EVCP Expresso – May 2016

May 2, 2016

Dear Colleagues:

May marks the beginning of commencement season – the occasion when the tassel is switched to the other side of the mortarboard. It’s a time to congratulate significant achievement at every level of education, from kindergarten to doctoral degrees. I send my best not only to our UCSF grads and their parents, spouses, and families, but also to everyone else celebrating graduations in the coming months.

In this issue of Expresso, I am writing about a different mortar – the mortar that goes with bricks. Specifically:

I know these issues affect many of your lives. Please share your thoughts with me at [email protected], and let me know what you’d like to see in future issues of Expresso.

Best wishes,



PZ2025/UCSF 2030: Bold ideas being tossed around about the future of UCSF

Our modern Mission Bay campus, a source of great pride with its dazzling new buildings, has left our Parnassus and Mount Zion sites looking a little tired. This motivated me to call together a task force last year to envision how we could bring back the luster to these locations and ensure that they remain an exciting, integral, and vibrant part of UCSF.

I’m happy to report that the task force – which has heretofore been named PZ2025, and will be evolving into “UCSF 2030” – is thinking big. Nothing has been decided yet, because we need to gather a lot more input before any decisions are made. So far, I am excited by the scope of vision our group is bringing to the table; so much so, that I have asked the group to organize its ideas into themes for the capital campaign that is currently being considered. Of course there are many uncertainties and unknowns.

As we project a future for these locations, one coming development is obvious: Moffitt Hospital, UCSF’s largest, is going to be replaced with a new hospital addition and repurposed for non-acute care functions. State seismic regulations—specifically Senate Bill 1953—dictate this significant change. We expect to accomplish this by January 2030 by first relocating the programs now in Langley Porter Psychiatric Institute (LPPI) to several new and existing spaces, then demolishing the existing LPPI buildings, then opening the new hospital addition on the site where LPPI now stands.

That spurred an idea from the group—would it make sense to have some further consolidation of basic science at Mission Bay and make Parnassus a hub of clinical and translational science and health professions education, synergizing with our clinicians and patients?

Of course, strictly dividing our campuses into themes won't be possible, or even desirable. Clinical and translational science continues at Mission Bay, particularly with our new hospital there serving women, children, and cancer patients; and basic science continues on Parnassus—both have an important role in all three major missions of UCSF: education, research, and patient care. The task force has been batting around all these concepts and issues.

While UCSF has traditionally been organized by field of study, with clinical and basic scientists collaborating on, say, research involving cardiology, or diabetes, or cancer, there is some logic to reorganizing instead around the type of science involved. Basic scientists studying different diseases may use the same type of expensive, high-tech equipment, as well as work within the same concepts; therefore, it may make more sense for them to be concentrated together at one location. Similarly, clinical scientists now considering the whole patient are finding much common ground as they develop therapies and cures for various diseases.

I wish I had the space (no pun intended) to go into all the nuances of this complex, stimulating issue. My colleagues on the PZ2025 task force (representing all schools and a range of disciplines) have my deep gratitude, especially the members who spent extra time this month sharing their thoughts and informing this write-up:

  • Lisa Kroon, PharmD, chair of the Department of Clinical Pharmacy in the School of Pharmacy
  • Thomas Lang, PhD, associate dean for research in the School of Dentistry and a professor in Radiology and Biomedical Imaging in the School of Medicine
  • Richard Locksley, MD, professor in the School of Medicine and a Howard Hughes investigator
  • Catherine Lucey, MD, vice dean for education in the School of Medicine
  • Robert Wachter, MD, interim chair of the Department of Medicine in the School of Medicine
  • Arthur Weiss, MD, PhD, professor in the School of Medicine and a Howard Hughes investigator

The following expands on some of the ideas coming before the committee:

