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Jack Widness-The Importance of Connections

John Widness portraitA Festschrift Celebrating Jack Widness

John (Jack) Widness, MD

It is with great pleasure that we honor the distinguished career of our colleague and friend, John (Jack) A. Widness, MD, Professor of Pediatrics, Division of Neonatology, Stead Family Department of Pediatrics, University of Iowa, at his retirement after nearly 40 years of teaching, mentoring, outstanding clinical practice, and paradigm-shifting research.

On the occasion of his retirement, we set out to honor Jack with a Festschrift. We were very pleased when the Journal of Pediatric Research agreed to publish his biographical essay in the ____issue, which begins the Festschrift. Our thanks also go to the University of Iowa for hosting the accompanying essays that provide its completion. The following essays are from 11 esteemed colleagues and friends who have written about Jack from their unique and distinct perspectives.

Those of us at Iowa (and beyond) along with countless patients and families have benefitted greatly from our interactions and collaborative projects with Jack and we will miss him. However, as you will see in the writings that follow, Jack puts great value in friendships and we will look forward to collaborations of a different type in the future.

Steven J. McElroy, MD
Interim Director, Division of Neonatology
Associate Professor
Stead Family Department of Pediatrics
Department of Microbiology and Immunology
University of Iowa

Contributors:

The Iowa Neonatal Anemia PPG

I have been privileged to know Jack Widness as a professional colleague and personal friend for over 25 years. Our key interactions have revolved around the Program Project Grant (PPG) funded by NHLBI titled, “Neonatal Anemia: Pathophysiology and Treatment.” This PPG was first approved and funded in 1992 and, remarkably, has achieved three additional successful competitive renewals, with a fourth application currently under review. Success of the initial PPG application did not come easy. It was preceded by three “approved, but not funded” applications involving three site visits, however, Jack has a contagious spirit of determination and perseverance, and at the end of these three site visits, the grant was funded for over $4 million! For the initial five-year award and the first competitive renewal, I served as program director with Jack as assistant program director. Our roles reversed for the second and third competitive renewals, and to date, the “Iowa PPG” has been funded by NHLBI for 24 years.

The initial Iowa PPG program consisted of four projects representing additional involvement with the University of Iowa and the University of Arkansas. Project #1, “Response to Anemia During the Neonatal Period;” Project #2, “A Nonradioactive Method for RBC Volume and Survival;” Project #3, “RBC Transfusion for the Anemia of Prematurity;” and Project #4, “Safety and Feasibility of Single-Donor Programs.” From these beginnings with major influence by the vision of Jack, the Iowa PPG continuously evolved and expanded to involve dozens of investigators, consultants, and collaborators from the University of Iowa and many distant locations including the University of Minnesota and Harvard University. One measure of success of the Iowa PPG is the large number of peer-reviewed publications, which at last count numbered 239, along with almost countless abstracts and summary articles at national and international scientific meetings. Perhaps the more important measures of success are the ways by which neonatal transfusion practices and policies have been improved throughout the world.

Obviously, the success of the Iowa PPG is the result of hard work by many individuals, but no one has played a greater role than Jack. He exemplifies the words of Sir Francis Drake written in 1587: “It is not the beginning, but the continuing of the same unto the end until it be thoroughly finished, that yields the true glory.” It has, indeed, been a privilege and honor for me to know and work with Jack for many years.

Ronald G. Strauss, MD
Professor Emeritus, Departments of Pathology and Pediatrics
University of Iowa College of Medicine
Associate Medical Director, LifeSource/ITxM/Blood Systems (Chicago)

An Accomplished Trainee

I first met Jack in January 1976, as the Neonatology Fellowship Program Director at Brown University/Women & Infants Hospital of Rhode Island. During my years of training fellows, I routinely met with the first-year fellow every Wednesday morning during the first month of their fellowship to figure out what he /she wanted to research and how to develop their career paths.

Right at the first meeting, Jack told me that he wanted to pursue an academic track and would like to work with Bob Schwartz, MD, who had just left Case Western Reserve in Cleveland to join our faculty as division director of Pediatric Endocrinology and Metabolism. Jack was a pediatric resident at Case Western Reserve and had considered Bob as his role model and potential mentor in his research. I promptly agreed and sent him on to Bob’s laboratory for his research training. They, along with a multidisciplinary team, made very important contributions to the understanding of the pathophysiology of infants of diabetic mothers. They created a hyperinsulinemia model in non- human primates by placing an insulin pump in the fetus and demonstrating the consequences of fetal hyperinsulinemia including multiple organ hypertrophy, increased hepatic erythropoiesis, elevated erythropoietin level, and neonatal hypoglycemia. It was a unique model that enhanced our understanding of morbidities occurring in the offspring of poorly controlled diabetes during pregnancy.

