Dr. Avery was a “marquee figure” among women in medicine, said Jessica Sedgwick, an archivist at the Harvard Medical School collection that contains Dr. Avery’s personal papers. More than 50 years ago, Dr. Avery took on and helped solve a medical mystery: the intractable mortality rate among premature babies who struggled to breathe.
In the late 1950s, as a young research fellow at the Harvard School of Public Health, Dr. Avery joined physiologist Jeremiah Mead to study a lung disorder believed to be a leading cause of death among preemies. Before Dr. Avery’s research, the condition was called hyaline membrane disease, taking its name from the glassy, or “hyaline,” film present in the lungs of many premature infants who did not survive. Today it is known as respiratory distress syndrome.
The condition entered the national consciousness in 1963, when first lady Jacqueline Kennedy delivered a baby boy more than five weeks before his due date. Patrick Bouvier Kennedy was diagnosed with hyaline membrane disease and lived two days.
“When medical scientists can solve the mystery of why the membrane forms,” the New York Times reported upon Patrick’s death, “they will have trapped one of the major killers of premature babies.”
During her own previous clinical studies at hospitals, Dr. Avery had watched babies succumb to breathing difficulties. She was spurred to pursue research because of her frustration at not being able to help them.
With Mead, Dr. Avery began examining the lungs of premature babies who did not live more than a few days. She made an unexpected observation: Unlike babies who died for other reasons, apparent victims of hyaline membrane disease had no trace of air in their lungs.
Dr. Avery’s research led her to John Clements, an Army doctor whose study of wartime nerve gases had significantly advanced the study of pulmonology. He showed her a handmade scientific instrument he built to measure surface tension in the lung.
Dr. Avery realized that the concept of surface tension would determine the course of her research. Surface tension, she learned, helps allow lungs to inflate, deflate and reinflate. She further learned that lungs maintain their surface tension with the help of surfactant, a foamy liquid that coats the inside of the organ.
Back at the laboratory, Dr. Avery observed that the underdeveloped lungs of premature babies lacked surfactant. That, she theorized, was why they couldn’t breathe.