Biography: Dr. Mary Ellen Avery
Year: 1974
Achievement: Dr. Avery became the first woman physician-in-chief at Children’s Hospital, Boston.
Year: 1974
Achievement: Dr. Avery became the first woman to chair a major department at Harvard Medical School when she was appointed the Thomas Morgan Rotch Professor of Pediatrics.
My next-door neighbor was professor of pediatrics at the Woman's Medical College in Pennsylvania, Dr. Emily Bacon, and she kindly reached out to me in many ways. I saw her life as more exciting and meaningful than most of the women I knew who were my mothers friends, for example, who were busy doing good works, raising children, and I admired them greatly; but I still thought Emily Bacon had something going for her in terms of reaching out to all children. But mainly, she reached out to me, and I'm eternally grateful.
In the 1950s, Dr. Avery's pioneering research efforts helped lead to the discovery of the main cause of respiratory distress syndrome (RDS) in premature babies. During a long career in academic medicine, Dr. Avery had a strong interest in helping train young physicians, particularly in pulmonary disease and neonatology. She was a role model and advocate for women entering the medical profession. Over the course of her medical career, she contributed significantly to the field of medicine as a researcher, educator, clinician, and administrator. In 1991 President George Bush conferred the National Medal of Service on Dr. Avery for her work on RDS.
Mary Ellen Avery was born in 1927, in Camden, New Jersey. Her father owned a manufacturing company in Philadelphia and her mother was vice-principal of a high school. An early inspiration was pediatrician Emily Bacon, who lived in Avery's neighborhood. She greatly admired Dr. Bacon, who took Avery to see her first premature baby. "She kindly reached out to me in many ways, and I saw her life as more exciting and meaningful than most of the women I knew," Avery recalled.
Graduating summa cum laude from Wheaton College in 1948 with a degree in chemistry, Mary Ellen Avery went on to earn a medical degree from the Johns Hopkins University School of Medicine in 1952. Soon after graduating, she was diagnosed with tuberculosis, and it was during her recuperation that she became fascinated with how the lungs work. Rest and medication would cure her, but she went about the regime her own way. Once she realized she was exhibiting no symptoms, she decided to go to Europe with a friend. "I packed one suitcase of medication and another suitcase of clothes, and spent three months in Europe on a regime that I programmed for myself," Avery said. "It consisted of 12 hours in bed every night, and in the daytime mostly walking around and looking at exhibits and enjoying myself, but not anything strenuous."
Dr. Avery returned to Johns Hopkins for her internship and residency, then moved to Boston in 1957 for a research fellowship in pediatrics at Harvard Medical School. At Harvard, she made a major discovery while comparing the lungs of infants who had died of RDS to those of healthy animals. "It's all because they had something they would have not needed before birth because they weren't using their lungs for ventilation before birth. But after birth, without it, they could not live more than a day or two. And therefore I found what was missing." What she had found was a foamy substance that she deduced must play a critical role. Dr. Avery's observation formed the basis of a breakthrough paper published in the American Journal of Diseases of Children in 1959. By 1995 there were 1,460 infant deaths a year in the U.S. from RDS, down from almost 10,000 a year twenty-five years earlier.
In 1960, Dr. Avery became an assistant professor of pediatrics at Johns Hopkins University and pediatrician in charge of newborn nurseries. She went on to serve as professor and chair of the department of pediatrics at McGill University in Montreal. In 1974, she joined the faculty of Harvard Medical School as professor of pediatrics. That same year she was the first woman named physician-in-chief at Boston's Children's Hospital, where she remained until 1985.
Dr. Avery's work is recognized around the world, and she received several major awards. In 1968, she was awarded the Mead Johnson Award for Pediatric Research. In 1984, she won the Trudeau Medal from the American Lung Association. In 1991, President George Bush presented her with the National Medal of Science, in recognition of her contributions to understanding and treating RDS. The award cited Dr. Avery as one of the founders of neonatal intensive care and "a major advocate of improving access to care of all premature and sick infants." In 1994, she was elected to the National Academy of Sciences and went on to become president of the Academy in 2003.
What was my biggest obstacle?
As the President of AAAS (American Association for the Advancement of Science) I recognized the role of women in medical research was very difficult at the time, not just because of the subject matter, but because there were so few women who had the opportunity to work in serious science. It just wasn't a womanly thing to do.
I applied to Johns Hopkins and Harvard. And Harvard didn't take women at that time but I didn't know it, and Johns Hopkins did. In fact they had to. They were founded by a woman who had insisted that they wouldn't get the money to build the school if they didn't take women on an equal basis with men, and I thought: "Hey, that neutralizes the problem in one dimension," and Emily Bacon graduated from Johns Hopkins. So there was no question where I was going to go to medical school.
I didn't feel anything serious in the way of discrimination. Of course I was helped enormously by the fact that the women all lived—most all of them—lived in the same row house on Broadway. We were called "the hen house," but we had a lot of mutual support.
There were only four of us, in my class of ninety. And we did stand out, there was no doubt about it.
I remember one of my faculty members said: "Well, I'll never have a women in my department." So, it's an uphill battle to some extent, but there are men who had been enormously supportive to me, so you can't just say it's a gender issue. It's more complex than that.
How do I make a difference?