Over the years of my training fellows, I have used the acronym CROWNS to inspire the fellows in developing their careers. C is for commitment, R stands for role model/mentor, O for on-going assessments, W is for work habits, N for native intelligence and S is for spouse’s support. With his clear-minded pursuit of a career in academic medicine, his unwavering commitment to hard work and inspiring others, and the support from his lovely wife, Mike, Jack more than ably fulfilled my CROWN acronym for a successful career and I am so proud of him.

Jack is also a warm and engaging person to his friends and colleagues. I vividly remember the emotional and passionate farewell remarks he made almost in tears during a goodbye dinner that we hosted for him prior to his move to Iowa. It really demonstrated his deep feelings for friends and colleagues. We love you Jack and wish you the best in retirement in the beautiful state of Vermont.

William Oh, MD
Professor of Pediatrics
Division of Neonatology
Alpert Medical School of Brown University
Women and Infants' Hospital

A Great Recruit

From the perspective of a department chairman who, with Ed Bell’s enthusiastic recommendation, hired Jack for the University of Iowa, he has been a “franchise recruit!” His work ethic is unsurpassed, his scientific productivity robust, meaningful, and has been continuously funded. He has built a worldwide network of collaborators with whom he has advanced the knowledge of fetal and newborn hematology, and transfusion medicine. Jack is a conscientious and insightful clinician, and an exemplary educator.

Jack led the Neonatology Fellowship Program for many years. He recognized the need for a series of lectures and discussions directed not only at the scientific and clinical content of neonatology that fellows should master, but also at the art of succeeding as a grant writer, investigator, publisher, speaker, and eventual faculty member. He recruited faculty and others from Pediatrics and additional departments and tended to the schedule details. Once these conferences were established, the other fellowship training programs in the department saw their value and joined in.

More recently, I have participated with Jack in clinical neonatology conferences and followed him often in the attending rotation on one of the busy NICU services at the University of Iowa. This latter routine in academic centers creates a window to look into the practice standards of one’s colleagues. Jack’s standards proved, as expected, to be superb.

As we both phased out of our respective University activities, I shared an office with Jack. That was also a window into another of the secrets of Jack’s success. I could not avoid overhearing Jack’s telephone conversations with research collaborators in Arkansas, Minnesota, Massachusetts, and in Europe. I observed from such eavesdropping how with great diplomacy and unfailing respect for the person on the other end of the conversation, Jack could advance his points in the discussions. That’s surely a key to his successful team research.

Frank H. Morriss, Jr., MD, MPH, Professor Emeritus
Division of Neonatology
Stead Family Department of Pediatrics
University of Iowa

Generous

Our friendship began in the mid 1990s due to our mutual interest in neonatal hematology, and more specifically, EPO. Jack had long been a giant in this field, contributing many important, landmark studies of neonatal erythropoiesis, transfusion medicine, and the pharmacokinetics of EPO in neonates. Jack has been a role model for me as I very much admire his logical, rigorous, and careful approach to research, and his willingness to share and help others in the field.

Over the years, I was fortunate to get to know Jack well as we met repeatedly at national and international meetings dedicated to neonatal hematology. When the PENUT (Preterm EPO Neuroprotection) trial was funded, I knew there could be no one better to act as medical monitor for this phase III multi-center trial! Jack was honest, fair, and knowledgeable about both prematurity and EPO, and excited about participating. PENUT began enrollment in December 2013, and completed enrollment of 941 subjects in September 2016. During this time, Jack fielded questions and made determinations about whether or not the significant adverse events (SAEs) reported were complications of prematurity, or possibly of EPO treatment. Since the target population in this study was comprised of preterm infants < 28 weeks of gestation, many SAEs were reported over the three years (N=626). Jack never failed to respond to each one quickly, asking for more information if necessary, and adjudicating fairly. I owe him a great debt for this service.

