Yale Psychiatry Grand Rounds: June 9, 2023

June 09, 2023

Information

State of the Department

John H. Krystal, MD, Chair, Yale Department of Psychiatry; Robert L. McNeil, Jr. Professor of Translational Research and Professor of Psychiatry, of Neuroscience, and Psychology; Co-Director, Yale Center for Clinical Investigation

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00:00The 2023 State of the Department address
00:04and just before I get started to let
00:10everybody know that next Thursday
00:14evening is residency graduation,
00:17which will be at the lawn Club next
00:20Friday's grand rounds, is from Mr.
00:22Dave Brown from the Human Rights Campaign.
00:25He's vice president,
00:26the Human Rights Campaign.
00:28And he'll be doing a special grand rounds
00:31with Christie Olazeski about L GB TQ issues.
00:35This is the graduation address, and Mr.
00:38Brown and Human Rights Campaign were
00:41selected by the graduating class as as
00:44their graduation speaker and then at the
00:49Ann Lien Center in the TAC auditorium.
00:52And and then that afternoon we'll have the
00:56graduation of the fellowship programs.
00:59And then on the 19th we have a special
01:04program for Juneteenth that has been
01:07organized and and was just chaired
01:10in a in a e-mail to the department.
01:14So to begin the grand rounds state of the
01:17department presentation is as I've done.
01:20For the last several years,
01:21I've invited a number of people to reflect
01:25on the past year and I'm going to start
01:30to this isn't in the form of a video,
01:34and I'm going to start that video
01:36now if I can manage the technology,
01:41Push the button, here we go.
01:47Good day. Hello. My name is Maria
01:49Crouch and my degnock name is Tavo.
01:52I'm Degaton and Quavi Tekken from
01:53the native village of Anvic, Alaska.
01:57Today Ioffer acknowledgement and respect
01:59to the indigenous peoples who belong
02:01to the land on which I live and work.
02:04These tribal nations include the Mohegan,
02:06Machentucket, Pequot, Eastern Pequot,
02:10Shagacoke, Golden Hill, Pagusa,
02:12Niantic and the Quinnipac and
02:14other Algonquin speaking peoples.
02:17They have stewarded through generations
02:18the lands and waterways of what
02:20is now the State of Connecticut.
02:22We honor and respect the enduring
02:25relationships that exist between these
02:27peoples and nations and this land.
02:29We recognize that these indigenous
02:31people's sovereignty was never seated.
02:33Rather, they had and still have society,
02:36governance, and jurisdiction.
02:37The Quinnipiac or the Long Water people
02:41were inhabitants of where we are today.
02:43And what my culture we would call
02:46the native village of Quinnipac.
02:47We stand on Quinnipac land.
02:49We stand on their tears,
02:51their laughter and their heartaches,
02:54The first breaths of their babies and
02:56the last breaths of their elders.
02:59We stand on their histories
03:01during colonization.
03:02They were ultimately pushed onto
03:04reserves and all land holdings
03:06were eventually extinguished.
03:08The Quinnipac are not a federally nor
03:10state recognized tribal nation, but.
03:13We recognize them and their
03:15cultural resilience, survivance,
03:17and indomitable spirit.
03:18We honor them and acknowledge
03:21their ancestors and ancestry.
03:23We pay our respects to the
03:26elders past present,
03:27the seven generations yet to come into
03:29their culture as well as their continued
03:32connection to land and community.
03:35I encourage you to learn more about the
03:37indigenous peoples of this region by
03:39visiting the Mashantucket Pequot Museum
03:41or the Tantukwidge in Mohegan Museum,
03:43amongst many others.
03:44I also encourage you to connect with the
03:48Native American Cultural Center at Yale.
03:50Lastly, Ioffer you this blessing
03:52as written by Joy Harjo,
03:55a member of the Muskogee Nation and
03:57the 23rd United States Poet Laureate.
04:00Bless the poets.
04:02The Workers for Justice,
04:04the dancers of ceremony,
04:05the Singers of Heartache, the visionaries,
04:08all makers and carriers of fresh meaning.
04:12We will all make it through.
04:14Despite politics and wars,
04:17despite failures and misunderstandings.
04:20There is only love.
04:22Yogadin.
04:22Thank you.
04:25And I think about this year
04:26and what it means to me.
04:28I think challenges, what comes up.
04:31I think we've dealt with so
04:34many challenges as communities,
04:35as a department,
04:37as a university, as a country,
04:41and these last few years have really
04:45taught us ways in which challenges
04:47can help us come together and build,
04:50and also the ways in which challenges can.
04:53Divide us and and make it harder
04:55for us to connect with each other.
04:56And so I've thought a lot about
04:59challenges and within that how
05:01we can find community and how
05:03those communities can change.
05:04And I think this year has been
05:08a time of being able to seek
05:10community in and outside of the
05:12department in in new ways and in
05:15ways that we're also familiar.
05:16And lastly I think about inspiration
05:20and really being inspired by.
05:23The the interns and other residents, the
05:30the PRA and all the work that's been done
05:34to really move the department forward
05:37and keep it progressive and evolving.
05:41And I've been really inspired by the
05:43collective action of my coresidence and and
05:48members of the faculty who have also been.
05:53Been helpful in moving things forward.
05:56So, you know, I think throughout the
05:59challenges as we continue to find
06:02community and inspiration among each other,
06:04we can continue to build a better department
06:08that can really make an impact for for
06:12our community here and globally. Good
06:15morning, everyone.
06:15My name is George Rogoy.
06:17I'm an Associate professor of Psychiatry.
06:20At Yale School of Medicine,
06:22I'm also a member of the molecular
06:24division in the department,
06:26so I was asked by John to give
06:29a 5 minute presentation of what
06:31the last year meant for me,
06:34so I'm happy to do it.
06:35My commitment is over 90% of research in
06:39basic basic science with implications
06:42for neuropsychiatric diseases,
06:44so I'd like to start by acknowledging.
06:47Some of our research which is which
06:50is done by very talented postdocs
06:52in the lab and just highlighting
06:54three of the projects who have that
06:57have made quite a lot of progress
06:59in the last year and we're hoping
07:01you will be able to see them as
07:03publications in the next year or so.
07:04So one is developmental approach into
07:08understanding the neural ensemble
07:10mechanisms underlying our episodic memories.
07:13Which is a is a major component
07:15of our cognitive life.
07:17So here we we raised animals from
07:22birds into a geometrically altered
07:25environments such that experience with
07:28Euclidean geometry is is abolished
07:31and noticed that that that that
07:33influenced the way the neural ensembles
07:36shape encoding of context later in life.
