What is your hometown?
I was born in Rochester, Minnesota and grew up in Denver, Colorado.
When did you join the UI faculty?
1992
How/when did you become interested in science and medicine?
I was initially interested, as a boy, in Veterinary Medicine because of my love for animals and my interest in physiology and medicine. However, in the late 60’s, the social climate turned my interests towards sociology. After one year of Sociology classes I came to realize that my interest was more in the area of psychology, focusing on people’s specific issues rather than society directed issues. Because of the experiential (work-study) education offered at Antioch College, I serendipitously ended up doing work for a semester in a laboratory where I found myself studying the firing parameters of the carotid sinus nerve to determine if, through this nerve, cardiac rhythm could influence higher cortical function and wrote my senior psychology thesis on this topic. Now thoroughly confused as to the direction I wanted to take in life, I combined my in terest in mountaineering and physiology by spending a year in the high altitude research laboratory of Drs. Grover, Reeves and Weil at the University of Colorado Medical School where they were adventurous enough to provide me, a graduate with a BA degree in Psychology, with a laboratory and a technician and an assignment to determine if histamine was the likely mediator of hypoxic pulmonary hypertension. Through the use of a newly discovered H2 blocker I demonstrated the role of the H1 and H2 receptors in the lung and demonstrated that histamine was a mediator but the not the primary determinant of hypoxic pulmonary hypertension. Now thoroughly convinced that I wanted to do graduate work in cardiovascular physiology, upon recommendation from my mentors in the Cardiovascular/Pulmonary Research Lab at the Univ of Colorado, I applied for and was accepted into a graduate program at the Mayo Clinic (part of the Univ of Minnesota at the time) to study with Dr. Earl Wood. Upon arrival, Dr. Wood assigned me the task of resolving the controversy surrounding the measurement of pleural pressure (a pressure in a space outside the lung but inside the chest which is so thin that any measuring device placed in the space alters the very pressure being sought to quantify). I used a bi-plane x-ray technique to approach the problem and as I worked on this question, the group was in the process of developing a one of a kind, two story high volumetric imaging system based upon x-ray computed tomographic methods to reconstruct the beating heart and breathing lung. I became the first person to utilize the system to study the lung and have been using advanced CT and more recently MR methods to study normal and pathophysiology of the lung ever since. Between my graduate work, a post doctoral fellowship and a faculty position, I remained at Mayo for 12 years. I left to become director of a Cardiovascular Imaging Research Center at the University of Pennsylvania and then joined the University of Iowa in 1992 where I formed the Division of Physiological Imaging and later the Iowa Comprehensive Lung Imaging Center, devoted to the use of advanced state-of-the-art imaging methods to understand the basis for pulmonary pathophysiology with particular interest in intestinal lung diseases including emphysema.
Is there a teacher or mentor who helped shape your career?
As an undergraduate student I was influenced profoundly by my psychology professor, Dr. Schig Kuwada who taught me how to build a racing bicycle and in doing so, offered me many long hours of philosophical discussions regarding science, the philosophy of science and the art of inquiry. During my graduate career I was guided initially by my mentor Dr. Earl Wood. His relentless pursuit of truth in the laboratory which knew no boundary between days and his open door policy which allowed me to ask questions anytime but hands off policy which encouraged me to seek answers to problems on my own, provide invaluable tools for success in my career. Later, Dr. Erik Ritman, who served as my mentor during my post doctoral fellowship and throughout my time at Mayo and beyond, taught me to ask the impossible questions and to question what everyone else knew to be truths.
How or why did you choose the UI?
The University of Iowa for the most part chose me. Shortly after I arrived at the University of Pennsylvania, the Department of Radiology invited me out to give Radiology Grand Rounds. The University of Iowa had taken a leading role in advanced CT imaging based upon the early instillation of a very high speed CT scanner known as the Electron Beam CT or Cine CT scanner built by Imatron. While I felt the need to stay in one place for a while, the offer at the University of Iowa grew to a level I could not refuse, but a major decision was a combination of the strong combined traditions of research in Cardiology, Pulmonary Medicine, Biomedical Engineering coupled with the state-of-the-art facilities within the Radiology Department. I had known Dave Skorton for many years, through a common interest in using medical images to quantitate structure-function relationships (he was interested in the use of ultrasound to study heart muscle), I had known of the work of Bob Wise who was using Cine CT to study myocardial perfusion and had many very positive experiences with him at meetings, I was attracted by the work of Geoffrey Galvin who was a Pulmonologist turned Radiologist, and in general I was very attracted to the mid-west life style of Iowa City with its small town, large university, and highly diverse cultural atmosphere.
