Mark W. Geraci, MD
When Mark W. Geraci, MD, moved to Denver to complete his pulmonary and critical care training at the University of Colorado 21 years ago, he joined an institution focused on developing the careers of academic pulmonary physicians interested in education, research and clinical care.
“I knew that the university was regarded as one of the top pulmonary and critical training programs and divisions in the country. While we have a lot of good competition, people from around the country and the world are referred here,” said Dr. Geraci, who is now head of the division of pulmonary sciences and critical care medicine, professor of medicine, director of the translational medicine program and co-director of Colorado Clinical and Translational Science Institute, all at the University of Colorado, Denver.
While Colorado has a population of about 5 million, the substantial concentration of pulmonary physicians and scientists has roots that date back more than 100 years. Dr. Geraci shared some of the many highlights of this history.
Early Years
He pointed to Gerald Webb, MD, and James Waring, MD, two tuberculosis specialists, who in 1924 founded the largest TB sanatorium in the country, the Webb-Waring Lung Institute in Colorado Springs. As a medical student, Dr. Waring contracted TB. He interrupted his education at Johns Hopkins University and moved to Colorado to recuperate under the care of Dr. Webb. He later earned his medical degree from the University of Colorado and was the chair of the Department of Medicine from 1933 to 1948.
“At the time, no one was sure why people got better when they came to Colorado,” Dr. Geraci said. “They thought it might be the good air of Colorado, but we now know that several different factors helped their recoveries, the most important being vitamin D, because of the intense sunlight exposure here, and the second being lower oxygen levels.”
The belief that ultraviolet kills the TB organism led city planners to build Denver on a grid that to this day maximizes sun exposure on city streets, he added.
In a span of 23 years—from 1930 to 1953—Drs. Webb and Waring, along with Colorado’s Henry Sewall, MD, a TB researcher and clinician, and Florence Sabin, MD, a preeminent basic science investigator, would win the American Lung Association’s Edward Livingston Trudeau Medal. The medal, which is presented each year at the ATS International Conference, recognizes lifelong major contributions to the prevention, diagnosis and treatment of lung diseases through leadership in research, education or clinical care.
Under the second chair of medicine, Gordon Meiklejohn, MD, who served from 1951 to 1975, Roger Mitchell, MD, was recruited in 1955 as the first director of the division of pulmonary sciences and critical care medicine, a post he held until 1970. He won a Trudeau Medal in 1980.
While the division then focused on the development of clinician investigators, its emphasis shifted in 1970 to one of training for academic careers and leadership roles in academic pulmonary medicine.
Modern Era
Boulder born and raised, Thomas Petty, MD, was named division head in 1971. A graduate of the medical school and former trainee under Dr. Mitchell, he led the division at a time when university physicians made a number of major discoveries.
Henry Claman, MD, who is now emeritus faculty, discovered that the human immune system must have two lymphocytes, T-cells from the thymus and B-cells from the bone marrow, in order to form the antibodies for immunity from infectious diseases. Dr. Petty and Dave Ashbaugh, MD, were the first to identify and define acute respiratory distress syndrome (ARDS).
In 1978, Dr. Petty and Reuben Cherniack, MD, who was chairman of the department of medicine at National Jewish Medical and Research Center, integrated the two pulmonary diseases programs.
“Most people would credit Tom, who along with Reuben, a Trudeau Medal winner whose work in asthma and emphysema is legendary, for building the division in size and expertise,” Dr. Geraci said.
The combined programs produced a “tremendous number of fellows who would become another generation of leaders,” he said, including nine physicians who would lead divisions at prominent universities throughout the country and additional Trudeau Medal winners, including this year’s winner, Steven Sahn, MD.
While Marvin Schwarz, MD, and Peter Henson, MD, were co-division heads for two years, in 1987, Dr. Schwarz became the sole head of the division, which also produced future leaders. In 1999, Ed Abraham, MD, became co-division head.
“Marvin focused on interstitial lung diseases, and he is still considered one of the preeminent clinicians in the world for caring for these patients,” Dr. Geraci said. “Ed’s area of expertise was acute lung injury and ARDS, the basic science investigation of the inflammation of the lung.”
Looking Ahead
In 2004, Dr. Geraci was named head of the division, which today has 124 faculty members. When Dr. Mitchell took over in 1955, that number was three.
According to Dr. Geraci, about 18 pulmonary medicine division heads and six medicine chairs in the United States trained in Colorado. He estimates that about 15 percent of all academic physicians trained at some point in Colorado.
“My focus is this new era of genetics and genomics, but our emphasis continues to be training the next generation of leaders—not only great scientists and clinicians, but also people who assume leadership positions around the country and the world,” Dr. Geraci said.
While he said it was a challenge to continue to offer an outstanding program, he is motivated by those whose University of Colorado training has spurred them to build successful programs modeled after Denver’s program.
“They’ve been extremely successful. That’s great for the science of pulmonary medicine and for Denver. Our exports are our greatest commodity,” he said.
Experts Share State of Scientific Research in Colorado
A collection of Howard Hughes investigators and National Academy of Science members will highlight the quality of research in Colorado during A11 “State of Scientific Research in Colorado” Sunday morning, May 15.
“This is current state of the science—what’s happening now and throughout the University of Colorado. The science is applicable to lung diseases,” said Mark Geraci, MD, head of the division of pulmonary sciences and critical care medicine, professor of medicine, director of the translational medicine program and co-director of Colorado Clinical and Translational Science Institute, all at the University of Colorado School of Medicine.
Dr. Geraci will co-chair the session with Andrew P. Fontenot, MD, also of the University of Colorado.
The five accomplished non-ATS scientists and their topics will be:
Role Of IL-1 In Inflammatory Disease
Charles Dinarello, MD, Aurora
The Causes and Consequences of the Obsession of T Cells for the MHC
Philippa Marrack, PhD, Denver
B Cells and Autoimmunity: Molecular Mechanisms and Therapeutic Strategies
John Cambier, PhD, Denver
Linking Lung Development and Disease Pathogenesis
Lee Niswander, PhD, Aurora
Microbial Ecology and Relationship to Human Disease
Norm Pace, PhD, Boulder