Rethinking breast cancer treatment options: Should chemotherapy or surgery come first?

Anees Chagpar, MD, illustrates a breast tumor with a chocolate chip cookie. Chemotherapy can either cause cancers to shrink concentrically or to break apart, leaving cookie crumbs. That’s why surgery, and often radiation, is recommended as a follow-up to chemotherapy, and why it’s important to make sure patients have clear margins (or no crumbs at the edge of the tissue that is taken out). Speaking at Upstate last fall, Chagpar explained the difficulty in predicting which patients will have tumors that will completely disappear with chemotherapy, which will fragment or shrink and which may not respond at all.


Many people with a breast cancer diagnosis will face surgery and chemotherapy as part of their treatment. A question more doctors and patients must answer is: In which order?

Chemotherapy is increasingly prescribed to help shrink breast tumors before surgery, similar to how it is used to treat some pancreatic, ovarian and bladder cancers. When it is used as a first step in treatment, chemotherapy is what doctors refer to as neoadjuvant therapy.

“The concept of neoadjuvant chemotherapy has really taken hold because it holds so much promise,” Anees Chagpar, MD, told caregivers and researchers at Upstate in her delivery of an annual lecture paid for by the Carol M. Baldwin Breast Cancer Research Fund. Chagpar is director of The Breast Center at the Smilow Cancer Hospital at Yale-New Haven.

Chagpar says survival rates are the same, regardless of whether patients receive chemotherapy or surgery first. The National Comprehensive Cancer Network recommends considering chemotherapy before surgery in certain patients with breast cancer, and Chagpar said she favors chemotherapy before surgery for several reasons:

* An inoperable tumor may shrink enough after chemotherapy for a surgeon to consider removing it.

* Women facing mastectomy, or complete removal of a breast, may instead be able to have a breast-conserving operation if chemotherapy adequately reduces the size of the tumor. “For patients who want breast-conserving surgery, this is a way to get that,” she says.

* Chemotherapy may wipe out cancer cells completely, providing what doctors call a “pathological complete response.” Chagpar describes operations in which she removes tissue believed to contain the tumor, only to have a pathologist report there are no viable cancer cells.

* Options are growing for clinical trials that involve neoadjuvant therapy, giving patients access to cutting-edge treatment that would otherwise not be available.

Support group meets monthly

UpstatePinkChampionsFINALUpstate Pink Champions is a breast-care support group that holds monthly meetings on the second Wednesday of the month from 5:30 to 7 p.m. in a conference room of the Upstate Cancer Center. The meetings focus on networking, support, education, advocacy and awareness. To learn more, email

                                                                                                                                                                                Layout 1This article appears in the winter 2017 issue of Cancer Care magazine.

Posted in cancer, health care, surgery | Leave a comment

Think you know how to wash your hands? Here’s how – and why – to do it the way the pros do

Waleed Javaid, MD

Waleed Javaid, MD

It’s simple, quick and one of the best ways to reduce the spread of disease.

Hand washing is paramount in hospitals, but its importance may be overlooked at home. Even if you recognize the health benefits of keeping hands clean, are you sure you’re washing your hands properly?

Here’s advice from Upstate infectious disease expert Waleed Javaid, MD, and the Centers for Disease Control and Prevention.

  1. waleed-javiad_md_hand-washing-16-044Turn on water to a warm — not boiling-hot — temperature.

Why: Water that is too hot can affect skin integrity. Repeated exposure to hot water increases the risk of dermatitis or skin irritation.

You might be tempted to wash with hot water, thinking the heat kills germs. It could. But as  Javaid points out, water that is hot enough to kill germs – greater than 100 degrees – would burn skin.

waleed-javiad_md_hand-washing-16-0552. Place hands under running water.

Why: This aids soap activation, or lathering. Experts recommend against using a basin of standing water because of the risk it could be contaminated through previous use.

waleed-javiad_md_hand-washing-16-0593. Apply just one squirt of liquid soap.

Why: Overuse of a soap product may cause drying of hands, and dry, cracked hands may harbor bacteria, viruses and/or fungus.

In a household setting, bar soap is another option, using just enough to get the job done.

Surfactants in soap help lift soil and microbes from the skin, according to the CDC. Also, people tend to scrub hands more thoroughly when they use soap, rather than just water.

waleed-javiad_md_hand-washing-16-0954. Rubbing briskly, wash all surfaces of hands, including between fingers, for at least 15 to 20 seconds. That’s about two rounds of the “Happy Birthday” song, beginning to end.

