The hidden value of herbariums | On Point – WBUR News

Duke University recently announced plans to close and re-home its century-old herbarium.

But with climate change and a looming biodiversity crisis, scientists say these preserved collections of old plants are more important than ever.

Today, On Point: The hidden value of herbariums.

Kathleen Pryer, professor of biology and director of the Duke University Herbarium.

Jacquelyn Gill, associate professor of paleoecology and plant ecology, School of Biology and Ecology and Climate Change Institute.

Joyce Onyenedum, assistant professor and principal investigator at NYUs Department of Environmental Studies.

Susan Alberts, dean of natural sciences at Duke University.

Part I

MEGHNA CHAKRABARTI: What happens when a little-known place, home to great treasures, may soon have no home at all? That's the puzzle Kathleen Pryer is facing. She's a professor of biology at Duke University and she joins us today. Professor Pryer, welcome to On Point.

KATHLEEN PRYER: Hello. Thank you.

CHAKRABARTI: So what is this little-known place, home to great treasures that you care so much about?

PRYER: I wouldn't call it little-known. The Duke herbarium is perhaps the 6th largest university herbarium in the United States. And it is tied with Cornell. So it's very well known in the area of biodiversity research and climate change research, but it's stunning that now, it's being told it needs to find a better home.

CHAKRABARTI: Okay, so what, for those people who don't know, can you describe Duke's herbarium a little bit? First of all, what is a herbarium? And then what is in Duke's that's so unique and valuable, as you say, to science?

PRYER: So every herbarium is unique. It's a collection of dried plant materials that have been collected over time from various professors, students, researchers that have gone on explorations, and brought these treasures home. So no herbarium replicates what another herbarium has. It's unique to the history of Duke and the people who worked at the Duke herbarium.

And so our collection of 825,000 specimens is special only to, it's special to Duke. It's not replicated anywhere else.

CHAKRABARTI: And 825,000 specimens, is that the equivalent to the number of different species represented in the collection, or is it just specimens?

PRYER: No, it's just specimens.

CHAKRABARTI: Okay. So can you just give me a visual tour of what it looks like? How are these specimens stored? When you want to look at them, what do you see?

PRYER: Duke is also well known for a lemur center. And the lemur center is easy to sell when you have creatures with bushy tails and bright eyes.

When you walk into a herbarium, it is a room filled with steel cases. And each case holds about a thousand specimens. And so the Duke herbarium is in two different locations. One is the smallest part of the collection, is within the bio side building, which is slated to go under renovation in the next couple of years. And the larger part of the collection, 70% of the collection is housed in a, essentially, brand-new facility underneath a research building.

... And so when you open a case, you're faced with all these sheets that are stored in boulders. And so these plants, whenever they were pressed and dried, glued to these sheets, are stored according to a very special classification. So they're easy to find and you locate the cabinet you wish, and you go in and have a look at the material that you need to maybe describe a new species, maybe to look at the variation a species encompasses.

CHAKRABARTI: And so are they stored in books? Sheaths? What, how are they stored?

PRYER: The very earliest herbaria, about 500 years ago, were books. And today that stopped a long time ago. And today, specimens are glued on to archival sheets that are 11 by 17 inches. So a very standard sheet size, and in the left, in the right-hand corner of every sheet, is a label that tells you what the plant is or who collected it, when they collected it, where they collected it.

And so it represents a specific plant that existed in a place at a special time and point. And so it has absolutely unique history. An orchid in our collection, say Cypripedium, the pink lady slipper from North Carolina. Other herbaria may have, certainly have specimens of the pink lady slipper, but no one has our specimen.

And so when you look at material from across a breadth of herbaria, you begin to understand the variation within a species. Yeah so we'll talk more about what is going to happen to the Duke herbarium. Because its home is in peril. That's why we're having this conversation with you.

But Professor Pryer, I'd still, I would love to hear a little bit more about some of the remarkable specimens in the collection. I understand there's one called the Lady Gaga fern, is that right?

PRYER: Yes, indeed it is the home to the lady. 15 years ago, my lab group was very intent on listening to her music in the lab while we were looking at herbarium specimens, processing them for extracting their DNA and that sort of thing. And I hadn't heard of her, but watched her on the Grammys in 2010, and she appeared in a costume that was so remarkable in that it looked exactly like the sexual stage of a fern gametophyte. And ferns are what I study.

