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Thursday, October 29, 2009

Magnificent at times: Jeremiah Mead & advances in respiratory research

In the famous joke by Woody Allen, two Jewish women are commenting on the food at a resort in the Catskill Mountains. One says, "The food is terrible here." The other responds sadly, "And the portions are so small!"

I often feel that my comments on healthcare are similar: It's so bad. And there's way too little of it! Yet sometimes I realize that our healthcare is also magnificent at times, and life-saving – as in the healthy birth of my son, 19 years ago.

My wife started labor nine weeks prematurely. Doctors were able to stop the labor from progressing, and gave my son the drug beta dimethasone to speed the maturation of his lungs. In a fetus' development in the third trimester, the walls of the lungs initially stick together, and can’t inflate with air, until a chemical surfactant is released. At that point, the lungs can inflate and deflate appropriately, readying the baby to breathe upon birth.

If a baby is born prematurely, before the surfactant changes the lungs in this way, respiratory distress syndrome can result, often fatally. In the past, this caused the deaths of 50,000 premature babies each year.

My wife got the drug in time, and it somehow made its way to Neil's lungs, triggering the release of the surfactant, before he was born a few days later. He didn't get RDS, and he didn't need a ventilator. He has long been in excellent health, and he's bigger and more muscular than me now.

Dr. Jeremiah Mead was the scientist who discovered the role of the surfactant, and opened the way for a series of discoveries that now make RDS much less frequent. I learned this only in reading his obituary; he died at age 88 in mid-August.

In a colleague's words, "his major contribution is that he set the agenda in respiratory mechanics, and posed the questions that everyone else picked up."

Read another NICU story.

Thanks to Emma Stickgold for the source article in the Boston Globe of August 18.

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