Why: The principle of good hand-washing technique is primarily that of mechanical removal of dirt and microorganisms, using friction.

The CDC guidelines acknowledge that the optimal length of time for hand washing depends on many factors. A surgeon who is likely to come into contact with germs that could spread to vulnerable patients washes her hands more thoroughly than a man who is preparing lunch for himself in his own kitchen.

waleed-javiad_md_hand-washing-16-0725. Rinse thoroughly under running water.

Why: This helps remove any dirt or microbes that were raised through the friction of hand washing. It also lessens skin irritation from soap residue.

waleed-javiad_md_hand-washing-16-0836. Pat hands dry with paper towels, discarding the paper towels in a waste container.

Why: Germs travel more easily on wet surfaces, so it’s important to dry your hands. The best method is up for debate. In the hospital, disposable paper towels are favored, but the CDC says air drying is also effective.

waleed-javiad_md_hand-washing-16-0907. Use a dry paper towel to turn off the fauce, if it is hand-operated.

Why: Treat faucet handles as if they were contaminated. You don’t want to get your nice clean hands dirty by touching a potentially contaminated faucet. The same advice applies to door handles in public rest rooms.


The Centers for Disease Control and Prevention says to wash your hands:

  • Before, during, and after preparing food
  • Before eating food
  • Before and after caring for someone who is sick
  • Before and after treating a cut or wound
  • After using the toilet
  • After changing diapers or cleaning up a child who has used the toilet
  • After blowing your nose, coughin, or sneezing
  • After touching an animal, animal feed or animal waste
  • After handling pet food or pet treats
  • After touching garbage.


Soap and water is the best way to wash your hands – and the only proper way if your hands are visibly soiled. If soap and water are not available, an alcohol-based hand sanitizer containing at least 60 percent alcohol may be a good alternative.


Sanitizers without alcohol or with lower concentrations don’t work as well on all types of germs, may not effectively kill germs, and may cause germs to build up a resistance to sanitizers, the CDC reports Sanitizers that do not contain alcohol also are more likely to irritate skin.

This article appears in the winter 2017 issue of Upstate Health magazine. 

Posted in community, dermatology/skin care, health care, infectious disease, prevention/preventive medicine, public health | Tagged , , | Leave a comment

Looking at eye development


A discovery by a research team at Upstate reveals the minimal recipe for the creation of the retinal cells that make vision possible. This new knowledge offers a hopeful glimpse that scientists might be able to prompt the development of cells to treat retinal diseases someday.

Multiple cell types necessary for vision (identified by the different colors) can be generated using only two genes in stem cells. (IMAGE COURTESY OF VICZIAN/ZUBER LAB)

Multiple cell types necessary for vision (identified by the different colors) can be generated using only two genes in stem cells. (IMAGE COURTESY OF VICZIAN/ZUBER LAB)

The retina is the neural part of the eye, responsible for translating light into nerve signals. It connects to the brain by the optic nerve. Diseases of the retina, including age-related macular degeneration, can lead to blindness.

The Upstate team discovered that just two genes — not seven, as previously believed — working together can begin the process of eye development. Those genes are called Tbx3 and Pax6. They are two of a seven-gene group known as “eye field transcription factors.” The whole group is necessary for the formation of a normal eye.

Andrea Viczian, PhD, Michael Zuber, PhD, Reyna Martinez-DeLuna, PhD and Zahra Motahari wrote the paper that appears in the August issue of the journal Development.

Michael Zuber, PhD, and Andrea Viczian, PhD. (PHOTO BY WILLIAM MUELLER)

Michael Zuber, PhD, and Andrea Viczian, PhD. (PHOTO BY WILLIAM MUELLER)

They study eye development in frog embryos, which contain the same retinal cell types and whose retinas develop in a manner similar to the human retina. They work with stem cells that have the potential to form a variety of adult cell types.

That’s important because one of the goals of their laboratory in Upstate’s Center for Vision Research is to identify the genes that are required to transform stem cells into cells that could be used to treat retinal diseases.

“An unlimited supply of retinal stem cells in the laboratory dish, using a patient’s own readily available tissues, would eliminate the risk of host rejection when using replacement therapies, such as cell transplantation to treat those suffering from retinal damage or degeneration,” Viczian explains.