And so I began to understand more about her music and what she stood for and so we named a group of ferns that is endemic to Southeastern United States and Central America. It was a group of ferns that needed a new name. And we gave it the name Gaga because of her voice as a champion for justice, for compassion and right to individual expression.

CHAKRABARTI: That's a beautiful story. And is there also a genetic component here? Because in terms that you were extracting DNA and looking, obviously, at what the DNA revealed. And please correct me if I'm wrong, but I understand that there was also like maybe a section of DNA that was GHEA.

PRYER: So that was the most unexpected part. Was that as DNA is made up of four nucleotides, ACGT, and they occur in random order.

But when we had the sequence data, all aligned at 1 point in a certain gene, there was a molecular signature where the nucleotides G, Alined up for all 19 species of the Gaga fern. And so the closest relatives and that area did not spell out Gaga. They spelled out something else. And so that was taken as a signal to us that we were doing the right thing.

CHAKRABARTI: I love that. I love that story. So let me ask you, what brought you, what made you fall in love with botany and the study of plants and took you to a place where you began, you were the director of, you are still the director of the Duke University Herbarium.

PRYER: I grew up in northern Quebec in Canada, surrounded by nature.

So I've always been fond of going out in the woods and looking at things. And my undergraduate career at McGill University, I was focused on becoming an animal behaviorist. Because I was thrilled with Jane Goodall and her stories and you could major at the time in animal behavior, which I signed up for.

But in my senior year, I took a botany course and the whole trajectory of my life changed. I found my people.

CHAKRABARTI: What is going to happen to Duke's herbarium? When I said earlier that it could soon no longer have a home, what has Duke said it wants to do with this collection?

PRYER: I don't think it really knows. So Duke is celebrating its 100th centennial and this collection is the same age as the university. It's a collection that's been built over a hundred years and it's very well-known across the world for the diversity of plants that we have, not only from a regional area, but also from a global perspective. Especially the neotropics. And it suddenly, we have been taking good care of it for 100 years and we are seeing now as not no longer being a place that should be a steward of such a treasure. It should go somewhere else. And this is rather unbelievable, because it really doesn't need much in order to survive.

The collection I told you about, the 70% of the collection that is in the newer facility, cost a million dollars to refurbish and that money came from NSF and Duke 15 years ago. And that collection is on a mobile carriage system, like you have in library, so you can compact the rows, and the plants are perfectly happy there.

They don't need watering. They just are safe and secure. And it's really a puzzle to us why that facility, which people who visit us marvel at. And wish that they had something so spectacular, that we have to go. And there is no place where it can go, where it could be accepted in its entirety at the present.

And so the idea of it being rifled through and bits and pieces sent to various places, it's actually quite horrific to us.

CHAKRABARTI: So to be clear, Duke is saying that it no longer, the university no longer feels that it's the best place for this herbarium and the implication there being that the space that the herbarium occupies may be better suited for other purposes.

We'll hear from some quotes from a university representative a little bit later in the show, but it really brings home this question, like in modern science, in a modern university, like there's costs and benefits to everything a university undertakes. And how to best balance that is now being played out with the story of Duke University's Herbarium, and we'll have a lot more when we come back. This is On Point.

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W&M Experiential Courses Bring Biology to Life and Transform the Student Experience – WYDaily

Anna Mehlhorn 22 delivers a field lecture to her fellow students at a rocky intertidal site. (W&M News)

WILLIAMSBURG Over spring break, a group of students clad in warm rain gear will squat by a tidal pool in the San Juan Islands, observing the diversity of species within the tiny ecosystem.

Two months ago, another cluster of students dressed in shorts and T-shirts leaned over a railing and caught sight of more than 600 manatees including calves in the crystal-clear water of a Florida spring.

These are scenes from two William & Mary (W&M) biology field courses that allow students to apply classroom concepts within natural environments. Course evaluations are decidedly positive, and many students describe their experiences as life-changing, according to a report in W&M News.

Theres an opportunity to put place and discovery together in the field that doesnt happen in the classroom, saidJonathan Allen, associate professor of biology. Even the best lecturers cant replicate that.

