Pamela King Ginsburg's first day as a law school student turned out to be even tougher than she expected. It was almost as if she had "PICK ME" stamped on her forehead. In class after class that day, professors singled her out as the very first student they called on.

By the time her Civil Procedure class rolled around in mid-afternoon, Ginsburg's nerves were frazzled--but sure enough, the young professor with the wild, curly black hair called on her, too, asking her to state the facts of Pennoyer v. Neff.

"Some people gasped and others snickered," Ginsberg remembers. "I threw up my hands, told him I did not understand the case, and suggested he call on somebody else. He was visibly stunned by the impertinence of the first student he ever called on."

That August day in 1987 was not only Ginsburg's first day as a law student--it was also Nicholas Zeppos' first day as an assis-tant professor. And neither could have known that, because her name just happened to appear at the top of the second column on the student roll, every professor had zeroed in on her as the first victim.

Ginsburg's law school career could have been off to a rocky start, but Zeppos, she remembers, "did not hold it against me. Months later, we had a good laugh when he told me he had learned of my plight that day and was sympathetic."

Ginsburg, JD'90, is now an attorney with the Cincinnati firm Ulmer & Berne. "I think his gifts as a professor," she says, "were his ability to accept students as humans with both strengths and foibles, his genuine interest in our development as lawyers, and his sense of humor and knack of never taking himself too seriously."

Zeppos, age 2, with older brothers Evan (left) and Jon (right). Their grandfather immigrated to Wisconsin from Greece around the time of World War I.

Zeppos at center with his brothers and cousin Joel.

Zeppos in his early days as a lawyer

Eloping with Lydia Howarth at age 31.

Story time with sons Benjamin (right) and Nicholas.

Zeppos, with Benjamin (left) and Nicholas, says he likes Nashville both for its creative vibe and its long golf season.

Zeppos and Lydia Howarth attend the Symphony Ball in Nashville.

Howarth is flanked by sons Benjamin and Nicholas.

"I always tell students, work for something bigger and more important than you," says Zeppos, shown here at a Vanderbilt Visions event.

With Vanderbilt students volunteering with Habitat for Humanity.

Leading a freshman Vanderbilt Visions seminar.

At a fundraising event with Monroe Carell Jr., chair of Vanderbilt's Shape the Future campaign.

Nicholas Zeppos has matured and evolved during his 21 years at Vanderbilt, but he has not lost the attributes that characterized him that first day teaching law school. He has climbed the academic ladder from assistant professor to associate dean for research and faculty development at the Law School, to associate provost to provost and vice chancellor for academic affairs. He has served as Vanderbilt's first vice chancellor for institutional planning and advancement, as interim chancellor and now chancellor.

That's just the condensed version. He has written widely about legislation, administrative law and professional responsibility; earned national renown as a scholar; won multiple teaching awards; and shaken the trees for scholarship money.

Universities like Vanderbilt do not often choose their top leader from within their own ranks. Vanderbilt has done it only once before: 71 years ago, when Oliver Carmichael ascended from dean of the graduate school to chancellor.

Yet Zeppos has been so much at the center of every major initiative at Vanderbilt in the last decade, it's difficult to imagine Vanderbilt having made any other choice. He has spearheaded innovative efforts in undergraduate admissions and financial aid, the planning process for The Commons and College Halls of Vanderbilt, the Strategic Academic Planning Group, and development of new programs in neuroscience, law and economics; Jewish studies; and medicine, health and society. He has overseen the university's Shape the Future fundraising campaign, helping raise more than $1.5 billion more than two years ahead of schedule. New plans are on the drawing board for initiatives in the environment, religion, health care, and life sciences and engineering.

"In my time at Vanderbilt, I've known professors who are brilliant intellectuals. And I've known administrators who possess a gift for making complex institutions run well," says John C.P. Goldberg, now associate dean for research at Vanderbilt Law School and one of the faculty members to whom Zeppos has been both a mentor and friend.

"What makes Nick almost unique is that he is exceptionally able on both scores. He is a first-class academic and a masterful leader."

Zeppos peppers his conversations with phrases like "wouldn't it be great if ... ." He pounds the table frequently as he talks, in a way that reveals enthusiasm rather than anger. His natural exuberance masks a Midwesterner's ingrained modesty, a deftness for turning any conversation around to focus on the other person or on the institution.

"I think I'm a pretty good lawyer, a pretty good professor, and I hope to be a pretty good chancellor," he allows. "But I don't like being the center of attention. I love doing all the work that comes with being chancellor. But there's nothing inherently important about me. Vanderbilt is so much more than the chancellor."

"Anyone who meets Nick will immediately observe two things about him," says Goldberg. "First is his love of knowledge. I've spent my life around academics and have never met anyone who is more widely read and more intellectually curious. Second, there is his love of humanity. Most of us like to tell the people we meet about ourselves. Nick is more interested in learning what is going on in others' lives and minds. Really, these two qualities are the same one--he is insatiably interested in the world around him."

A Lawyer Called to Teach

Now a youthful 53, Zeppos grew up in Milwaukee, the youngest of three brothers in a family just one generation removed from its Greek origins. His grandfather, who was born in Athens, left for America with his four brothers and never returned.

"He and others in our family came through Ellis Island. There was a big migration west to Detroit and Chicago among Greeks," Zeppos says. "I'm sure they knew somebody in Milwaukee and went where the jobs were."

The area was Green Bay Packers and Chicago Cubs country by the time Nicholas Zeppos came on the scene. He developed an early interest in both sports and history. "I love history, and I love the history of civilization," he says. "I thought I would teach history."

At the University of Wisconsin, he graduated Phi Beta Kappa in 1976, with a history major and a growing interest in the law. He enrolled at the University of Wisconsin Law School, served as editor-in-chief of the Wisconsin Law Review, and was outstanding graduate of his class. He thought he would be the kind of lawyer who helps people who most need it.