Identifying which genes begin the process of eye development puts scientists one step closer to a more complete understanding of how stem cells transform.

Stem cell basics

Embryonic stem cell – These baby stem cells come from newly fertilized embryos and are “pluripotent,” meaning they have the ability to generate almost any type of cell in the body. Think of them as college freshmen with undeclared majors.

Adult stem cell – As if they had matriculated and declared their college major, these stem cells are specific to a particular type of body tissue. They generate only cells of the same tissue to replace those that have died or lost function. For instance, blood stem cells make blood, and neural stem cells make neurons. Scientists call them “multipotent.”

Differentiated cells – When a cell matures into a specialized, functioning cell, scientists say it has “differentiated.” It’s kind of like college graduation.

Progenitor cells – Similar to a stem cell, progenitor cells have the ability to replicate, but not indefinitely. They are tissue specific; they come into college knowing what they want to study. Mostly the role of progenitor cells is to replace cells lost through attrition.

This article appears in the winter 2017 issue of Upstate Health magazine. Hear Zuber and Viczian tals about their research in a radio interview/podcast.

Posted in eye/vision/ophthalmology, health care, research | Tagged , | Leave a comment

Science Is Art: Motion capture and posture

skeletonA common complaint after a concussion injury is a feeling of unsteadiness or impaired balance. Monitoring balance deficits and recovery of balance may help to better understand concussion injury and recovery. Scientists at Upstate Medical University use infrared motion-capture technology to track body motion during a balance test. This allows analysis of various strategies used to maintain upright posture and to investigate impairments that lead to balance problems. People participating in the research stand on foam pads and on firm floor surfaces, allowing scientists to measure and compare their centers of pressure

nevillechristopherChristopher Neville, PhD, PT, has a doctorate in health practice research with a concentration in biomechanics.  He is an associate professor in the department of physical therapy education in the College of Health Professions and serves as the director of research for the Upstate Concussion Center.

This article appears in the winter 2017 issue of Upstate Health magazine.



Posted in brain/neurology, health care, research, technology | Leave a comment

Amazon ecolodge becomes enduring hobby for father and son eye doctors

The Amazon Yarapa River Lodge.

The Amazon Yarapa River Lodge.


What started with a vacation trip in the 1990s has blossomed into something of a second career in Amazon ecology and tourism for an Upstate ophthalmologist.

Charles A. Mango, MD

Charles A. Mango, MD

Charles W. Mango, MD

Charles W. Mango, MD

Charles A. Mango, MD, 72, of Solvay, who has a private practice in Syracuse and has been on the Upstate faculty for decades, said it was his son’s idea to see tropical wildlife that kicked off their family trips into the Latin American jungles.

His son, Charles W. Mango, 42, had studied birds and tropical lowland ecology, and a college field trip to Costa Rica inspired him to get his family to visit there, and later to cruise near the headwaters of the Amazon in Peru.

This and the following photos show some of the wildlife on view around the lodge.

“We loved Peru – the people, the environment, the birds and animals,” says the younger Mango, who graduated from Upstate Medical School in 2000 and today is a clinical associate professor of ophthalmology at the Weill Cornell College of Medicine in New York City.

Return trips included a visit to a pristine branch of the Amazon, the Yarapa River, where the Mango family decided to create a preservation-minded project.

They befriended Victor Serrubio, a Peruvian guide the same age as the younger Mango, whom the elder Mango later brought to Syracuse to fix an eye problem and to see snow and who eventually became like a member of the family.

130I asked him what his plans were,” the elder Mango said, “and he said he’d love in the future to own a small lodge, and that’s how the whole idea formulated, to start building this lodge. I said, ‘OK, let’s build something for you and your family to run, and it’ll be a fun project. Well, it turned into a huge project.”

Serrubio oversaw the building project for the Amazon Yarapa River Lodge, which had to be constructed faster and larger than originally planned to accommodate a Cornell University botanical research program. The Cornell program lasted several years and resulted in a large body of research being published about medicinal plants and the animals that ate them. Now the facility is used by a variety of schools from around the world.

The lodge has a full-time staff of about eight and can accommodate about 40 guests, with dormitory-type rooms for about 28, and the remaining rooms larger, with private baths. Food and drinking water are brought in, and meals are cooked by chefs from a restaurant that Mango owns downriver in Iquitos, a city about 3½ hours away by car and boat. Serrubio and his wife manage both the lodge and the restaurant. (Learn more about the lodge here.)