The classes serve as an example of the universitys commitment to personal education, research and the opportunity to solve global challenges, according to William & Mary, adding that in line with W&Ms strategic plan, Vision 2026, a common theme throughout both courses is finding innovative solutions towater-related issues.

Field experience also makes students more desirable to future employers, creating pathways to careersin natural sciences.

Allen, who designed the Washington field course, explained to W&M News that an extensive body of research indicates that field study dramatically increases the recruitment and retention of STEM students at universities. He said that field experiences foster scientific enthusiasm and expand students perceptions of practical applications for knowledge gained in the classroom. Confidence in their own ability to pursue scientific careers also increases.

It happens for everyone, especially students who are underrepresented in STEM disciplines, said Allen. Its the first time that many students realize, Oh, I can do this.

Dan Cristol, Chancellor Professor of Biology and designer of the field course in Florida, also sees that spark in students.

If someones going to get hooked by science, its probably going to happen outside, Cristol told W&M News. Ive seen 25 years of student comments on course evaluations, and these have a distinctly different tone to them. Theres a greater level of excitement and enthusiasm that I think is largely due to the intensity of the experience.

Raquel Layton has taken both courses and counts both of them as favorite experiences at W&M, Marine Ecology and Conservation gave us a unique opportunity to observe many of the coastal and marine ecology topics we learn in classes up close in nature as they are actually occurring.

I credit this class with really sparking my love for marine biology/ecology and changing the trajectory of my academic journey throughout college, Layton said.

Read more about these programs in W&M News.

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W&M Experiential Courses Bring Biology to Life and Transform the Student Experience - WYDaily

Professor of Biology/Zoology/Physiology (Tenure-Track) job with BLACKBURN COLLEGE | 37620424 – The Chronicle of Higher Education

Blackburn College, a unique four-year liberal arts college with a student-managed work program located in Carlinville, IL, seeks applications for a full-time, teaching-focused, tenure track position in Biology.Qualifications for the position include:A Ph.D. related to a topic in Biology, Zoology, Human or Animal Anatomy and Physiology, or a date of Ph.D. defense completion by May 2024.A strong commitment to teaching and advising undergraduatesCandidates will need to be able to teach courses including a one-year sequence in Zoology, Human Anatomy and Physiology, and additional courses Animal Physiology, and other coursework based upon the expertise of the applicant.Willingness and ability to mentor students in multiple contexts as part of the colleges signature student-managed work program.The Biology Department offers small class sizes in the upper-division classes and many opportunities to mentor, advise, and otherwise work closely with students. The Department has excellent facilities in a LEED certified building that include a green-houses and a vivarium. There is generously sized, dedicated lab space to support teaching and undergraduate student research to each faculty member of the department. The college also has access to local field sites, including one adjacent to campus, for research and teaching lab field trips. Blackburn is designated as a Bee Campus and a Tree Campus as a result of efforts originating in the Biology Department.Blackburn College is an Equal Opportunity Employer and seeks to build an inclusive communitythat can engage the interests of a diverse population. Wearecommitted to fostering, cultivating, and sustaining a culture that reflects the diversity of our country, and assuch weparticularly encourage applications from members of underrepresented groups such as women, people of color, LGBTQ+, veterans, and those with disabilities. Applicants should be legally permitted to work in the United States; Blackburn is not able to sponsor faculty visas for employment immigration.Your application materials should include a CV, a cover letter,a statement of teaching philosophy, a diversity statement describing what diversity means to you and why it is important, and three letters of recommendation. Please include the names/addresses/phone numbers of the three current, and professional references you are requesting letters from as part of your application materials.

Send application materials to:Human Resources, Blackburn College, 700 College Ave., Ludlum 215, Carlinville, IL 62626or emailhr@blackburn.edu.Employment-based immigration sponsorship is not offered for this position. Phone calls or walk-ins not accepted. Review of applications will begin March 29th, 2024 and continue until the position is filled.

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Professor of Biology/Zoology/Physiology (Tenure-Track) job with BLACKBURN COLLEGE | 37620424 - The Chronicle of Higher Education

Generative AI in Biology Market Poised for Remarkable Growth, to Surpass USD 346.9 Billion by 2032, – PharmiWeb.com

Marketresearch.biz reports that the Global Generative AI in Biology Market size is expected to be worth around USD 346.9 million by 2032 from USD 72.0 million in 2022, growing at a CAGR of 17.50%during the forecast period from 2023 to 2032.

