The purpose of the American Society of Anesthesiologists Award for Excellence in Research is to recognize outstanding research that has had a major impact on the practice of anesthesia and to recognize research that represents a mature and sustained contribution to the science of anesthesiology. Carol Hirshman clearly fulfills both criteria. Many investigators have made discoveries that advanced the science of anesthesia, but, for our specialty to remain visible and to thrive in the twenty-first century, physician–scientists must act as role models not only in the laboratory, but also in the operating room. Carol Hirshman is a physician–scientist who sustained a lifetime research role and who also inspired and mentored young faculty members.
Dr. Carol Hirshman earned her M.D.C.M. degree from McGill University, Montreal, Canada in 1969, and then underwent anesthesia residency training in Denver, Colorado from 1969 to 1972. Pulmonary physiology training in Denver has always been first class, and Dr. Hirshman elected to do a research fellowship in cardiovascular–pulmonary physiology and remain in Colorado. In 1976, she moved to the Oregon Health Sciences University, Portland, Oregon, where she was promoted to Professor of Anesthesiology and Pharmacology, with tenure, in 1984. In 1986, she moved to the Johns Hopkins University, Baltimore, Maryland, as Professor, also with tenure. In 1998, she was recruited to the College of Physicians and Surgeons of Columbia University, New York, New York, where she remains, to fill the position of the endowed chair, named for the Henrik Bendixen Professorship. FIGURE
Dr. Hirshman is recognized as one of the world’s leading physician–scientist scholars in anesthesiology. For more than 20 yr, she has asked questions that test important hypotheses in the laboratory and in the clinical arena. Her funding record and list of publications during this time speak for themselves. She obtained the prestigious Parker Francis Research Award in 1976 and since that time has been funded continuously by the National Institutes of Health, Bethesda, Maryland, and other sources. Dr. Hirshman has played an exemplary role as a mentor and has trained approximately 50 postdoctoral students, postdoctoral fellows, anesthesiology fellows, and pulmonary faculty members and fellows, who have gone on to build successful research careers. Her kindness, support, energy, commitment, and hours of hard work that she devotes to her fellows are legendary. She supports her “people,” and those who are hard working and committed have Dr. Hirshman for help, to ensure that they flourish and to analyze data and help publish results.
Carol Hirshman is an innovative and creative scientist who is able to take findings in one area and recognize their relevance to another; for example, her research on β2-adrenoreceptor control of airway smooth muscle tone has been adapted to investigate how regulation of G protein–coupled receptors controls the initiation of labor at the end-stage of pregnancy. She has the courage to take scientific risks to explore new concepts and to see broadly across specialties. Some of her specific observations have led to significant advances in clinical medicine. The basenji–greyhound dog model of asthma that Dr. Hirshman developed in the late 1970s and early 1980s, which contributed enormously to the understanding of reactive airway disease, has broad significance for anesthesiology and for other subspecialties, such as genetics, immunology, and pulmonary medicine.
Dr. Hirshman’s interest in asthma did not start during her medical school days, but rather during her residency in anesthesiology at the University of Colorado. Many severely asthmatic patients from the National Jewish Hospital (which had become a basic and clinical research center for patients with asthma who were considered “untreatable” elsewhere) presented for anesthesia and surgery at the University of Colorado Medical Center because the National Jewish Hospital had no surgical services. Dr. Hirshman recognized that there was very little information regarding how these difficult cases should be managed and decided to develop an animal model for asthma. With the help of Hal Downes, Professor of Pharmacology, and Norman Bergman, Chairman of Anesthesiology at Oregon Health Sciences University, her basenji–greyhound model of asthma became a “registered animal model of human disease.”1This model allowed her to perform many of her future investigations. She went on to demonstrate the mechanism by which inhalational and intravenous anesthetics affect airway tone, the role of mediators in allergic and nonallergic asthma, the effects of leukotrienes in hyperactive airways, and how drugs, such as β-adrenergic blocking agents and steroids, act on bronchial muscle during anesthesia. More recently, she characterized multiple signal transduction pathways at the biochemical and molecular level in airway smooth muscle, including muscarinic receptors, calcium and potassium channels, heterotrimeric and monotrimeric G proteins, tumor necrosis factor-a, and nitric oxide. Her work includes whole animal physiology, biochemical signal transduction, molecular biology, and genetics. Her use of a wide range of methods to ask important questions reflects her commitment to the question and her unwillingness to see herself restricted by methodologic constraints. The breadth and depth of her thinking is extraordinary, and this, coupled with her determination to work in the operating room on a weekly basis, makes her a unique physician–scientist.
Carol Hirshman is recognized as a gifted and organized speaker, and she contributes regularly to national and international meetings. She participates in administrative committees for many national organizations, most notably the American Society of Anesthesiologists and the National Institutes of Health Study Sections. She also has served on many editorial boards, including a role as an editor on the editorial board of Anesthesiology. The combination of her scientific research achievements and her abilities as a teacher, mentor, and clinician makes her a very special candidate to receive this award.
On a personal level, Dr. Hirshman is a devoted wife and mother. Her son David is an independent and delightful young man who is a credit to Dr. Hirshman and her husband John. A collie and golden retriever mix named Crackles was brought home from her research laboratory (complete with a tracheostomy!) before David was born. Crackles became a fixture in the Hirshman household. Dr. Hirshman is an advanced and bold snow skier, and she uses the same determination and energy on the mountain slope that she invests into every facet of her life—this is Dr. Hirshman. Carol Hirshman is a wonderful role model for the academic anesthesiologist and an admirable recipient of the American Society of Anesthesiologists Excellence in Research Award for the year 2000.