783“At this point, the lodge is a sustainable ecology facility,” Mango says, noting that water for showers is unheated and guests are asked to limit electronic device use and spend time exploring the jungle.

If you catch a piranha while fishing, a chef will cook it for you. As for unhooking a piranha, “We let the guides do that because they’re very vicious,” Mango notes.

The lodge recently installed a 5-acre botanical garden, and a Peruvian professor oversaw the labeling of all the trees using GPS devices.

ayrl-4-08-464Mango would like to attract more research programs, but at the moment the lodge is mostly used by tourists, who can stay for either four or seven days at a time.

When speaking about the lodge and area, Mango enriches the story with background on everything from the local flora and fauna to his encounters with Amazon natives and government health care and public works officials.

“My main focus is on preserving the area around the facility. We have about 200,000 acres of land now in different trusts as well as owned, and seven lakes.” He has conservation agreements that limit commercial tree cutting and fishing but allow small-scale and traditional tree cutting, fishing and hunting that benefit the local communities.

dsc_0254“Everything I’ve done there, I’ve done because I love it. It’s not a moneymaker for me. I enjoy it because I think I’ve helped a lot of local people, so it’s been fun for me,” he said, noting, “My family thinks I’m crazy.”

Mango currently enjoys overseeing all of the main tasks associated with running an ecolodge. He answers guest emails, confirms bookings and works with the locals on expanding the reserve. His son is content with continuing his role as adviser and promoter.

Both men agree that this project has enriched them with an understanding of how precious the people and natural environment of the Amazon truly are.  “It won’t be around forever” says the younger Mango, “so experience it while you still can.”

What is an ecolodge?

An ecolodge is a place for ecologically minded tourists to stay that is designed to have a minimal impact on the environment and is usually small and remote, to offer closeness to nature. It often resembles indigenous dwellings and is staffed and/or owned by local residents to help support the local economy.

This article appears in the winter 2017 issue of Upstate Health magazine.


Posted in alumni, eye/vision/ophthalmology, health care | Tagged , , ,

Triage for masterpieces: Preserving medical history through art

Art conservator Susan Blakney uses an LED light to examine the World War II portrait of Arthur Ecker, MD, PhD, founder of the neurosurgery department at Upstate Medical University. Cara Howe, Upstate's curator of historical collections, observes. (PHOTO BY WILLIAM MUELLER)

Art conservator Susan Blakney uses an LED light to examine the World War II portrait of Arthur Ecker, MD, PhD, founder of the neurosurgery department at Upstate Medical University. Cara Howe, Upstate’s curator of historical collections, observes. (PHOTO BY WILLIAM MUELLER)


On the table is a banged-up World War II soldier.

His left elbow is punctured. His skin is cracked. Something brown and gelatinous is stuck to his back.

The soldier is photographed. His injuries and overall state of health are recorded. A chunk of the “unidentified organic matter,” is scraped off and placed in a numbered glass vial for further analysis.

The portrait of Ecker, who died in 2006 at age 93.

The portrait of Ecker, who died in 2006 at age 93.

This checkup lasts an hour and results in a four-page report on the care needed for the 1944 portrait of Arthur Ecker, MD, PhD, a neurosurgeon from Upstate Medical University who served in the U.S. Army’s 52nd General Hospital Unit in England.

The analysis of the Ecker portrait is part of the first-ever art conservators’ condition survey of Upstate’s collection of 56 portraits of doctors, deans and scientists. The paintings, which hang throughout Weiskotten Hall and the adjacent downtown hospital, were moved to the Health Sciences Library for this project, under the supervision of Cara Howe, curator of historical collections.

Transporting the collection from Syracuse to an art conservator in Chicago, Boston or Philadelphia would have been cost prohibitive. Fortunately, Howe says, an experienced conservator was found nearby, in Skaneateles.

“Paintings are like people,” says Susan Blakney, chief conservator of West Lake Conservators. “They are born, and then they begin to age. Our goals are to maximize life expectancy.”

Blakney recommends that paintings undergo a survey of their physical condition by a trained conservator every 10 years.