Generative AI in Biology refers to the application of artificial intelligence (AI) algorithms to generate novel biological data, models, and insights. This market harnesses AIs computational power to accelerate drug discovery, protein engineering, and biological research. Despite promising advancements, challenges such as data quality, ethical considerations, and regulatory hurdles influence market dynamics.

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Transforming Diversity of a Family Medicine Residency Program – University of Utah School of Medicine

Jos E. Rodrguez, MD, and Kirsten Stoesser, MD were recently published in The New England Journal of Medicine (NEJM) for their journal article Transforming Diversity of a Family Medicine Residency Program.

The NEJM featured the article as part of a series of case studies to offer perspectives of various initiatives to address discrimination in medicine and health care.

The full article is available to subscribers.

Listen to the publicly available interview with Jos Rodrguez, MD on an intervention aimed at recruiting a diverse class into a family medicine residency program.

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Transforming Diversity of a Family Medicine Residency Program - University of Utah School of Medicine

WellSpan Health opens new health center at Penn National Golf Club, expanding access to care for patients in Franklin … – WellSpan Health

As part of its ongoing commitment to expanding access to care, WellSpan Health opened a new health center in eastern Franklin County on Monday that offers an array of primary and specialty care practices at one convenient location. The WellSpan Health Center at Penn National is located off the main entrance of the Penn National Golf Club at 8131 Spyglass Hill Drive in Fayetteville.

We are proud to offer an integrated healthcare facility including a variety of services in fields like primary care, imaging, laboratory, and rehabilitation services all at one spot, said Niki Hinckle, senior vice president of WellSpans west region. In furthering WellSpans vision to be a trusted healthcare partner, this health center improves access to care for patients in this growing area of Franklin County.

The 15,000 square feet health center is the new home for the WellSpan Family Medicine Penn National practice, formerly the family medicine practice located in nearby Mont Alto. The center will also include rehabilitation, podiatry, and laboratory services, with the ability to expand and meet future healthcare needs.

With this expanded level of care and treatment now available, patients will have access to doctors and advanced practice clinicians that are specialists in preventative care, diagnosis, and treatment of acute and chronic illnesses through primary care services. The family medicine practice is accepting new patients.

Patients can also receive timely and precise results with access to convenient lab services close to home. Additionally with an active community like Penn National, there will now be rehabilitation services to help local patients achieve maximum, functional independence and regain their preferred lifestyle as quickly as possible after an injury or illness. Furthermore, if adults or children experience foot or ankle disorders or diseases, patients will be met with experts to help support their diagnosis, treatment, and prevention.

The new facility is conveniently located just off the Anthony Highway and is easy to access for residents of the growing Penn National community and those in the Mont Alto, Fayetteville, and Waynesboro area.

In celebration of the opening of the WellSpan Health Center at Penn National, the community is invited to an open house on Saturday, March 9 from 11 a.m. to 2 p.m. Attendees can meet members of the WellSpan team, tour of the new facility, and enjoy light refreshments and giveaways.

For more information on services offered at WellSpan Health Center at Penn National and across the area, visit WellSpan.org/GetCare.

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WellSpan Health opens new health center at Penn National Golf Club, expanding access to care for patients in Franklin ... - WellSpan Health

Tuition-free medical schools alone won’t fix diversity problems – STAT – STAT

Medical students at Albert Einstein School of Medicine in New York City gathered last week to hear a life-changing announcement: Ruth Gottesman revealed she would be donating $1 billion, ensuring no student at Einstein will pay tuition ever again.

Leadership at Albert Einstein School of Medicine celebrated the donation as a means to attract a more diverse student body. Improving diversity in the nations physician workforce is a public health imperative. Forty years of affirmative action policies were unable to compensate for the devastating impact of the 1910 Flexner Report, which led to the mass closure of medical schools that admitted Black students, and an estimated loss of 35,000 Black physicians into the field. Despite the urgency of improving diversity in our physician workforce, the number of applicants from Black, Hispanic, and other underrepresented groups in medicinebeing admitted to medical school has decreased in the United States. Black/African American, low-family income, and first-generation students are less likely to be admitted to M.D.-Ph.D. programs, despite being as qualified or more qualified than other applicants. In trying to explain these gaps, as well as the shortage of students interested in entering primary care, experts often point to the high cost of medical school. But the truth is more complicated than that. Simply going tuition-free cannot address entrenched issues of racial and socioeconomic disparities in medical school admissions.

