CEPI Now Accepting Applications for the 2017/2018 Out4STEM Program

Students from CEPI's various youth programs pose for a group photo on the steps of the PA State House with Dr. Rachel Levine and Dr. Loren Robinson

Students from CEPI’s youth programs (Out4STEM, Teva Pharmaceuticals Internship, and Karabots Junior Fellows) pose with Dr. Rachel Levine (front, left), the first transgender women to hold the office of Physician General for the Commonwealth of Pennsylvania, and Dr. Loren Robinson (front, center), Deputy Secretary for Health Promotion and Disease Prevention of the Commonwealth of Pennsylvania

Attention: Philadelphia 10th and 11th Graders! We are now accepting applications for enrollment in the Out4STEM Program. The Out4STEM Program aims to provide Philadelphia’s LGBTQ+ youth with STEM-centered mentorship, academic support and career advice in an inclusive, safe space.

This one-year program will address the unique challenges facing LGBTQ+ youth while providing a safe environment to learn about careers in science and medicine. The Out4STEM Program covers the following areas:

  • Introduce students to careers related to science, technology, engineering, mathematics, and healthcare/medicine.
  • Acquire practical job skills in a healthcare field by successfully completing a Phlebotomy Technician Certification (CPT)
  • Cultivate relationships between like-minded, motivated Philadelphia LGBTQ+ students.
  • Develop a greater understanding of the body’s physiological response to stress.
  • Facilitate stress relieving techniques.
  • Address the impact of bullying and discrimination and develop responses.
  • Learn to communicate, heal, and build a community.

The next cohort will start in March 2017 and continue through the 2017-2018 academic year. The program will consist of after-school sessions once a week (every 1st and 3rd Tuesdays) and summer sessions on select days in July.

10th and 11th grade students in the Philadelphia School District (including charter, private, and parochial schools) are eligible to apply. To be considered all interested candidates must complete an application, obtain one letter of recommendation from an adult affiliated with a related high school or after-school program (examples: a teacher, coach, counselor, principal, volunteer leader, or church or community leader), and submit a 1-2 page essay. Applicants must also obtain a Pennsylvania state work permit (more information on obtaining one can be found here) and receive permission from a parent or guardian. Note: There are no costs to enroll or be enrolled in the Out4STEM Program.

Completed applications can be submitted via email or standard mail to the following address:

Attn: Quincy Greene (Out4STEM Internship)
The College of Physicians of Philadelphia
19 South 22nd Street
Philadelphia, PA 19103

The deadline to apply is FRIDAY, FEBRUARY 17, 2017 (all mailed applications must be postmarked by that date to be considered). If you have any questions, please contact Quincy Greene, Youth Support Coordinator. For more information about the Out4STEM Program, please consult our website.


CEPI Curiosities: What Killed William Henry Harrison?

CEPI Curiosities: Tales from Medical History's Strange Side

Hello, fellow historio-medico aficionados, and welcome again to another installment of CEPI Curiosities, a monthly foray into the interesting and unusual of medical history. This time around, we are celebrating two milestones. For one thing, it is the first CEPI Curiosities of 2017. It also happens to be the one-year anniversary of this now staple of the CEPI Blog. Over the course of twelve months, it has been my pleasure to let you in on the inside stories of such topics as measuring faces for moral character, electrocuting faces for scientific research, stealing bodies for research, manufacturing bodies for profit, reanimating the dead using root vegetables, and the whereabouts of the skull of one of history’s greatest musicians. This is to say nothing of guest articles from our Karabots Junior Fellows on the difference between venom and poison, the unfortunate life of Harry Eastlack, Chevalier Jackson’s swallowed objects, and the exploits of Chang and Eng Bunker.

For our one-year anniversary, I felt it necessary and proper to go back to our roots: Presidential weirdness. If you recall our first episode, we covered the controversy surrounding the death of Zachary Taylor, which led to his body being exhumed in 1991 and tested for arsenic poisoning. Since today is inauguration day, allow me to shed light on what has to be one of the most unusual inauguration stories: the death of William Henry Harrison.