07:42So we're happy that this project is gonna
07:45highlight the role of prior experience,
07:48particularly special and temporal experience,
07:50which are otherwise pretty
07:52hard to to monitor.
07:54On a second project,
07:56we took a more liberal view on
07:58what it what it means to have
08:00experiences within the day.
08:01And we acknowledge that most most
08:05previous research has been focused
08:07on one isolated experience and try to
08:10analyze what's happening with that.
08:12However, we took we we exposed the animals,
08:15in this case rats, adult rats,
08:16to over 30 sequential experiences
08:19within the day and
08:23how the brain avoids interference
08:26between these experiences and how is
08:28able to keep a record of of everything
08:31that happened during the day.
08:33And probably most interesting,
08:34the brain is also able to keep a
08:38record of the whole day within.
08:41Flashes of of of memories or supported
08:45by brain activity which which
08:46resembled a little bit the time of
08:49compression that I have to do today,
08:51compressing a full year into
08:535 minutes or so presentation.
08:55And finally we had the longstanding
08:56interest in the role of prior knowledge,
08:59prior experience in accelerating
09:01learning of new information.
09:03So we think of this as a simulation
09:06into preexisting schema more
09:08of a yes yes type of thinking.
09:10But we we getting to the neural
09:13mechanisms distributed between the
09:15hippocampus and mediaperfrontal cortex,
09:18distributed between activity during
09:20awake States and then sleep.
09:22So it's a lot of fun to to finally,
09:26I think,
09:27add our contribution to the general
09:30understanding of of accelerated learning.
09:33I have a strong commitment to
09:35teaching and mentoring,
09:36mentoring in the lab and outside.
09:39I'm I'm very pleased to see the
09:42diverse batch of of mentees to
09:44which I had interacted with.
09:46I had contributions towards have
09:49been offered tenant track positions
09:51in prestigious universities.
09:52So three of them in this last year
09:56have moved on to continue research
09:58in their own lab and continue the
10:00line of thinking and and develop
10:02new lines of thinking on their own.
10:06In addition I.
10:07More of a premiere for me here at Yale.
10:12I had deliver a full semester
10:14course graduate course on critical
10:17thinking of in learning and memory,
10:20which achieved in the end two goals,
10:23two major goals.
10:24One was to cover the major
10:27discoveries in the field of learning,
10:29a memory that guide our research to,
10:33and second was a parallel approach
10:36to study the critical thinking.
10:38In in in understanding and
10:41judging those discoveries.
10:42So this was done either through
10:45dual perspectives that argue
10:47or complement those research,
10:49and also to a series of additional
10:54commentaries on on prior research.
10:57And finally,
10:58as no no research can can
11:00be possible without funding,
11:02I'd like to acknowledge that this past year.
11:07We received a very generous grant from
11:11the NIH that that will bring to Yale
11:15a total sum of $4.6 million over the
11:19next eight years, with all that cost
11:23costs directed to to my laboratory.
11:26So, as as Aristotle long said, the whole
11:31is greater than the sum of its parts.
11:34We all acknowledge that this
11:36this great department.
11:37Is is goes well beyond what what each part,
11:42each laboratory,
11:43each person can contribute to.
11:45But today I gave you a slice of
11:47of what a part of this department
11:50could mean and and also I'd like
11:52to acknowledge the fact that the
11:56whole cannot exist without a part.
11:58And and with this I'd like to thank
12:00all my laboratory members and all
12:02the mentors that throughout the
12:04years have guided me with this.
12:07I'd like to give give time back to the John.
12:10Thank you.
12:12My name is Danita Monta Vertice.
12:14I'm an assistant professor in
12:16the Department of Psychiatry.
12:17I am honored and thankful to
12:19have been invited to reflect on
12:21what the year has been for me.
12:23After several years of the
12:25covidnineteen pandemic,
12:26this year I felt that we finally
12:28started to see the light at the end
12:31of the tunnel and getting out from it.
12:33It was so refreshing to be
12:34able to see in person,
12:36away from the soon fatigue,
12:37a lot of my colleagues and friends attending
12:41seminars and going to conferences.
12:44It felt like going back to normal.
12:46And as a very social person myself,
12:48I am so happy, happy seeing my
12:50boys going to birthday parties,
12:53traveling to see our family
12:55in Puerto Rico and Spain,
12:56see my boys playing with
12:58their cousins and friends.
12:59It has been a blessing.
13:01In my lab, things are also running smoothly.
13:04When the lockdown happened
13:06back in March 2020,
13:07I was just starting my lab with a one
13:10year old and pregnant of my second one.
13:13These were very difficult
13:15and challenging times,
13:16but with the hard work of the
13:18talented people in my lab, Shayla,
13:20Diana, Jaime, Batista, and Diego.
13:23In the support of my mentors,
13:24collaborators, family,
13:25friends,
13:26my husband,
13:27and community building efforts such as
13:31Lara Latinas revolutionizing academia,
13:33we were able to surpass them.
13:36The work of my lab focuses on
13:38studying genomics and epigenomics
13:39of psychiatric disorders.
13:41We pioneer the characterization of
13:44novel epigenetic mechanisms associated
13:46with organ use disorder and post
13:49traumatic stress disorder in the human brain.
13:52This work has been supported by R21,
13:55the first thing I each grant of my lab,
13:57a Career development award from the VA.
13:59And potentially,
14:00and fingers crossed since I'm still
14:02waiting for the notice of Award,
14:04an Ave.
14:05award from the National Institute
14:06on Drug Abuse which could support
14:09award for the next 5 years.
14:11I am a strong believer that in
14:12order to do excellent science,
14:14collaboration is key.
14:15That's the coshare of the Psychiatry
14:18Genomics Consortium Substance Use
14:20Disorders Epigenetic Workgroup.
14:21I'm sorry for the very long name.
14:24Researchers from the US,
14:26Germany,
14:26Canada,
14:26Mexico and Brazil are uniting forces and
14:29resources to conduct the best power genome
14:32wide studies in epigenetics and other omics,
14:35not only human postmortemic tissue,
14:37but also peripheral tissue,
14:39IPSC cells and organoids.
14:42This work will be unprecedented.
14:45As a Puerto Rican,
14:46I see myself and my community unfortunately
14:49often underrepresented economic studies,
14:51which now has the promise of developing
14:54novel tools that can guide treatment,
14:56prognosis,
14:57and even prevention of disease risk.
