It is a long-standing pearl among medical students that pure oxygen therapy for breathing difficulty in premature infants puts them at risk for blindness caused by retrolental fibroplasia. The man who discovered that connection, Dr Arnall Patz, died last week.
Stephen Miller reports in the WSJ:
Arnall Patz helped solve the riddle of how 10,000 babies went blind. Dr. Patz, who died [on March 21st] at age 89, was the … ophthalmologist who in 1954 showed that treating premature babies with pure oxygen had the unexpected result of destroying eyesight in some. By the simple expedient of regulating oxygen levels inside incubators, the epidemic was quelled. "Never in the history of ophthalmology has a blinding condition become so quickly widespread and equally rapidly been abolished," wrote Sir Stewart Duke-Elder, a Scottish ophthalmologist, in the 1970s.
A epidemic of retrolental fibroplasia (RLF) seemed to have grown up just as treatments for preemies had improved. By the time of Dr. Patz's investigations in the early 1950s, an estimated 10,000 children had been blinded in the U.S. and abroad…. Ophthalmologists were searching for a cause in the way preemies were treated—possible culprits included vitamins and hormones. Dr. Patz, a resident at Washington's Gallinger Municipal Hospital, nearly didn't manage to bring his study off, because it involved experimenting on babies, and because the idea that oxygen could cause harm was so counterintuitive. The gas provided obvious benefits for preemies, often turning them to a healthy pink from blue in the incubator. "It had become standard practice to put babies in incubators and crank up the oxygen," he said in a 2004 interview with the Baltimore Sun.
Having failed to obtain a grant, Dr. Patz borrowed funds from his family and demonstrated that oxygen could cause blindness in opossums, rats and kittens. The gas did this by causing blood vessels in the eye to became overdeveloped, damaging the retina. The scientific community was skeptical. "These guys are going to kill a lot of babies by anoxia to test a wild idea," warned grant referees for the National Institutes of Health.
By turning down the oxygen on half the infants in his study, Dr. Patz was able to demonstrate that oxygen therapy had caused the epidemic. A wider study confirmed his results and was announced in 1954.One man is challenged by a problem, thinks through a solution on his own (and his family’s) dime, and dramatically improves the lives of thousands. A great American story, a great human story.
Soon after his discovery, Dr Patz met Helen Keller:
Just two years after the RLF results were announced, in 1956, Dr. Patz and another researcher, Everett Kinsey, who performed the wider study, were given the Lasker Award for clinical research. Also honored was Jonas Salk, who developed the first polio vaccine.
Helen Keller presented Dr. Patz's award in a ceremony in Atlantic City, N.J. Ms. Keller seemed nervous, Dr. Patz later told his son, Jonathan Patz. She kept feeling the inscribed nameplate on the statuette. After she handed it to Dr. Patz, he realized why: Someone had given her Dr. Salk's statuette instead of Dr. Patz's.Dr Arnall Patz, a great American, RIP.
Richard Balsamo