James Reid Lambdin's Presidential portrait of William Henry Harrison

Harrison is mostly known as a historical footnote these days, known primarily for holding the shortest tenure as president (32 days). Born on February 9, 1773, to a wealthy Virginia family, he went on to serve for twelve years as Governor of Indiana Territory where he gained popular distinction with an armed clash with Native American confederations at the Battle of Tippecanoe (November 7, 1811). He went on to serve in the US House of Representatives and the US Senate and earned the 1836 Whig nomination for president, losing to Democrat Martin Van Buren (electoral count 170-73).

He faced Van Buren again in a Presidential rematch four years later, this time defeating the incumbent (electoral college count 234-60) thanks in no small part to the Whig’s campaign strategies. Advocates for Harrison painted him as a war hero under the catchy slogan of “Tippecanoe and Tyler, Too.” Democrats criticized Harrison’s advanced age (67) and argued he should be put to pasture, not given America’s highest office; Democratic writer John de Ziska commented about Harrison, “Give him a barrel of hard cider, and settle a pension on him…he will sit the remainder of his days in his log cabin by the side of the fire and study moral philosophy!” The Whigs, in a move that should be familiar to modern audiences, spun the attack into a focal point of their campaign, casting Harrison, despite his aristocratic background, as a common salt-of-the-earth man who could connect to lower class and rural white voters (the campaign came to be known as the “Log Cabin Campaign”).

Harrison was sworn in as America’s ninth President on March 4, 1841 (US Presidents originally received the oath of office on March 4, until the passage of the Twentieth Amendment in 1933, which moved it to the current day of January 20). He proceeded to deliver a verbose, rambling, two-hour (8445 word) inaugural address, a speech that remains to this day as the longest inaugural address in Presidential history. Despite it being a cold, rainy day in March, Harrison refused to dress for the weather, foregoing hat, coat, and gloves, as he dispensed long paragraph after paragraph on the historic evolution of representative democracy and the basic duties of the government.

Lithograph depicting the inuaguration of William Henry Harrison

Source: Library of Congress

Roughly three weeks after his inauguration, Harrison began to feel unwell. On March 26, he called upon Dr. Thomas Miller, his personal physician, complaining of fatigue and dyspepsia. Initially, Miller prescribed rest; however, Harrison’s symptoms persisted and he began to experience chills, constipation, and severe pain followed by a heavy cough. Miller prescribed numerous remedies, including laxatives, enemas, and applications of mustard plaster to his stomach (a common 19th century treatment for numerous ailments, including pneumonia); he later blistered the President’s skin (to balance out his humours) and gave Harrison laudanum to relieve pain (a brief report of Miller’s treatment can be read here). Despite initial signs of improvement, his conditioned worsened over the course of the week; on April 3, 1841, at 8:45 PM, President Harrison succumbed to his illness, dying a mere thirty-two days after taking the oath of office. His death gave him the dubious distinction as the first US President to die in office (his death triggered a Constitutional crisis over how succession would work in the event of a President’s death, but that’s for another article).

Most historical accounts cite pneumonia as Harrison’s cause of death, laying the blame on Harrison’s advanced age and long inaugural speech in the cold without proper winter wear as the instruments of his demise.

However, recent scholarship has placed the pneumonia diagnosis into question. To understand why, you need to briefly understand how pneumonia affects the body. According to the American Lung Association, pneumonia is a respiratory disease caused by numerous factors (viruses, bacteria, fungal infection, complications from another respiratory illness such as influenza); whatever variety of the disease, when it infects the lungs, pneumonia causes air sacks called alveoli to fill up with fluid. This fluid buildup can restrict the amount of oxygen the lungs take in when a person breathes; that lack of oxygen can cause cell damage that can eventually be fatal. People of any age can contract pneumonia but it is especially serious when the patient is very young or very old. Symptoms include a heavy cough, fatigue, fever, chills, and difficulty breathing.

