In Memoriam: Dr. John A. Clements
Myron Yaster MD and George Gregory MD
When I (MY) was a kid, President John F. Kennedy and his wife Jacqueline lost their prematurely born newborn son Patrick to a respiratory disease that affected prematurely born infants. As pediatric anesthesiologists we now know that the disease, infantile respiratory distress syndrome, was caused by the absence of pulmonary surfactant. But what you probably don’t know is the process of discovery that resulted in conquering this disease. Indeed, it is almost incomprehensible today, but at the time (1962), RDS had an almost 100% mortality if the infant required intubation. AND Patrick was born at 34 weeks gestation!
The disease was “cured” by Dr. Clements and his colleagues and students (including Dr. George Gregory) who discovered surfactant, the use of CPAP and the underlying physiology and pathophysiology of RDS. “How could the millions of tiny air sacs in the lungs deflate when a person breathes out but not collapse like a balloon? Dr. Clements theorized that there must be some chemical that relaxes the surface tension of the air sacs. He went on to identify the substance as a surfactant, a class of lubricants that work like household detergents.”1 He went on to develop a synthetic surfactant that was used therapeutically for many years.
“In 1994, Dr. Clements won the Albert Lasker Clinical Medical Research Award for what was “widely regarded as the most important discovery in pulmonary physiology in the last 50 years,” according to the award citation. Dr. Jordan U. Gutterman, the head of the awards at the time noted how extraordinary it was for a scientist to be responsible for both a breakthrough in basic research and the development of a marketable treatment.”1
From George: Dr. Clements was an incredible teacher who always started his teaching by going back to basic principles. He was constantly available to people who wanted to learn and/or had questions. He had the great ability to draw out of us the answers to our questions and showed us how to get there.
A great interview with him can be found on Youtube:
References
1. Gabriel T. John A. Clements Dies at 101; His Research Saved Thousands of Babies. New York Times: NY Times Corporation; 2024.