15:01With the lack of representation
15:03of populations like mine,
15:04there is a risk of exacerbating
15:07health disparities in our
15:08already underserved communities.
15:11That's a Latin American.
15:12We also have a complex that
15:14makes sure bans the streets,
15:15which which makes it even
15:18more challenging to study.
15:19As a result,
15:21we confounded the Latin American
15:23Genomics Consortium with now more
15:25than 150 investigators from 9
15:27different Latin American countries,
15:29the US and others.
15:30Our aim is to tackle beyond their
15:33representation of Latin American
15:35population and genomic studies.
15:37We develop novel methods that can
15:39allow us to account and study
15:41the complex that make sure in our
15:44populations and support capacity
15:46building efforts across Latin America
15:48to conduct this study in a local,
15:50equitable and sustainable manner.
15:52My interest in diversifying
15:54genomic studies is not limited
15:57to Latin American population,
15:58but also across traditionally
16:00underrepresented populations
16:01in our country and globally.
16:04In the US,
16:05the All of Us Research program
16:07represents the largest and most
16:09ambitious petition meditating
16:10efforts with the goal of recruiting
16:13more than 1,000,000 people and
16:15representing the most diverse
16:17cohort for genomic studies ever.
16:19This also represents a rich and
16:21unique resource for the study of
16:23social determinants of health.
16:25To understand how things like income,
16:27education, housing,
16:28access to healthcare,
16:30and social support can inform
16:32help these parties and its
16:34impact on health outcomes.
16:35Currently all of us has more than
16:37half million people enrolled,
16:39most of these with HR data and genomic
16:42data accessible to researchers.
16:44And I'm happy to announce that
16:46this year Yale will become a new
16:49recruitment site for all of us,
16:50and I have the honor to leave this
16:53important work with the white CCI.
16:55We will be launching in early June,
16:57so feel free to reach out For
16:59more information.
17:00This is a valuable opportunity
17:02for clinicians and scientists to
17:04expand their ongoing research work
17:06and become part of all of us.
17:08Thank you very much.
17:10Good morning everyone.
17:12It's my real pleasure to talk
17:15about some of the exciting things
17:17in from the psychology section.
17:19In the past year that have that have
17:21happened that I'd love to share with you.
17:23I'm going to go ahead and share my
17:26screen just to keep us very organized
17:28because there's so many good things and
17:31I've had to select from from several.
17:34And so I'm just going to go ahead
17:38and start with our very first one
17:40which is that the Yale pre doctoral
17:44psychology internship program which
17:46has been longstanding and is.
17:49Well established across the steam,
17:52HC and Yale New Haven health
17:55systems went through accreditation
17:57and we passed with blind colors
17:59and we were renewed for 10 years.
18:01And I want to thank Amber Childs,
18:03who is the director of the Prepactual
18:05training program and she led the training
18:08faculty through this whole process,
18:10which took place over really two years,
18:13two to three years because of the pandemic.
18:16And she was joined with the by Jack
18:19Cheebs and Dwayne Fan who lead the
18:22institutions that Timothy and and
18:24Young Human Health and of course
18:27all of our training faculty at both
18:29of those institutions and are a new
18:31psychology administrator, Patrick Riley.
18:33This was a joint effort and with the
18:38Dean's office of course John Crystal
18:40and several of you were involved,
18:43our full time faculty,
18:45voluntary faculty.
18:46I would just really want to thank
18:48everybody for their wonderful
18:50efforts in showing off our program
18:53and we did really well.
18:55And I want also share this new
18:58initiative initiative called the
18:59Getting Racism Out of the Workplace,
19:01the grow program,
19:02you may have already heard about it.
19:04The cofounders are again Amber Childs,
19:08Rebecca Miller and Cindy Cresto.
19:10And this the goal of this program is
19:13to create racially and culturally
19:15responsive clinical leaders,
19:17supervisors and practitioners.
19:19And the program builds competency skills,
19:24cultural competency skills and a
19:27related training so that we can
19:29get racism out of the workplace.
19:32And this is really taking off.
19:33It's getting regional and national attention.
19:35And real kudos to our faculty here,
19:40Amber,
19:40Replica and Cindy for leading this effort.
19:44I want to also note Doctor Galena Portnoy,
19:48who has just started and received
19:50funding for an intimate partner
19:52violence Center of Innovation and
19:55Research at the VA Healthcare System.
19:57The center focuses on screening for
19:59IPB and veterans and the provision of
20:02treatment simultaneously and of course
20:04evaluation and outcomes assessment.
20:05So thank you Galena for this
20:09wonderful center that I think
20:10is going to be doing very,
20:11very important work.
20:13I also want to acknowledge the Yale
20:15Measurement Based Care Collaborative.
20:17This is the collaboration across
20:20the Yale Movement Health VA and
20:23the Consultation Center to deliver
20:25training and care that is tied to
20:28measurable changes and outcomes.
20:30It's a three-part training,
20:32video training that has been
20:34now launched across the nation.
20:36We already have 1500 registrants
20:39and of course the cofounders are.
20:42Amber Childs,
20:43Elizabeth Connors,
20:44Jessica Barber and Sandy Resnick,
20:46thank you all for this
20:48beautiful collaborative effort.
20:49I think it's going national and and
20:52you all are showing really wonderful
20:54national leadership in this in this area.
20:56It's being cited by the American
20:59Psychological Association as a primary
21:01resource for education on MVC.
21:05I also want to acknowledge David Klemanski,
21:07who's led the effort in developing
21:09the CL Patient Experience tool
21:11to assess patient healthcare
21:13experiences and patient reported
21:15outcomes during hospitalization
21:17and other healthcare settings.
21:19This has been highlighted by CMS
21:21and endorsed by them and it's on
21:23its way to becoming a national
21:25standard for reporting on behavioral
21:28health patient satisfaction metrics.
21:30So thank you David for that,
21:31for that wonderful work.
21:33I want to acknowledge this new program.
21:35Some of you may have heard about it,
21:37the Elm City Compass,
21:39Compassionate Allies Serving our streets.
21:42This initiative creates a sustainable
21:44system of supports for individuals
21:46with mental illness in New Haven.
21:48And it's in partnership with a
21:51number of community organizations
21:52and the City of New Haven DMS&amp;CMHC.
21:55And this is led by Jack Teebs
21:59and Derek Gordon.
22:00And I it has already received the
22:032023 Yale Nammy Advocacy Award.
22:06So please look it up.
22:07And this is you.
22:08I'm sure you will hear about it
22:10in in the coming months.
