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Mary Ellen Avery
For Tetsuro Fujiwara’s paper see Lancet 1980; 315: 55–59
Courtesy of Children’s Hospital Boston
Obituary
Mary Ellen Avery Paediatrician who discovered the cause of respiratory distress syndrome. Born on May 6, 1927, in Camden, NJ, USA, she died in West Orange, NJ, USA, on Dec 4, 2011, aged 84 years. By her own account, it was a flash of inspiration in the late 1950s that led Mary Ellen Avery to discover why tens of thousands of babies were dying of respiratory distress each year. “There was one moment of insight”, she told Harvard Magazine in 1977. “And that was it.” Whether it was as simple as all that, her discovery—that the lungs of babies with respiratory distress syndrome lacked surfactant—has since saved hundreds of thousands of lives. Her achievement was “the major advance in neonatal care in the last 50 years”, said Jerold F Lucey, professor of paediatrics at the University of Vermont when Avery was awarded the American Pediatric Society’s highest award, the John Howland Medal, in 2005. Avery’s interest in the workings of the lung dated back to her own experience with tuberculosis shortly after she graduated from Johns Hopkins University School of Medicine in 1952. Told to spend a year in bed, she instead signed herself out of a sanatorium in New York state and went home to bed. Later, after some months of being symptom-free, she decided to spend 3 months travelling in Europe. Avery then went on to complete her internship and residency at Johns Hopkins. In 1957, she moved to Boston for a research fellowship in paediatrics at Harvard Medical School. It was at Harvard that Avery began thinking about the importance of surface tension in bubbles of air in the lungs. Working with her mentor physiology professor 610
Jeremiah Mead, she made her major discovery while comparing the lungs of infants who had died of respiratory distress syndrome with those of healthy animals. It was a discovery that built on work done by John Clements, who had developed a surface film balance to measure surface tension in lungs through his research on defences against war gases. In 1959, Avery and Mead published their findings in a paper in the American Journal of Diseases of Children. At first, the response to this breakthrough was “hohum”, Avery said in a 2005 interview. “It changed the scenery to think about surface tension. People couldn’t see why it mattered. I heard things like, ‘Mel’s playing with soap bubbles again’.” A paediatrician from Japan, Tetsuro Fujiwara, spent years building on Avery’s work. “He demonstrated that he could instil artificial surfactant in a living baby, and within minutes, the baby would be able to breathe”, Avery said. Fujiwara’s definitive experiment, showing the beneficial effect of delivering surfactant to a lung, was published in The Lancet in 1980. Highly committed to her medical and scientific career and fundamentally committed to children, Avery was a trailblazer in many other ways. She was the first woman to be appointed, in 1974, as physician-in-chief at Children’s Hospital Boston; the first woman to head a clinical department at Harvard Medical School; the first woman to be chosen president of the Society for Pediatric Research; and the first paediatrician to lead the American Association for the Advancement of Science. If she ever faced discrimination because of her gender, she didn’t complain about it. “She somehow persisted and put her head down, and she really was a role model and looked out for women who were interested in paediatrics”, said her friend and colleague Joseph Brain, professor at the Harvard School of Public Health. Stepping down as chief from Boston’s Children’s Hospital in 1985, Avery visited many countries with UNICEF to promote oral rehydration therapy and polio vaccination. In 1991, she was awarded the National Medal of Science by US President George Bush. Asked once how she made a difference, Avery replied that the discovery of surfactant deficiency was probably the most obvious answer. “But I’m not sure it’s the most important thing”, she said. “I think the most important experience has been with the people with whom I’ve worked. I know well a number of very senior scientists in this country, and around the world, and I find them totally stimulating and generous.” Brain highlights other achievements: “Also very notable was her work showing the value of giving steroids in women threatening to deliver prematurely to enhance lung maturation in their infants. She was also instrumental in the development in the neonatal intensive care unit, and was a key figure in saying let’s adapt all these technologies that adapt in the ICU to support children.” Avery is survived by her nieces and nephews.