Zeppos met his future wife, Lydia Howarth, in Madison, where she developed her skills as an academic editor. They married in Washington, D.C., when Zeppos was practicing law and Howarth was working at National Geographic. 

"We lived in Dupont Circle, and I would walk Lydia to work and then get on the subway and head down to the Justice Department," Zeppos remembers. "One of our regular 'romantic dates' was meeting after work at the Washington Monument and then running home together along the mall and through Rock Creek."

Busy with their careers, they decided to elope. "Eloping was one of the best things I've ever done," Zeppos says cheerfully, "especially since it was with Lydia. I got married relatively late. I was 31. By then we had both lived away from our families for some time and were working all the time. We thought, why spend a lot of money and a lot of time?" Zeppos remembers filing a brief in the Second Circuit that day and meeting Lydia and her "bridesmaids" at the Gallery Place Metro station. They headed off to get married and were back at work the next day.

Zeppos discusses the practice of law with passion, crediting great mentors along the way. He first practiced in Washington, D.C., at Wilmer, Cutler & Pickering, and then worked for more than five years at the Justice Department, taking a substantial cut in pay to go from private practice to the government. "I was in court all the time. Each case was like a challenging law school exam, and when I stood up to argue I was privileged to say, 'I represent the United States of America.' That was an honor and well worth the cut in pay. I learned so much and am grateful for being able to represent our nation in court."

Among his law career highlights: "Arguing before then-Judge Antonin Scalia was an intense and demanding experience. Judge Richard Posner taught a cerebral seminar, and then-Judge Stephen Breyer was the consummate and reflective professor but cared deeply about the real world.

"I'm intellectually drawn to the law and its intersection with politics, history, philosophy, psychology, biology, sociology," he adds. "It is the ultimate multidisciplinary area, yet it has a practical side."

But he still felt called to teach, and in 1987 he headed south to Vanderbilt with Lydia and their 8-month-old son, Benjamin. "I had never been in Nashville. I found that Vanderbilt mirrored the wonderful things about the region: community, civility and warmth. There's something very special about this region of the country and its sense of being nice to each other as opposed to everything being zero-sum and dog-eat-dog.

"People want to be here. Vanderbilt bears a lot of the qualities and characteristics of this region, and I like that. It distinguishes us," he says, speaking like someone who has just gone on the local chamber of commerce board. 

"It's one of the most entrepreneurial, creative cities, and it's a lot more interesting than cities where other universities are located. Faculty love it."

His first year at Vanderbilt, Zeppos claims, his students gave him teaching evaluations that were "brutal." But, he adds, "Student evaluations are pretty reliable indicators. There's a myth that they're not good predictors, or that you can inflate grades and get your evaluations up. That doesn't work. Where you really get evaluated is when you read your students' examinations. The ultimate feedback is when you read a great set of examinations."

By the time John Goldberg joined Vanderbilt's law faculty in 1995 as an entry-level professor, he says, "Nick was already one of the school's leading lights. Although he was incredibly busy with his own work and with the life of the law school, he was a generous, constructive and inspiring mentor. I have vivid and fond memories of the hours I spent as Nick listened patiently to my half-baked ideas, then steered me--sometimes gently, sometimes not so gently--toward a better way of thinking through a problem."

Zeppos is proud to have raised his children in Nashville. "This is a wonderful community for families. My only disappointment was that our second son, Nicholas, could not be born at Vanderbilt. They were on diversion and had no room for us."

Now, he says, "We'll have at least two freshmen beginning at Vanderbilt this fall who were with my younger son at Vanderbilt's preschool since age 1."

What Happens Next

What can those students expect with Zeppos as their chancellor? Student debt is clearly a top priority, and the university is stepping up efforts to make Vanderbilt accessible.
What parents care about for their college-bound children, Zeppos believes, is not only the intellectual and academic challenge of academia, but the kind of adults they will become--ethically, emotionally and socially. "That's what Vanderbilt has always cared about, and that's what our strategy and mission are."

Beginning this fall all first-year students will live in The Commons, Vanderbilt's first step in making residential life at the heart of the Vanderbilt experience. "We have small classes and great teachers who are committed to the undergraduate experience," Zeppos says. "Why not build on that? 

"My hope is that all these great youngsters in America--rich, poor, black, white, north, south, east, west--will say, 'I've been blessed with the ability to achieve in school. I want to be a leader. I'm a hard worker. I should look at that place called Vanderbilt.' And we work with them to develop their human potential."

He believes the university needs to examine its role in educating the next generation of scholars, scientists and researchers and how Vanderbilt's undergraduate, graduate and professional schools can feed into each other, and that graduate studies deserve more emphasis and more resources.

"It goes back to our core mission and aspirations: research, discovery, teaching and healing," he says. "We are a research university, and we want to take a more prominent place in training the future leaders in research, policy, and at the great educational institutions of the world."

Ever the optimist, Zeppos publicly tells audiences that Vanderbilt will go to a bowl game this year "absolutely. I don't make predictions--I make promises."

He embraces wholeheartedly the integration of athletics into student life begun under his predecessor, Gordon Gee. "An important part of leadership in America is athletics," he says. "Some years a third of our freshmen are athletic-team captains. Part of what distinguishes Vanderbilt is our sense of balance. The kids have multiple interests--they are interesting intellectually and also service-oriented community leaders. Athletics is a critical part of our culture and our balance."

His ability to step out of a scholar's comfort zone and look at the university's needs as a whole is part of what has elevated the former professor to the halls of Kirkland. In 2001, Gordon Gee appointed Zeppos as Vanderbilt's first vice chancellor for institutional planning and advancement. Up to that point, Zeppos says, "I had not been involved with fundraising at all. I think the reason some provosts don't become president is that they don't enjoy it.

"I always emphasize that the word philanthropy doesn't mean 'give me money.' It means 'love of humanity.' I've had wonderful training, from the most junior development officers at Vanderbilt to our most senior people. 

