Saturday, February 21, 2009

Princeton gives highest awards to top students


by Ruth Stevens

At a reception before the Alumni Day luncheon in Jadwin Gymnasium, President Shirley M. Tilghman (left) and Dean of the Graduate School William Russel (right) congratulated the winners of the University's highest awards for students: (from second from left) Pyne Prize winners Alexander Barnard and Andy Chen; and Jacobus Fellowship recipients Daniel Bouk, Hannah Crawforth, Peter DiMaggio and Jianfeng Lu. (Photo: Denise Applewhite)
Princeton University recognized the winners of the highest honors it awards to students at Alumni Day ceremonies Saturday, Feb. 21.

Seniors Alexander Barnard and Andy Chen shared the University's Moses Taylor Pyne Honor Prize, and graduate students Daniel Bouk, Hannah Crawforth, Peter DiMaggio and Jianfeng Lu were presented as co-winners of the Porter Ogden Jacobus Fellowship at a luncheon in Jadwin Gymnasium.

The Pyne Honor Prize, the highest general distinction conferred on an undergraduate, is awarded to the senior who has most clearly manifested excellent scholarship, strength of character and effective leadership. The Jacobus Fellowship, which supports the final year of graduate study, is awarded to students whose work has displayed the highest scholarly excellence.

The previously announced winners of the top honors for alumni also were honored at the luncheon: Claire Max, a professor of astronomy and astrophysics at the University of California-Santa Cruz, who earned a Ph.D. in astrophysical sciences from Princeton in 1972 and was this year's James Madison Medalist; and 1993 graduate Rajiv Vinnakota, co-founder of the SEED School of Washington, D.C., the nation's first urban public boarding school for disadvantaged students, who was this year's Woodrow Wilson Award winner.

Pyne Prizes
Barnard, who is from Flagstaff, Ariz., is majoring in sociology. In December, he was named the recipient of the 2009 Daniel M. Sachs Class of 1960 Graduating Scholarship. He will use it to pursue a master's degree in development studies at Worcester College at the University of Oxford.

Barnard has done extensive research on social activist movements and has been an activist himself. He is a co-founder and vice president of the Princeton Animal Welfare Society, which promotes veganism and creates awareness about the treatment of animals. He also has been a member of the Princeton Coalition Against Capital Punishment and the Latin American Legal Defense and Education Fund, which helps immigrants.

For the last two years, Barnard has focused his academic research on the "freegan" movement, which promotes efforts to live outside the conventional economy by limiting the consumption of resources. Instead of buying goods, participants procure much of what they need by making items, searching for discarded goods or getting them from communities existing outside of capitalism. Barnard has done more than 200 hours of direct observation fieldwork and has interviewed 15 to 20 highly involved freegans for his senior thesis titled "Pulling Sustainability From the Dumpster: Environmental Ethics, Animal Practices and the Individuals Behind the Freegan Movement."

"His thesis makes a significant contribution to the exploding field of environmental sociology by concretely linking the global animal commodity chain to local consumption practices," said Mitchell Duneier, a professor of sociology, who is Barnard's thesis adviser. "His arduous ethnographic fieldwork illuminates how everyday individual choices about what we eat and throw away are inherently political."

Barnard has been captain of Princeton's mock trial team and has twice received the Shapiro Prize for Academic Excellence. Also a musician, Barnard plays the trumpet and bass guitar, and has served as president and drillmaster of the Princeton University Band.

In recognizing Barnard at the Alumni Day ceremony, Princeton President Shirley M. Tilghman said, "While he does not hesitate to express his views both inside and outside the classroom, it is always in a way that elevates the conversation and leaves no stone -- or, rather, idea -- unturned. As his stellar transcript testifies, he is as much a scholar as an activist, one whose quest for understanding in the service of social change will make him a force to be reckoned with wherever life leads him."

Chen, who is from Los Angeles, is majoring in sociology and pursuing a certificate in East Asian studies. He is writing a senior thesis that explores the impact of economic liberalization on China's urban population. His preparation included traveling to China to conduct interviews, participant observation and archival research. Titled "The Dragon Divided: An Ethnographic Study of Urban Inequalities in Shanghai," his project demonstrates that China's rapid modernization masks serious anxieties and inequities among its middle and lower classes.

