EVCP Expresso – September 2019

Dear Colleagues,

Over this past holiday weekend, the nation was yet again shaken by the news of another mass shooting that has resulted in the deaths of seven individuals and injured over twenty others in Midland and Odessa, Texas. And, at the Minnesota State Fair yesterday three more were shot and injured. We are now learning that the person responsible for the Texas shooting failed a background check but was still able to obtain an assault-style rifle. Again…what will it take to stop gun violence?

We also learned that last month U.S. Citizenship and Immigration Services decided to eliminate a “humanitarian deferred action” program that allowed immigrants to avoid deportation while they or a relative received life-saving medical treatment. While the decision is now being reconsidered, read more about how it would have a devastating impact on one of our own patients.


While it’s critical to stay informed and engaged on these national issues, I encourage everyone to find an approach towards their own wellness.

I just returned from a fantastic wilderness canoe trip in northern Canada and was once again reminded of the astounding experience of travel and exploring the rest of the world. (Being entirely off the grid for two weeks was also mind-bending – I’ll write about this later.) This month, read about the results of the first EVCP Poll – your recommendations of natural and human-made destinations that are bucket list worthy. Are you planning a trip? The UCGO website is a portal to information and resources focused on travel safety, in support of UC’s global activities.

Additional September topics provide a continued update about clinical trial process improvements and insights from my monthly conversations with junior faculty.

Later this month on UCSF.edu, you’ll learn more about the Comprehensive Parnassus Heights Plan – the final report of the Parnassus Master Planning Steering Committee. The future of Parnassus includes a new research academic building (RAB). We have a lot of work and potential challenges ahead of us, but Chancellor Sam Hawgood, Senior Vice Chancellor Paul Jenny, and I are committed to the process and the plan to erect the RAB by 2025. More to come in the October issue of Expresso.

With Labor Day behind us, do you feel the push to get back into the swing of things? How about starting by predicting the “Future of Health” in 2050? Please take five minutes and complete this UCSF Magazine survey.

And, as always, send me your feedback on something you’ve read or want to read about. Just drop me a note at [email protected].



Improving Clinical Trials Activation #2: Incorporating the faculty voice

Last month, I wrote part one about improving the clinical trial activation process. To ensure our continued progress, we need to understand and incorporate the perspective of our diverse faculty community – from Zuckerberg San Francisco General Hospital and Trauma Center, to the Veterans Administration, to clinicians in pediatrics, AIDS, neurology, cancer – you name it. Each has unique issues, and we must be cognizant that as we implement change, we may be introducing added complexities.

To connect all the complicated dots, the Office of Research has developed a new associate director (AD) faculty leadership role focused on clinical trial operations (CTO) and has just completed an internal search for its inaugural incumbent. Hal Collard, associate vice chancellor of Clinical Research in the Office of Research, says the AD CTO’s function will be to “bring the faculty voice to the clinical trials support conversation, helping our staff leadership in setting priorities for the clinical trial activation and operations going forward.” Among other responsibilities, Hal says, “the AD CTO faculty position will establish and chair an enterprise-wide CTO committee of clinical researchers representing the diverse interests and needs of the UCSF faculty. This CTO committee will be charged with providing the Office of Research with guidance and recommendations for improving clinical trial operations across UCSF.”

And, we are proud to announce that Payam Nahid, professor in the Department of Medicine, has been appointed and will assume the role this month.

Clinical trials are complex clinical and administrative operations, and the Office of Research is responsible for ensuring patients are safe, rules are followed, and bills go to the proper place. But the staff and faculty leadership also recognize the great need to improve administrative efficiencies so patients who are waiting for clinical trials, and the faculty researchers who are waiting to conduct those trials, can move forward. “As a clinical trialist myself, I feel the impact of delays in the clinical trial operations process acutely,” notes Hal. “Delays can cause crises for patients and researchers; this is simply unacceptable.” Case in point: Hal recalls being at a conference where researchers were discussing that progress in clinical research takes time. At the end of the conversation, a man stood up and said, “With all due respect, I’m a patient with this disease and I don’t want to hear that I should understand that research to improve my life is going to take a while. I don’t have a while. I’m dying from this disease and need you to push.”

Indeed, we are pushing! With the efforts described in last month’s story strengthened by the CTO efforts described above, we are now in a much better place to improve our clinical trial operations.  The entire team welcomes your input and guidance going forward.

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Gift of Gab: Nothing trivial about conversations with junior faculty

Monthly conversations with our junior faculty members are a highlight of my role as EVCP. It’s always a small, vibrant, and engaged group, representative of a great cross section of faculty at the beginning of their academic careers. While it’s an opportunity for me to provide updates about what’s going on in the University, the most important time during the 90 minutes is when faculty share their passionate stories and concerns.

We begin with introductions, each person describing their path from childhood to UCSF, and then I ask everyone to describe one passion they have. I love hearing these, whether it’s cooking, playing the saxophone, salsa dancing, traveling in the wilderness, or whatever it is that brings delight. I then invite the group to bring up any issues, questions about how this place works, or advice they’d like to impart to leadership.

I’m glad to field the many questions and have noticed a theme that runs month to month: How does the business of the University run? Why does it seem the University brings in an enormous amount of money but it always feels like we’re working on the margins? Do we recognize how much of an impact the cost of living is having on the faculty and the community at large? Yes, finances and economy.