"I've worked with Martha Ingram and Monroe Carell Jr. and other fabulous philanthropists. What I've learned is that people who have been blessed with resources want to make a difference in somebody else's life and in society."

Ingram is chairman of the Vanderbilt Board of Trust, which unanimously elected Zeppos as Vanderbilt's eighth chancellor in March. "Chancellor Zeppos is both a visionary and a pragmatist," she says. "He is a deeply ethical person whose guiding principle is, 'What's the right thing to do?'"

The University as Utopia

Zeppos refers to universities as a kind of utopia "of intellectuals who don't think it has to be a race to the bottom." His speeches often draw on his love of the ancient classics and of history. "I like to refer to things that I know about, that are important to me, because I think my only value as a speaker is to talk about things that are in my heart and in my mind."
He has a richly textured voice and a sincerity that makes you believe Vanderbilt really can and does change the world. This is important business, he is saying, even though he seems to be incapable of taking himself too seriously.

Vanderbilt is in the final 30 months of its university-wide Shape the Future campaign, stretching toward a goal of $1.75 billion. During a recent address, his first since being named chancellor to a crowd of development and alumni relations staffers at Vanderbilt, the room is hushed as Zeppos outlines the university's ambitious goals and lofty mission.

"There are challenges ahead," he says. "I think we'll meet them, just like my predecessors met them. We're one of the greatest universities in the world, part of a very small group of Research 1 universities that educates undergraduates. It allows us to focus on leadership and educating the whole person. I believe very deeply that it really matters for Vanderbilt to be here, to thrive, and to have the resources to heal and teach and discover."

Somewhere in the crowd a cell phone shatters the quiet with a jaunty tinkle. A crimson-faced staffer scrambles for her purse.

"Is that the ice cream truck?" Zeppos asks gleefully.

In the face of a weak stock market, a housing industry in crisis, and a long list of other economic woes making headlines every day, Vanderbilt is about to bite off a very big obligation in scholarship assistance. The Monroe Carell Jr. Children's Hospital is undertaking a $203 million expansion. The athletics department has just announced a planned $50 million in facilities upgrades. And that's just the tip of the iceberg.

"I graduated from law school in 1979," Zeppos says. "I have lived through stagflation and hyperinflation. I've lived through probably the highest unemployment since the Great Depression. I've lived through recession, stock market crash, the insolvency of the American banking system. I've seen the Internet bubble, I've seen 9/11. I've seen wars--popular and unpopular. I've seen the subprime crisis. And I think of Chancellor Kirkland and Chancellor Carmichael dealing with wars and depression and plagues and epidemics. I think of Chancellor Heard during the Civil Rights Era and the Vietnam war, the oil embargo, hyperinflation, the Peabody merger. These great institutions endure and lead."

Nicholas Zeppos is clearly enjoying the challenge. 

"I plan on finishing my career here," he says. One of the perks of being chancellor, he adds, is the option of being buried on the Vanderbilt campus. 

"I'm thinking 50-yard line." 

Clockwise from top: Max Notowitz is the first boy standing on the left end of a group of Jewish boys wearing Star of David armbands as they shovel snow; Notowitz (in white suit) with a friend before the war; Fred Westfield's identity card; Inge Smith in 1936; Star of David armband worn by Walter Ziffer.

When Walter Ziffer applied to Vanderbilt University in 1949, he was a 22-year-old man with only six years of formal education and six high school credits on his transcript.

Ziffer's youth had allowed little room for childhood, let alone school. The Nazi war machine overtook his town in Czech Silesia at the start of World War II. When Ziffer emerged from the war, having survived seven slave labor and death camps, he was 18 years old and weighed 87 pounds.

Walter Ziffer

His body, he says, healed long before his spirit did, but he was determined to reclaim his life. In 1948 he left Europe to live with an uncle who had escaped to Nashville before the war. He quickly enrolled in high school, graduating in less than a year. Ziffer then appealed to Fred Lewis, dean of Vanderbilt's engineering school, to take a chance on him. Lewis did.

Ziffer, BE'54, believes his education transformed his life. Inspired by his liberal arts courses--he still talks about the spark he felt in Professor Samuel Stumpf's philosophy classes--he went on to graduate from Vanderbilt and then earned advanced degrees from the School of Theology at Oberlin College and from the University of Strasbourg.

"Vanderbilt was a life-changing experience for me," he says. "It is a sad fact that after World War II, many survivors of the Holocaust were not able to put their broken lives back together because of the damage inflicted upon them by their Nazi captors and torturers. I have been one of the lucky ones."

Ziffer was one of more than 300,000 Jewish Europeans who made their way to the United States between 1933 and 1952. Some had escaped Germany's reach before the war broke out. Others had been forced to fight for their lives in the crucible of the Nazi genocide. Many were young people whose childhoods had been destroyed by war. But for Ziffer and others, despite all obstacles, education remained a cherished goal and a crucial step on the path back to a better life.

Each year fewer and fewer Holocaust survivors and refugees remain to tell their stories. We thank the alumni interviewed here for sharing theirs. In the face of cruelty and destruction, they chose to create and rebuild. Pushed toward despair, they sought meaning. Through their commitment to education, they answered barbarity with civilization. We also thank the Tennessee Holocaust Commission and the Western North Carolina Center for Diversity Education for sharing many of the photos that accompany this piece.

Max Notowitz (near center of front row, wearing white collar) with schoolmates at Hebrew School in Kolbuszowa, Poland, before the war.

Max Notowitz, BA'52

On a shelf across from his desk, Max Notowitz keeps a photograph taken in Kolbuszowa, Poland, more than 70 years ago. It is of his cheder, the Jewish religious school he attended in the afternoons. Notowitz, about 9 years old, sits smiling in the middle of the first row. There are several dozen boys and teachers around him. Only four, including Notowitz, survived the war.

Notowitz still can repeat from memory religious lessons he learned as a little boy. He remembers reciting them while perched on his father's arm.