What kinds of professional opportunities or advantages does being a faculty member at Iowa provide? What about challenges?
The most important strength of the University of Iowa is the fact that one can so easily collaborate with other faculty not only across the borders of departments within the University of Iowa Carver College of Medicine but also across the borders of Colleges. The ease with which one can collaborate between Medicine, Radiology, Surgery, Anesthesiology, Pathology, Biomedical Engineering, Electrical and Computer Engineering, Mechanical Engineering, Computer Science and more is almost unique within American universities. The accessibility of high level administrators all the way up to the president has been invaluable as I, and my collaborators have sought to develop unique research relationships with companies such as Siemens, with whom we partner currently to evolve imaging methods to study the lung. There have been some challenges at times in getting new initiatives to move as quickly as is needed to take advantage of narrow windows of opportunity, but the open doors throughout the institute have made it possible to marshal the resources to build what has become an internationally recognized unique imaging resource dedicated to the imaging of the lung. Much of what we have accomplished in our research laboratories have considerable commercial potential, and the University of Iowa has taken on the challenge to understand how to enhance its support of entrepreneurship, and the State of Iowa has awoken to the fact that the innovations at the University can serve to significantly influence the future business environment and thus economy of the state.
Please describe your professional interests.
My professional interests lie in the use of advanced imaging to understand how the lung functions, with particular interest in the determination of how blood flow and gas delivery within the lung match and how this is altered in disease. I have a great and growing interest in the use of imaging and the quantitative tools we are developing to help using imaging speed the process of discovery regarding novel pharmaceutical and device-based interventions to lung disease including the evaluation of the interventions needed to gain approval for clinical use.
What are some of your outside interests?
My primary outside interest in my 8 year old daughter, her interest in ice skating keeps me rink-side quite a bit lately. My work has increasingly taken me on travels both within the US and over seas and I have enjoyed using this as an opportunity to introduce my daughter to the world and in doing so seeing the world through the eyes of a child. I like hiking, reading, gardening, and photography and enjoy skiing, camping, and most other outdoor, wilderness activities.
Do you have an insight or philosophy that guides you in your professional work?
I try to look for the over-looked obvious answers and generally believe that if the answer to a question is too complex then the answer was likely not the right one. I believe that one should not take the safe road simply because it is safe. If one works hard and does the best they can do in their chosen task, good will always come of the effort. Goal oriented research is fine up to a point, but often the most exciting discoveries come from taking a side branch, following one’s curiosity simply for the sake of curiosity.
If you could change one thing about the world (or the world of medicine), what would it be?
I would reduce the paperwork and bureaucracy and find a way to provide individuals with a career-long freedom to follow interesting avenues of discovery.
What is the biggest change you've experienced in your field since you were a student?
The power of computing and international communication.
What one piece of advice you would give to today's students?
Follow what is of interest without worrying about where that interest will take you career wise.
What do you see as "the future" of medicine?
I believe that medicine will become increasingly personalized as we are able to characterize one’s genetic make-up and their individual responses to their environment. I believe that the traditional boarders between disciplines will increasingly fade and major discoveries will come more and more from teams of researchers rather than individuals.
In what ways are you engaged with the greater Iowa public (i.e. population based research, mentoring high school students, sharing your leadership/expertise with organizations or causes, speaking engagements off campus, etc.)?
We have had grade school classes spend a morning in the lab, learning about the lung and then learning about the tools used to make new discoveries about the lung. We have made sure to provide a focus on the numerous career paths which people have taken to join our research group including physicians, scientists, programmers, radiology technologists, image processors, lab managers, etc. I have also participated in the University of Iowa outreach program, providing lectures on our research to groups around Iowa. Recently I have put considerable time into the efforts at the state level to identify ways the state can promote the development of new business based upon the unique resources provided by research within the state universities.