22:12This is a new initiative.
22:15I want to also just acknowledge several
22:17faculty awards and recognitions.
22:19Donna Lapaglia and who has taken over
22:21as a PA Division Twelve president.
22:24Allison Ponsey and she is chair
22:27of an APA task force on doctoral
22:30competencies Kim Smulderin,
22:32Who's APA Division 38,
22:33Chair for Health Advocacy and Policy Council.
22:36Dwayne Fan,
22:37Chair of the Council of Clinical
22:39Health Psychology Training Councils.
22:41Michelle Silva received the 2022
22:43STAR Vega Distinguished Service
22:45Award from the National Latinx
22:48Psychological Association and Cle.
22:50Has just been elected chair of the
22:52APA Board of Professional Affairs,
22:54and Derek Gordon is receiving
22:55the Ron Mincy 2022 Research and
22:58Scholarship Award for the National
23:00Partnership for Community Leadership
23:02for his research on fatherhood.
23:04I want to acknowledge 2 exciting
23:07large center grants that we've
23:10received in the last year.
23:13Our faculty in the psychology section
23:15have been getting numerous grants and
23:18they've just been doing fantastic work.
23:21I want to highlight Elon Harper's
23:23rotem who has received a large
23:26grant over $6,000,000 on Academy to
23:29extinguish Geo memories in PTSD.
23:31And Declan Berry,
23:32who received a large center grant
23:34along with our medicine colleagues
23:36William Becker and David Filene.
23:38And this is on chronic pain
23:41and opioid use disorder.
23:43And so with that,
23:44I want to thank all of our
23:46psychology faculty for just the
23:48a wonderful year that we've had,
23:50a very productive year and for all
23:52of your accomplishments and your
23:54hard work and I really we are very,
23:56very grateful for all of your efforts.
23:58Thank you so much.
24:06I think that's the
24:09end of this part. So first I want to thank
24:16So how do I? What
24:19did I do here
24:23a day? Hello. My name is.
24:25There we go. All right.
24:28So first I want to thank
24:31everybody who took time out to
24:33make those wonderful vignettes.
24:35And I'll try to speak to issues in some,
24:40to some extent raised by those vignettes,
24:42but also try not to overlap on on
24:45the issues that I highlight in terms
24:48of progress in the department.
24:50So am I sharing?
24:53I'm going to share my screen
24:57like this one.
25:01All right?
25:04You know, but I'm in the wrong slide show.
25:05It's Okay, it's not showing
25:07up on there. All right, good.
25:12So let's continue and and and I'll I'm
25:18really pleased to have the opportunity
25:21to talk about the department today.
25:24Before I go further,
25:25I want to share my financial disclosures.
25:29Particularly my role in cofounding
25:31Freedom Biosciences in consulting
25:33to another number of companies and
25:36involvement in patents that have
25:38been licensed particularly to Jansen
25:41Pharmaceuticals related to to use
25:44of catamine to treat depression.
25:48I also want to acknowledge folks
25:50who helped make some of the
25:52slides today Vicki D'agostino,
25:54Mary Kate DeMarco, Issa Dube Dube.
25:57Chris Gardner, Steve Gentile and Steve Healy.
26:01And so I'd like to begin with our
26:04new Mission Vision Value statement,
26:08and I'm going to read it to you,
26:09and I may read it to you every year.
26:12It's a wonderful statement and it says
26:15a lot about who we are as a community,
26:17as well as the community
26:19that we aspire to become.
26:21The old Department of Psychiatry is
26:23dedicated to enhancing holistic wellbeing,
26:26facilitating recovery,
26:27and reducing the suffering and oppression
26:31associated with mental illness.
26:33We do this through the education
26:35of transformative leisures,
26:37excellence in research practice and policy,
26:40and restorative and reciprocal
26:43community engagement.
26:44We embrace multiple approaches to learning,
26:47levels of analysis, and ways of knowing.
26:51And throughout this work,
26:52we strive to nurture a diverse
26:55community of trainees, staff,
26:57faculty and partnerships characterized
27:00by compassion, inclusivity,
27:02humility, dignity, and justice.
27:06This is a wonderful statement and I
27:08would like to acknowledge the group
27:12that that pulled this together.
27:16This is an outgrowth of the
27:18Anti Racism Task Force.
27:21Cochaired by Sonya Udalin and Mirage.
27:25And I want to thank you for your
27:28leadership of this effort and
27:31for everybody for their input.
27:33I think this will be a wonderful
27:36document to refer to going forward.
27:43You know Biden declares pandemic over.
27:50What a remarkable several years it has been.
27:55I think it will take us many years
27:58to come to understand the impact that
28:02the pandemic has had on our lives,
28:05on our children's lives, on our department,
28:10on our trainees and their careers.
28:13It is in inestimable and estimable.
28:19It's difficult to estimate the the
28:25impact that it that it has had on all
28:27of us and the impact has been terrible.
28:30We've lost friends, relatives, colleagues.
28:35It has been terrible in the
28:37burden in which we've shouldered.
28:39It's been terrible in with respect
28:44to all the issues that we have
28:47had to face in our country.
28:50During this time,
28:54and it's been wonderful,
28:56it's been wonderful to pull together
28:59with all of you to care for the people
29:03who've struggled with the stress and
29:06burden of of COVID in their lives
29:08as we have supported them through
29:11providing mental health services,
29:13through providing mentorship,
29:15through supporting our colleagues
29:17in the healthcare community.
29:19Through providing guidance nationally
29:22in ways that people could cope,
29:26we have been a remarkably resilient
29:33community in adapting rapidly to
29:36provide services in the in the
29:39changing context created by COVID.
29:43But now Covid's over and and as if.
29:48All that we have built up would suddenly
29:52become better once the pandemics,
29:56medical urgency had passed.
29:59In large part, that is obviously a fallacy.
30:06Instead,
30:07we find that we are continuing to
30:11deal with the fact that COVID did
30:16not create many issues that we face,
30:18but rather.
30:19Highlighted and drew our attention
30:21to them and that while the pandemic
30:26risks have passed,
30:27the the residual of that time remains
30:32as we continue to deal with the
30:36impact of the pandemic on our lives,
30:39on our work, on our families,
30:42on our careers,
30:44on our children and their careers.
30:47This is this is a remarkable of time
30:51which in its own way is challenging
30:54our capacity for resilience
30:58and and our ability to be focused
31:02on the mission and vision and
31:04values that I just articulated.
31:08There are some hidden changes in the
31:11community and as you can see I I have
31:14brought in some of the best photographers.