Patricia Fernández-Kelly, a senior lecturer in sociology and his thesis adviser, said that during her 30 years as an educator she has "met less than a handful of students more talented, hard working or congenial than Andy Chen. As a freshman at Princeton he was intellectually ambitious. He took part in seminar discussions and often contributed valuable insights that set the tone for the collective exchange. … By the time he wrote his junior paper, it was sheer delight to see how much he had grown in poise and intellectual acuity. Every time I meet with Andy, I marvel at the way he has worked without respite to shape himself into an exceptional human being, a remarkable young scholar and a creative spirit."

Chen has dedicated a significant amount of time to extracurricular activities. As founder and manager of the Student Design Agency, he led a team of 25 designers who have produced more than 500 posters, websites and other graphic materials in the past three years. He also has been a proponent of civil and responsible public discourse, creating the designs for the Princeton-initiated "Own What You Think" campaign against anonymous character assassination allowed by certain websites.

In 2007, he received a Martin Dale Summer Award from Princeton to hone his skills as a yoga teacher in India. He created an online photojournal of his experience and has offered free classes on campus for the University community. He has served as student administrator/webmaster for the Student Volunteers Council and as publicity chair of the Taiwanese American Students Association.

Chen also has been a participant and publicity chair with the Princeton University Gospel Ensemble. In addition he has been a peer academic adviser and a lesbian/gay/bisexual/transgender peer educator. In 2008, he was one of eight students selected to receive Spirit of Princeton awards for their contributions and service to the University.

During the Alumni Day ceremony, Tilghman said, "Andy plans to develop his graphic skills, hitherto completely self-directed, at Yale this fall, laying the groundwork for a career that promises to do for the world what he has done so well for Princeton. Thank you, Andy, for giving visual expression to the things that matter most."

Jacobus Fellowships
Bouk, a doctoral student in the Program in History of Science, earned his bachelor's degree with high honors in computational mathematics from Michigan State University. His research agenda on science in American life focuses on the intersection of three established fields: American history, environmental history and the history of science. His dissertation, "The Science of Life Insurance: Cultures of Science and Commerce in America," probes the pivotal role that science played in building the American life insurance industry and generating knowledge that has influenced understanding of everything from human mortality to racial discrimination to the character of America itself.

Daniel Rodgers, the Henry Charles Lea Professor of History and director of the Davis Center for Historical Studies, described Bouk's transition from mathematics to history. "His retooling was quiet, disciplined and dramatic," he said. "In workshops, in the Davis Center seminars and in job candidates' presentations, it is Dan whose questions will be the most acute and the most illuminating, the ones that stick in one's mind after the session is over."

Rodgers, who is Bouk's dissertation adviser, has called him "the intellectual leader of his graduate student cohort." Bouk served as president of the Graduate History Association from 2006 to 2008 and founded two forums for graduate students -- the Modern America Workshop's Graduate Works-in-Progress initiative and the Study Group for the History of Capitalism.

Crawforth, a Ph.D. candidate in English, came to Princeton as a Procter Visiting Fellow after earning two degrees -- in English and American literature -- at Christ's College at the University of Cambridge. Her dissertation, "'True Expounding': English Etymologies in Renaissance Poetry," is a pioneering exploration of the ways in which Elizabethan and Jacobean understandings of England's Anglo-Saxon linguistic heritage influenced the work of writers such as Edmund Spenser, Ben Jonson and John Milton.

Crawforth has been spending time in the United Kingdom, consulting the manuscript holdings of several libraries for her research. The book that is already beginning to emerge from her dissertation will, she said, "be the first work to consider the literary impact of the new interest in the history of native English words that arose as a result of the Reformation and the influence of continental humanism."

Nigel Smith, professor of English and one of her dissertation advisers, described the project as "an extremely important, field-changing account of the genesis of the poetry in which Shakespeare's generation wrote." Of Crawforth, he said, "She is a future academic of considerable importance, and her demonstrated diligence and acuity is most deserving."

DiMaggio, a doctoral student in chemical engineering, earned his bachelor's degree in chemical engineering, summa cum laude, from the University of Rhode Island. His dissertation, "Discovery Through In Silico Approaches for Mass Spectrometry-Based Proteomics," focuses on the new field of proteomics -- the large-scale study of proteins in a living system.