Notowitz is matter-of-fact as he talks about this, as he is when he holds out a picture of his father taken at Auschwitz. Osias Notowitz was murdered there in 1941, one day after Max's 14th birthday. Less than a year later, the Germans imprisoned Max in a labor camp and executed his mother, brother and sister at the Belzec death camp.

"I tell this story simply because it happened to me, and because I witnessed it," Notowitz says. "I'd much rather it hadn't happened to me."

Notowitz's story is overwhelming in sadness and cruelty. Yet he tells it gently, in a soft, kind voice. It almost defies belief that he could survive such horror with any impulse toward gentleness intact. In 1942, Notowitz escaped the labor camp with 41 other prisoners. Only eight lived through the end of the war. Many were murdered while foraging for food.

"I saved my life by devious means," Notowitz says. "I didn't follow the rules. You were supposed to surrender and be killed, but I didn't follow the rules."

After the war Notowitz worked hard to find a way out of Europe. He earned money as he could, again not following the rules. In 1947, using false papers, he secured a visa to the United States. Once in New York City, he worked at a handbag factory by day and studied at night. He was a 20-year-old in fifth grade.

"I asked myself, 'How long do I have to be in fifth grade?' Others encouraged me to stick with the factory work--that it was a steady, dependable living--but I noticed they did not want it for their children," Notowitz says. "I had in the back of my mind a letter I got from my mother when I was in the camp. I think she knew she would never see me again. She wrote, 'I hope to be able to see you again, but if the good Lord denies me that, I want you to do one thing for me. Promise me that if you have a chance, you will get an education.' This thing stuck with me. My mother said education was the best way to make your way in the world. That was my dream."

Notowitz's father before the war and at Auschwitz shortly before his death.

Notowitz held fast to this dream. He found a cousin in Memphis, Tenn., who took him in and sent him to private high school. Less than two years later, despite his lack of credits, he applied to Vanderbilt.

"At Vanderbilt nobody asked me where I came from, what I did. And I didn't talk about it. But my work was recognized," Notowitz says. He graduated in three years, a member of both the Phi Beta Kappa and Omicron Delta Kappa honor societies. "Vanderbilt gave me something that I really had to earn. By the time I graduated, I was established."

Notowitz before imprisonment in a labor camp where his mother, brother and sister were executed.

Though their years at Vanderbilt overlapped, Notowitz never knew Walter Ziffer, who also survived the Holocaust as a teenage boy.

"I always wondered if there were other survivors at Vanderbilt," Notowitz says. "I never met any."

Notowitz found success in the insurance industry and, after a stint with U.S. military intelligence in Germany, settled down in Memphis with his wife, Fannie. They have four children and two grandsons. He has embraced his roles as philanthropist, active Jewish community member and Holocaust educator.

In 1997, Notowitz returned to Kolbuszowa with Fannie and his 14-year-old grandson. They went to visit the man who, on the night of the escape from the labor camp, turned to Notowitz and asked, "Are you coming?" After the war Notowitz gave this man, Janek, a photo of himself, writing on the back, "To the man who saved my life." Janek still had the picture.

"When we got to the town, we had a lot of trouble finding his house," Notowitz says.

"He'd met a Polish girl, converted, and become a sexton in the church. But when we finally found him, his granddaughter said to us, 'You should have asked where the Jew lived.'

"He has died since then. With him died the last Jew in the town."

Inge Smith believes that her father's dedication to her education saved her life.

When the Nazi regime seized his silk wholesale business in Dresden, Germany, Walter Meyring no longer had a way to support his family. But he was just as devastated by her expulsion from school because she was Jewish. He resolved to leave Germany.

Inge Meyring Smith, BA'65, MA'67, EdS'74

"My father raised me to believe that educaion was of foremost importance," Smith says.

"What was going to happen to his child? My father's friends--friends who had connections in the Nazi regime--told him it was not going to get better."

Meyring had a nephew in the United States who sponsored the family. Two nights before they boarded a ship in Hamburg, in November 1938, Kristallnacht raged across Germany. During the rioting, thousands of Jewish businesses and synagogues were attacked. Tens of thousands of Jews were arrested. Meyring, who had gone to say goodbye to his mother, spent the night hiding in her apartment. He would never see his mother again; she was too old to qualify for a visa. Smith's family learned after the war that to avoid deportation, she had been euthanized by a doctor and family friend. Most of Smith's extended family died in Auschwitz.

The Meyrings arrived in New York City at Thanksgiving. The following Monday, Meyring enrolled his 15-year-old daughter in school.

Her father, once a successful businessman, took whatever work he could find. In order to go to the opera, which they had attended regularly in Dresden, her parents worked nights at the Metropolitan Opera. Her mother sold candy there.

"We came to the U.S. with $15 between us. That's all they would let us take," Smith says.

"The Council of Jewish Women helped us with so much. We would have starved to death without them."

In the meantime, Smith became Americanized. She studied hard. She took her textbooks home, translated the lessons into German, did the exercises, and translated them back to English. After graduation she worked as a secretary and went to night classes at City College of New York.

Inge with Paul, a Tennessee native who began corresponding with Inge after seeing a photograph she'd sent to another U.S. soldier during the war.

Then she fell in love. "We had nothing in common," Smith says. "Paul came from a farming community in western Tennessee. I was a big city girl." Nevertheless, they married six weeks after he finished his Army service.

When Paul Smith took a job in Franklin, Tenn., his young wife panicked.

"I loved New York City. I adored my job. My family was there. All my friends were there. I loved going to school," Smith remembers. "But my father said, 'You are married now. You have to go.' It was very hard."

Smith spent her first few years having children and adapting to her new home. "It's a wonder they didn't run me out of town," she says. Her faux pas included going to the liquor store and taking her baby out for walks in the winter. "People would say to Paul, 'You want to know what Inge did this time?' They would say, 'Oh my goodness, that poor foreigner.'"