31:16Around to help take pictures of things.
31:19Actually this is my phone that
31:21took a picture of a slide.
31:24But in the background in the
31:27everything that we do are the kind
31:29of broader kind of contextual issues
31:33that affect the Medical Center,
31:36the medical school the the the department
31:38and I I just wanted to share this with
31:41you because it was really striking.
31:44This is the.
31:45Operating margin of the average operating
31:49margin of hospitals in the United States
31:52and you can see that until December 2021,
31:57these hospitals maintained
31:59about a 4% profit margin.
32:02And then beginning January 2022
32:06and continuing through all of
32:092022 and we're still in this.
32:13Basically,
32:13the average hospital in the United States
32:17lost money and and we're not out of it.
32:22And Yale New Haven Hospital and
32:24Yale New Haven Health System
32:26are no exception to this trend.
32:29We are all struggling as an
32:32institution with the fact that the
32:35context of delivering healthcare
32:37changed dramatically during COVID.
32:40The economic context.
32:42And so the shape of healthcare going forward,
32:46what it's going to look like is uncertain,
32:49but it's not likely to simply revert
32:52to business as usual that that a
32:56new kind of way of thinking about
32:59healthcare will be healthcare delivery
33:02is evolving and will shape the future
33:07of what Healthcare is like here at Yale.
33:11This is a time when we are fundamentally
33:14reworking our institutional relationships.
33:17The hospital and the medical school
33:20are engaged in a level of dialogue to
33:24transform the nature of the collaboration
33:28between these institutions in fundamental
33:31ways that have no precedent in the
33:34history of either institution,
33:36to my knowledge.
33:39The way in which money will move back
33:41and forth between the medical school
33:43and the hospital and vice versa,
33:45The way that accountability
33:48for administration,
33:49yeah, is taking place,
33:51the level of transparency,
33:53the integration of the collaboration
33:55and the delivery of healthcare,
33:58all of these things are moving in
34:02novel directions that where the
34:06outcome is not yet entirely clear.
34:08But the one thing we can say is that it
34:11will have an impact on all that we do.
34:14A second issue,
34:16which is also obvious in some ways
34:19but not so obvious in other ways,
34:22is that having a new Dean who arrived
34:25at the start of COVID with a new
34:29vision for how for the future of
34:32the medical school and how we as
34:34departments relate to the medical school.
34:37And to each other is now rolling
34:41out and we will see how this plays
34:44out in the years ahead.
34:46As we have a number of new collaborations,
34:50some of which are really extremely exciting
34:53like the Center for Brain and Mind Health,
34:55which will bring psychiatry,
34:57neurology and neurosurgery together
35:00in an academic collaboration that
35:02that could have profound benefits
35:04for all of us going forward.
35:08One of the messages that I wanted to
35:11send today is with so much change,
35:15with so much baggage, if you will,
35:20with so many distractions and so much to do,
35:25it's important to recognize that it's easy
35:27for us to lose sight of how wonderful
35:31and special the work that we do together.
35:35Really is We have so much to celebrate
35:40and the videos helped to identify many
35:45areas both of of work and of celebration.
35:51But I just wanted to highlight some
35:53statistics which I I know many
35:55of you are already familiar.
35:58We continue to be #2 in the country and NIH
36:02funding our residency is continued to be.
36:05Among the top residencies in the country,
36:10we had 14140 applicants to the
36:14psychiatry residency this year.
36:16In 1992, there were 425 matched
36:22residents in psychiatry.
36:25This year there are 17150 match
36:29residents in psychiatry and we had 14140.
36:35Applicants.
36:36The psychiatry as a field is thriving
36:40with many people attracted to many of
36:44the exciting developments in the field
36:47as well as its traditional commitment
36:50to understanding another person.
36:54And it's become extraordinarily competitive.
36:58I think in the end this is a very good and
37:01important development for us and something.
37:04That in invisible ways will
37:06drive the field forward.
37:08In our class, that entering class
37:12of a very diverse candidates,
37:1711 of the 16 entering residents have advanced
37:21degrees in addition to the MD degree,
37:25speaking to both the depth of
37:29experiences that they've pursued to
37:31prepare themselves for psychiatry.
37:33As well as the level of accomplishment
37:36that they have achieved,
37:39our department and the Department
37:41of Psychology are ranked the number
37:43four department of psychiatry in the
37:46world in terms of medical student
37:48education and psychiatry number six,
37:50psychology program with psychiatry
37:53number six,
37:54Our psychiatric hospital #8 the internship
37:58ranked among the top group in psychology.
38:03So by these big external metrics,
38:08this is really an incredible community.
38:11I'd like to highlight at
38:13this point some people,
38:15some programs and some advances
38:18in the field which have made this
38:21past year in some ways both very
38:24exciting and and perhaps pivotal.
38:28Charles,
38:29DK.
38:30Deputy Commissioner and Medical
38:32Director for DEMIS and interim leader
38:37of the upcoming interim leader of
38:40the Division of Law and Psychiatry
38:43after Howard Zananna steps down has
38:47is an really important figure in
38:49the field of forensic psychiatry.
38:52In the Forensic Psychiatry Association,
38:55Apple has created the Charles
38:58DK Diversity Scholarship.
39:01RINA Pechotto,
39:03I think it's now ready to begin in November.
39:08Is that right? Your presidency?
39:10Finally,
39:10after being elected the president
39:12of the Society for Neuroscience,
39:15the largest and most impactful
39:18organization in the field of neuroscience,
39:21Ezra Griffith received the Cato
39:23Lorenson Lifetime Research Award from
39:26the National Medical Association.
39:28Fujita Sinha, who,
39:30enlisting many of the accomplishments
39:32of the Psychology section,
39:34neglected to mention that she
39:36too was elected president of the
39:39Research Society and Alcohol,
39:40the most important society
39:42in that field of research.
39:44And this year we received news
39:47of the creation of the Ale Center
39:50for the Science of Cannabis.
39:52It can cannabinoids led by Cyril D'souza,
39:56who also this year.
39:58Was a word of the Albert
40:00E Kent professorship.
40:03Two other important words signal really a
40:07transformative evolution in neuroscience.
40:10The first from this cover.
40:13It has to do with the emergence of
40:16cellular models for psychiatric disorders,
40:18whereby stem cells collected from the
40:23blood can be cultured and converted into.
40:27Neurons and various cells in the brain
40:30and used to to tell us something
40:33fundamental about the neurobiology and
40:35genetics of psychiatric disorders.
