How did the surfactant discovery come about?
I was a fellow at the Harvard School of Public Health, and was asked to find out more about the foam that formed in the lungs of people with pulmonary edema—they literally foam at the mouth. At night, I worked in the delivery room at the Boston Lying-In Hospital where I could see the babies take their first breaths. There were many premature babies with hyaline membrane disease, now called respiratory distress syndrome, who were struggling to breathe. I had access to lungs from babies who had died, and I found there was something wrong with their capacity for gas exchange. The babies couldn’t keep the air spaces in their lungs open—they closed when the babies exhaled. The material that was important—the foam—was missing, and they were struggling to re-inflate their lungs. Nature put this foam, or surfactant, in the lung to lower surface tension. You cannot keep air spaces inflated without it; the lung becomes airless. In the autopsies, surfactant was present in all the babies that surv
