From astronauts to elders, Brian Clark studies how we stay strong

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Brian Clark, Ph.D., came to our medical school in 2006 as an assistant professor of physiology and neuroscience, fresh out of graduate school at Syracuse University. He admits now that he arrived expecting to quickly migrate somewhere else.

“I always joke that when I came to Athens, I did not anticipate staying very long,” says Clark. Rather than moving on, however, he has risen to be a full professor, executive director of the Ohio Musculoskeletal & Neurological Institute, holder of the Osteopathic Heritage Foundation Harold E. Clybourne, D.O., Endowed Research Chair and an internationally recognized authority on healthy aging.

It wasn’t that Ohio University and Athens didn’t suit Clark’s younger self; he just feared that he couldn’t find enough volunteers in a small rural community for the kinds of clinical research studies he wanted to do. Instead, he recalls, “I was just flabbergasted by what strong support members of the local community give to research projects.”

Over the years, he has become friends with many of the people who have volunteered for his aging-related research studies. One reason is probably the deep commitment to the safety and comfort of study subjects that’s instilled in OMNI staff at all levels.

“My philosophy has always been, when somebody is volunteering for a study, the key word is ‘volunteering,’” Clark says. “So we do everything in our power to make it a positive experience.”

When Clark started at the Heritage College, his research focused on the effects and causes of muscle fatigue and the effect of prolonged disuse on muscles. Because astronauts on prolonged space flights can suffer such effects, NASA was an important funding source for his early work.

While Clark had long had an interest in aging as a health issue, his research wasn’t focused in this area until NASA moved away from supporting investigator-initiated muscle-disuse studies shortly after his arrival at the medical school. This prompted Clark to look for a field of research in which his expertise could come into play and which could attract support from the National Institutes of Health. Healthy aging fit the bill.

As the percentage of seniors in the U.S. population has grown, NIH has sought ways to help keep the elderly mobile, self-sufficient and out of nursing homes. And the phenomenon of muscle pain and wasting through disuse, which Clark had already been studying, in some ways parallels what happens to our muscles as we age. “It’s actually a model of aging to some extent,” he explains. He took to the new research agenda enthusiastically – and quickly caused something of a shake-up in the field.

At that time, most scientists who studied aging believed they should look primarily at the muscles themselves to understand loss of muscle strength and function in the elderly. Though research dating from the 1970s and ’80s had shown that the nervous system “is a very heavy contributor to muscle function,” Clark says, the aging research community still “basically saw the muscles as the prime culprit in muscle function losses.”

Clark – who maintained that the neuromusculoskeletal system was a better, more holistic subject for research – took a deliberate step toward refuting the consensus view when he and colleague Todd Manini from the University of Florida College of Medicine, Gainesville, published a paper in the Journal of Gerontology, which they intended as something of a shot across orthodoxy’s bow. “We tried to write it in a pretty provocative way,” Clark admits.

Titled “Sarcopenia ≠ Dynapenia,” the article argued that sarcopenia (age-related loss of muscle mass) and dynapenia (loss of muscle strength with aging) are two very different things, and that the first is less a cause of the second than many scientists then believed. Instead of assuming that age-related loss of muscle mass equates to loss of strength, the authors suggested, researchers should be looking at other mechanisms that might underlie dynapenia, including changes in neurological function. In other words, the brain and nervous system may be major players in the process.

The 2008 paper, and a follow-up article in 2011, have had their intended impact in shifting scientific perspective, Clark says, and since their publication have been cited more than 1,000 times. They also mapped out a research territory that Clark and OMNI have made their own, and that has helped make Clark one of the college’s top translational scientists.

The entity now known as OMNI was created in 1979, and was originally known as the Somatic Dysfunction Research Institute; from 1979 to 2008 it was under the direction of John Howell, Ph.D., associate professor in the Department of Biomedical Sciences. Clark credits Howell’s vision for the institute’s growth with laying the groundwork for its future advancement; he also pays tribute to the foundational work of Bob Hikida, Ph.D.,distinguished professor emeritus of microanatomy; and exercise physiology and anatomy professors Fritz Hagerman, Ph.D., and Gary Dudley, Ph.D., both now deceased.