Proteins are the principal molecular machines in all living systems. The ability to quantitatively analyze their expression levels is very challenging, since the entire complement of proteins produced by an organism is dynamic and changes from cell to cell. DiMaggio seeks to formulate and implement efficient algorithms for peptide and protein identification and quantification using tandem mass spectrometry data. Also, his work in optimal data clustering has important implications for the diagnosis and treatment of disease; he already has developed an algorithm that will enable scientists to target the molecules most likely to be effective in the synthesis of drug-related compounds.

Christodoulos Floudas, the Stephen C. Macaleer '63 Professor in Engineering and Applied Science, who is his dissertation adviser, described his "impeccable theoretical, analytical and computational ability, his great scientific maturity and persistence when attacking even an impossible problem, his naturally inquisitive and independent research mind and his amazing drive for perfection. Pete is clearly an extraordinary researcher with a great future lying ahead."

Lu, a Ph.D. candidate in applied and computational mathematics, earned a bachelor's degree in mathematics at Peking University in China. His dissertation, "Mathematical Analysis and Numerical Algorithms for Density Functional Theory," focuses on a popular framework for studying the electronic structure in fields including chemistry, material science and biology. His work sheds new light on a complex but powerful tool for analyzing the electronic structure of systems of large size.

His insights are so numerous and original that there are plans to turn his dissertation into a book -- something that seldom happens in the field of mathematics. Faculty members in the Program in Applied and Computational Mathematics have described Lu as more of a collaboration partner than a student.

"I have no doubt that with the completion of his thesis, Jianfeng will already have established himself as the leading expert in a promising area at the intersection of applied mathematics, material science and theoretical chemistry… ," said Weinan E, professor of mathematics and applied and computational mathematics, who is his dissertation adviser. "The future of our field depends on having students like him."

Saturday, February 14, 2009

Cancer patients facing costly treatment can benefit from frank talks with doctors


By Francesca Lunzer Kritz
February 16, 2009

"So how much for that surgery to remove my breast and possibly save my life?" Cancer patients seldom ask that or other cost-related treatment questions in an oncologist's office. And, even if they did, many oncologists wouldn't know the answer or would want to separate treatment from expenses.

But a study released earlier this month found that even cancer patients who have health insurance are seeing their expenses mount as deductibles and cost-sharing continue to rise each year. And an earlier study found that about half of all personal bankruptcies are the result of heavy medical debt -- most declared by people with insurance. For those with no insurance, the situation is much more dire.

Such trends are pushing patients, doctors and oncology support staff to talk frankly about costs, make some treatment decisions with expenses in mind and look for government, national and community organizations that may be able to help with some expenses. A Harvard School of Public Health survey two years ago found that 22% of cancer patients with health insurance used up most or all of their savings on cancer-related costs; 5% decided to forgo some care because of costs.

"Recent research shows that the cost of cancer care is increasing at a rate of 15% per year -- nearly three times the rate of increase of overall healthcare costs in the country," says Dr. Richard Schilsky, president of the American Society of Clinical Oncology. "In addition," he says, "the newest cancer drugs can cost thousands of dollars per month of treatment, and many families report problems paying their cancer care bills."

The organization even recently released an online guide to managing cancer expenses. (Go to www.cancer.net and look under "New.") The guide includes a glossary of cost terminology (such as "co-pay" and "out of network care"), recommended cost-related questions (such as "If I cannot afford this treatment plan, can we consider other treatment options that don't cost as much?" and "Are there ways to change my treatment schedule, if necessary, to work around my job or child care?") and links to organizations that may be able to help with expenses. (See resource box for additional links.)


Doctors shy from topic

Neal Meropol, an oncologist at the Fox Chase Cancer Center in Philadelphia who helped produce the online guide, says he'd like to see physicians begin to weave cost into their knowledge of cancer care while in medical school. If that happens, it could be a boon to patients. A survey of just over 160 oncologists, published two years ago in the Journal of Clinical Oncology, found that 31% felt uncomfortable discussing costs with patients. Also, 42% said they always discuss treatment cost, 32% sometimes did and 26% said they rarely or never did.

The growing need for frank conversations about the high cost of cancer care was underscored by the report published in early February by the Kaiser Family Foundation, a nonprofit health research group based in Menlo Park, Calif., and the American Cancer Society. The report found that even cancer patients who have insurance can find themselves bearing costs that are difficult to pay off.