Before becoming EVCP, I used to think that UCSF administration and operations was a puzzle of mysterious processes and decisions that took place behind closed doors. Now that I’ve been part of the administration (almost five years!), it is definitely less mysterious, and I’ve gained insight into what it takes to try and effectively run a large organization like ours, and I share that with the group.

Another theme goes like this: they find their passion in life, and find what it is they need to pursue as a result of that passion. They discover UCSF, a seemingly perfect place for them. They say, “I can’t believe how amazingly collaborative UCSF is. There was something about the atmosphere, the ethos that really spoke to me.”

At the same time, we invariably agree, it’s such a struggle to be so strongly drawn to this incredible community and feel it is the place where we want to pursue our work, and on the other hand, reconcile this with the seeming impossibility of living in the Bay Area. Yes, junior faculty are concerned for themselves, but they are particularly concerned about the plight of their staff, who they see commuting two hours or more because they can’t afford to live closer.

The lack of affordability bothers me to no end, and I appreciate hearing about it from others every month, helping ensure that it stays at the forefront of my mind. (I know the chancellor thinks about it every day, too.) Unfortunately, I often wind up explaining that there are just a limited number of levers we can pull that will affect the cost of living for our employees. We also talk about the vital importance of philanthropy, the vast majority of which goes to people and programs (as opposed to buildings).

Every once in a while, someone brings up a very specific issue or a problem they’re having that simply shouldn’t be occurring. Maybe it’s a perfect example of unnecessary bureaucracy. Or a policy that is counterintuitive, at least on the surface.  It’s important to me to help with those problems because I can remember clearly what it felt like as a junior faculty and, even earlier, as a medical student. It helps me relate, and I always ask them to email me and follow up with specifics, and then do what I can do to try to resolve it.

In the end, each of these conversations is about creating community, bringing folks together to share common situations, witness similar challenges, appreciate their collective voices, see their futures at UCSF, and know that they have a conduit to leadership who are actively listening.

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A Monkey, a Pair of Glasses, and Me: No joking – bucket list poll results

Not the lead-in to a great joke – but three elements of a particularly memorable trip to India that Mylo and I took back in 2011 – I’m happy to tell you the story about the monkey any time. No doubt, we each have had a similar experience that brings a smile to our face. So, thank you for submitting places you have experienced and deemed bucket list worthy!

The results of the inaugural UCSF Bucket List Poll are in, and it reads like an itinerary that would satisfy Phileas Fogg. Reading the list, I was transported to places near and far. From the natural – Antarctica to Wrangell-St. Elias National Park – to the human-made – Versailles to the Western Wall – with many beautiful and intriguing places in between. No Westeros, but I was heartened to see both the Hiroshima Peace Memorial Museum and the National Memorial for Peace and Justice in Montgomery, Alabama.

By the very nature of our institutional mission of advancing health worldwide, we are a global community, and traveling to and interacting with people from other countries are inherent to our work lives. But how does travel affect you?

For me it’s the opportunity to connect with people (and other animals) on their home turf – encounter their sights, smells, and sounds. Or be in places of stunning, natural beauty. Listening to the buzz of another language, being a visitor, engaging as a spectator, getting out of my comfort zone – all stir an excitement that I experience every time I leave the routine of UCSF and my day-to-day world. Travel also has afforded me many friendships that have had profound professional, spiritual, and personal impact. I still feel that the most important educational experience of my life was when I was 21 years old and circumnavigated the world for a year.

So where did some of you recommend? Natural destinations that were mentioned multiple times include the Redwoods National Park, the Grand Canyon, and Yosemite, and human-made ones include Angkor Wat and Machu Picchu. Then there were the fjords of Norway and New Zealand, our own Crater Lake, the Pyramids, and Venice (by day and night). Just reading the list of places is a mind-expanding travelogue in and of itself.

This wonderful planet of ours is precious, and we must tread lightly to preserve it for future generations. And in a genuine effort to do just that, the Duke of Sussex launched today a new program called “Travalyst.”

If you’re focused on sustainability or a long plane ride or car trip are not quite to your liking, take a jaunt through the many neighborhoods, each with its own personality, of San Francisco or any Bay Area city. Put out the welcome mat and engage with the many visitors and newcomers to our fair city who bring their home countries and cultures here. And if you have young people in your life, you can explore the world through a myriad of media – I remember shows like Where in the World is Carmen Sandiego? – and now we have Dora the Explorer. A few great books are A Long Walk to Water and The Atlas Obscura Explorer’s Guide for the World’s Most Adventurous Kid.

I’ll close with this excerpt from the poem “Travel” by Edna St. Vincent Millay (1892-1950):

   My heart is warm with the friends I make,
      And better friends I’ll not be knowing;
   Yet there isn’t a train I wouldn’t take,
      No matter where it’s going.

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Dan’s Tip of the Month

 If the end of summer (or the world we find ourselves in) is bringing you to tears, consider the humble onion. Ubiquitous and essential to every cuisine on the planet, always waiting to be peeled, chopped, minced, sliced, and diced. They cross all borders, giving backbone to any recipe from any country. Rich in vitamin C, they also contain calcium, potassium, iron, and fiber and for centuries have been used to provide anti-inflammatory and antibacterial benefits. All this without fanfare or praise or notoriety. But – the TEARS! Well, here’s my solution (and perhaps a nifty gift for the cook in your life): this device is amazing…

Update, October 2020: Unfortunately, I recommended the Mueller Vegetable Chopper but it has been recalled. More details, including determination if a purchase is impacted and what should be done next, can be found here.

Image: Peeling Onions – Lilly Martin Spencer, 1852 (American, 1822–1902)

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