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Summer 2007 Vol. V, No. 4

Faculty of Medicine and Medical Center: Deep Roots, Endless Skies

Rx for Success

Celebrating the 140th anniversaryof the Faculty of Medicineand the Centennial of theMedical Center at AUB

The creation of the first medical school in Lebanon and Syria in 1867, one year after the founding of the Syrian Protestant College (the name was changed to the American University of Beirut in 1920), reflected the foresight of the founders who realized the importance of medical education and health care from the outset. Initially working in several hospitals located throughout Beirut, the faculty delivered quality medical education, provided exceptional patient care, and engaged in research. Students in the first class studied in a small rented building in Zokak Al Blat in Beirut. In 1871, the first class of six medical doctors graduated. Two years later, in 1873, the first medical building was built on campus (the building that now houses the Suliman S. Olayan School of Business). The facilities eventually included schools of pharmacy, dentistry, and nursing—and three hospitals: Maternity and Women’s (1908), Eye and Ear (1909), and Children’s and Orthopedic (1910). The three were later combined as a 200-bed hospital complex located where the parking garage, the Saab Memorial Library, and Issam Fares Hall now stand. Dale Home was built to house the School of Nursing in 1925.

Today, the American University of Beirut Medical Center (AUBMC) and the Faculty of Medicine are leaders in medical care, research, and instruction in the Middle East. It is impossible to chronicle all the many “firsts” which have, over the years, marked the progress toward this significant anniversary year. Only some of the key programs and medical advances that have defined both institutions as the regional trendsetters for medical research and education will be noted here.

AUB’s medical programs and innovative research have continuously set new standards over the years. Medical conferences and networking with other medical people in the region began in 1913. The first Middle East Medical Assembly (MEMA), which was then called the Medical Symposium, was held in 1951 and attracted medical people from many countries in the region and the United States. That same year the Department of Public Health—the first in the country—was established. (In 1978 the department became the independent Faculty of Health Sciences.)

Post-doctoral training in the form of apprenticeship had begun in 1905, but between 1942 and 1946 the postgraduate training program was upgraded and reorganized, the first in Lebanon and the Middle East for the training of residents. Drs. Stanley Kerr, George Fawaz, and Henry Badire were responsible for building research laboratories in the basic medical sciences, while Drs. Munib Shahid and Najib Abu Haidar built laboratories in hematology and endocrinology—developments that increased research output significantly. In 1966, the University introduced a PhD program in biochemistry, the first such program in Lebanon and the region. The program evolved into a PhD program in the basic medical sciences in 1972, but had to be frozen in the eighties during the civil war. The first fellowship training programs for physicians began in the early 1970s in some of the divisions of the Department of Internal Medicine.

In 1871, Dr. George Post used chloroform for the first time in Lebanon. He coined the term “kulfara” to describe the procedure.

To meet the growing needs of a medical center that was attracting patients from the entire region, a new medical center with a 425-bed hospital was inaugurated in 1970. The Diana Tamari Sabbagh Building, home of the Faculty of Medicine, opened in 1975.

The introduction of new programs and research slowed during the Lebanese civil war (1975-91) while the Medical Center treated most of the victims in the immediate area: 8,326 casualties were admitted to the Emergency Unit in 1976-77. In spite of the war, new departments and programs were introduced. The first Family Medicine Program in the Arab world was established at AUBMC in 1979. In the early years the program helped set up a sister program in Bahrain, and Family Medicine faculty members have regularly provided expertise to neighboring countries. The program was the first in the region to implement electronic practice management health records. Today the department provides AUB students and employees, and citizens of all age groups, medical services ranging from general medical exams to chronic disease care. In 1980 three new interdepartmental programs were established. The Infectious Diseases and Immunology Programs were based in the Department of Microbiology and Immunology,

while the Genetics Program was based in the Pediatrics Department. The new programs focused on teaching students and updating interns and residents, while promoting interdepartmental research.

Since 1993, AUBMC has adapted quickly to peacetime, rapidly expanding the range of specialties in its programs and units. In 1995, the Adult and Pediatric Epilepsy Program was created. Its four important units extend help to many countries in the region and treat patients from as far away as India and the United Kingdom. The Monitoring Unit identifies precisely the nature of epileptic fits. The Pharmacotherapy Unit determines drug therapy and helps in planning for surgery. The Surgery Unit, established in 1997, has performed a number of firsts: the first epilepsy surgery in the country and the region, the WADA test for locating speech and memory deficit, subdural electrode insertion, and awake-craniotomies with resection. The first core research facility was opened in 1997 to support research and enhance recruitment of academic physicians. The Basic Laboratory and Clinical Research Unit is vigorously engaged in ongoing research.