Church was an important part of life in Franklin. Smith and her husband, who was not Jewish, joined a Presbyterian congregation, to which she still belongs. Smith remembers choosing it because she heard it had the best Sunday school in town.

Smith had left much behind in New York City, but not her passion for education. In 1952 she founded Franklin's first kindergarten in her church's basement. She took her own children to work with her.

First grade at Inge's girls-only school in Dresden, with Smith in the center of the back row (wearing white collar).

"None of us had any money," Smith remembers. "Families only had one car. I learned to drive so I could go around town picking up children for school."

In 1958, after Inge's mother died, Inge's father came to live with her family. He helped her to build a small school adjacent to her home. The bustling Smith Preschool, with lovely tree-shaded playgrounds in the backyard, still serves about 55 children a year.

Then, with money and babysitting, her father helped her return to college. She earned three degrees from Peabody College, including an educational specialist degree. Her career blossomed. She helped to launch Tennessee's Head Start program and supervised early childhood educators across the region. She helped to establish Franklin's Harpeth Academy, an elementary school that has since merged with a larger institution. Smith headed the school until her retirement in 1991. She loved her work.

"My father always told me, material things can be taken away from you from one day to the next, but what you have in your mind--no one can take that away from you," Smith says.

"Going to Peabody was a very special time in my life. Without my father's help, I couldn't have gone back. My father saved my life twice. He fulfilled his promise to give his daughter an education so she could become the woman she was meant to be."

Walter Ziffer, BE'54

In the decades following World War II, Walter Ziffer wandered physically and spiritually.

His journey started in his hometown of Cesky Tesin, Czechoslovakia, where he, his parents and his sister reunited after liberation. All four had survived years in Nazi slave labor and concentration camps. Ziffer was 18.

"I was afraid of everyone," Ziffer remembers. "Four years in the camps had really set me back. It was a rough time."

By 1947, Ziffer knew he could not stay in Czechoslovakia. Communist takeover of the country was imminent, and the military draft loomed. Ziffer left for France, where he spent almost two years, all the while hoping to join his uncle in Nashville.

Ziffer's family in late 1930s Czechoslovakia, with young Walter in knee socks. Of those pictured, two uncles, a great-uncle, a cousin and two aunts perished in Nazi concentration camps; Walter survived seven slave labor and death camps.

Not everything turned out as Ziffer planned. He made it to Nashville, and at Vanderbilt he became an engineer just as he had hoped. But he also began a spiritual journey that would estrange him from his uncle's family and set him on a completely new path.

"My friend Burton Grant, whom I met in class, was going away to study. He asked me to move in with his mother to help take care of her in his absence," Ziffer says. "Through Mrs. Grant I was exposed to the Churches of Christ, and I converted."

Ziffer also married. He had met Carolyn Kinnard, BA'52, in an introductory social science class. After graduation they moved to Ohio, where he had taken an engineering job with General Motors, only to find himself drawn toward a life in the ministry.

"At GM I dealt in car parts, but through church contact I became interested in people, in educating," Ziffer says. "I wanted to improve the world a little bit."

Religious study also spoke to Ziffer's profound need to make sense of what he had witnessed during the war.

In a Holocaust Remembrance Day speech he gave in Florida last April, Ziffer described in graphic detail a murder he had witnessed in the Brande labor camp:

"The blood streams in rivulets from the man's mouth, nose, ears and body wounds. I see the man's eyes being beaten from their sockets ... The Kapos lift Rabinowicz from the blood-, urine- and excrement-drenched floor and carry him out. They dump the body into the coal bin. ... I, 14 years old, stand there, unable to move, sick to my heart and stomach. My feelings? They have gone dead. I am paralyzed ... ashamed, speechless, motionless ...

"How can a 14-year-old, witnessing this unspeakable brutality, survive and then go on with his life, even though the picture of that murder often haunts him in waking and sleeping hours? How can the rest of the world let this happen, stand by this obscenity of obscenities, reenacted hundreds of thousands of times all around Germany and its occupied lands? And finally, question of questions, where was God in that moment at Brande?"

Walter Ziffer with George Loeffler, his best friend during the two years between the Nazi invasion of Czechoslovakia and deportation. George, whom Ziffer remembers as "a lovely boy with big blue eyes," died in a concentration camp.

After Ziffer completed two master's degrees at Oberlin College's Graduate School of Theology, he resumed his wandering, family in tow. Working as a minister and educator, he never stayed more than five years in one city. He took jobs in France, Belgium and the United States. In 1982 he retired with Carolyn to Nova Scotia. It did not last. They moved to Maine, where Ziffer continued research that he had started in Canada.

"I had become interested in anti-Semitism," Ziffer says. "I'd run into it all the time in my years as a minister--not against me, but in front of me: anti-Semitic jokes, remarks about the Holocaust. I set out to do some research, which resulted in a book, The Teaching of Disdain, about New Testament attitudes toward Jews. And then I realized that my place was with the Jewish people."

After more than 25 years as a minister, Ziffer converted back to Judaism and became active in synagogue life. He moved once more, in 1993, to a town near Asheville, N.C.

This year he will have lived there longer than he has lived anywhere else in his life. Now divorced and remarried, he turns 81 this year and continues to teach as an adjunct professor of Jewish studies at Mars Hill College in North Carolina. He published The Birth of Christianity from the Matrix of Judaism in 2000.

After years of study, teaching and searching, Ziffer seems to have found some of what he sought. At the end of his speech in Florida last spring, he was able to offer an answer to his question of questions about God's presence in the world. He quoted a rabbinic interpretation of God's words to Israel in the book of Isaiah: "When you are my witnesses, I am God. When you are not my witnesses, I am not God."

"What does that mean?" Ziffer asked the audience. He answered with conviction. "The miraculous is for us to achieve. By witnessing to God--by practicing kindness, compassion, justice and love--we, you and I make God present. When, on the other hand, we turn our heads away in an effort not to see and not to get involved, God is truly absent."