Working much like an emergency physician doing triage, Blakney  first assessed all 56 paintings to determine which were in greatest need of treatment, and then developed a plan to care for the entire collection long term. Because they hang in public spaces, the paintings have suffered from changes in humidity and temperature, light, accumulated dirt and, in some cases, insects, water damage, spilled drinks and dents from accidental encounters with passers-by.

The painting of Ecker, a professor in the medical school from 1939 until 1963, was deemed a top priority.

His portrait was created in England during World War II and, because of wartime shortages, was painted on burlap using house paint rather than on canvas with artists’ paints. The puncture wound on his elbow was one of four holes made by thumbtacks. Paint was flaking around the holes, and water damage led to some buckling. The frame was pressing against the edge of the painting, causing the burlap to fray in spots.

Ecker’s portrait was reframed with padding, backing board, and removable hardware to prevent further damage.

Blakney and her staff spent a week in the Upstate library, photographing, analyzing and reframing the portraits. Howe says restoration of individual portraits will take place over time.

The U.S. Army's 52nd General Hospital Unit, with which Ecker served in England.

The U.S. Army’s 52nd General Hospital Unit, with which Ecker served in England.

A varied collection

Upstate’s art collection is historically significant and valuable in its artistic quality. The individual portraits are of people who shaped health care in Central New York and beyond.  The earliest are the 19th-century portraits of Frederick Hyde, MD, the first dean of the college of medicine, and William Plant, MD, a founder of the specialty of pediatrics. The portrait of Elizabeth Blackwell, MD — an 1849 graduate of the medical college and the first female physician in the United States — was painted posthumously and added to the collection in 1963.  To view the collection on line, click here.

This article appears in the winter 2017 issue of Upstate Health magazine. Hear a radio interview/podcast with Blakney and Howe.





Posted in health care, history, medical education

Recipe: Apple and Pear Salad With Almonds and Blue Cheese

Here’s a light and tasty way to enjoy fruits that are available in Central New York during the winter months.


1 Anjou pear, cored and sliced

1 Fuji apple, sliced

1 teaspoon fresh lemon juice

1 ounce red onion, julienne sliced

4 cups spring mix lettuce

½ cup dried cranberries

2 ounces bleu cheese crumbles

¼ cup sliced toasted almonds

¼ cup balsamic vinaigrette


Slice apple and pear into matchsticks. Place in water with lemon juice for 10 minutes to prevent browning. Drain and reserve.

Toss apples and pears with the remaining ingredients just before serving.

Chef’s note: Use any local crisp fresh apples or pears in this recipe.

Nutritional information

This recipe makes four 1-cup servings, each containing:

205 calories

5 grams protein

28 grams carbohydrates

10 grams fat

11 milligrams cholesterol

331 milligrams sodium

4 grams dietary fiber

— Recipe from Morrison Healthcare, the food service provider for Upstate Medical University.

 This article appears in the winter 2017 issue of Upstate Health magazine.





Posted in diet/nutrition

Ailing med student Alex Paley: ‘A brilliant mind, a true friend’

Upstate medical students donations to support their calssmate, Alex Paley, who has a brain tumor. Front row: Gabrielle Ritaccio, Kathryn Conway, Victoria Fairchild, Kathleen Donovan, Samantha La Qua. Standing: Peter Congelosi, Daniel Santarsieri, John Lofrese, Mckinzie Neggers, Mary Powers, Emily Kellogg, Caitlin Nicholson, Caroline Shank, Omazonna Amadi, Larissa Assam, Emily Malavenda, Danielle Faivus, Katie Patrick. Photo by Susan Keeter.

Upstate medical students set up a fundraising run and crowdfunding site for their classmate, Alex Paley, who has a brain tumor. Front row: Gabrielle Ritaccio, Kathryn Conway, Victoria Fairchild, Kathleen Donovan, Samantha La Qua. Standing: Peter Congelosi, Daniel Santarsieri, John Lofrese, Mckinzie Neggers, Mary Powers, Emily Kellogg, Caitlin Nicholson, Caroline Shank, Omazonna Amadi, Larissa Assam, Emily Malavenda, Danielle Faivus, Katie Patrick. (Photo by Susan Keeter.)

Mckinzie Neggers, a third-year medical student, left Binghamton at 5 a.m. Sunday, Feb. 5 to join Upstate classmates in Syracuse for the “I’m with Alex” fundraising run at Fleet Feet Sports.

