Highlighting the Austens, a family whose innovations have revolutionized medical care and clinical research since the 1950s.
For a fortunate few, vision isn't just one of the five senses. It's the predominant sense; it's a way of life. Vision is imagining a solution, already attained: What does it look like? How does it work? Where did it come from? And so it is for the Austens, a family whose innovations have revolutionized medical care and clinical research since the 1950s when two young brothers, incoming Harvard Medical School (HMS) students from northeastern Ohio, first arrived on campus. For the next 60 years, those brothers – Drs. Frank and Gerald (Jerry) Austen – later joined by the next generation of Austen physicians trained at HMS, Drs. Jay Austen and Elizabeth Austen Lawson, have defined and redefined what it means to think beyond the boundaries of contemporary care. “I believe in chance. And I very much believe that you have to be awake and alert to see the unexpected solution or direction that appears when you actually begin to work at something,” says Frank Austen, MD, the Astra Zeneca Professor of Respiratory and Inflammatory Diseases in the Department of Medicine at the Brigham and Women's Hospital. “I tend to look at what's possible, because that initiates action or direction. And I usually find that a solution appears that I might not have thought of if I had tried to plan everything before I started,” he says. A dazzling array of discoveries have stemmed from this line of thought, so deeply instilled in the Austen brothers by their father, a brilliant Czechoslovakia-born PhD engineer, and aeronautical pioneer who immigrated to Akron, Ohio, after World War I to become Vice President of Engineering for the Goodyear Tire and Rubber Company. Their mother hailed from a German family with a strong tradition of practicing medicine, and she encouraged the boys to become physicians. “He was, without question, a world-renowned innovator and leading designer of airships, both rigid and non-rigid,” recalls Jerry Austen, MD, Surgeon-in-Chief of the MGH from 1969 to 1997, a founding father of the Partners HealthCare System, and founding chairman and CEO of the Mass General Physicians Organization. “Both of our parents made us feel that the important things in life were to use your brain to the best of your ability; to measure your success not by money but by the approbation of your colleagues; and to work very, very hard.” The brothers took this message to heart, and their facility for discovery was apparent even before they completed their formal medical training. During the nation's polio crisis in the 1950s, MGH house officer Frank Austen – inspired by his own encounter with the disease as a teen – saved lives by revealing that patients treated in the negative pressure ventilators known as iron lungs suffered from a deadly ventilation-perfusion imbalance that could be avoided by abandoning the iron lungs for a positive-pressure method of treatment. The experience triggered an intense love of discovery and kicked off a rich career in scientific research. Frank was elected to the National Academy of Sciences (NAS) at an unusually young age in 1974; his laboratory at the BWH has maintained a constant influx of NIH funds for decades to support research on the key mechanisms of allergy and inflammation – a considerable feat, considering the many shifts in federal priorities during that time. He received the Warren Alpert prize for his research leading to a new a class of drugs targeting the mechanism of airway constriction in bronchial asthma. Jerry Austen's career began with a similarly life-saving discovery as a new surgery intern at MGH in the 1950s. Together with staff surgeon Robert Shaw, MD, Jerry built the first MGH cardiopulmonary bypass machine from spare parts the pair found in the hospital basement and at the local hardware store. And in 1993, he helped shape the merger of the MGH and BWH. Dr. Austen became a full professor of surgery at HMS at the young age of 36 and continues as the Edward D. Churchill Distinguished Professor of Surgery. A globally recognized cardiac surgeon, Dr. Austen has made major contributions to the understanding of the physiologic effects of cardiopulmonary bypass and improving the outcomes for cardiac surgical patients. He was a pioneer in developing new techniques of circulatory support for the failing heart and in the surgical treatment of patients with complications of coronary artery disease. And he was one of the first surgeons elected to the Institute of Medicine of the NAS. Since those fateful first years, the brothers have amassed long lists of accolades and achievements. But their general views on choosing a career are clear and simple. “It's immensely important to do what you like and then build on it, as opposed to what you think you should be doing to accommodate your mother or your father or your best friend or even your girlfriend,” Frank says. “Being happy with what you do is immensely important to doing it well on the one hand, and to continuing to be happy on the other. I have similar joy in sharing discoveries and in developing the careers of numerous generations of physician scientists.” That message came through quite clearly, recalls Jay Austen, MD, Chief of Plastic and Reconstructive Surgery and Chief of Burn Surgery at the MGH, an associate professor of surgery at HMS, and son of Jerry Austen. “When I was growing up, I always wanted to be an inventor. We had this family culture: Grandpa was an inventor, my father and uncle are inventors, it just seemed natural to me. That's just what people did. There was no problem you couldn't solve,” he says. An innovator in his own right, Jay has accelerated the pace of innovation at MGH. Earlier this year, his team was among the first to receive an Innovation Discovery Grant from Partners HealthCare to support the development of a novel device to avoid the blood vessel thickening that can arise after vein grafts. He also helped lay the groundwork for a new company that hopes to market technology allowing skin to be tightened and moved without surgery. Another ongoing project aims to revolutionize reconstructive surgery using novel tissue surfactants that keep grafted fat tissue alive. Though his specialty is plastic surgery, Jay makes a conscious effort not to define himself by the limits those words evoke. “If you think of yourself as just a surgeon or just a plastic surgeon or just a heart surgeon, you subconsciously and consciously limit yourself from looking at other possibilities. And I think we should be able to think about everything. You never know where your next great inspiration will come from,” Jay says. That sentiment is shared by Jay's younger sister, Elizabeth Austen Lawson, MD, a Director of the Interdisciplinary Oxytocin Research Program in the Neuroendocrine Unit at MGH and assistant professor of medicine at the Harvard Medical School. Lawson's clinical research focuses on understanding appetite pathways in anorexia nervosa, and whether certain abnormalities in these pathways make it harder for some patients to recover. Her research promises to identify therapeutic targets for the condition. Another ongoing project involves the study of the hormone oxytocin as a key to treating obesity. Her passion for clinical research began at a young age, Lawson recalls. “I grew up in a family where I was surrounded by medicine, and to me it was the most important career that you could go into. When I was little, my mom put a great deal of effort into emphasizing how important it was for my dad to be working hard, taking care of people.” The mother of Frank and Jerry – Lawson's grandmother – was a true ‘renaissance woman,' Lawson says. “She was an incredibly strong woman. Her deep respect for medicine had a big impact on me. She always said that if she had been able to have that kind of career, she would have been a doctor. For her, it was a little bit too early – she was born in 1898. But she saw that our generation would have the opportunities that she didn't.” Elizabeth's mother, Patty Austen – a graduate of the Simmons School of Nursing – similarly set high standards. “She has been an MGH volunteer since the early days. She does a lot for the museum and for the archives, and she has always had a real presence at MGH. She was the most supportive and nurturing mom you could imagine, and always told us that we could do whatever we wanted to do.” As a young girl, Lawson set her sights on becoming a doctor, but when she saw her brother pursue a career in medicine she opted for a major in history instead. But she soon returned to medicine, unable to shake the feeling that she had overlooked her true calling. She enrolled at HMS, and the rest is history. It's clear that the Austen family's success has much to do with an attitude toward innovation that has been instilled not only in the younger generations of Austens, but in countless young trainees at Harvard Medical School who have been influenced by the family's vision. “We have tried to transmit to our children that you should always be open-minded,” Jerry says. “It isn't that you should be suspicious, but that you should be willing to consider that maybe there are better ways of doing things that have become standard. Is there more information that you can learn that might improve what's being done?” Always.