Since Clark took over as head of OMNI upon Howell’s retirement in 2008, the institute has grown into a powerhouse of research, whose two main areas of focus are pain disorders and healthy aging.

From 2014-2018, OMNI attracted close to $11.5 million in external funding – 93 percent of its total funding for the period. It’s consistently one of the best externally funded institutes at Ohio University. This support has come most heavily from NIH, but also from the state of Ohio, private industry and the Osteopathic Heritage Foundations. OMNI’s principal investigators and junior scholars published 204 peer-reviewed PubMed articles with an OHIO affiliation during this time – up 39 percent from the previous five years.

With over 110 published journal articles or book chapters to his credit, Clark’s research has illuminated the role of neurology in muscle function and assessed the effectiveness of drug and exercise interventions in helping seniors retain muscle strength and mobility. In addition to scholarly outlets, his work has caught the attention of the popular press, earning write-ups in major media outlets including the New York Times, Scientific American and The Atlantic.

When he shifted his focus into healthy aging studies, Clark says, it headed him down a path of discovery that he still finds deeply rewarding every day.

“I can easily say that the aging work is what keeps me excited, and engaged, and happy to come to work,” he says.

 

3 questions all health care providers should be asking veterans

 

The 20 million veterans living in the U.S. today have specific health care needs unique to their military experiences, but research has shown that many civilian physicians feel uncomfortable or inexperienced dealing with health-related exposures and risks these veterans might encounter.

To help close this gap, Todd Fredricks, D.O. (’93), an associate professor of family medicine at our medical school, and Brian Plow, an associate professor in the School of Media Arts & Studies in OHIO’s Scripps College of Communication, created a feature-length documentary, “The Veterans’ Project,” with the goal of helping health care providers better treat veterans. The film uses real stories from veterans and health care professionals to highlight the challenges many combat and service-wounded veterans face when seeking care from military, VA and civilian health care systems.

To help physicians better understand and build trust with their veteran patients, Dr. Fredricks, a U.S. Army Colonel and medical officer with the West Virginia National Guard, has identified three simple questions that health care providers should ask all patients.

Question 1

Have you ever served in the armed forces?

Question 2

Did you ever experience any wounds, illnesses or injury as a result of your service?

Question 3

Have you registered with the VA?

These closed-ended questions help health care providers understand who the veterans are within their patient population, while giving veterans who are not comfortable with in-depth conversations about their experiences an out. To hear Dr. Fredricks explain more about the importance of asking these three questions, watch this video.

 

“The Veterans’ Project” is a production of Media in Medicine, a collaborative project led by Fredricks and Plow that brings together visual media, the arts and medicine to create and teach through storytelling. The award-winning film was shown Nov. 10 during the inaugural Columbus Veterans Film and Arts Festival, and has also been presented at the Columbus International Film & Animation Festival, the Broadcast Education Association Festival of Media Arts and the National Communication Association Annual Conference.

 

Our People: Tom Fries, Sponsor of Founding Legislation

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Tom Fries was on hand at the Ohio Statehouse in April 2016 when the Heritage College celebrated 40 years of service to the state.

How lucky I was to be asked to have a part”

Tom Fries, a Democrat from Dayton, was serving his third term in the Ohio House of Representatives when he became lead sponsor of the 1975 legislation that created what is now the Ohio University Heritage College of Osteopathic Medicine. The former Major League Baseball player served six terms in the Ohio House and was appointed to fill a vacant Ohio Senate seat in 1982. Rather than seek election to a full term in the senate, Fries retired from the legislature and founded his own consulting firm.

Favorite memory: “Walking into the renovated Grosvenor Hall with George Dunigan [now the college’s director of governmental relations].” Fries had seen the building previously: “It was still a dormitory ready to become a medical college.” After the renovation, “the cafeteria had been transformed into an anatomy lab complete with 16 cadavers in the walk-in cooler! We commoners don’t see that every day.”