New York University School of Medicine announced at its 2018 White Coat Ceremony that it would become tuition-free. The change was similarly hailed as beneficial for expanding student body diversity and the primary care workforce. While the number of applications to NYUs medical school increased by 47% between 2018 and 2019 and applications from students from underrepresented groups rose by 102%, the percentage of matriculants at NYU who identified as Black/African American has averaged just below 11% between 2019 and 2022, down from 14% in 2017.

NYUs matriculating student MCAT range narrowed from 506-528 in the 2017-2018admissions cycle to 516-527 in the 2022-2023 admissions cycle, and their accepted GPA range narrowed from 3.45-4.0 to 3.62-4.0 in the same time frame. Thanks at least in part to this increased selectivity, their U.S. News and World Report Ranking rose from No. 11 in 2018 to No. 3 in 2019. In addition, no students in NYU Grossman School of Medicines inaugural tuition-free class, who matriculated in fall 2018 and graduated in 2022, matched into family medicine. Three students from the class that matriculated in fall 2019 matched into family medicine in 2023, and the number of students matching into pediatrics decreased from 10 in 2022 to six in 2023.

Tuition-free medical school has also been suggested as an intervention to improve the financial diversity of medical school matriculants, which may contribute to increased enrollment by people from groups underrepresented in medicine. A study found that between 2017 and 2019, one-quarter of student doctors reported a family income in the top 5% of income earners, while the percentage of students from the lowest household income quintile has never exceeded 5.5%.

Relieving the burden of student loan repayment does nothing to address the link between wealth and medical school admissions in the United States. Applicants reporting a family income of less than $50,000 are 48% less likely than applicants reporting a family income of $200,000 or greater to be accepted into an M.D. program, most likely because medical school admissions policies heavily favor wealthy applicants. Wealth facilitates applicants participation in unpaid activities such as shadowing, volunteering, and clinical research, while family income is linked to success in college admissionsand on the MCAT. After NYU became tuition-free, the percentage of students who self-reported as financially disadvantaged fell from 12% in 2017 to 3% in 2019 and has remained between 3% and 7% since.

Relief from student loan debt for medical students should be celebrated. However, absent any additional interventions it is unlikely to substantially improve the racial, ethnic, and financial diversity of our physician workforce. The nullification of affirmative action policies in the United States presents an additional challenge, but not an insurmountable one, as is evidenced by the University of California at Davis success in achieving representation that matches or exceeds the United States population. (California has prohibited state institutions from using race or ethnicity for admissions decisions since 1996.) The UC-Davis admissions committee focuses on socioeconomic disadvantage, which is deeply interwoven with race in the United States through centuries of racial violence and disenfranchisement.

Addressing racial bias and socioeconomic disadvantage will require a shift away from traditional admissions metrics. Medical schools could deemphasize the MCAT, an exam known to favor white, wealthy applicants, or prioritize applications from community college graduates, a cohort of diverse students with a high prevalence of intention to work with underserved communities. Because the process of applying to medical school unfolds over several years, the expansion of pathway programs for students from underrepresented groups is essential to provide mentorship, networking opportunities, and academic support to counteract the interpersonal discrimination that adversely affects students of color. (Pre-medical students from underrepresented backgrounds, for instance, experience greater discouragement from their pre-health advisors than their white counterparts.) As gatekeepers to the profession, medical school admissions committees and pre-health advisers must confront their own biases and embrace a holistic admissions approach that considers hardshipsexperienced by applicants.

These interventions will require not only a financial investment on the part of medical schools but also an investment in changing perceptions of what it means to be a qualified applicant.

One of us is now a resident physician, and the other is currently in medical school. We are thrilled for the students at Albert Einstein School of Medicine who will benefit from Ruth Gottesmans generosity. But as people celebrate, we hope they will realize that there is no single fix even one as significant as free tuition for the complex issues of racial, ethnic, and socioeconomic disparities in medical school admissions.

Tricia Pendergrast, M.D., is a resident physician in the Department of Anesthesiology at the University of Michigan. Jared E. Boyce, ScM, is an M.D.-Ph.D. candidate in the Medical Scientist Training Program at the University of Wisconsin School of Medicine and Public Health.

