVAC). He recently enrolled in the HVAC program at Emily Griffith Technical College in Denver.

Asked what he found inspiring about Bill, Willie said, “I just think he’s a perfectionist. He’s a good man.” 

Putting his life back together

Willie performed a seven-year hitch in the Army, serving in Korea and Japan and, stateside, in Florida and California. He was discharged in 1983, but soon fell into drug abuse and homelessness. “The whole thing,” he said, shaking his head, “just a few years after I got out of the service.”

Gradually, he began to pay heed to the few positive influences in his life. He reconnected with a Lutheran pastor he’d first met during a spell of living in California. When the pastor moved to Wisconsin, Willie followed and began seeking the clergyman’s counsel.

“He helped me kick drugs,” Willie said. “I needed that – I really did – because I was heading down a bad street.”

Things turned more for the better when he sought the help of his mother. “I was just tired of how I was living, so I had to make a change. I started to hang out with my mom and going to church, and then I got the hang of it.”

About a year ago Willie made the move to Colorado, where his sister lives. Still, life was a struggle, as the veteran didn’t have a place to call his own. The Bill Daniels Veteran Services Center connected him to the Samaritan House, a transitional housing facility. Willie was riding the 16th Street Mall shuttle one day when he bumped into Heidi Tyrrell, RDH, assistant director and clinical instructor in the dental school’s Heroes Clinic.

“He was grinning ear to ear and wearing a suit that was a little too big for him,” said Tyrrell, who also noticed that Willie was in need of some dental work. “He ‘ma’amed’ me and I said, ‘Are you a veteran?’ He said yes and I handed him my card.”

Willie, Bill and Heidi at CU School of Dental Medicine graduation
At the CU School of Dental Medicine’s graduation on May 26 are, from left, Army veteran Willie Peterson, graduate Bill Berguin and Heidi Tyrrell, assistant director and clinical instructor in the dental school’s Heroes Clinic.

That’s how Willie ended up in a dental chair with Bill as his care provider. Growing up in Grand Junction, where he saw many friends join the military, Bill has a built-in respect for veterans and he felt honored to care for Willie. “I treated him the way I treat all my patients,” Bill said. “He’s a really good guy, so it was easy.”

With each visit, Willie’s smile brightened and his sense of accomplishment soared. “One less thing to do,” he said with another big grin.

‘Cool to feel like I was helping’

Willie enjoys his job as a housekeeper at the VA Medical Center in Denver. Besides his recent enrollment in technical college, he now has a permanent home, a new girlfriend and a burgeoning sense of security.

“I’m tired of living poor – I don’t want to keep living like that,” said Willie, sporting a U.S. Army hat and the ever-present Packers lanyard. “I feel good about myself now.”

Bill likes the idea of giving back to veterans and said that of all his clinical rotations during dental school, the Heroes Clinic became his favorite. Willie was even more special in that he is the clinic’s first Pathways 1 patient. “Folks in that population are a little more at risk,” Bill said, “so it was cool to feel like I was really helping somebody out.”

Bill will return to Grand Junction with a goal of eventually having his own practice. His father is a dentist, and he plans to join his dad’s practice to learn the ropes of daily dentistry while paying off student loans.

Bill said his rotation in the Heroes Clinic, especially his time with Willie, will remind him of the very reason he aspired to become a dentist – to help people. “I want to do community service and whatever I can to volunteer and give my time, so I can provide care for people who can’t afford it,” he said. “It’s something I want to continue and not lose sight of.”

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