On changing attitudes: “In the beginning, barriers existed among the established disciplines of medicine. I believe [the Heritage College] was the driving force in Ohio to help completely destroy the roadblocks and biases that existed. Today, osteopathic medicine is totally integrated in all disciplines of health care and has been the leader in a more holistic … approach in treatment to the patient.”

Making the grade: “I go back to the original criteria for entering students, which was, ‘Would this young man or woman be the kind of practitioner [the college] wanted to produce?’ By that I think they always wanted to graduate a doctor with personality, compassion, common sense … and of course the ability to succeed academically. But grades were not always the determining factor. And that’s the way it should always be.”

Point of pride: “Having a small part in creating such a vibrant, progressive institution that’s made a difference in millions of lives for 40 years now. Every once in a while I stop and think how lucky I was to be asked to have a part in the creation of [the Heritage College]. Not to mention the wonderful people I’ve met along the way.”

Parting thought: “Whatever you all are doin’, keep on doin’ it!”

40 Things to Know: Our Family Health radio program offered consumer health information for more than 30 years

Pictured: Frank Myers, D.O., dean emeritus; Carl Denbow, Ph.D., director emeritus of communications; and Doug Partusch, a producer for WOUB at that time.
Pictured: Frank Myers, D.O., dean emeritus; Carl Denbow, Ph.D., director emeritus of communications; and Doug Partusch, a producer for WOUB at that time.

“In this photo, which was taken in the control room of the recording studio at WOUB, we appear to be discussing a script – probably looking at a troublesome sentence that needed to be reworded in some way. We had a good team and always worked together to provide sound medical information in an easy-to-understand way. We’d make changes as necessary right up to the point that we did the recording.”  

– Carl Denbow, Ph.D., director emeritus of communications


In the age before WebMD and Internet-accessible medical and health news-you-can-use, there was Family Health radio. The program was the brainchild of Dr. Myers and championed by Dr. Denbow, Don Bilski, and many other radio announcers, producers and writers for more than 30 years. The two-and-a-half-minute program offered listeners timely, practical consumer-oriented health information. At its height, the program reached an estimated hundreds of thousands of listeners, on 250 radio stations domestically and worldwide in China, Canada, New Zealand, United Kingdom and the American Forces Radio Network.

40 Things to Know: Our college was led by the first female African American dean of a medical school

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Embracing diversity and serving the underserved are bedrock values for both our college and the osteopathic profession. So it shouldn’t be too surprising that we made history in August 1993, when our university and college chose an African American woman to be our dean.

When we announced that our new physician leader was Barbara Ross Lee, D.O., sister of Motown superstar Diana Ross, it marked a step forward for diversity in medical education. And Dr. Ross-Lee clearly understood that bringing more minorities into health care can mean better care for underserved populations. She also stressed the important role that osteopathic medicine can play in making that happen.

Speaking to Black Issues in Higher Education about her new job, Dr. Ross-Lee said osteopathic medicine offers great opportunities for minority physicians to improve care delivery to populations “we are most concerned about.” And as she has throughout her career, she spoke frankly about racial disparities in health care, calling them “a scandal of such long standing that it has lost the power to shock.”

Predictably, the national press had some fun with the fact that the new dean was sibling to a pop music icon. “Diana Ross’s big sister hit No. 1 on the charts this month,” deadpanned Knight Ridder/Tribune News Service. “Not the record charts. The medical charts.”

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Dr. Ross-Lee speaks at the 2014 Ohio Osteopathic Symposium.

African American media, though, cheered the appointment as a landmark. Dr. Ross-Lee herself hinted it was about time, telling Jet magazine that initially, she hadn’t realized her appointment was a historic first. “I probably, like the rest of the country, was a little surprised,” she admitted, adding that she hoped “this breaking of a barrier will just turn into a tide and we’ll see a lot more black females achieving in medical academics.”