  • Mount Zion. Some say this venerable hospital went from historically feeling like “second fiddle” to Parnassus, to being “third fiddle” once Mission Bay was built, and now “feels like it’s not even an instrument,” as most of its cancer services will move soon to Mission Bay. But Bob Wachter, for one, sees an exciting opportunity to re-imagine this prime San Francisco campus as the hub “where we focus on primary care, prevention, wellness, social science-type research, outcomes research, telemedicine, population health… all of the things that are about taking care of less sick people, keeping people healthy, and the research that relates to that—things that don't really require a lab, and don't require that you're next to hospitalized patients.”
  • Education. “This gives us an opportunity to really re-envision what we understand to be educational space,” Catherine Lucey says. It’s not just classrooms and labs. It’s space for students to collaborate within and across professions, common areas where they can bump into faculty, and quiet spots for deep thinking. And, it opens a new mindset she calls a Health Care Learning System that embeds learning into the research and patient care environments. Educational space has traditionally been crammed into Parnassus in a “Motel 6 mentality,” she says, “where as long as the bed is clean, we’re fine.” Instead, Parnassus, with its gorgeous views, its great history, and its teaching environment, should reflect the message that “this is a campus that values education.” “We’re good at that in San Francisco,” she says. “We buy a landmark house and make it look welcoming and spectacular.”
  • Capital Campaign. The chancellor has just formed a group to start thinking about a new major fundraising campaign for UCSF, and a big idea like transforming Parnassus and Mount Zion into futuristic, thematic centers of excellence in translational science, population health, and prevention could be one of the proposals that the group will consider.
  • Process. These are exciting ideas, but they are just that – exciting ideas, nothing more at this point. No proposal is without its drawbacks, and we need to hear from a lot of people, as well as conduct detailed scoping and estimating, before anyone moves anywhere. We have learned many lessons from Mission Hall and Operational Excellence, and the main one is to ensure we consider as many aspects of a plan or issue as appropriate before making any major decisions or changes.

If you have thoughts on any of this, I welcome your input. Please write to me at [email protected].

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More $$ for a neuroscience building: The backstory as to how such huge donations actually materialize

Speaking of stunning new buildings at Mission Bay, perhaps you’ve seen the Sandler Neurosciences Center, with its sweeping atrium and modern architecture. And you can’t possibly have missed the news that UCSF has received its largest single gift ever: a $185 million donation from Sanford I. “Sandy” Weill and Joan Weill, a major portion of which will be used to launch the UCSF Weill Institute for Neurosciences, just a stone’s throw away from the Sandler Center, and you’re wondering why.

Let me tell you, the new UCSF Weill Institute for Neurosciences is going to push the boundaries of brain research. I realize that, being a neurologist, I can’t be fully objective about all this, but here is the way the plan came to be. The Weills were seeking an opportunity to do something truly transformative, even revolutionary, in the field of neuroscience. They could have turned anywhere in the U.S. (and beyond, I suppose). But what attracted them to UCSF was the vision, from people like Matt State, the chair of Psychiatry, and Steve Hauser, the chair of Neurology, to bring the fields of psychiatry and neurology, and other related fields, under one umbrella. The key driving force behind this has been the confluence of basic neuroscience research, where there is essentially no longer a dividing line between those who are studying basic mechanisms underlying psychiatric versus neurological disease. And, I can tell you from first-hand experience that the vast majority of patients who I see in my epilepsy clinic, and many, many people with neurological diseases such as stroke, dementia, and Parkinson’s disease, also suffer from psychological distress and outright psychiatric illnesses. I believe we have been doing them a disservice by not thinking about their diseases from a more holistic perspective that links the brain and mind.

The gift will bring together many of UCSF’s neuroscience researchers from psychiatry, neurology, neurosurgery, and the basic sciences, including anatomy and physiology. We recruited Matt to UCSF from Yale three years ago precisely so he could unite researchers in mental health with others in neuroscience, particularly with Langley Porter’s expiration date looming.

Importantly, a substantial amount of the funding will be for programmatic support (i.e., not all bricks and mortar), including funding for the neuroscience graduate program, for internal grants open to any member of the scientific community working on problems in neuroscience, and resources to attract the most talented young scientists on the planet to UCSF. Steve agrees that the time is right for this kind of major investment in neuroscience. “We are entering an era in which understanding how the nervous system functions is becoming more possible,” Steve says. “With advances in technology, engineering, big data, and cellular and molecular biology, we are now poised to be able to understand the workings of the more than 100 billion nerve cells in our brains,” and regarding the application of those advances, Matt says that the opportunities for advances in psychiatric research, which have generally lagged behind other areas of medicine, are unprecedented: “This investment and the bringing together of basic and clinical neuroscience will help UCSF revolutionize the understanding and treatment of mental disorders.”

