After his many successes in both the clinical care and scientific arenas, it seems like destiny that Christian Larsen would be chosen for his new role as dean of the Emory School of Medicine, vice president for health center integration at the Woodruff Health Sciences Center (WHSC), and chair of the Emory Clinic board.
But it wasn't always so clear to the boy who was fascinated by science and nature and grew up exploring the tide pools of Miami what he wanted to do. He thought he might study marine biology, which in his mind meant he could swim at the beach and do science.
Then Emory happened. While Larsen doesn't remember any particular point of decision during his undergraduate studies, it became clear to him that he wanted to be a physician, maybe a pediatrician.
As often happens, Larsen didn't stay with the specialty that he had planned to pursue at the beginning of medical school. Instead, he became more and more interested in surgery. He liked the opportunities that surgery presented to make an immediate difference in patients' health and what he describes as its "elegance and beauty." He began thinking of a career in congenital heart surgery, which would marry his interests in children and surgery.
But along the way, nephrologist David Lowance introduced transplantation into the mix. During his rotation with Lowance, Larsen noticed a striking difference between patients who had received a transplant and those on dialysis. "The restoration of health and vitality was evident in the transplant patients," he says.
That observation changed his course once again, and he applied for a residency in general surgery, snagging a coveted slot at Stanford. Larsen's life was about to change again.
Back at Emory
Later, Larsen came back to Emory and with Thomas Pearson with 10 years, built a comprehensive transplant center that integrated patient care and research. They were making progress on their understanding of immunity after transplantation. They had developed collaborations with scientists at the Yerkes National Primate Research Center and with other disciplines across the Emory campus. They had redesigned how clinical care was provided to transplant patients.
The effort was so impressive in such a short time that Oxford University, where Larsen earlier served a fellowship and earned a DPhil in transplantation immunology, came calling. Peter Morris, whom everyone called "The Professor," was retiring, and Larsen was offered the chance to take over his program. It gave him pause. There was the chance to enjoy the prestige of Oxford and to step into the big shoes of a mentor he respected. Pearson remembers standing in the rain outside the DeKalb Farmer's Market and taking Larsen's call about the offer. "You've got to come with me," Larsen told his colleague and friend.
His wife Cloé Larsen and his daughters were willing to go. Pearson, his wife, and two daughters were considering the move. Larsen had a running list of pluses and minuses on whether to go or stay. It tied both families in knots. Then one winter's day as he walked among the Japanese maples that he and Cloé had recently planted, Larsen made his decision. With Pearson, he had built a program in Atlanta and made relationships that were starting to grow and bear fruit. "In the end, I couldn't conceive of starting over or of making the advancements any place else," Larsen says. He stayed.
Dean of School of Medicine
Larsen's decision turned out to be the right one for patients, his field, his own career, and Emory. It was here that he and Pearson built a truly interdisciplinary program that pulls together surgeons, nephrologists, nurse practitioners, infectious disease specialists, nutritionists, social workers, and pharmacists to improve the experience for patients. Here that they did the pivotal research that eventually led to FDA approval of a new immunosuppressant, belatacept, that causes less long-term damage to kidneys than cyclosporine. Much of that success goes back to Larsen's fundamental approach to everything he touches: building teams.
Larsen takes on his new roles at Emory at a time of acute challenges to health care, in particular to academic, tertiary medical centers that provide care for some of the sickest people in the country. Tremendous downward pressure is being exerted on the finances of medicine, and changes are afoot in the way medical centers and providers are reimbursed. The nation is facing a shortage of doctors, and while new slots are opening up for medical students, the number of residency positions are not keeping pace. Research opportunities have never been better in some respects, but the NIH most likely is facing a budget that will stabilize or decline.
In light of such challenges, why would Larsen want to take on the deanship? He laughs when asked, but his answer is serious. "It might be more comfortable to stay in my current roles, which are challenging enough. But I feel a broad desire to serve people, to share what we've learned in the transplant center and surgery to help Emory rise to meet the challenges of today's environment."
Larsen's new role also carries the title of vice president for health center integration, a function that Wright Caughman, Emory's executive vice president for health affairs, describes as looking holistically at the medical enterprise and working closely with Emory Healthcare. "The new environment requires creativity and courage and someone who can focus us on the areas where we can have the biggest impact," he says. "Chris embraces that. He's a good leader who instills confidence in others and coalesces what he learns to create a synergy in the teams he puts together. He respects no barriers, and I mean that in a good way."
Larsen also has the advantage of already knowing the challenges particular to Emory. But being "home-grown" from his undergraduate years all the way through his professional career could have had a downside. Sometimes trainees aren't taken as seriously when they transition at the same institution from resident to fellow or fellow to faculty member. When Larsen was named chair of surgery in 2009, some of the faculty in his department were his teachers in medical school. "I learned that that's okay," he says. "The relationships have been great, and people have been supportive."
As Larsen considered applying to succeed Tom Lawley, who had served for 16 years as dean of Emory's medical school, he turned as usual to his two sounding boards—his wife and "chief of staff" and the man who has had his back all these years, Tom Pearson.
Through more than 30 years of marriage, Cloé Larsen has come to know her husband as a hard worker with "a lot of drive, energy, and vision." She's fully on board with his new roles, even with the higher profile and the inevitable entertaining role that comes with being the wife of an Emory dean. "I'm all for it as long as I don't have to cook," she jokes, "and you can quote me on that."
Pearson believes that his best friend and collaborator is up to the challenge of these new jobs in this new time. "The amazing thing about Chris is that he is so incredibly competent in diverse arenas and can switch from one to another easily. He can go from discussing state-of-the-art bench immunology to analyzing complex financial spreadsheets, to showing great clinical judgment in the operating room. Being dean will be very challenging. I'm glad we have Chris to do it."
* Additional titles that Larsen has held include the Joseph Brown Whitehead Professor and Chair of Surgery and the Carlos and Marguerite Mason Professor in the medical school.