Fred Westfield, BA'50

The realities of refugee life dampened Fred Westfield's faith that he would attain a college education.

He and his family escaped Germany before World War II started, but not all at once. Westfield's older brother, Erich, was the first to obtain a U.S. visa. He joined his uncle Robert in Nashville in 1936, when he was just 15.

In January 1939, 12-year-old Fred was sent to England as part of the Kindertransport, the famed rescue effort that relocated 10,000 German, Austrian and Czechoslovakian Jewish children to Great Britain in the late 1930s.

"Every night I doubted whether I would ever see my parents again," Westfield says. He was placed with a foster family of Polish Jewish immigrants in London.

Westfield's parents managed to secure visas to England in the summer of 1939. They were helped by money that Westfield's uncle Walter had smuggled out of Germany. It was painful for them to have to use it.

Twelve-year-old Fred Westfield as his train departs Germany en route to England, where he would stay with a foster family.

"Uncle Walter was arrested two weeks after Kristallnacht. He was an art dealer, and they accused him of smuggling art and foreign exchange violations, because he'd been sending dollars to my uncle Robert in Nashville," says Westfield. "He was tried, imprisoned, his art auctioned off to pay his fine."

Walter was in prison for two and a half years. At the end of his sentence, the Nazis deported him to concentration camps. He died in the death chambers at Auschwitz.

Westfield and his parents were allowed to immigrate to the United States in 1940. They joined Erich in Nashville. Another of Westfield's uncles, the artist Max Westfield, also escaped to Nashville with his wife and two children.

Fred was born Fritz Meinhard Westfeld, but German officials added "Israel" to Jewish males' names and "Sara" to Jewish females' names when they issued identity cards.

Nashville's community of German Jewish refugees was small, but strong. Many were somehow related to each other and to families that had emigrated from Germany decades earlier. But life was difficult for Westfield's father, Dietrich, who was already in his 60s. He had been a well-regarded lawyer before the Nazis rose to power. He had served as a judge advocate in World War I, for which he received the Iron Cross. In Nashville he was without a profession and penniless.

"He didn't want to use my Uncle Walter's money," Westfield remembers. "How would you feel using your brother's money--a brother who's been imprisoned and later murdered? My father took odd jobs. He sold cola at the Mays' hosiery factory. My mother worked, too."

Westfield wanted to do his part.

"The summer before I turned 16, I took a job," Westfield says. "There was a program where you could go to school an hour early and then get out in the afternoons to work, with the idea that you were learning a trade. My father--with all that was happening to us--I think he liked the idea of a Jew on the move learning a trade. I became a watchmaker and sold jewelry. I was good at it. I thought that is what I would become."

The Army changed all that. Westfield served as an instructor at Aberdeen Proving Ground in Maryland, applying his watchmaking skills to the repair of optical instruments used in weaponry. After his service, Westfield used the G.I. bill--which included an extra stipend for those who were supporting parents--to go to college. He chose Vanderbilt, as had his brother, Erich, BE'43.

A 1936 portrait at the family home in Essen, Germany, includes Fred, at the front and to the left of his cousin, Gerd Michael Westfield, BA'49, with brother Erich, BE'43 (wearing breeches), and cousin Hannah Westfield Kahn, BA'48, at the right end of the back row.

Like Erich, who had earned the Founder's Medal for the School of Engineering, Westfield excelled. He completed his economics degree, magna cum laude, in only three years. He did his graduate work at the Massachusetts Institute of Technology, studying with some of the greatest scholars in the field, including Paul Samuelson and Robert Solow.

After earning his Ph.D. there, he became a professor at Northwestern University. In 1965 he accepted a professorship from his alma mater and came home to Vanderbilt. Now retired, he is professor of economics, emeritus.

Besides Fred and Erich, who lives in Oklahoma, there were others in the family who came to Vanderbilt, too--their cousin Hannah Westfield Kahn, BA'48, who lives in New Jersey; Hannah's late husband, Charles Harry Kahn, BA'46; and another cousin, the late Gerd Michael Westfield, BA'49.

Dietrich Westfield, who was an intellectual at heart--in his 70s, he started reading the classics in Greek--was proud of his sons' academic and professional achievements. He had lost much in the war. But his sons had found their way in a new country.

Vanderbilt's Holocaust Lecture Series

Each fall Vanderbilt invites the community to participate in what has become the longest-running Holocaust lecture series at any American university. Begun in 1977 by Beverly Asbury, then Vanderbilt University chaplain, it provides a forum for diverse perspectives on the Holocaust and other genocides. Find out more: www.vanderbilt.edu/religiouslife/holocaustlectures.html

Last winter Shane Thurman, a 42-year-old construction worker from Crossville, Tenn., became one among an estimated 45 million Americans without health insurance when he was dropped from the rolls of TennCare, Tennessee's state-run Medicaid insurance program. Thurman's employer didn't provide health insurance, and his income wasn't sufficient to meet his other basic needs and pay for medical insurance.

On Jan. 10, 2007, a few weeks after he lost his insurance coverage, Thurman was working on the roof of an old building in Crossville, helping to demolish it, when his body came into contact with an electrical transformer attached to a power pole. In a millisecond, the high-voltage electrical current grabbed his body and held him in its deadly grip for what felt like forever. When Thurman finally broke free from the current, he was thrown from the roof to the ground 30 feet below.

Thurman sustained critical electrical burns to 40 percent of his body. The fall broke most of his ribs and several vertebrae in his back. He was flown by Vanderbilt's air ambulance, LifeFlight, 110 miles to the Vanderbilt Regional Burn Center where he spent the next 52 days.

"I wasn't even aware I was alive for 48 days," Thurman says. "I had eight or 10 skin grafts and four or five back surgeries."

The accident left Thurman a paraplegic, paralyzed from the torso down. "I'm lucky to even wake up each morning," he says. "The doctors told my family on several occasions that I was going to die. But I fooled them."