Thomas Olszewski, 62, of Graham, Texas, was treated for prostate cancer in 1999 and needs yearly tests so that any recurrence can be detected early. But his insurance comes with an annual $3,750 deductible, and he still owes $500 from his last checkup. He now has his cancer checkups every other year, instead of annually. "I am afraid to go to the doctor," Olszewski says, "because I never know how much it will cost me."

Schilsky, also an oncologist at the University of Chicago Medical Center, says that, difficult as it is, some patient-doctor conversations should include whether the patient wants to continue care that could be a long shot and leave patients or their families saddled with debt -- particularly when the prognosis is poor and many treatment options have already been exhausted.

"The decision is up to the patient, but the doctor should facilitate that conversation. We treat whole patients, not just an isolated cancer," Schilsky says.

Along those lines, Meropol says a chemotherapy patient recently told him that a prescribed anti-nausea drug was just too expensive. The doctor then prescribed a less expensive but also somewhat less effective drug.

Resources are available

Arash Naeim, head of the geriatric oncology program at UCLA Medical Center, says he hopes that by having the physician bring up cost, patients will feel more comfortable discussing their needs and concerns, and doctors can then refer patients to financial and social work staff to see if resources might be available or if a payment plan can be worked out. Paying at least something regularly shows good faith that could garner added assistance from the billing office.

Jamie Drzewicki, 58, of Pembroke Pines, Fla., who was diagnosed with breast cancer more than two years ago, reached her annual health insurance limit of $100,000 a few months after her diagnosis and ended up owing about $75,000 for her treatment. She paid at least something regularly and, though she still owes $30,000, the hospital recently forgave $40,000 of the debt

Diane Blum, head of CancerCare, a national social service agency that offers counseling and financial assistance for cancer patients, says financial assistance from CancerCare and other agencies can be based on a patient's income as well as availability of funds. Some agencies have funds that cover a particular cancer, but stop giving out money once that allotment is used up. If that's the case, patients can apply to other agencies, and reapply to the closed fund the following year, if necessary, when coffers may have been refilled.

Blum and others also suggest that cancer patients cede the financial quests, at least at first, to a trusted friend or family member as they take in the news about the cancer and begin treatment.

There is no guarantee of assistance, especially now, when so many people are losing their jobs and their insurance and many will likely need help with costs, Blum says. But it can't hurt to try.

Just ask Maria D'Acosta, 59, of Carlsbad and her daughter, Paola Campos-D'Acosta, 30. Campos-D'Acosta left her job with a temporary employment agency in New York City after being diagnosed with breast cancer last summer. She had no insurance when doctors told her she'd need a mastectomy and chemotherapy to treat the Stage 3B cancer, and is now $100,000 in debt.

Help for mom, daughter

Social workers at Harlem Hospital, the city hospital where she had a mastectomy, recommended applying to Medicaid in New York state to cover her bills retroactively, and a friend referred her to the Ralph Lauren Center for Cancer Treatment and Prevention, affiliated with Memorial-Sloan Kettering Medical Center in New York City.

Just before coming to New York to look after her daughter, D'Acosta felt a lump in her own breast and mentioned it to her daughter's doctors. They insisted she have a biopsy, which showed the lump to be malignant. D'Acosta, who closed her interior design business last year, had dropped her insurance some months before, as business dwindled.

Now she too is getting her care at the Ralph Lauren Center for low-income women, where both women pay a $50 co-pay for doctor visits, with costs mounting. Family and friends are helping out.

But one concern they don't have, in a city filled with studios renting at $2,000 or more per month, is how to pay for their living space.

The women have been living in two cozy rooms near New York's famed Penn Station, free of charge, since November. They're at the American Cancer Society's Hope Lodge, where cancer patients referred by their medical team can stay, first come, first served, for as long as treatment is ongoing. In addition to private rooms, the lodge offers communal kitchens, computer rooms, open areas, meditation rooms and even cooked dinners a few times a week.

"The cancer, that's a shock," D'Acosta says, "but we're blessed to be living in this place while we get our care."

Don't assume your income is too high to ask for help, says David Knowlton, a board member of the Healthwell Foundation, based in Gaithersburg, Md., which provides financial assistance for insurance premiums and co-pays for patients with many different conditions. Knowlton says grants might even be made to families with a yearly income of $80,000 or higher, depending on family size and other circumstances.

"This is a tough time for too many people," Knowlton says, "and funds are trying to help as much as they can."

health@latimes.com