Edward Ashwood’s office in the Leprino Building at University of Colorado Hospital is an out-of-the-way place even in a building filled with thickets of anonymous cubicles ringed by nondescript offices. Ashwood’s hospital home tucks into the south end of a small suite of offices on the second floor, concealed behind a wall, invisible to the hundreds of people who pass by every day.
The off-the-beaten-path location befits an office dominated by a powerful symbol of the past: a large, sturdy bookcase containing a shelf lined with volumes, some of them dating to near the turn of the century – the 20th, that is. Yet these volumes are more than links to Edward Ashwood’s past. They contain the accumulated knowledge that will help him guide UCH’s Clinical Laboratory into the future and, he believes, to prominence.
Ashwood took over as medical director of the lab March 1, succeeding Ronald Lepoff, MD, and joined the faculty of the University of Colorado School of Medicine as professor of Pathology and vice chair for Clinical Pathology. He arrives after a long leadership tenure at ARUP Laboratories, a non-profit arm of the University of Utah that specializes in clinical and anatomic pathology as well as research and development. His new job, however, returns Ashwood to his Colorado roots.
Home on the range
His father was a medical technologist with the military. Ashwood has called many places home, but he says the strongest pull was from western Colorado and his grandparents’ ranch in Gunnison. He spent 13 summers there, irrigating fields, baling hay, repairing equipment, riding horses and herding cattle. After graduating from high school in Northglenn, Ashwood enrolled at the University of Colorado Boulder, pursuing a degree in chemical engineering. Each summer, while his classmates looked for research projects, Ashwood loaded his car and headed over Monarch Pass to the ranch.
The physical work was a break from an intellectually rigorous program that proved too much for many of Ashwood’s fellow students.
“There were 80 students when I started and 40 by the end of the first week,” he said. At the end of the four-year program, only eight graduated – four of the originals, including Ashwood, and four others who transferred in.
The class of 1975 represented the end of an era, in that it was the last that required students to take a slide rule test to demonstrate their calculation prowess. Ashwood still has his, which he slips from a leather case as he sits at a desk in his office. Newly invented electronic calculators, he recalls, ran about $500 in those days – a small fortune. “I couldn’t afford that,” he said. “Only the rich kids had that kind of money.”
His chemical engineering degree did not lead him into the field. Ashwood’s early ambition had been to follow in his father’s footsteps and he spent time before college in CU’s Medical Technology Program. The program director, Roger Hamstra, MD, encouraged him to consider medical school. Ashwood says he worried he “wouldn’t be good enough” for med school and an advisor at CU Boulder later seconded that.
Undeterred, he took pre-med classes while he fulfilled his chemical engineering requirements. As a junior, he took his MCAT (Medical College Admission Test). He scored well, was accepted for early admission to CU’s School of Medicine, and earned his MD in 1979. He chose the University of Washington for his residency in Laboratory Medicine because it offered training in straight clinical pathology – the analysis of bodily fluids in the service of patient care, including disease diagnosis.
Lab by the book
He carried another Colorado connection with him to Seattle. During his medical school classes, he’d noticed pathology residents referring again and again to a certain book. It turned out to be the “Manual of Clinical Diagnosis” by James Campbell Todd, MD. Todd was a CU School of Medicine faculty member; his book, first written in 1908, was a pioneering compilation of laboratory methodology. Todd became the first head of CU’s Department of Clinical Pathology in 1916 and went on to write five editions of the book before his death in 1928. The bookcase in Ashwood’s office holds all of them.
During med school and beyond, Ashwood made Todd’s work his clinical Bible. “People thought I was super-smart,” he recalled. “I was just using that book.”
He developed and honed his lab skills during his University of Washington residency in the crucible of the stat lab at Harborview Medical Center, a busy level 1 trauma center in Seattle. It was far from the rarified air of clinical research, and Ashwood found that using his expertise to provide direct patient care suited him perfectly. He’s gone on to develop many tests, but prefers the place where theory moves into practice.
“I do applied research,” Ashwood said. “I take things that have been discovered at the bench and bring them to the bedside, which in my case is the clinical lab.”
Like Todd, Ashwood has also lent his knowledge and expertise to generations of clinicians following him. With colleague Carl Burtis, PhD, Ashwood edited two editions each of the “Tietz Textbook of Clinical Chemistry,” and “Tietz Fundamentals of Clinical Chemistry,” standard laboratory references authored by Norbert Tietz, PhD, a leading figure in the field.
Ashwood and Burtis later collaborated with David Bruns, MD, on another edition of Tietz’s “Fundamentals of Clinical Chemistry” text as well as the “Tietz Textbook of Clinical Chemistry and Molecular Diagnostics” and “Fundamentals of Molecular Diagnostics.” All of these textbooks occupy another section of Ashwood’s office bookcase.
Through thousands of hours of writing and editing, Ashwood kept his feet firmly planted in the everyday bustle of medicine. During a 30-year career at ARUP, Ashwood built a national laboratory that leads research and performs a wide range of tests for a large clientele, including University of Colorado Hospital. He also taught and contributed to national organizations, including CAP (College of American Pathologists), for which he has served more than three decades.
A year ago, leadership at the University of Utah asked Ashwood to shift a portion of his attention to working with the Food and Drug Administration on regulatory affairs, an assignment he found didn’t suit his interests. With Lepoff’s retirement, he saw an opportunity to carry on his predecessor’s commitment to high-quality patient care.
“That’s my most important goal,” Ashwood said. “I want to make sure that patients and providers get accurate, timely test results. We will be looking at the data and the test patterns and finding better ways to provide medical care.”
He is also intrigued by the possibilities for growth and integration among the clinical labs of the hospitals that make up UCHealth.
“It’s an exciting opportunity,” Ashwood said. He sees potential for keeping more tests within the system, expanding the menu of available tests, and building economies of scale to boost efficiencies and improve patient care while controlling costs.
Ashwood also aims to explore the many possibilities the Epic electronic health record offers the lab. The interest isn’t academic. He recently drove to Medical Center of the Rockies in Loveland for day-long training on Beaker, Epic’s laboratory application.
“I want to learn like a tech,” Ashwood said. It’s a willingness formed during his days as an undergrad, he said.
“My training in chemical engineering has helped in the lab,” he said. “I’m not afraid of instruments, and I embrace data analysis and computers.”
Yesterday, today and tomorrow
He’s also hit the sprawling grounds of the Anschutz Medical Campus running. He’s worked closely with Ann Thor, MD, chair of CU’s Department of Pathology, and with UCHealth executive leadership, aiming to improve communication and the logistics of ordering tests. He is also looking to the future, which for the Clinical Lab at UCH will include not only adding new tests and instrumentation, but also investigating ways to improve on conducting established tests.
If a single principle guides Ashwood, it’s to find what works best and use it, even if it means discarding old practices and belief. For example, in 1982 he developed a urine test to detect or rule out pheochromocytoma, a rare adrenal tumor. But he has no problem saying that a blood plasma test now generally does a better job.
“I’m not wedded to any given lab test,” Ashwood said. “The value of our work is in the questioning rather than in the test itself.”
But the past still exerts its pull. It’s evident in the thinning pages of James Campbell Todd’s books, the slide rule that lies on the table before him and the string tie with a silver overlay depicting two Hopi gods – the work of a northern Arizona artist. He’s worn the ties proudly throughout his medical career.
“I gave up the boots and Levis,” Ashwood said, “but my roots are on the ranch and the ties are my symbol of that time.”