Dr. Ross-Lee’s seven years at the helm were important for more than barrier-busting. Dean emeritus Jack Brose, D.O., who served from 2001-2012 and is now vice provost for health affairs, praises Ross-Lee for her bold innovation and “terrific leadership skills. I know I certainly learned a lot from her.”

Creative leadership was indeed, as Dr. Brose suggests, a hallmark of her tenure. Under her direction the college developed the nation’s first osteopathic post-doctoral training institute; its Centers for Osteopathic Research and Education; its two curricular options; an independent Department of Biomedical Sciences; and a Center of Excellence for Multicultural Medicine.

In 2001 Dr. Ross-Lee left our college to go to the New York Institute of Technology, where she currently serves as vice president for health sciences and medical affairs, and site dean for the Jonesboro, Ark., campus of NYIT’s College of Osteopathic Medicine.

Since moving on, she has continued to carry the standard for osteopathic medicine, health care diversity, and serving the underserved. In doing so, she has carried on a tradition as old as osteopathic medicine founder A.T. Still, who battled throughout his 19th century career against slavery and racism, and in favor of women’s rights.

Perhaps the symbolic breakthrough she achieved should have come earlier. We’re proud that it happened here.

40 Things to Know: We’re recognized nationally as innovators in medical education

AMA_sig_RGBWe launch our transformative care curriculum in Cleveland in 2018, and the new competency-based, primary care-focused program is already capturing national attention. Referencing our efforts with Cleveland Clinic to develop a new and better model for medical education, we were recently named a member of the American Medical Association’s Accelerating Change in Medical Education Consortium.

As one of 32 medical schools selected nationwide to help lead the transformation of undergraduate medical education to better align with today’s health care systems, we’re in very good company.

We’re proud of our ongoing efforts to adapt our training to the changes our graduates are already experiencing in patient care. And it’s always gratifying when national experts acknowledge that we’re headed in the right direction. As members of the consortium, we’re ready to learn from our colleagues what curricular innovation looks like nationally – and we’re ready to share with them how it’s done in Ohio.

Our People: Harry Meshel, Senator and Lobbyist for the Heritage College

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“The rest of the state still needs you”

It could be fairly said that the Ohio University Heritage College of Osteopathic Medicine would not exist without Harry Meshel, an Ohio state senator from 1971-93. The Youngstown Democrat forged a coalition of lawmakers, physicians and academics to lobby for and pass the legislation that chartered and funded the college in 1975.

Osteopathic connection: “I had always had an affection for the osteopathic process. My late wife had a D.O. who was a good friend of hers. Both of our kids were born to her.”

A college’s difficult birth: “Everybody was against us except [the Ohio Osteopathic Association]. My tradition in life is, when people start objecting, you fight harder. You teach them to respect you and understand you. That’s what you have to do with legislation. We began working, we drew allies in, got the speaker of the house interested, and got people in the senate interested.”

Motivation: In addition to his belief in osteopathic medicine, Meshel saw the college’s potential to transform health care in southeast Ohio. “I was on a social mission. There was virtually nothing else down in that corner of the state.”

A sweet victory: “Politics is usually a long line of headaches – people making you crazy, you never get to close any doors. It’s like a doctor: Sometimes you can’t solve the problem. But when you’re able to close a few doors, when you get to solve the problem, that’s satisfaction. [Helping establish the college] has been a wonderful experience for me.”

Point of pride: “That the doctors coming out of Ohio University stay here. They stay in the state. The school has just gone great guns. It’s one of the most pleasant surprises, how fast OU grew and how well they did. I was very happy and proud to be a part of it.”

Parting thought: “Don’t stop! You’ve just begun to build. You’re so successful. It’s like sports: Just because you’ve won a few games doesn’t mean you get to quit. The rest of the state still needs you. Kick the pants off the competition!”

 


Founding Voices
Perspectives from those whose personal story is woven into the college’s beginning.