AUB pioneered the first Children’s Heart Center in Lebanon in 2001, where the first fetal echocardiology and the first coil embolization in both Lebanon and the region were performed. Doctors at the Children’s Heart Center developed a number of neonatal interventional catheterization procedures and a novel treatment for acute rheumatic fever. They also work with the first patient fund in Lebanon that was established to provide financial assistance to needy families of children suffering from heart defects—the Brave Heart Fund.

AUB’s Division of Orthodontics and Dentofacial Orthopedics was established in 2001, 67 years after the closing of the School of Dentistry, and included the first postgraduate training program in orthodontics in the Faculty of Medicine, an orthodontic residency. On May 31, 2007 the Karekin G. Tabourian Dentofacial Clinic, equipped with seven dental chair units and facilities providing for orthodontics and a range of other dental and maxillofacial disciplines, was officially named and inaugurated.

The new Medical Practice Plan, introduced in October 2001, paved the way for multidisciplinary programs such as the Abu-Haidar Neuroscience Program,

In 1951, the Department of Public Health—the first in the country—was established. In 1978 the department became the independent Faculty of Health Sciences.

established in 2002 for the study and treatment of all neurological and behavioral psychiatric diseases, and the Naef K. Basile Cancer Institute, which began in 2004 with both outpatient and inpatient units and a bone marrow transplant unit. As part of the Medical Practice Plan, these programs bring together physicians from different disciplines to create patient-focused clinical services.

The first family medicine program in the Arab world was established at AUBMC in 1979.

All of these significant new programs have made many groundbreaking advanced medical interventions possible at the AUB Medical Center. After World War II medical pioneers flocked to the hospital, including Drs. Riad Tabbara (1947) and George Rubeiz (1958), who brought with them expertise in electrocardiography and cardiac catheterization that enhanced the accurate diagnosis of heart disease and post-operative monitoring of patients. In April 1959, Dr. Ibrahim Dagher, now professor emeritus, performed the first open-heart surgery on an adult patient at AUBMC. On this occasion, he placed the patient in ice water to slow vital heart activity. In May of the following year, however, Dagher performed a similar operation on a child without external cooling, by using an artificial pump oxygenator built in the hospital’s machine shop.

In 1910 AUB founded the first dental school in the Middle East.

Recent advances in technology have introduced many additional surgical “firsts” to the region. In 1998 AUB doctors adopted the InstaTrak System for image-guided surgery—a sophisticated system that permits the surgeon, guided by the system’s computer monitor, to navigate successfully inside concealed anatomy— revolutionizing head surgery.

The success of other new surgeries at the hospital encouraged organ donation for transplant. In 1998, in another “first” in Lebanon and the Middle East, a split in-situ liver transplant was performed. The following year the first live liver transplant occurred when a mother donated the small lobe of her liver to her four-year old daughter. AUBMC also became one of a handful of centers worldwide to perform the removal of kidneys for transplant using laparoscopy. The Cardiology Division and the Radiation Oncology Department joined forces in 2002 to relieve blocked stents—the first time treatment of this kind was performed in Lebanon. In the same year, the acquisition of the latest state-of-the-art excimer laser made AUBMC the first hospital in the country to offer laser technology for vision correction.

Also in 2002 surgeons from the Children’s Cancer Center, affiliated with St. Jude Children’s Research Hospital in the United States, introduced an expandable prosthesis, the Phenix device, for the treatment of children with bone cancer. Using a magnetic field, the surgeons eliminate the need for further surgery by lengthening the leg from the outside as the child grows. Most recently, in early 2007, the director of the Spinal Program led a team which performed the first successful artificial cervical disc implant at AUBMC.

In a very recent first involving outreach to the community, in spring 2007 AUBMC physicians in Beirut, using WiMax technology provided by Intel, were able to consult with doctors in the government hospital in Nabatiyeh by video conferencing to help diagnose and treat, from afar, a child’s skin lesions.

As the AUBMC moves toward a century and a half of providing medical services to Lebanon and the region, the Medical Center continues to expand health care through the creative introduction of innovative new treatments, techniques, and programs. The numerous successes celebrated in recent history give every reason to believe that many exciting and promising years at AUBMC and the Faculty of Medicine are yet to come.

In 2002 surgeons from the Children’s Cancer Center brought new hope to children with bone cancer through the introduction of an expandable prosthesis, the Phenix device.