Total charges for Thurman's lifesaving care during the 52 inpatient days he spent in Vanderbilt University Hospital: $919,587.76.

Thurman's will to survive certainly helped, but the real reason he's still alive is the comprehensive and highly specialized medical care he received, without consideration of cost.

Vanderbilt opted to write off Thurman's nearly $1 million in medical bills. "That tickled me to death," he says, "because I have enough else to deal with."

During fiscal year 2007, Vanderbilt University Medical Center provided $240 million worth of uncompensated medical care to patients.

Across the country, treating patients like Shane Thurman is becoming an ever-greater challenge for academic medical centers that are struggling with unprecedented growth in the numbers of uninsured patients.

"The increase in uninsured patients is placing the entire health-care system in jeopardy, and academic medical centers are especially vulnerable," says Dr. John Sergent, BA'63, MD'66, professor of medicine and vice chair for education in the Vanderbilt University School of Medicine. "Our emergency departments are usually the major sources of emergency care for our communities. And we often are the sole providers of critical services."

In addition to caring for patients like Shane Thurman who face immensely complicated courses of treatment, Vanderbilt University Medical Center each year provides uncompensated care to thousands of other medically uninsured or underinsured patients, young and old, whose health problems span the spectrum of illness and injury.

To put $240 million worth of free medical care into context, this dollar amount represents approximately 7.4 percent of the medical center's $3.2 billion in gross patient revenue for the current fiscal year.

"Teaching hospitals end up bearing a disproportionate share of the cost of treating the uninsured because they are typically the only providers in a marketplace for trauma services, burn services, organ transplantation, and limb amputation due to mismanagement of diabetes," says Paul Keckley, executive director for the Deloitte Center for Health Solutions in Washington and one of the nation's leading experts on health-care economics and policy. Keckley helped establish, and is currently a professor in, the Owen Graduate School of Management's Healthcare MBA Program.

"This type of care happens largely in the world of academic medicine," Keckley says. "And the care of these patients represents one-half the impact of the nation's total uncompensated care pool."

"About 6 percent of VUMC's patients have no form of health insurance," says Warren Beck, VUMC's vice president of finance for the clinical enterprise. "Another 1.5 percent may have insurance but cannot pay their portion of the balance after insurance."

A Growth Industry

Middle Tennessee's health-care industry is enormous--by most measures Nashville has evolved into the nation's third-largest aggregation of health-care companies.

For the health-care market in which VUMC operates--competing with other nonprofit and for-profit hospitals for its patients--Vanderbilt provides more free care than all other Metro Nashville hospitals combined, including Baptist, St. Thomas, Centennial, Metro General, Summit, Skyline, Tennessee Christian and Southern Hills.

Vanderbilt University Hospital and the Monroe Carell Jr. Children's Hospital at Vanderbilt operate at nearly 90 percent patient occupancy year-round. "One of our primary missions is to provide those unique and essential medical services that no other health-care facility in Middle Tennessee is willing to provide," says Dr. Harry R. Jacobson, vice chancellor for health affairs. "Affording patients access to these services based strictly on someone's ability to pay would be contrary to our philosophy and our mission."

Over the last 12 years, the significant role VUMC plays supporting TennCare, and its commitment to providing care for the uninsured, has positioned Vanderbilt as Nashville's charity hospital and Tennessee's largest provider of Medicaid services.

The Decline of Employer-Sponsored Health Insurance

While TennCare has presented a significant challenge for Vanderbilt as it copes with a growing population of uninsured patients, it's not the only factor. Compounding the problem are three significant trends that are producing huge numbers of patients unable to pay their medical bills: a decline in the number of employers who provide health benefits; more workers who carry modest health insurance on themselves but not for family members; and an influx of millions of uninsurable immigrants.

As more Americans struggle to find a way to access affordable health insurance, changes in the insurance industry and in employer-based insurance programs are causing more of the cost for health care to be shifted to enrollees. The percentage of Americans who are uninsured keeps rising largely because the percentage of people with employer-sponsored coverage continues to decline.

And therein lies the fundamental systemic flaw in our nation's health insurance delivery, says Keckley--our dependence on employers to provide health insurance. "Only the U.S. and a few other nations such as New Zealand have similar systems of employer-sponsored health insurance. But there is no law in our country that says employers must provide health insurance."

Approximately 60 percent of U.S. employers now provide health insurance. The 40 percent that do not offer insurance tend to employ large numbers of hourly workers and have substantial employee turnover.

As health-insurance costs keep rising, so does the number of employers that offer health insurance only for the employee but not for the employee's family. The average health-insurance premium for a family without employer-provided coverage is about $1,000 per month.

No wonder half of all the nation's involuntary bankruptcies are the result of medical bills, says Keckley.

"Horrible traumatic accidents most often happen to the working class," says Dr. Jeff Guy, director of Vanderbilt's Regional Burn Center and a member of the team of physicians and nurses who saved the life of Shane Thurman. "Unfortunately, it's people like Mr. Thurman who are in that abyss and ineligible for health insurance through their employer, or through any other form of assistance."

As access to various normal avenues to health insurance has dwindled over the last several years, Guy's burn program has been left to cope with more highly resource-intensive patients with no insurance.

Guy oversees the only dedicated burn-care facility in Tennessee, and the largest burn center in several adjoining states. Burn care is so expensive that many hospitals--including every health-care facility in the state of Mississippi--have backed away from providing this service. Even one patient can make a huge impact on the bottom line, and Guy is forced to deal with the economic challenges of treating several Shane Thurmans each year.

At the same time more employers are opting out of offering health insurance, some states, like Tennessee, are aggressively working to control their Medicaid spending through measures such as denying insurance coverage or capping reimbursement fees.

"We're at a point where Medicare and Medicaid are now paying less than the cost of care for the lives they cover," says Keckley. Reimbursement providers that may not match the cost of care include Medicare, Medicaid, Worker's Comp and SCHIP (State Children's Health Insurance Program).

