It's a life or death decision no one would want to make. Which child gets a new heart?

It's a decision Dr. Clifford Chin has beeninvolved with a couple of dozen times since coming to town 16 months agoas the Medical Director of Pediatric Heart Transplant Services atCincinnati Children's Hospital Medical Center.

He is well aware that for every hearttransplant, others in need won't get one. Heart donors remain lowbecause of the traumatic decisions that need to be made when a childdies.

"It is difficult. But you have to divorceyourselves from the emotions even though it is a very emotional thing,"says Chin. "As a transplant community, we have to be good stewards ofthis process. And we are. We have a vigorous selection process."

Chin says the decision is based on a numberof standards that ultimately evaluates which patient has the best chancefor a lengthy survival.

In a short time Chin has put Children's on the map as one of the country's premiere pediatric heart transplant facilities.

The New York native (SUNY Medical School)spent 20 years as a fellow at the prestigious Stanford University LucilePackard Children's Hospital, home to Dr. Norman Shumway, regarded asthe father of the heart transplant.

When offered the chance to come to Cincinnatihe jumped at the chance, impressed by the leadership Dr. JeffreyTowbin, executive co-director of Children's Heart Institute.

"Dr. Towbin's vision was to grow aworld-class, advanced care heart institute in a way that really hasn'tbeen done anywhere in the world," says Chin. "I was overwhelmed by theenergy, the facilities, the infrastructure and the way people worktogether."

In 2006, two heart transplants were performedat Children's. So far this year, 12 have been performed. About 450transplants in children are done each year worldwide.

"We aren't just trying to build numbers,"Chin says. "We need to transplant people that need it and we really needto be able to get 30-40 years out of this heart. We don't want to justprolong someone's life for a couple of months or a couple of years."Chin says the Children's team is also focused on working with new drugs,researching antibodies and developing procedures that can delay atransplant, hopeful that with swift advances in medicine and otherdevices even more options will be available to a patient in 5-10 years.

"Our team is growing, bringing in variousexperts, exploring these alternative procedures," Chin says. "AtChildren's, we are pushing the envelope, but doing it in a verythoughtful manner to advance the care of children and adults with heartdisease."

The Rewards of Her Work — Beautiful Babies

After 25 years in the field ofobstetrics/gynecology, Dr. Kellie Flood-Shaffer says she is still movedby the amazing doctor-patient bond, which may be unique to this field ofmedicine.

"You develop these relations in very intimatesettings," she says. "Delivering a baby with a husband and wife is justso intimate it really creates a bond. And they come back every year fortheir care."

Flood-Shaffer says her interest in the fieldwas first triggered by a paper she did as a sophomore in high school inEl Paso, Texas.

"I did a biology class project on a brand newprocedure called amniocentesis. Ever since that high school term paper,I was fascinated with OB/GYN. I never changed my mind all through medschool."

Flood-Shaffer came to Cincinnati in 2009 aspart of an effort by UC Health to expand patient care in OB/GYN beyondteaching and research. She had been interim chairman of OB/GYN at TexasTech University in Lubbock, where she had received her medicaleducation.

Besides seeing patients, Flood-Shaffer is anassistant professor in charge of UC's OB/GYN residency program. She isalso engaged in research in a joint National Institutes of Health-fundedventure with the Department of Neurology studying epilepsy medicationsand pregnancy.

While she loves keeping a foot in academia, Flood-Shaffer says what makes her job most rewarding is that patient bond.

"You watch them go through a pregnancy andyou get a reward at the end. You are able to hand them a beautifulbaby," she says. "But that's a short-term reward. It results in along-term relationship where women come back year after year."

And there is another facet of her practicewhere she is, in a sense, delivering "babies" of a different kind —watching students become doctors.

"You see these medical students who are likethe deer in the headlights. You watch them as residents and you are ableto teach them skills and create this foundation of learning andexpertise. Then you watch them walk out the door at graduation.

Dr. Paul Keck may be the chief administratorfor one of the area's leading mental health facilities, but he says hismost satisfying time is that spent with his patients.

"My best days of the week are the days I havemy clinic hours," says Keck. "The most rewarding thing for me hasalways been working with people and their families. It's a balancing actI try to strike. I very much enjoy my work as a clinician. I try to usehalf my time to see patients."

That's probably no small goal for thepresident and CEO of the Lindner Center of HOPE, the state-of-sciencemental health facility in Mason that opened in 2008 thanks to thebacking of Craig and Frances Lindner, who felt the mental health needsin Greater Cincinnati were not being met.

