The work of Dr. Mary Ellen Avery, who died December 4th, is well-known to anyone who has worked in an intensive care nursery in the last 50 years. Her career was studded with a long list of “firsts”–first woman to be appointed physician in chief at Children’s Hospital Boston; first woman to head a clinical department at Harvard Medical School; first pediatrician to head the American Association for the Advancement of Science, etc., etc.–but she is best known for a discovery that to date has saved nearly a million premature babies.
In the early 1960s, Avery and her colleagues unravelled the mystery of why so many premature babies died of respiratory distress syndrome (or hyaline membrane disease, as it was known then). She and her team were the first to recognize that it was the absence of something, rather than an excess of something else, that caused babies’ lungs to collapse and kill them. That absent something was surfactant, a slippery mix of fat and proteins that coats the breathing tubes of healthy term babies and helps their lungs stay inflated.
Building on her research, a team of Japanese researchers revolutionized the care of premature newborns when they developed a surfactant replacement from cow lungs. In the early 1960s, 15,000 babies a year died from respiratory distress syndrome; by 2002 fewer than 1,000 did.
All of this came too late for my brother, James Bernard Sloan. Born eight weeks early in 1948, he died at two days of age from a lack of surfactant. (I wrote about James’s brief life in my book, Birth Day. It was the mystery of his death, which happened five years before I was born, that first got me interested in caring for sick babies.)
Had he been born twenty-five years later, James Bernard would have been an easy “save,” thanks to Mary Ellen Avery’s work.