Pioneering Innovations in Health Care
By Valerie M. Reynolds
What drives medical innovation? Many technologists would suggest that the key driver of innovation is big data and technology. Some scholars in higher education might argue that more experimentation and research to advance science is what is needed. Yet, others might conclude that, as the saying goes, necessity is the mother of inventions.>
All of the aforementioned answers hold truth, but if the question is asked of a “Labbie” they might say to take one good look at the Schools’ mission and home in on the part about igniting an “enduring spirit of scholarship, curiosity, creativity, and confidence.” For over 127 years, these tenets have created a confluence of ideas that have led to a growing body of world-renowned alumni. As the youngest learners of a tier one research university, it’s no surprise that so many Lab students have, in fascinating ways, contributed to advancements that run the gamut of sectors, including medical innovation.
Matriarch of Cancer Genetics
In February 2022, the Biden administration reignited the Cancer Moonshot, a White House initiative to mobilize a national effort to end cancer as we know it. It was designed to bring renewed leadership to the fight against cancer, facilitate new collaborations, and drive progress in the field of cancer research. Arguably, one of the most significant strides that was made in cancer research within the last fifty years was made by Lab alumna Janet Rowley, LAB’42, PhB’44, SB’46, MD’48.
Dr. Rowley was a human geneticist who made an enduring mark in cancer research when she became the first scientist to identify a chromosomal translocation as the cause of leukemia and other cancers. This discovery proved that cancer is a genetic disease. Before Dr. Rowley, few scientists suspected that chromosomal aberrations caused cancer. Beginning in the 1970s, however, she made a series of fundamental discoveries, including her landmark study in 1972, when she became the first scientist to find evidence that alterations in chromosomes could lead to forms of leukemia and other forms of cancer. She soon uncovered more than a dozen similar translocations in other leukemia and lymphoma cells.
“The concept at the time was that cancer was chaos; that these chromosomes that hold the DNA, they would just randomly get all crazy and that’s how cancer started,” said Dr. Sonali M. Smith, chief of the section of hematology/oncology at UChicago Medicine and chair of the Lymphoma Research Foundation’s Scientific Advisory Board. “What she showed is that it is not random, that there’s actually a pattern and that this pattern reflects these chromosomes that rearrange. We still, to this day, call them chromosomal rearrangements.”
Dr. Rowley not only blazed a trail for cancer research, but she also blazed a trail for women in science. She began at Lab at the age of 15 when she was awarded a scholarship that allowed her to enroll in the Hutchins College at the University of Chicago and combine her last two years of high school with the first two years of college. She earned her bachelor of philosophy in 1944, and although she was accepted into medical school, she unfortunately had to wait nine months before she could enter because the University of Chicago had met its quota of women in medical school—three women out of a class of 65.
After graduating medical school in 1948 at the age of 23, she married Donald Rowley, a pioneering researcher in his own right, and spent the next 20 years raising her four boys and working three days a week at a number of different research institutions and health care facilities, including a Chicago clinic for children with Down syndrome. In 1962, after a year at Oxford University, where she learned newly developed techniques of chromosome analysis, her interest in chromosomes and cancer took focus.
According to a 2013 UChicago News profile of her career, she made her first big discovery at home, when, after a second sabbatical in Oxford from 1970 to 1971 to learn new staining techniques to highlight the different stripes or “bands” on chromosomes, she began to photograph the chromosomes using the fluorescence microscope. In the spring of 1972, in her Hyde Park home, Dr. Rowley “lined up the chromosomes from leukemia cells on a table and told my kids not to sneeze.” She noticed that the chromosomes of a patient with acute myeloid leukemia (AML) had two abnormalities; chromosomes 8 and 21 had made a switch. As she studied more patients with AML, she saw the same process. Though her findings changed cancer research as it was known at the time, for years Dr. Rowley struggled to convince fellow researchers, which at the time was a field that was dominated by men. According to The Lancet, she wrote a short report for The New England Journal of Medicine that was rejected. “When I phoned to ask why,” Dr. Rowley recalled, “I was told that in their judgment my paper was unimportant.” She resubmitted it to the French journal Annales de Génétique, which published it in 1973.
“She started medical school at a time when there were very few women in medical school,” said Dr. Smith, who, in 2021, became the first woman to be appointed chief of the section of hematology/oncology at UChicago Medicine, where she worked with Dr. Rowley and published with her as a fellow. “I have four children as well, and what she taught me was that, if we’re lucky and life is long, you still have years of contribution, that you’re not over the hill when you’re forty. Listening to her story of how she came back and contributed so much to our field later life, that kind of gave me hope. If we have role models like that, we can think that it’s possible for ourselves too.”
Dr. Rowley is highly recognized for her accomplishments. She was appointed by President Jimmy Carter to serve on the National Cancer Advisory Board from 1979–1984. She also served on President George W. Bush’s Council of Bioethics from 2002–2009. In 1998, President Bill Clinton awarded her the National Medal of Science, and in 2009, she received the National Medal of Freedom from President Barack Obama.