40:37And we are very fortunate to have
40:39in the department Kristin Brennan,
40:41the first person to create neurons
40:44from stem cells from a person with
40:47schizophrenia who received the A/C and
40:50P Daniel Efron Basic Research Award.
40:54Another kind of.
40:57Shocking a bit of research from
41:01someone with a secondary appointment
41:03in our department was celebrated
41:05in this cover of Nature,
41:07which is the work of Nenad
41:10Sestan to understand
41:14the biology of neural preservation,
41:18and he has studied ways to restore
41:22brain function after death.
41:25In tissue from in animal tissue
41:29and he received the for this work.
41:33The National Geographic
41:34Amazing Discovery Ward.
41:36You know you can just imagine what the
41:38other National Geographic awards were
41:40like happy pandas and and you know,
41:44who knows but this fundamental work may
41:48open a new window in ways for curing stroke.
41:54And other neuro neural injuries I
42:01I don't have time to go over all
42:03the honors that and accomplishments
42:05that people have gotten.
42:07But I do want to show you the people
42:13who we should all celebrate each one
42:17for their wonderful accomplishments
42:19like the A/C and P travel awardees or.
42:25The Zhao Duquino,
42:29the ICCTM New Investigator Award,
42:33or Godfrey Pearlson giving the floor
42:35Henry Lecture at the University of Alberta?
42:38Or are three new members to the
42:41Connecticut Academy of Science
42:43and Technology,
42:44such as Knee Addie Laura Hawkins
42:46and his Meanie Petrakis.
42:52Or Matt Gigenti, who received the CIMP
42:56Raffleson Young Investigator Award
42:58and of course our Seymour Lustman
43:01Awardees who we celebrated earlier.
43:06I thought I would just take a few moments
43:09to talk about how the last year was
43:12potentially A pivotal year in terms
43:14of a new generation of treatments in
43:17psychiatric disorders historically.
43:21For the last 20 years at least,
43:24maybe even more, CNS drug development
43:28has lagged behind other areas
43:30in medical research.
43:32As you can see here in red,
43:36the number of treatments with
43:38really novel mechanisms in in
43:41psychiatry have been nearly zero.
43:44Shocking. But this year?
43:48In a study led by Chris Van
43:50**** in our department,
43:52we had the first
43:56disease modifying treatment
43:58for Alzheimer's disease,
43:59an antibody for the amyloid protein.
44:02The a beta part of the amyloid protein
44:08and signaling a new generation of
44:11treatments that are not only aimed at
44:14trying to alleviate the behavioral.
44:18Consequences of Alzheimer's disease,
44:20but affect the actual biology
44:24of the disease itself.
44:26As many of you know,
44:27we are revisiting the Age of Aquarius
44:31in that psychedelic research is
44:35blossoming at Yale and elsewhere,
44:38and we saw not from Yale,
44:40but in a but a large national study from.
44:45Multicenter consortium led by
44:47the Compass Pathways Company,
44:51the first really informative study about
44:54the impact of psilocybin treatment.
44:56And what you can see in this slide
44:59is that from a single dose of
45:03psilocybin that people who got the
45:06full psychedelic dose had 12 weeks of
45:11persisting benefit including a rapid.
45:15Reduction in depression symptoms.
45:18What's what's really striking
45:21here is not only the magnitude
45:23of the fact in a population that
45:25had treatment resistant symptoms,
45:27but the persistence of the and magnitude
45:30of the benefits from a single dose.
45:33Now psilocybin is something that
45:35has been studied here at Yale
45:38and and it's A and it's a very
45:42exciting advance an opportunity.
45:44But treatment sessions are
45:45long and very involved.
45:46The process is very taxing,
45:49with several preparatory treatments,
45:52psychotherapy treatments,
45:53the 68 hour infusion,
45:55and then then followup treatments.
45:58And one idea about where this
46:00field may be heading comes
46:02from a work done here at Yale.
46:05Cyril D'souza and his colleagues at the
46:09VA have studied dimethyltryptamine,
46:11a short acting.
46:13Psychedelic whose effects may only
46:15last an hour or less and yet already
46:19show signs of antidepressant efficacy.
46:22So this is a very exciting and very
46:25rapidly evolving area of research.
46:27We will be very much engaged
46:30in trying to understand the how
46:33to implement these clinic,
46:35these treatments as they are
46:37shown to be effective,
46:38as well as trying to understand
46:40how they work.
46:44And I should say that this whole
46:47field of work of psychedelics has
46:50an important part of its history
46:52here at Yale, with pioneers,
46:55particularly George Agajanian
46:57and his mentor Daniel X Friedman,
47:01who really opened the study of the
47:05signaling mechanisms through which
47:07psychedelics produce their effects.
47:09The acerotonin systems in the brain
47:14schizophrenia another area where for
47:1750 years, 60 years all the treatments
47:20in schizophrenia have worked by
47:22blocking the dopamine D2 receptor.
47:25A model of the pathophysiology
47:28of schizophrenia developed in
47:30part from work here at Yale,
47:33beginning with some initial
47:35findings from B to Mogadom.
47:37Going way back into the 1990s and
47:40amplified through the work of many people,
47:42Alan and Tichevich,
47:44John Murray and many others
47:47have led to kind of
47:50an additional story to the
47:53neurobiology of schizophrenia.
47:54Many of you know that the main
47:56information highways of the brain,
47:58the glutamate system in the cerebral cortex,
48:02is compromised in schizophrenia.
48:04But what's often not appreciated
48:06is that downstream from that,
48:09the inhibitory neurons,
48:10the GABA neurons,
48:12are also compromised,
48:15resulting in disinhibition
48:17of glutamate neurons,
48:20increased noisy communication in the cortex,
48:24and excessive excitatory drive
48:26to the Strida in the area in the
48:31brain traditionally targeted
48:33by antipsychotic medications.
48:36What's exciting about this year is
48:40that 2 new mechanisms have moved
48:43forward as potential alternatives to
48:45dopamine D2 receptor antagonism as
48:49antipsychotic treatments for schizophrenia.
48:52One of these is M4 muscarinic
48:56receptor stimulation.
48:57The other one is trace amine associated
49:00receptor 1 receptor stimulation.
49:02And these may have an effect for
49:06compensating for disinhibition within
49:08the cortex by suppressing noisy
49:11or excessive glutamate release,
49:13and for compensating for the
49:16disinhibition of cortical inputs
49:18into the striatum.
49:20Too much dopamine,
49:21too much glutamate by reducing
49:23both the release of both of those
49:26transmitters in the striatum and,
49:28in a series of studies with
49:31a drug called ulanorant.