Some of Harrison’s symptoms, namely the chills, pain, and heavy cough may point to pneumonia. His advanced age would have made him more susceptible to infection and complications. Pneumonia’s incubation period (the period between infection and when symptoms begin to manifest) is between 1-4 weeks depending on the strain, so it is plausible he could have contracted it during his speech; remember, he reported symptoms to Dr. Miller on March 26 and it isn’t clear how long he was ill before that. However, pneumonia is a respiratory illness (affecting only the lungs) and would not adequately explain his gastrointestinal distress. Recent scientific studies have suggested cold weather may help contribute to illness; however, a person ultimately catches pneumonia from exposure to an infected person, and Harrison’s choice to forego gloves and coat might make him more susceptible to hypothermia (depending on how cold it actually was, and there is some debate over the actual weather conditions in DC on March 4, 1841) rather than pneumonia. Even Dr. Miller himself was reticent to conclude that pneumonia was ultimately what did in President Harrison. In a report in the 1841 edition of Medical Examiner, Miller expressed his doubts with his own diagnosis:

“The disease was not viewed as a case of pure pneumonia; but as this was the most palpable affection, the term pneumonia afforded a succinct and intelligible answer to the innumerable questions as to the nature of the attack.” (Thomas Miller, The Case of the Late William Henry Harrison, President of the United States, Medical Examiner, Vol. 4 (1841), pp 309-12.)

So if it wasn’t pneumonia, what killed William Henry Harrison? A pair of recent scholars have offered an alternative cause of death. Jane McHugh and Philip A. Mackowiak examined Miller’s report and conducted a differential diagnosis based on Harrison’s reported symptoms. In their 2014 report published in Clinical Infectious Diseases, they concluded Harrison’s constipation and abdominal pain pointed toward “enteric fever,” a gastrointestinal illness caused by either salmonella typhi  or salmonella paratyphi, better known as typhoid fever and paratyphoid fever, respectively. Both are spread through contact with contaminated food or water and cause high fever, cough, malaise, rash, and diarrhea or constipation.

Possible presidential assassin? Image Credit: Sanofi Pasteur, Used under CC BY-NC-ND 2.0

Possible presidential assassin? Image Credit: Sanofi Pasteur, Used under CC BY-NC-ND 2.0

As to where he contracted it, while Harrison’s speech may not have killed him, his living in the White House very well may have. McHugh and Mackowiak pointed to Washington DC’s lack of an adequate sewer system and the White House’s proximity to a marsh where much of the Nation’s Capital’s human waste accumulated. These conditions combined with general poor sanitation and cleanliness practices in the 1840s created breeding grounds for such diseases as cholera, dysentery, and enteric fever. They further offered these conditions as an explanation for two other Presidential deaths within ten years of Harrison: James K. Polk (cholera, 1849) and our friend Zachary Taylor (cholera morbis, 1850). According to their report:

There is ample reason to conclude that Harrison’s move into the White House placed him at particular risk of contracting enteric fever. In 1841, the nation’s capital had no sewer system (nor, for that matter, did any other American city). Until 1850 sewage from nearby buildings simply flowed into public grounds at a short distance from the White House, where it stagnated and formed a marsh. The White House water supply, which came from springs in the square bounded by 13th, 14th, I, and K streets NW [now known as Franklin Square], was situated below a depository for night soil that was hauled there each day from the city at government expense. This might explain why 3 antebellum US presidents, Harrison, James Polk, and Zachary Taylor, each developed severe gastroenteritis while residing at the White House. (Jane McHugh and Philip A. Mackowiak, “Death in the White House: President William Henry Harrison’s Atypical Pneumonia,” Clinical Infectious Diseases, Vol. 59 (October 1, 2014), 993-994.)

Following Harrison’s death, Vice President John Tyler ascended to the Presidency, where he was nearly killed in a cannon explosion in 1844. As we’ve already covered, Harrison’s son–John Scott Harrison–was stolen by resurrectionists and sold to an Ohio medical college after his death.

Until next time, catch you on the strange side!