Breathing New Life into CPR
Dr. Rowley’s legacy began to take root many decades ago, but there are many more recent Lab graduates leading new advancements in medical innovations such as Diane Meier ’69, a geriatrics and palliative care specialist who founded the Center to Advance Palliative Care in 1999, and David Melzer ’82, a professor of medicine at the University of Chicago and health economist who has made major contributions to the fields of medical cost-effectiveness analysis. This list also includes Ben Abella ’88, a physician, emergency medicine practitioner, and academic researcher that studies the evaluation of CPR, resuscitation performance, and new methods to teach CPR in the community.
This past January, Monday Night Football unexpectedly sent its live viewers into a tailspin as they watched Damar Hamlin, safety for the NFL’s Buffalo Bills, receive a seemingly innocuous tackle from a player on the opposing team. Hamlin got up from the tackle in a manner that most football players do over and over again and then he suddenly went limp and collapsed on the field. Hamlin had suffered a cardiac arrest.
In typical pop culture fashion, the next day—and several days to follow—media outlets were full of talking heads about Hamlin’s cardiac arrest and his road to recovery. One of those talking heads was Dr. Ben Abella. Dr. Abella is a professor of emergency medicine and vice chair for research in the department of emergency medicine in the Perelman School of Medicine at the University of Pennsylvania. He was appointed the director of the Center for Resuscitation Science in 2016 and, just this past July, Dr. Abella was appointed to serve on the Pennsylvania State Board of Medicine after being nominated by Gov. Josh Shapiro and unanimously confirmed by the Pennsylvania Senate in late June.
“Dr. Abella has demonstrated outstanding leadership throughout his career, most notably in his efforts to educate the public about cardiac arrest and CPR,” Pennsylvania State Senator Amanda Cappelletti stated in a press release announcing his appointment to the Pennsylvania State Board of Medicine.
As a student at Lab, Dr. Abella was inclined toward science at a young age. At the age of 17, he won the Museum of Science and Industry’s Outstanding Young Scientist Award which awarded him the opportunity to fly to Oslo for the Nobel Peace Prize Ceremony. He also won third place in the national Westinghouse Talent Search (now known as the Society for Science Regeneron Science Talent Search) for his genetic-engineering research project mapping bacterial chromosomes. After graduating from Lab, he went on to receive his undergraduate degree from Washington University in St. Louis and attended the Johns Hopkins University School of Medicine. He completed his residency in internal medicine and emergency medicine, as well as his fellowship training in resuscitation and emergency medicine, at the University of Chicago Hospitals.
“Being at Lab was much more important than I realized at the time. As I get older, I come to appreciate more and more how important the education I received at Lab was,” said Dr. Abella. “I’ve loved science forever and received a superb science education at Lab. There were a number of science teachers at Lab that absolutely inspired and propelled me to continue thinking about science starting all the way back in fourth grade to Ms. [Barbara] Wehr, who made a big impact on me in grade school. But throughout middle and high school, I had amazing science teachers including David Derbes and, importantly, Murray Hozinky, an incredible biology teacher who went out of his way to help students get positions in University of Chicago laboratories to do research, and he did that with me.”
Today, Dr. Abella is one of the nation’s top research experts in cardiac arrest and the evaluation of CPR. He is recognized as one of the first to establish that therapeutic hypothermia after cardiac arrest (intra-arrest targeted temperature management/TTM) could dramatically improve arrest outcomes. According to the Centers for Disease Control, more than 356,000 people have an out-of-hospital cardiac arrest in the United States every year, and about 60 to 80% of them die before reaching the hospital. Therapeutic hypothermia is a type of cooling treatment to lower the body temperature of a patient and is sometimes performed on people who have a cardiac arrest. He was integral in establishing post-arrest TTM protocols at both the University of Chicago and the University of Pennsylvania, and has led TTM training workshops around the world.
In addition to cardiac arrest and CPR quality, he and his research colleagues have also studied automated external defibrillator (AED) usage. They made an impact in this field after they researched the analysis period that determines when, and if, an electric shock can be given or if CPR can be administered when using an AED. When administering an AED, typically, before the first shock, there is a point when the AED must analyze the person’s heart rhythm. After the first shock, the AED machine will instruct the user to perform CPR for approximately two minutes and then tell the user to stop compressions while it rechecks and analyzes the heart rhythm.
“The old AEDs—about 10 to15 years ago—had an analysis time of about 20 seconds. That would be 20 agonizing seconds where the victim is not receiving blood flow or getting CPR,” said Dr. Abella. “We asked the question, whether this mattered, and in fact we found out that it mattered a lot that when people receive a shock more quickly their survival is better.”
Dr. Abella’s team worked with AED companies to help them understand the importance of this, and now, with the advancements of computers and technology, analysis time in most AEDs is down to about eight seconds. His team did not develop the technology to speed up the time, but they did help to develop the science of why this matters and why AED companies should care about it. Dr. Abella was proud to share that this research was conducted in conjunction with a current University of Chicago faculty member, Dana Edelson MD, a student of his at the time.
Throughout history, advancements in medicine and science have signaled turning points in the way diseases are diagnosed and treated, providing medical professionals with opportunities to better diagnose and improve quality of care. But with all the fanfare, at the end of the day, it saves lives, something Dr. Abella considers the pinnacle of his career.
“I’ve met many cardiac arrest survivors at this point” said Dr. Abella, “and it’s a very gratifying part of my career to know that some of the work I’ve done may have actually contributed to people being alive to be with their families and enjoy their life again.”
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