Alex Paley

Alex Paley

Neggers and classmates organized the run in honor of Alex Paley, a medical school classmate who’s been diagnosed with glioblastoma, a brain tumor.

Paley and Neggers are two of the 42 medical students who chose to get part of their education at Upstate’s Binghamton campus.

Just a few weeks before, Paley had an excruciating headache and went to the hospital emergency department in Binghamton to have it checked out. The medical staff noticed a slight paralysis in his face, and ordered a  scan, which showed a  mass in his brain.

After stabilizing the pressure in his brain, Haley was rushed by ambulance to Upstate University Hospital in Syracuse. Lawrence Chin, MD, chief of neurosurgery at Upstate, performed an emergency 8-hour surgery and removed nearly all of Paley’s tumor.

After the surgery, Paley was moved to a neuro-rehabilitation center close to home. When he left the center, he joked that, “it only took four days in rehab to kick my brain tumor habit.”

The light-hearted comment fits Paley, who’s known as the class clown, a good friend and the guy who wants to go into family medicine to help those in need.

A sign and photo of medical student Alex Paley was on display at the Feb. 5 run.

A sign and photo of Alex Paley was on display at the Feb. 5 run.

“Alex organizes nightly dinners for the med students,” says Neggers, smiling. “We’re like a family. We rotate who cooks, and his only rule is, make sure there’s a vegetable.”

Paley is also at the top of his class academically.

“Alex wants everyone in our class to succeed,” says Neggers. “He does everything he can to make sure we’re going to graduate as a team.”

Gabrielle Ritaccio, a medical student who met Paley at a Fleet Feet store in Albany prior to medical school, describes him: “Alex is an incredible man. The truest friend. An impossibly fast runner with a brilliant mind.”

The day after the “I’m with Alex” run, the YouCaring website created by Paley’s classmates showed that more than $65,000 had been raised to help with expenses related to his treatment.

“If the tables were turned,” explained Ritaccio, “Alex would be doing everything he could for us.”

Today, Paley is at home with his family in Albany. He’s recuperating and preparing for further treatment, which is likely chemotherapy and radiation.

An 2/8/17 message from Alex Paley: 

Do I not have the best friends? I’d like to add my personal thanks and admiration to my classmates and friends who stood by my side. They cooked for me and my family and made me laugh when I needed company. 

Also I’d like to express my eternal appreciation to the Upstate administration and faculty who were there for my family and me from day zero.  Julie White visited me every day and made sure my sisters and mother had a place to stay. Dr. Mantosh Dewan, Dr. Anthony Weiss and President Laraque-Arena were amazingly supportive of me and my family. They met with my parents while I was in surgery and told them they would do everything they could to help. Dr. Kaushul Nanavati visited with me multiple times to encourage me and keep me positive.

Third-year medical students Mary Powers, John Lofrese and Peter Congelosi — wearing “I’m with Alex” t-shirts — start the run for Alex Paley.

Third-year medical students Mary Powers, John Lofrese and Peter Congelosi — wearing “I’m with Alex” t-shirts — start the run in support of  Alex Paley. (photo by Susan Keeter)

Posted in brain/neurology, cancer, community, education, entertainment, family medicine, fundraising, health care, illness, medical education, medical student, patient story, physical therapy/rehabilitation, surgery

His world is on stage: Medical technician performs his life story

In this scene from his long-running one-man show, “From Cuba to ‘Cuse,” JoséMiguel Hernández recalls how he ended up in Syracuse in November.


For years, JoséMiguel Hernández would make people laugh and cry with his stories about growing up in Cuba and ending up in Syracuse.

Hernandez says

In the program to his show, Hernández tells his audience: “These stories are my gift to you. If you want to cry, cry. If you want to laugh, laugh. But I want to be sure that you leave the theater with part of my essence, my being, my soul.” Above and below are some of the costumes he wears in the production. (PHOTOS BY SUSAN KAHN)

A few years ago, Hernández, 45, a technician in Upstate’s pediatric emergency department, took a friend’s advice and turned those tales into a one-man stage show that he performs annually in Syracuse and around the region.

“From Cuba to ‘Cuse” tells about a shy Cuban boy who found his voice in the theater, got a nursing degree and immigrated to the United States in 1997.

The show, performed in English, showcases his struggles with the language and his effervescent personality.