CEPI Students Take Part in MLK Day of Service

Movie Poster for Hidden Figures

Image Source: IMDB

In honor of Martin Luther King Jr. Day of Service, Pennsylvania State Senator Vincent Hughes hosted a screening of Hidden Figures, the inspiring story of a group of African American women who were influential mathematicians involved in the early American space program. Over 200 students, educators, and members of the community joined Sen. Hughes at the Rave Cinemas at University City for the event, including several members of our Teva Pharmaceuticals Internship and Out4STEM Programs.

Students from the Teva and Out4STEM Programs stand at a table covered in literature about CEPI programming at Rave Cinemas at University City

After the movie, several of our CEPI youth presented information about our various programs to the public. Participants also took part in a raffle with the chance to win an Amazon Kindle, and one of our students–Gloria–was a lucky winner.

Philly Youth Kick Off Pennsylvania Teen Health Week 2017

Students from CEPI's various youth programs pose for a group photo on the steps of the PA State House with Dr. Rachel Levine and Dr. Loren Robinson

Did you know that teenagers make up 13% of the total US population? However, despite making up such a significant portion of the population there was no week focusing on teen health until 2016. In January 2016, Pennsylvania became the first state to devote a week to spreading awareness about the health issues directly affecting teenagers with the creation of Pennsylvania Teen Health Week (THW). Teen Health Week was the brainchild of Dr. Laura Offutt. Dr. Offutt is a Pennsylvania physician, Fellow of the College of Physicians of Philadelphia, and the host of Real Talk with Dr. Offutt, an online resource devoted to teen health. CEPI is proud to be an active partner in Pennsylvania Teen Health Week. January 9-13 is the observance Pennsylvania Teen Health Week 2017. This year each day focuses on one of five themes: Nutrition and Fitness, Violence Prevention, Mental Health, Sexual Health, and Substance Use.

Teva intern Su Ly stands at a podium in front of attendees to the proclamation of Pennsylvania Teen Health Week 2017 at the Pennsylvania State House

This past Monday we traveled to the Pennsylvania State House in Harrisburg to commemorate the second annual Pennsylvania Teen Health Week. Philadelphia youth representing the Karabots Junior Fellows Program, the Teva Pharmaceuticals Internship Program, and the Out4STEM Program were on site to show their support. The festivities began with statements from four prominent Pennsylvania physicians: Dr. Rachel Levine, Physician General for the Commonwealth of Pennsylvania; Dr. Loren Robinson, Deputy Secretary for Health Promotion and Disease Prevention for the Commonwealth of Pennsylvania (and Fellow of the College of Physicians of Philadelphia), Dr. Robert Sharrar, Executive Director of Safety, Epidemiology, Registries and Risk Management and Member of the Philadelphia Board of Health (as well as a Fellow of the College of Physicians of Philadelphia), and Dr. Offutt. The event concluded with a reading of Gov. Tom Wolf’s proclamation announcing January 9-13 as Pennsylvania Teen Health Week 2017. Several Philadelphia youth, including Xavier Gavin and Su Ly of the Karabots and Teva Program, respectively, bravely read Gov. Wolf’s proclamation.

Students from CEPI's various youth programs sit in the observation deck atop the Pennsylvania State Senate chamber and listen to a guide conduct a tour of the State House

After the reading, our students took a tour of the Pennsylvania State House, visiting the chambers of the Pennsylvania Senate, House of Representatives, and Supreme Court. While they viewed from the observation decks of the respective government houses, we hope to see some of them as lawmakers and policy developers in the future (remember: the minimum age to serve in the Pennsylvania House of Representatives is 21).

Image displaying the logos of the sponsors for Teen Health Week: Pennsylvania Southeast Region Area Health Education Center (AHEC); System of Care, a program of the Delaware County Department of Human Services; the Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia; and Honeygrow.

Pennsylvania Teen Health Week 2017 is sponsored in part by the Pennsylvania Southeast Region Area Health Education Center (AHEC)System of Care, a program of the Delaware County Department of Human Services; the Craig Dalsimer Division of Adolescent Medicine, Children’s Hospital of Philadelphia; and Honeygrow.