My Tribute to Mary Ellen Avery

“Life is that which can mix oil and water”- Robert Frost Mary Ellen Avery was a force of Nature. I first met her while I was a graduate student at McGill University in the early ‘70s. She and her colleagues had been studying the effects of glucocorticoids on fetal lung maturation and surfactant production, and had stumbled onto a curious ‘neighbor effect’- when they treated one of the fetal rabbits in the womb by direct injection, they found an effect on the maturation of the lungs in the collateral pups. I was studying fetal endocrinology at the time in Claude Giroud’s laboratory at Montreal Children’s Hospital, and had access to radiolabeled cortisol, so I could determine if the hormone was passing from one fetus to the other. Having demonstrated this effect, Dr. Avery named me as a co-author on their paper describing this phenomenon, which was quite generous of her- but that was in her nature, as I was to discover in a 20 year journey with her as my mentor. In the spring of 1974, while on an elevator at Montreal Children’s Hospital Dr. Avery invited me to join her research group at Harvard Medical School. She said that it was important to maintain the highest scientific standards in developing the burgeoning discipline of Neonatology because she was concerned about doing harm in the name of doing good. I had already committed to a post-doctoral position with Jack Gorski and N.L. First in the NIH Reproductive Endocrine Program at the University of Wisconsin-Madison, so I had to decline the invitation, with the understanding that I would come to Boston after my Fellowship. I joined the Joint Program in Neonatology in July, 1976 as a Research Associate. During my early years at the Boston-Lying-In Hospital (BLI), where in the 1950s Dr. Avery had previously discovered that Hyaline Membrane Disease was due to surfactant deficiency in preterm newborns, I conducted studies on the physiologic role of hormones in fetal lung development in support of the clinical use of antenatal steroids to accelerate the production of surfactant. Antenatal steroid treatment dramatically improved the survival of preterm infants. It is considered one of the major breakthroughs of 20th Century medicine, saving the lives of hundreds of thousands of newborns. During the course of the first clinical trials of antenatal steroids for the prevention of Respiratory Distress Syndrome, it was found that males were much less responsive to such treatment than females, reprising my interest in the sexual dimorphism of fetal development, the subject of my Masters’ thesis in graduate school