49:33A drug called CAR XT and a
49:37drug called emraclidine.
49:39We saw a very exciting and novel pattern
49:44of clinical efficacies associated
49:47with these antipsychotics that block,
49:50that have actions on psychosis without
49:53blocking dopamine D2 receptors.
49:55First and most importantly across
49:57all of these studies it looks
50:00like these medications.
50:04Treat psychosis, but are relatively very
50:07good at treating the negative symptoms
50:10of schizophrenia that traditionally have
50:13not been so effectively treated with our
50:17traditional antipsychotic medications.
50:19And these medications seem to be
50:22very tolerable and they in particular
50:24they don't make people feel so dull.
50:29And they don't have,
50:30they don't produce extra pyramidal
50:32side effects and it is raised the
50:35possibility that we over the next
50:385 to 10 years will enter a time
50:40when the traditional concerns
50:43about antipsychotic treatment i.e.
50:45I don't want to take these medications
50:47because they make me feel dull.
50:49They make me feel less of myself,
50:52they they make me feel drugged
50:55that those effects.
50:56May not be so much associated with
50:59these new medications and if so,
51:02this could be a really
51:05transformative advance.
51:06As you heard in in Regina's comments,
51:08progress is being made in
51:10many areas in the department,
51:12digital health,
51:13biomarker development and here
51:17we recently celebrated at the
51:20Yale Innovation Summit two
51:21of our department faculty.
51:23Who made advances in biomarker development
51:27or digital health and are launching
51:31new companies based on their work.
51:36At this point,
51:37I'd like to transition to
51:39making some general comments
51:40about our our department.
51:42As you know,
51:43we're the second largest department in
51:45the medical school 270 ladder faculty
51:5169.26%. Caucasian and 55% female.
51:58And that's really an important
52:00characteristic for our department
52:02that distinguishes us from not every
52:05department but nearly every department.
52:07In the medical school,
52:09we're now 50% MD or MDPHD and 50% PhD,
52:17and so we're a very professionally
52:21diverse department.
52:23We're 15% in the clinical track,
52:26a little less than half in the
52:29clinician educator track and
52:31then the remainder about 40%
52:34in the various research track.
52:36So we're we are relatively balanced in
52:42our clinical educational and research
52:45missions and we're obviously making very,
52:48very important.
52:49Commitments in all of those areas
52:54our our book of business continues to grow.
52:58This year our budget was $212 million,
53:02fifty four, 4% of that budget
53:05comes from our research grants,
53:1141% or 87 million comes from our collective
53:15clinical activities which come from
53:17our work at Yale New Haven Hospital.
53:20Our work through the faculty
53:21staffing contract of the
53:23Connecticut Mental Health Center,
53:24our work within Yale Medicine and
53:27our other related clinical activities
53:30through Yale by Alvaro Health.
53:33About 9% of our our revenue or
53:38support comes from a hospital
53:42support for educational mission
53:44and 1% support for administration.
53:48As I mentioned earlier,
53:50our department research portfolio
53:52continues to grow.
53:54We've we took a hit with the loss
53:58of a number of really exceptional
54:00scientists in our department
54:02over the past several years,
54:04but we are building back and we
54:08remain #2 in the country again.
54:12In terms of new leaders in the department,
54:14I really want to acknowledge and
54:17thank on Millard for stepping up as
54:20Frank Fortunati's illness advanced
54:21and and for her assuming of the
54:25interim leadership of Yale New Haven.
54:27Psychiatry
54:31revenues at Yale New Haven
54:32Hospital have continued to grow,
54:34but so have our costs and so
54:37it's always a challenge to
54:39manage the balance of our.
54:42Of our costs and revenues,
54:44but things are I'd say relatively
54:47stable there for the moment.
54:51One interesting trend in the department as
54:53we look at the composition of our faculty
54:56as that is as you remember the number of
55:00faculty has gone up from about 250 to 270,
55:04but the number of Caucasian faculty at each
55:08rank has gone down and what that is saying.
55:12Is that that the the faculty
55:18is diversifying slowly.
55:20We have a long way to go,
55:23but we are making slow progress.
55:27A very this is an interesting moment
55:30in terms of gender diversity in
55:32the apartment many years ago now,
55:35probably a decade or so ago,
55:38maybe even more.
55:40Our assistant professors were
55:43first predominantly female this
55:45year for the first time.
55:47We have transitioned in our associate
55:51professors from 2222 when we were
55:56had more male than female associate
55:59professors to 2023 where we have more
56:03female than male associate professors.
56:06And I think you know where
56:08this story is going.
56:09In in a few years that red box is going
56:12to move over to the professors and and
56:17we will continue to grow and diversify
56:20in very positive ways as an apartment.
56:23And so I think this is,
56:25this is wonderful
56:29in terms of our education mission.
56:31This has been in as you can imagine
56:34an extraordinarily challenging
56:35year we have been through.
56:37A lot. As a community,
56:39we continue to try to come to grips with
56:43all the changes of the past year or so,
56:47but we continue to have amazing,
56:50dedicated, accomplished leadership.
56:53I want to thank Richard Belitsky
56:56for his continued interim leadership
56:58of the Residency program,
57:00Esperanza Diaz and Katie Klingensmith
57:03for their continued leadership as well.
57:05And for Katie.
57:07For her leadership of this remarkable
57:10recruitment season that we had for
57:13the Residency and to welcome 2 new
57:15leaders to the residency program who've
57:18already who are already hard at work.
57:21Ruby Lekwawa and Mu and King who are
57:25have stepped in seamlessly and are
57:28really playing an important role.
57:31Our Residency is looking forward, Richard.
57:35Solitsky will head the search
57:37for a new program director.
57:40He is structuring roles in his
57:42leadership team to enable greater
57:44focus on the core missions of our
57:47residency training program and
57:49actually structuring restructuring
57:51rotations in the upcoming year
57:54to reduce tensions between the on
57:57unit responsibilities of residents
57:59and their offunit activities to
58:02to minimize those attentions.
58:05With restructuring call to some
58:07extent that dactics and and how
58:10big vacation time is utilized,
58:12I think that these will be very
58:14positive steps and another positive
58:16step will be the initiation of
58:18an outside program review which
58:21I committed to in in the context
58:24of the last round of of residency
58:29program director search.
58:31We hope that that external review
58:33will help us to build a platform for
58:35future growth of the residency program,
58:41climate and communication.