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Tuition-free medical schools alone won't fix diversity problems - STAT - STAT

Smart Creates Interactive Program to Increase Access to Healthcare, STEM-Related Fields | Newsroom – UNC Health and UNC School of Medicine

Danae Smart, MD, MS, second-year family medicine resident at the UNC School of Medicine, created Healthcare Sparks to inspire the next generation to consider professions in healthcare and related fields.

CHAPEL HILL, NC Danae Smart, MD, MS, noticed a disparity in many pre-college-aged students access to healthcare and STEM-related fields early in her time in medical school at Loma Linda University in California. In response, Smart, now a second-year resident at UNC Family Medicine, created Healthcare Sparks at the end of her first year of medical school to encourage professionals in training to engage with middle and high school students with the goal of sparking their interest in medicine and related scientific fields.

Smart emphasizes the need for representation in healthcare, stating,I believe there must be more diversity in healthcare. Lack of resources and lack of exposure to black and brown healthcare professionals are two barriers that inhibit minority students from pursuing health careers, barriers which Healthcare Sparks addresses.

The program, initially supported through the Healthy Neighborhood Projects program at Loma Linda, began with an afterschool enrichment program in San Bernadino and included many children coming from households of incarcerated parents. The sessions were led by medical students and explored basic anatomy and physiology concepts reinforced with educational games, using an interactive Healthcare booklet that Smart has now published.

Starting her residency at UNC Family Medicine, Smart hoped to expand the program to more institutions, noting the positive feedback from students.

I conducted a survey at the US Dream Academy in San Bernadino, and all of the respondents reported learning more about science and being more interested in health careers since starting Healthcare Sparks, Smart said. Feedback at Culbreth Middle School in Chapel Hill was similar, with students noting the session was better than they expected, and that they didnt know a science lesson would be so enjoyable.

With the use of the published Healthcare Sparks book and video resources available on the website, the goal is to have more professionals in training who can lead the learning sessions.

Ultimately, I hope Healthcare Sparks inspires students to pursue health careers and creates mentorship opportunities for volunteers who decide to start the program at their institutions, Smart said. I want students to see providers who look like them and to know they can achieve whatever goals they aspire to.

To learn more about the program, watch this video and visit healthcaresparks.org.

Media contact: Reid Johnson, Communications Director, UNC Family Medicine

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Smart Creates Interactive Program to Increase Access to Healthcare, STEM-Related Fields | Newsroom - UNC Health and UNC School of Medicine

NJ Doctor Practices the ‘Art’ of Primary Care with Patients – Hackensack Meridian Health

When family medicine doctorAmelia Pawaroo-Balram, M.D., was still in high school, she was considered a budding artist skilled at drawing and painting, who won awards in local competitions. Her parents thought she would follow that creative path in college, but she surprised them by saying, Im going to study medicine.

Born in New York, she grew up in Montville, New Jersey, with her parents, who are from Guyana, South America. With ancestors from India, she completed her academic studies at St. Matthews University School of Medicine Grand Cayman, and her residency at St. Josephs University Medical Center in Paterson, New Jersey.

Dr. Pawaroo-Balram began her practice withHackensack Meridian Health in September 2023, and is now affiliated withHackensack University Medical Center.

Because of my international background, I enjoy working with people from different backgrounds, and I can assimilate into different scenarios. I like working as a team with my patients to achieve a common goal. Just like my patients, I get excited when the information comes together perfectly to achieve that.

Spending time with my 5-year-old daughter, Madisonwho is going on age 20is such a joy. Shes into art, as well. She told me she wants to be a doctor because then she can work with me!

I fund the Wi-Fi at an orphanage in Guyana. When my daughter grows out of her clothes, I pack them up and send them there, too. I used to send baby bottlesI mean, I had 20 at one time, and I think of someone there who has none, and how important that one thing is to them. I want to continue to remain grounded, and this helps me.

Bill Gates. His story is so inspiring: dropping out of college, then starting Microsoft and doing so well as a global business leader and philanthropist. He used his creativity to mold technology, and its a big reason why we are where we are with tech today. I have a ton of questions for him!

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

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NJ Doctor Practices the 'Art' of Primary Care with Patients - Hackensack Meridian Health