“I try to do whatever I can do to be happy about myself. I cannot make somebody happy if I am not happy myself,” he says. His boundless energy is obvious on the job, too, as he tells a co-worker she looks like a movie star, gets a blanket for a patient or recalls a favorite phrase, such as “everything’s coming up roses.”

One of his show’s more poignant moments is when he recalls how a stranger once offered him a flower.

“When I end my show, I look into the audience at somebody, and I say, ‘Did I tell you that a stranger gave me a flower?’ So I have everything I need to be happy.’”

Hernández was given the choice of settling in Miami, somewhere in Texas or Syracuse. He thinks Syracuse was a good choice, partly because both his native city of Santa Clara and Syracuse share a love of the color orange, and both have sports teams that wear that color.

His show portrays one of his ongoing challenges. “English is very hard to me to speak because the pronunciation and the phonetics, and there’s so many meanings one word, and it gets hard,” he says.

Prior to coming to Upstate, he worked for several years as a physical therapy assistant at Rosewood Heights, a local nursing home that closed in 2014, and became known there as “Mr. Smile.”

He has loved working with both the elderly and children, which ties in with another of his free-time pursuits: directing a children’s theater troupe, which he started in 1999 through the Spanish Action League. The kids work all year to perform a play in Spanish every October.

josesuperThat program, La Joven Guardia del Teatro Latino, is free of charge, and Hernández hopes it helps keep underprivileged kids off the streets, build their self-esteem and expose them to music, drama and dance.

Most of the kids in his plays do not grow up speaking Spanish; they learn it for the performance, he notes, and many go on to college and successful careers in various fields.

He draws on his training at a prestigious Cuban theater school and on his desire to be positive about himself and others in both of these stage pursuits.

josewomanA phrase he saw on a lottery billboard soon after arriving in town sums up his can-do attitude.

Hernández repeated that phrase when he spoke to his fellow graduates of Syracuse’s Johnson Center/Adult Education program years ago. He thanked everyone who had helped him and said, “This is just the beginning of what I want to be in this country,” then added the lottery slogan with his own ending: “Hey, you never know … until you try.”

This article appears in the winter 2017 issue of Upstate Health magazine.


Posted in community, emergency medicine/trauma, entertainment, health care, international health care, Upstate Golisano Children's Hospital/pediatrics | Tagged , , , ,

Making music: Web designer’s secondary career is onstage singing, playing


Cathy Cadley is Upstate’s senior Web designer. Her hands spend much of her workday on a computer keyboard.

On her favorite evenings, her fingers caress the strings of a guitar, and she sings of a land that she heard of once in a lullaby.


Cadley is an accomplished musician who performs with her husband, John Cadley, and bandmates John Dancks and Perry Cleaveland. The group plays mostly new acoustic and bluegrass. “Somewhere Over the Rainbow” is one of their most-requested songs. They perform monthly at the Upstate Cancer Center and at a variety of venues throughout Central New York. Go to for dates and locations and to listen to their music.

Cadley recalls a love of music and rhythm from an early age. Around age 7, she chose the violin for a school instrument. A few years later she learned guitar. Then it made sense to begin singing as she played. Her earliest performances were in her church.

“I made a decision early on that I didn’t think I’d be able to make a living doing music. I made a conscious decision to pursue visual arts,” Cadley says. She earned a bachelor’s degree in fine arts in visual communications from Syracuse University.

After graduation, her pastor asked her to direct the church ensemble, a side job she kept for more than 20 years. She and John Cadley began playing as a duo in 2009, married in 2012 and enjoy what a Syracuse New Times review described as “an easy rapport that reveals much about their shared virtuosity and musical kinship.”

Their band includes Dancks on bass and Cleaveland, who sings and plays mandolin and fiddle. John Cadley, who sings and plays guitar and mandolin, writes some of the group’s songs. Cathy Cadley has also begun songwriting, a process she admits does not come easily.

She describes how she slowly develops ideas for songs by jotting down phrases or interesting things that she reads or overhears. The lyrics and the melody start taking shape together.

“You hear the rhythm because language has so much rhythm to it,” she says. “There’s rhyme and rhythm in every line. You have to pay attention to the mood, the tenor and the tone of the lyric and follow that with the composing and the structure. Hopefully they support one another.”

Cadley confesses to occasional butterflies before a performance, “but once we get to making music and everyone is clicking, I’m good.

“I really do enjoy making the music.” 

This article appears in the winter 2017 issue of Upstate Health magazine.

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