I was once asked what was the most important event in my professional life. The answer is clearly on record—the discovery of surfactant deficiency, for which I got the National Medal of Science.
But I'm not sure it's the most important thing. 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. Maybe I've lucked out. But I have so many friends.
The other spin-off is the multiple invitations I have around the world. And that's the result partly of publishing textbooks... I get credit for having now the 8th edition of a book called "Diseases of the Newborn," which has pretty well saturated the world market, although the competition now is tremendous.
This has been very, very rewarding. I've been in every state in the United States, and I've been in most of the countries of Europe, some of Asia. And New Zealand and Australia multiple times. I have also travelled to Kenya, South Africa, Nigeria and Egypt, all in Africa. I feel that I am a citizen of this one world, and that I can resonate with people, with a lot in common—it's called science, science methods. And I am so saturated and pleased to share it with anybody who will listen. And that makes for a very fulfilling life.
How has my career evolved over time?
I did have a brief, or rather a lengthy, I guess I should say, bout with tuberculosis shortly after graduating from medical school in 1952. I went to the Trudeau Sanitarium in New York, which was a place in Saranac Lake where people went when they had to spend a year at rest—which meant bed rest, at the time that was about the only treatment. Shortly after that I think I was put on streptomycin and PAS, and the drugs and rest did put me back on the track.
I did it in a rather different way than most people. I signed myself out of the sanitarium and went home to bed, with a pair of parents who were very supportive of my making that move. And I also, when I was really totally asymptomatic all this time, decided to go to Europe and take my pills with me, and did. I packed one suitcase of medication and another suitcase of clothes, and got a good friend, and spent three months in Europe, on a regime that I programmed for myself, which was 12 hours in bed every night and in the daytime mostly walking around and looking at exhibits and enjoying myself, but not anything strenuous.
I'm pretty sure that my interest in the lung was stimulated by my own experience with minimal tuberculosis. I think that what was most important to me, was to know more about the physiology of the lung.
The experience as a researcher with Dr. Jerry Mead and others at the School of Public Health led me to do a lot of reading and thinking about the lung with guidance from them, and one time I came upon an article which said: "Bubbles from lungs are stable, and have very low surface tension, and that's why the lung can retain air and expiration."
I thought: Gee, that's interesting, that these babies can't do that. The babies' lungs become airless. And they have a hard time getting air in again. Do you think maybe this was important? And I said it to myself, I guess, because I wasn't able to communicate much more than I am to you right now. But when the word "surface tension" surfaced, I said, "Hmm. I need to know more about surface tension, and how it could be lowered in these little babies."
Just then, by doing a literature search, I came upon a very important article by Dr. John Clements, who had a little instrument, a surface film balance to measure surface tension in lungs. As an aside, he was in the Army at the time studying defenses against war gasses. This was in 1957. And what was a baby doctor doing going to visit somebody who was studying war gas defenses? Well, I was the somebody that said, "I've got to meet this man." And one spring vacation, I lived near Philadelphia, I got in my car and drove to Edgewood, Maryland, and John Clements showed me what he was doing. And I, in turn, told him why I wanted to know.
And I said, "I've got little babies who can't retain air in their lung, because the lung just... the little bubbles eventually collapse. And why does the lung retain air?" And he said, "The surface tension changes with surface area." Ahhh. Then I knew I had it, and I had to have a surface tension measuring machine, and I went right back to Boston, and coerced my mentor into building me a little machine like John Clements had so that I, too could measure surface tension on the lungs of the infants.
And I remember the thrill I had when that connection took place, and it was clear that I could make measurements on lungs, because the babies were dying. If I went to the autopsy, I could get a little piece of lung and study it, and also, just looking at the lungs—they had no foam, and they didn't foam when you squeezed these little bits of tissue. And then, of course, I measured the surface tension and found that it was too high in the babies, and got on to lowering it.
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Mary Ellen Avery, M.D.
Courtesy Mary Ellen Avery, M.D., photograph by Bachrach
Dr. Mary Ellen Avery
Dr. Mary Ellen Avery
My next door neighbor was professor of pediatrics at Woman's Medical College in Pennsylvania-Dr. Emily Bacon- and she kindly reached out to me in many ways, and I saw her life as more exciting and meaningful than most of the women I knew-who were my mothers friends, for example, who were busy doing good works, raising children (and I admired them greatly), but I still thought Emily Bacon had something going for her in terms of reaching out to all children. But mainly, she reached out to me, and I'm eternally grateful. So I applied to Johns Hopkins and Harvard. And Harvard didn't take women at that time but I didn't know it, and Johns Hopkins did. In fact they had to. They were founded by a woman who had insisted that they wouldn't get the money to build the school if they didn't take women on an equal basis with men, and I thought, 'Hey, that neutralizes the problem in one dimension,' and Emily Bacon graduated from Johns Hopkins. So there was no question where I was going to go to medical school.
I received the National Medal of Science in 1991. It is America's highest award for all of science. And so there had been very few pediatricians if any, that had ever been given the medal. They've given maybe ten or fifteen a year. It's presented by the President of the United States to the nominee. This has been very, very rewarding. And I feel that I am a citizen of this one world and that I can resonate with people with a lot in common-it's called science and science methods. And I am so saturated and pleased to share it with anybody who will listen, and that makes for a very fulfilling life.