Dr. Jeffrey Cummings has just hung up the phone in his office at the Cleveland Clinic Lou Ruvo Center for Brain Health, and he seems still stuck in that conversation. The call was a follow-up discussion centering on the care of one of Cummings’ patients at the clinic, a woman who is suffering from a severe case of Alzheimer’s disease.
On the other end of the conversation were the woman’s husband and daughter. They asked tough questions, the type that offer no easy or simple answers.
“They were asking whether we should increase her medicine, so I said that we could increase the medicine, but at some point some families decide that the quality of life is such that it would be preferred to allow nature to take its own course and they no longer want the doctor to intervene,” said the Ruvo Center’s director and chief doctor since he was lured from his position as director of the Mary S. Easton Center for Alzheimer’s Disease Research at UCLA. “I asked, ‘Is that where you are?’ “
And the husband said something to Cummings that gave the doctor pause.
“He said, ‘ ‘If I could just have her back for a day or two and we can relive those memories,” Cummings says, repeating the message. “ ‘If I could just have her back for a day or two.’ It just seemed like such a crisp, sort of homespun statement. That is exactly what we want, to give people back those memories, but of course not for a day or two. If was such a heartfelt statement of how he felt about his wife and her ‘missing-ness’ now. It just struck me, how important is the work we do here.”
So, if you are wondering how the work that is performed in the office of Dr. Cummings is at all linked to the Keep Memory Alive “Power of Love” gala set for Saturday night at MGM Grand Grand Garden Arena, there you have it. That event is once again to be an opulent, power-packed evening of love and generosity, this year honoring Andrea and Veronica Bocelli.
Among those scheduled to appear are Celine Dion, Quincy Jones, Robin Thicke, Gloria Estefan, Martina McBride, Sharon Stone and George Benson. Isabella Rossellini will introduce Bocelli (for a wrap on what to expect, read my colleague Ubiquitous Robin Leach’s account posted last Thursday).
The money raised from table seating and the live and silent auctions is delivered directly to the Frank Gehry-designed clinic in Symphony Park. Cummings and his wife, Dr. Kate Zhong, boldly moved to Las Vegas in 2010 to join the Larry Ruvo-founded center. It was a risk moving to an area not known for its scientific achievement. But five years on, the results have been awe-inspiring. As Cummings himself reminds, the quality of what is offered at what is considered one of the Top Five medical facilities in the country far outpaces the amount of revenue on hand.
“For example, we have an hour with a new patient, and even UCLA, where I came from, has 45 minutes for a new patient, and that time and care requires resources,” Cummings says. “We are committed to a patients-first philosophy and want to do what is right for the patient, and that takes more time. The difference between the cost of the care we deliver and the revenue we generate is made up by philanthropy.”
The Ruvo Center’s advanced research and clinical trial programs also require a high level of resources.
“Money that comes in allows us to do innovative things, new and innovative trials and research. For example, a trial that is very interesting is a drug that was tested in animals and found to have a dramatic effect on Alzheimer’s disease in animals and was available because the drug already had been approved for cancer,” Cummings says of a continuing trial using mice at the center. “We were able to take philanthropic funds and construct a clinical trial, and we are now just at the end of that process, and we’ll soon have very interesting results.”
The Ruvo Center might also be the world leader in connecting the advanced technology used in smart phones, where such medical testing as blood pressure and pulse rate are now available to anyone who owns an iPhone.
“The technology exists already. It has just leapt ahead,” Cummings says. “We can now have the monitoring ability to have data on all of the different physiological functions, from sleep, how active you are, your diet, your pulse or blood pressure, all of these things are readily monitor-able now, and yet they have not been imported into either clinical care or research. “
As usual, the Ruvo Center is where such advances can be enacted.
“I would like to put these things into clinical trials. Right now we bring a patient in every four months to give them a memory test,” Cummings says. “How likely is it that the one hour we are testing is representative of the last three-month period? If you look at clinical care, when you come in to see me, I don’t think the first thing I say should be, “How are you?”
“I’d like to know how you are because I’ve just looked at your dashboard, and I’ve seen how you’ve been sleeping, I’ve seen your blood pressure, your pulse. I know exactly how you are. Let’s get into a discussion of how we can make you better.
“I think there is a real opportunity here in terms of technology importation, and I think we’re the place to do it.”
Such efficiency can expedite a patient’s care, which can lead to more patients being treated and a shortening of the time for patients awaiting consultation or treatment at the center. Right now, patients are waiting as long as six months, as the volume of patients and caregivers receiving care is astonishing — as many as 25,000 in 2014.
Cummings says it is vital for anyone who believes that they are experiencing early symptoms of these brain disorders to start asking questions immediately.
“If we are making a diagnosis of Alzheimer’s disease in every person who is concerned about their memory, then that means people are coming in too late,” Cummings says. “There are normal changes of memory, particularly the kind of lapses in recall in remembering someone’s name when you only have three steps to make it socially appropriate. That’s eroded in the course of normal aging.
“We should see a lot of those people and reassure them and tell them they don’t have Alzheimer’s disease and send them away. So, what we’re concerned about is waiting too long to come in, when it’s unequivocally abnormal, and by then the disease is well established in the brain.”
Just last week, Cummings and Ruvo Center officials met with a team of international experts, including officials with the Food and Drug Administration, to talk of performing “combination” drug trials at the clinic. Here, too, is where philanthropic money can be used to finance an advanced form of research.
“Right now, we are testing one drug at a time, and that hasn’t won in cancer, it hasn’t won in HIV, it hasn’t won in tuberculosis, and it’s not likely to win in Alzheimer’s disease,” Cummings says. “So we had a very good conference about how we might put drugs together in a way that would be more meaningful in impacting these lives.”
The impact, ideally, would be for the patient to have a meaningful, continuing relationship with his or her family.
“That would be a really satisfying outcome. If we can make sure people remember their family members’ names, had memories of their lives together and don’t’ require constant companionship, these are the kinds of things, even if you were forgetful, would still be OK with most people,” Cummings says. “That is what my goal would be, to have a family life that is meaningful for both sides of the family, for the family members and for the person who is suffering.”
As Cummings speaks, visible just over his shoulder is a sketch of himself donning a New York Yankees uniform and cap. The inscription reads, simply, “Babe II.” It was a gift to the great doctor from Larry Ruvo, who said at the time, “If you build Yankee Stadium, you need to get Babe Ruth.”
Cummings smiles as he looks over at the image. He’s certainly one to swing for the fences.
“What I like about Nevada is the kind of frontier, we-can-do-it spirit here, and if you have an idea, people get out of your way and let you do it,” he says. “We were taking a risk, leaving a major institution and a 20-year career for what was an unknown area. But what we have found is that this is the cradle of creativity.”
“We have been given the resources and freedom that are as special as the building, and I am proud of it. I honestly am.”
Follow John Katsilometes on Twitter at Twitter.com/JohnnyKats. Also, follow “Kats With the Dish” at Twitter.com/KatsWiththeDish.
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