Stephen Pincock www.thelancet.com Vol 379 February 18, 2012
Courtesy of Children’s Hospital Boston
Obituary
Mary Ellen Avery Paediatrician who discovered the cause of respiratory distress syndrome. Born on May 6, 1927, in Camden, NJ, USA, she died in West Orange, NJ, USA, on Dec 4, 2011, aged 84 years. By her own account, it was a flash of inspiration in the late 1950s that led Mary Ellen Avery to discover why tens of thousands of babies were dying of respiratory distress each year. “There was one moment of insight”, she told Harvard Magazine in 1977. “And that was it.” Whether it was as simple as all that, her discovery—that the lungs of babies with respiratory distress syndrome lacked surfactant—has since saved hundreds of thousands of lives. Her achievement was “the major advance in neonatal care in the last 50 years”, said Jerold F Lucey, professor of paediatrics at the University of Vermont when Avery was awarded the American Pediatric Society’s highest award, the John Howland Medal, in 2005. Avery’s interest in the workings of the lung dated back to her own experience with tuberculosis shortly after she graduated from Johns Hopkins University School of Medicine in 1952. Told to spend a year in bed, she instead signed herself out of a sanatorium in New York state and went home to bed. Later, after some months of being symptom-free, she decided to spend 3 months travelling in Europe. Avery then went on to complete her internship and residency at Johns Hopkins. In 1957, she moved to Boston for a research fellowship in paediatrics at Harvard Medical School. It was at Harvard that Avery began thinking about the importance of surface tension in bubbles of air in the lungs. Working with her mentor physiology professor 610
Jeremiah Mead, she made her major discovery while comparing the lungs of infants who had died of respiratory distress syndrome with those of healthy animals. It was a discovery that built on work done by John Clements, who had developed a surface film balance to measure surface tension in lungs through his research on defences against war gases. In 1959, Avery and Mead published their findings in a paper in the American Journal of Diseases of Children. At first, the response to this breakthrough was “hohum”, Avery said in a 2005 interview. “It changed the scenery to think about surface tension. People couldn’t see why it mattered. I heard things like, ‘Mel’s playing with soap bubbles again’.” A paediatrician from Japan, Tetsuro Fujiwara, spent years building on Avery’s work. “He demonstrated that he could instil artificial surfactant in a living baby, and within minutes, the baby would be able to breathe”, Avery said. Fujiwara’s definitive experiment, showing the beneficial effect of delivering surfactant to a lung, was published in The Lancet in 1980. Highly committed to her medical and scientific career and fundamentally committed to children, Avery was a trailblazer in many other ways. She was the first woman to be appointed, in 1974, as physician-in-chief at Children’s Hospital Boston; the first woman to head a clinical department at Harvard Medical School; the first woman to be chosen president of the Society for Pediatric Research; and the first paediatrician to lead the American Association for the Advancement of Science. If she ever faced discrimination because of her gender, she didn’t complain about it. “She somehow persisted and put her head down, and she really was a role model and looked out for women who were interested in paediatrics”, said her friend and colleague Joseph Brain, professor at the Harvard School of Public Health. Stepping down as chief from Boston’s Children’s Hospital in 1985, Avery visited many countries with UNICEF to promote oral rehydration therapy and polio vaccination. In 1991, she was awarded the National Medal of Science by US President George Bush. Asked once how she made a difference, Avery replied that the discovery of surfactant deficiency was probably the most obvious answer. “But I’m not sure it’s the most important thing”, she said. “I think the most important experience has been with the people with whom I’ve worked. I know well a number of very senior scientists in this country, and around the world, and I find them totally stimulating and generous.” Brain highlights other achievements: “Also very notable was her work showing the value of giving steroids in women threatening to deliver prematurely to enhance lung maturation in their infants. She was also instrumental in the development in the neonatal intensive care unit, and was a key figure in saying let’s adapt all these technologies that adapt in the ICU to support children.” Avery is survived by her nieces and nephews.
Stephen Pincock www.thelancet.com Vol 379 February 18, 2012