Charging Peter to Treat Paul

"That shortfall in reimbursements, in combination with the growing number of uninsured individuals, is forcing doctors and hospitals to try to make up the difference on the backs of employers who do provide a benefit," Keckley says. "What we are facing is a perfect storm, a meltdown.

"We are asking a third of the people who use the system and who have insurance to pay for the other two-thirds, either in full or in part."

Shifting costs to paying patients is undeniably a part of the budgeting strategy for medical centers like Vanderbilt. But, fortunately for all Vanderbilt patients, recent unparalleled growth has allowed it--so far--to combat major changes in Tennessee's health-care policy.

In fiscal 2007, VUMC's hospitals recorded 50,716 inpatient discharges, its emergency departments treated 98,107 patients, and 1,095,559 outpatients were seen in its clinics. Demand for services remains so high that in January, VUMC embarked on a $235 million construction project to erect a third inpatient tower on Vanderbilt University Hospital. The new tower will add 141 inpatient beds, new operating rooms, procedure rooms and intensive care units.

"For the last two years, we have been dealing with near double-digit volume growth across all major indicators," says Warren Beck. "Whether it is inpatient admissions, outpatient visits, surgery or emergency-department visits, this growth has allowed us to meet our obligations and improve our ability to conquer diseases like cancer, diabetes and heart failure. If we hadn't had this growth, we would be in a horrible situation."

Managerial oversight during the past five or six years also has helped Vanderbilt to cope with a huge increase in uninsured patients. Efforts to add inpatient and outpatient capacity--through new clinic space and the recruitment of new faculty, for example--have allowed new growth. More patients overall means more paying patients to help offset those who cannot.

Operations-improvement initiatives that began in the early 1990s and ongoing efforts to provide the best care in the most efficient manner (called "best evidence medicine" within the industry) have so far allowed the medical center to provide services and still finish each fiscal year in the black. Every year, though, the financial picture becomes more challenging. Changes with Tenn-Care in August 2005 increased uncompensated care by $87 million in fiscal 2006 and by an additional $45 million during fiscal 2007. That sort of growth in uncompensated care isn't sustainable.

Virtually all of VUMC's clinical programs, says Beck, have seen growth in the number of uninsured patients they treat due to changes TennCare made in 2005. Trauma and burn-care services, cardiology, orthopaedics and general medicine have all felt the impact, with the division of trauma and surgical critical care hit the hardest. But the medical center has made an effort to ensure that clinical programs shouldering a greater percentage of uninsured patients are not penalized for financial performance based on their predicament.

"In order to recoup a portion of lost revenue, we are placing an emphasis on growing higher-margin services and offering a broader menu of services that brings insured patients into the hospital," Beck says. "We've learned that we're far better off to have our margin spread across all our services rather than rely on just a few."

The Road Ahead

"Clearly, one of our ongoing challenges is figuring out how to better manage the population of uninsured patients," says Beck. "We need the state to develop a broader network of doctors and hospitals participating in TennCare so patients don't have to travel long distances to come to Vanderbilt. Another initiative we have pursued is working with Nashville's Emergency Medical System to make sure patient transports by Metro EMS are rotated from hospital to hospital--not just brought to Vanderbilt. But implementation can be slow and difficult to monitor."

At the same time Vanderbilt is taking on an ever-growing number of uninsured patients, Tennessee's state treasury is sitting on a huge budget surplus. A large pot of money in reserve probably means drastic changes to TennCare are unforeseen for the time being, Beck says.

"And, optimistically, this might indicate a possibility of some form of relief in the TennCare program--perhaps an expansion of benefits offered through TennCare's new program for employees of small businesses called Cover Tennessee," he adds. "Something like that might push excess reserve funds back to the hospitals and doctors that are bridging the gap for so many of the working folks who are uninsured.

"The clinical programs we want to provide are very expensive, high-acuity programs you don't see in community hospitals. If we are the only provider in the region who offers them, then everyone needs to have access," Beck says.

Jeff Guy likens his role and responsibility to that of a park ranger in a national forest. "We have to be good stewards of our resources so those resources will be around for all of us," he says. "We have never denied anyone access to burn care based on their ability to pay, and we won't."

Until academic medical centers like Vanderbilt and their patients get some form of relief, says John Sergent, "virtually every doctor I know will continue to be an amateur social worker trying to help uninsured and underinsured patients get the care they need.

"Tax credits, medical savings accounts, purchasing pools for small businesses and other ideas have been floated," he adds, "but it is unlikely that any of them would have a significant impact on the uninsured."

Keckley says flatly, "There are no solutions that do not require us to think about funding some level of benefit for those 45 million people who are uninsured."

Americans already spend more money per capita on health care than any other country, says Vice Chancellor Jacobson. But he doesn't believe the entire responsibility should fall on the state or federal government. Better cooperation between health-care providers who are focused on patient care and insurance companies who are focused on the bottom line could help. "Eighteen percent of health-care costs goes to insurance companies getting their money, and 2 percent goes to the provider battling the insurance company."

And more health-care providers need to step up to the plate, Jacobson adds. "Hospitals and doctors need to share more evenly the burden of caring for uninsured patients, rather than leaving it to the academic medical centers. If doctors were true to the Hippocratic Oath they took, they would take care of their fair share of Medicaid and TennCare patients and the load would be distributed more evenly."

Small employers also should be asked to contribute to the solution somehow, says Jacobson. And patients themselves need to consider how their own behavior is driving up costs. "We overuse the health-care system. We run too many tests and give out too many prescriptions."

"I don't think anyone at Vanderbilt would want to say we have to start discriminating on trauma patients or premature babies based on their ability to pay," says Beck. "Taking care of these patients is our mission, it's our job, and the thing that keeps us coming to work every day."

"It is our mission and our responsibility to heal people regardless of their ability to pay," adds Jacobson. "For the moment, that means we have to work hard and be as efficient as we can be."