58:44As as I noted earlier,
58:46the pandemic were some longstanding
58:49unaddressed issues in our
58:51department and we saw over the
58:53past years for a lot of reasons,
58:56erosion of community spirit
58:58at many levels between groups.
59:00Attentions say for example between
59:03residents and faculty within groups as well.
59:07And we are have engaged an external
59:10group of consult and consultation to
59:13help us to think about our community
59:16and ways to build the community.
59:21Spirit want to acknowledge now Retirements
59:24in the department Howard Sonana.
59:27Really.
59:28Such a pivotal and critical leader
59:32in the department in so many ways.
59:35His leadership of the, of the,
59:37of the forensic programs in the department,
59:41but also stepping in on so many
59:44challenging ethical issues that we have
59:46faced as a department over the decades.
59:51And Howard, you can't thank you
59:53enough for all of your contributions.
59:56To our community and for
59:58your dedication and service,
01:00:02I want to also acknowledge our losses.
01:00:06The 1st is Chris Andreazzi.
01:00:08Now many of you may not know him.
01:00:10He was an advanced Practice nurse
01:00:13on the L V2 unit at Yale New Haven
01:00:16Hospital and he died this year at the
01:00:19age of 35 in a tragic car accident.
01:00:22His loss is really felt.
01:00:25Very painfully throughout of the Yale
01:00:28psychiatry Yale New Haven community,
01:00:32and I wanted, wanted to acknowledge him here.
01:00:37William Sledge in some way.
01:00:40The most youth,
01:00:41most youthful person that
01:00:43I will commemorate today.
01:00:45William died at the age of 77.
01:00:49After serving in so much,
01:00:51so many critical roles in our department
01:00:55from interim department chair,
01:00:57deputy chair for Yale
01:00:59New Haven Health System,
01:01:01leader of the psychiatry residency program,
01:01:04Innovative leader of the outpatient
01:01:07community services at at the
01:01:09Connecticut Mental Health Center.
01:01:11A remarkable figure the life of
01:01:14every party that he attended.
01:01:16A wonderful colleague, mentor,
01:01:19friend who will miss terribly.
01:01:23And then Frank Fortunati.
01:01:28I don't know if you know that
01:01:30fortunati in if you translate
01:01:33the word fortunati into English,
01:01:35it means one of the lucky ones.
01:01:39And Frank lived his life
01:01:41to the absolute fullest.
01:01:43He was committed.
01:01:45To his family, he was committed.
01:01:49To his patients,
01:01:50he was committed to his colleagues
01:01:54and and pretty much everybody he met.
01:01:57He was a person of remarkable humility,
01:02:03selflessness, generosity,
01:02:05kindness and his death at the age of 58.
01:02:12Is really a a terrible loss
01:02:15for for all of us and and
01:02:21to lest we ever forget what a remarkable
01:02:27model he provided for us about
01:02:30selfless commitment to our community,
01:02:34many of us came together to
01:02:37create a an award in his memory.
01:02:40Which will be presented each
01:02:42year at residency graduation.
01:02:48I didn't want to end on sad note
01:02:51and so I want to highlight the
01:02:53incredible work of the Anti Racism
01:02:55Task Force in the department.
01:02:57And we had a chance to get together
01:03:00in person recently at a celebration
01:03:02and it was truly, truly wonderful.
01:03:05This is a group of people.
01:03:09Over 90 people who've worked together,
01:03:12mostly meeting at least every week.
01:03:15For some people who are both on a
01:03:17committee and the steering committee,
01:03:19they would meet twice a week for the
01:03:22last more than 2 1/2 years and in
01:03:26their work have developed a kind of
01:03:30a community that can help us model
01:03:34what we seek for our department.
01:03:37A model of inclusive collaboration,
01:03:40of commitment to equity, transparency,
01:03:44transparency and accountability of
01:03:47collaboration across disciplines,
01:03:50across levels of seniority,
01:03:54across hierarchy,
01:03:57and to identify and target areas
01:04:00that we could work on and build
01:04:03on in the department that work.
01:04:07Has carried us to this point in the
01:04:10anti racism work in our community and at
01:04:14this point where we have accumulated,
01:04:18collated,
01:04:19sorted the recommendations
01:04:21from the six subcommittees,
01:04:23we are now ready to move
01:04:26towards implementation,
01:04:27just as the anti racism task force work
01:04:31up and to this point has been inclusive.
01:04:36Welcoming,
01:04:36inviting process.
01:04:38We want this next implementation phase
01:04:42to similarly be open and engaging,
01:04:45and we just circulated
01:04:51to everybody a request for people
01:04:55to volunteer to be engaged in this
01:04:58implementation phase of the recommendation
01:05:01of the Anti Racism Task Force.
01:05:03We're looking for people who
01:05:05wish to lead the five identified
01:05:07implementation groups and to serve on
01:05:11the five implementation committees.
01:05:14This is really an important
01:05:16and pivotal pivotal time,
01:05:18just as pivotal to having a treatment
01:05:21for Alzheimer's or a new treatment for
01:05:24depression or a digital technologies
01:05:26or other kinds of leadership
01:05:29healing our community from within.
01:05:33Is so important to us and I hope
01:05:38those of you listening today will
01:05:42consider playing a part in that.
01:05:49Yeah.
01:05:51So in conclusion.
01:05:58You know, I, I, I don't know the
01:06:00origin but I'm I'm reminded at this
01:06:02moment about that of the saying if
01:06:04you want to go quickly you should go
01:06:06by yourself but if you want to have
01:06:08it you know impactful you should.
01:06:11We go together and we are a
01:06:14community organized around impact
01:06:17and to do that we all we all
01:06:22go together this is. That we are.
01:06:25We are such a good department not
01:06:27because we have one great person,
01:06:30but because everybody is remarkable,
01:06:32everybody contributes everybody as
01:06:37part of our success and and I hope
01:06:42everybody feels ownership for the
01:06:45kind of community that we have and
01:06:49commitment to making us even better.
01:06:53I I realized before I closed that I I
01:06:56one person who has played a particularly
01:06:58important role over these last 2
01:07:011/2 years is Cindy Crusto and Cindy,
01:07:04I want to thank you for your leadership
01:07:06of the Anti Racism Task Force and helping
01:07:09us as a community to to move forward,
01:07:13have the kind of community where
01:07:15we can all move forward together.
01:07:17So with that I will stop and.
01:07:23If there is,
01:07:24if you have questions or comments
01:07:27anyone would like to make,
01:07:28we could we could try to do that
01:07:31and people can put questions into
01:07:33the chat and there are.