What a great article, Rachel. thank you. Lynne----- Original Message ----- From: "Rachel" <rachel720@xxxxxxxxxxxxxx>
To: <Recipient list suppressed:> Sent: Tuesday, June 02, 2009 9:50 PMSubject: [infoshare] Fw: [acb-l] Fwd: [leadership] Very Interesting Obit in Today's Washington Post
Doctor Helped Link Extra Oxygen, Blindness in Newborns. David Brown.Leroy Hoeck, 97, a Washington pediatrician who helped solve one of the greatmedical mysteries of the postwar era, died May 25 at a retirement home in Salisbury, Md. He had arteriosclerotic cardiovascular disease. Dr. Hoeck(pronounced Hake) was a staff member at the District's public hospital when he teamed up with a physician still in training to figure out why an unusual number of premature infants were becoming blind after prolonged stays in thenewborn nursery. Their hunch that supplemental oxygen might be the cause turned out to be correct. But first they had to prove it. They did so in arandomized controlled trial, the first in ophthalmology, that ran from 1951to 1953 at Gallinger Municipal Hospital, the huge institution in Southeast Washington that was later renamed D.C. General. That a pair of unknownresearchers could show that a substance as beneficial as oxygen could cause a condition as devastating as blindness was so surprising that the pediatric medical establishment repeated the experiment on a huge scale to confirm the findings. Nevertheless, the initial clinical trial at Gallinger was crucialto showing the importance of testing medical therapies -- even those asseemingly beneficial as extra oxygen -- with randomized trials. Doctors haveto approach their patients, and what they think they know, with a certain amount of humility," said Steven Goodman, a physician at Johns HopkinsUniversity's Bloomberg School of Public Health and an expert on the history of medical research. This is one of the trials that taught us humility. Dr.Hoeck's partner in the study, Arnall Patz, went on to become chairman ofophthalmology at Johns Hopkins Hospital and winner of the prestigious Lasker Award for his research on retrolental fibroplasia, as the oxygen-caused eyedamage was then called. Dr. Hoeck, in contrast, became a private practitioner after he left Gallinger in 1954. He had an office in his home in the Prince George's County community of Hillcrest Heights until the 1980s. He then joined two other pediatricians at an office in Clinton. Heretired in 1990. His role in the pivotal oxygen trial is largely forgotten, although Patz has credited him with having the initial suspicion that oxygenwas the culprit in the mysterious blindings. He played a huge role in finding the cause of the premature-baby blindness," his one-time collaborator, 88, said yesterday. Patz received the Presidential Medal of Freedom in 2004, largely for his work on the condition, which is now knownas retinopathy of prematurity. I do think he felt overshadowed," Dr. Hoeck'sdaughter, Barbara Hoeck Miller, a retired radiologist, said yesterday. But he was not the sort of person who was going to go after the recognition. There was something that needed to be learned, and he wanted to learn it. Leroy Edward Hoeck was born Nov. 2, 1911, in Sibley, Iowa. His mother had gone there as a child from Illinois in a covered wagon. His father ran a grocery. As a high school junior, Dr. Hoeck later recalled, he took a trip with a friend to Mount Rushmore, which at the time consisted of GeorgeWashington and half of Thomas Jefferson. He graduated from the University ofIowa and its medical school, did an internship at a hospital in Indianapolis, and worked as a general practitioner in Indiana until he was drafted into the Army Medical Corps, for which he worked in hospitals in California, Alaska and England. In 1947, he married the former Dorothy Cosner. She died in 2006. Besides his daughter, of Rockville, survivorsinclude a son, Edward Hoeck of Salisbury; a sister; and four grandchildren.He and his wife had a third child, Carolyn Sue, who died shortly after birth. After the war, Dr. Hoeck trained as a pediatrician at Gallinger, which at the time was the largest public hospital between New York'sBellevue and New Orleans's Charity. Around that time, he was the doctor forthe first baby born weighing less than 1,000 grams at Gallinger to survive and be discharged. When Dr. Hoeck saw the boy several months later, it wasclear the infant was blind. Recalling the moment 50 years later still caused him to choke with emotion. That was devastating. I just felt we had to find the cause," he said in an interview for a story published in The Washington Post in 2005. Dr. Hoeck's research led him to an obscure 1940 article on the effects of supplementary oxygen given to pilots at simulated high altitude.It showed that when someone breathed nearly pure oxygen, the blood vessels in the back of the eye constricted severely. Patz and other researchers later showed that this response was especially dramatic in preemies and could lead to the destruction of the retina. Dr. Hoeck mentioned thediscovery to Patz, an ophthalmology resident at Gallinger also interested inthe problem. Patz proposed that they do a trial in which some prematurebabies got constant oxygen -- which was the customary practice -- and othersgot it only if they were in respiratory distress or turning blue. In the first group, 12 of 60 babies became blind. In the second, 1 of 60 did. Thepublication of the study caused such consternation that pediatricians at 18universities cooperated to run the experiment again. They confirmed Dr.Hoeck and Patz's findings, and the practice of routinely giving concentratedoxygen to preemies quickly stopped. By that time, however, nearly 10,000 infants (including the singer Stevie Wonder) had been blinded by the practice, although in many cases the oxygen might also have saved their lives.
-------------------------------------------------------------------------------- No virus found in this incoming message. Checked by AVG - www.avg.comVersion: 8.5.339 / Virus Database: 270.12.51/2151 - Release Date: 06/02/09 17:53:00