Keck, one of the world's leading researchersin bipolar disorder and psychopharmacology and the author of 525scientific papers and textbooks on psychiatry, was picked to helpestablish and administer the facility.

"It was a once in a lifetime opportunity tobuild something from a blank slate and capitalize on the best knowledgein the field," says Keck.

The lodge-like building breaks from theinstitutional feel, with amenities for families to stay over in anindividual's room, which is unusual in a mental health facility. Servingpatients age 12 and older, the facility treats all types of psychiatricand mood disorders and addictions, with a special treatment team foradolescents.

In just four years the center and its staffhas made it on Best Doctor and Best Hospital lists locally andnationally. Keck says part of the quick success was having the backingto build a world-class staff.

"We were able to recruit some of the best andthe brightest clinicians and scientists from around the country. That'swhat makes the place truly special."

The center also does research into the causes and treatments of mental illness, including genetic research and brain imaging.

Keck, a western Pennsylvania native withmedical training in New York and Boston, says early in his career he wasfascinated by bipolar disorder and arrived at a time when amazing newdrugs were being developed in the field.

"I was fortunate to be involved in that earlyresearch, truly help people and learn more about the biology of theillness and its genetic tendencies."

When people talk about doctors, it's rare that physiatry is part of the conversation.

That could be changing, however.

Dr. Matthew McLaughlin is a physiatrist withWellington Orthopaedic & Sports Medicine. According to the AmericanAcademy of Physical Medicine and Rehabilitation, physiatrists aremedical doctors who are nerve, muscle and bone experts who treatinjuries or illnesses that affect how people move.

Specifically, physiatrists diagnose and treatpain with non-surgical treatments. They restore function by treatingthe whole person, not just the problem area.

"The value of physiatry has become morerecognized over the past decade, especially the role of physiatry in thetreatment of spine disorders," McLaughlin says. "Here at Wellington, Iwork closely with my orthopaedic colleagues to provide integrated,coordinated care."

Physiatrists add value to a medical group bythe breadth of their training. Take back problems, one of the mostcommon, painful and frustrating conditions for people.

"The vast majority of spine problems are bestmanaged without surgery. However, many patients don't get appropriateconservative treatment prior to considering surgery," McLaughlin says."There are a variety of highly effective, nonsurgical options for mostspine problems. As a physiatrist, I coordinate the patient's care bydiagnosing the problem, prescribing effective physical therapy andperforming spine injections when needed to control pain. I also spend alot of time educating the patient about their condition, treatment andthe recovery process.

"I understand the indications for surgery forselect patients and for those who fail to respond to appropriateconservative management. I work closely with spine surgeons and oftenhelp postoperatively manage and rehabilitate patients. The focus ofphysiatry is on restoring and maximizing function."

McLaughlin, who is from Kettering and graduated from the Ohio State College of Medicine, joined Wellington in 2001.

"Since coming to Wellington, my focus hasbeen on comprehensive spine care," he says. "I still occasionally seeand treat other things, and I often treat a spine patient's othermusculoskeletal issues in a coordinated fashion."

That focus will pay off when McLaughlin will become team leader of a new program.

Thefamily medicine practitioner is said to be in short supply these daysbecause so many medical students are opting for the more lucrativespecialty fields. But Dr. Sri Murthy says she was always drawn to familypractice.

"Iam rewarded just to be able to be there and serve people, to see asmile on their faces and the happiness to know they are getting better,"she says. "I enjoy having the first contact with patients.

"I wanted the challenge of diagnosing a problem when someone walks in your door."

Murthysees patients of all ages — infants to the elderly. (About the onlything she doesn't do: "I don't deliver babies," she says with a laugh.)

Murthy,raised in Mumbai, India, says she knew from the age of 7 she wanted tobe a doctor. She fondly recalls long conversations with her father, apharmaceutical rep, about advances in medicine.

"Mydad was my biggest inspiration. We would always be talking aboutdifferent drugs and different diseases. It just made me even morecurious about being a doctor."

Aftergraduating from medical school in Mumbai, Murthy did her residency atClinton Memorial Hospital in Wilmington,Ohio. She quickly embarked on acareer path of family medicine, opening a family health center in ButlerCounty, geared to people with limited means and no health insurance. In2007, she entered a family practice group with UC Health.

Inher practice, she tries to emphasize preventive health care.Ultimately, she says, there is no mystery as to what it takes to be agood family practitioner: It's pretty much the Golden Rule.

"Agood doctor is one who actually feels the pain and the happiness of thepatient," she says. "A good doctor is one that does exactly what theywould want any other doctor to do for them.

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