Lest anyone wonder whether the money should go to another branch of medicine, the reality is that virtually all wealthy donors have their own ideas of how they would personally like to have a hand in changing the world. In this case, the stars were aligned behind an opportunity to transform the way we can advance our understanding of the brain and mind. If UCSF had not been seen by Sandy and Joan Weill as the ideal place to achieve this vision, or if we had been disinterested (or tried to convince them to commit to other, important priorities), you can be sure that this enormous infusion of resources would have gone to another institution.

I’ve been hoping for many years now that the artificial divide that has separated psychiatry and neurology for almost a century and a half will finally come down. This latest news may actually mark the beginning of that revolution.

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Renovation blues: Grinning and bearing life under construction at Parnassus

With all this talk of construction, I’m sure it hasn’t escaped denizens of our Parnassus campus – like me – that scaffolding, blocked sidewalks, and heavy machinery seem to have taken up permanent residence. I wish I could tell you that things are looking up, or give you tips on how to cope. We will need to bear it for a while longer, but I will say that the end result will be a great improvement for all of us here at Parnassus.

The Clinical Sciences Building (CSB) was built in 1932 and will be undergoing major seismic improvements and renovation for the next two years as it’s converted to open work spaces including dry research, offices, and new classrooms, with wet labs being relocated to other areas of the campus. UC Hall is even older, built in 1917, and will be gutted, seismically retrofitted, and converted to student housing on floors 3 through 5, with open work spaces including dry research and offices and other program space to be defined on the lower floors. This will follow after CSB has been completed.

Also, workers will be improving the streetscape along Parnassus Avenue, making it not only safer but much more attractive. The streetscape plan, which will be highlighted in a future Expresso, includes designs to make Parnassus significantly safer, greener, more pedestrian-friendly, and more welcoming for our community. The first phase of the improvements will occur with the renovation of CSB and include the area on the north side of the street from the Library to 5th Avenue. Improvements on the south side of the street from UC Hall to 5th Avenue will occur during the UC Hall renovation.

The work is inherently noisy, and we apologize. A major cause is that some of the buildings were attached to each other when they were built, and, in recent years, seismologists have learned that creating some space between buildings gives them room to independently sway a little during an earthquake. Moffitt and Long Hospitals were already separated; now we’re demolishing the entryway that CSB and UC Hall share. As you can imagine, sawing that space out of a concrete connector can raise quite a ruckus!

For me, the need is quite clear: the construction is absolutely necessary, as much of it is mandated by the state, which does not want its employees or students inhabiting seismically unsafe buildings here on one of earth’s most notorious fault lines. (State law requires us to be seismically safe by 2019.) Another reason for the construction is that UCSF has an agreement with its neighbors not to exceed a certain square footage on the Parnassus campus (excluding housing), and we need to eliminate, repurpose, or reconfigure space to stay within those limits. I am also heartened knowing that, as my mother often said, “This too shall pass.” The construction will end, we’ll have a much better working environment, and our surroundings will be commensurate with the world-class work we do here, as well as with the world-class views we command.

Cristina Morrison, manager of Change Management and Facilities in the School of Medicine, says you can find out all about the $400 million project at space.ucsf.edu. Cristina also is redoubling her efforts to have up-to-date signage posted all around Parnassus, letting people know which corridors are closed and when. However, please note that if you were used to cutting through those buildings, now you have to go around the construction zone – and we all should get used to that because when the buildings are done, only occupants will have the access needed to enter, so we’ll still have to take the scenic route. See the March–June fact sheet to get an idea of the major work underway at Parnassus.

As for the layouts inside the buildings, we’ve had loads of committee meetings to make sure many constituents, across all levels, have shared their input on how the new buildings will look, including how the interior spaces are designed.

Thank you for your patience—and thank you also to Capital Programs and the planning groups that are working hard to make Parnassus safer and more comfortable for all of us.

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Dan’s Tip of the Month

Ramon Rising documentaryRAMÓN RISING is a documentary feature on the life of Dr. Ramón Resa, whose remarkable life path exemplifies all the qualities that we at UCSF aspire to: laser-focused commitment to lessening suffering in the world, persistence, drive and the ability to work incredibly hard, and the power of imagination and creativity to solve seemingly impossible problems. Please join me and the filmmakers on Thursday, May 12 at 5:30pm in N-217 as they capture a personal conversation with Dr. Resa for inclusion in the film.

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