When I reflect on Jack, the things that stand out are his generosity with his time, his knowledge and wry humor, and his perseverance in following through on details. I wish him a wonderful retirement, filled with a balance of peace, adventure, and intellectual fulfillment.

Sandra E. Juul, MD, PhD
Professor and Chief, Division of Neonatology
W. Alan Hodson Endowed Chair in Pediatrics
University of Washington Department of Pediatrics
Seattle Children’s Hospital

Mentor, Colleague, Friend, and Neighbor

For the past 29 years, I have had the pleasure and privilege to call Jack Widness a mentor, colleague, and most importantly, a friend. Jack came to Iowa while I was beginning my third year of pediatric residency. One of my first meetings with Jack was when he was house shopping and he and Ed Bell walked by the house where my family lived. In fact, Jack ended up living around the corner from me. Many of our early interactions resulted from family walks around our neighborhood, including my young daughter pushing her doll “Lucy” in a stroller. Almost 30 years later, we all continue to laugh about Lucy being pushed up and down the Widness’ street.

I will allow others to espouse Jack’s academic achievements, which are extensive, and focus on the role model Jack served for me and many others – as a mentor and a collaborator. While the actual number of graduate and post-doctoral students (fellows) that worked in Jack’s laboratory is relatively modest (opportunity lost in my mind), the number of trainees and young faculty he supported, advised, and counseled is copious. While time is one of our most treasured commodities, it is what Jack was always willing to share with others. Any document he reviewed was returned with large amounts of red ink – with all comments being appropriate and delivered in a very nurturing way. Jack thrived on interacting with young investigators. He never left anyone with the impression that he had anything else to do other than focus on his or her needs, and the advice he provided, solicited or spontaneous, was sage and valued.

Aside to being an unparalleled mentor, Jack embodied and embraced collaboration and team science – well before the phrase was fashionable. I would venture fewer than 20% of Jack’s publications have all authors from a single institution. Even within the University of Iowa, Jack interacted with faculty in the Colleges of Nursing, Dentistry, Engineering, Liberal Arts and Sciences, and Pharmacology.

A pillar in the field of neonatal transfusion medicine, Jack has shown countless colleagues and investigators that success in academics can and should be measured not only by funding and publications, but also by the number of lives touched and impacted. You will be greatly missed my friend, and as you know, our door (and basement) is always open.

Jeffrey L. Segar, MD
Professor, Stead Family Department of Pediatrics
University of Iowa Stead Family Children's Hospital
University of Iowa Carver College of Medicine

A Knack for Opening Doors

In 1988, I was contemplating Iowa for my neonatology fellowship. At the time, little was known about EPO in babies and Jack was studying this area. I had developed an interest in hematology during my undergraduate degree and neonatal hematology and EPO sounded like a great fit. After meeting Jack, it was evident that he was an ideal mentor and nearly 30 years later, he continues to guide me. Jack provides a terrific mix of logic, intelligence, and dogged determination – and is just plain nice. Over my career, he has provided key advice and guidance, opening up many doors to national and international neonatal hematology and iron researchers.

Again and again, Jack has guided many physician-scientists and not just those in neonatology. Sometimes his guidance is simple, as he encourages us to identify our passions and to understand that success comes easier when you are happy. Jack’s methodological precision also has inspired me and his work ethic and integrity are a part of all he has touched. When lecturing to clinical fellows on a practical statistic or as an expert on medical student tutoring, his picture is routinely on my first slide. And I often ask “WWJWD? - What would Jack Widness do?” He was always tough but fair in reviewing our writing, making it “bleed red ink.” This strategy has propagated, as trainees in my lab know that if it isn’t marked up in red, it wasn’t read.

I would be remiss if I did not also mention the support of Mike, Jack’s wife and his partner in life. Early on, they adopted several of us into their extended family during our training and beyond, and the guestroom was waiting in the Widness home. Mike was an essential element in Jack’s success, graciously opening their door to collaborators and trainees often for impromptu scientific assemblies in their living room. One important door I hope to soon open is that of the Widness retirement home, where Jack and Mike take on their next project.

Pamela J. Kling, MD
Professor of Pediatrics, Division of Neonatology
Director of Health Professions Student Research
UW-School of Medicine and Public Health
University of Wisconsin-Madison

An Unexpected Mentor

I tell my students that success in a scientific career depends on having great advocates. Many successful physician-scientists have great mentors at their own institution that guide them through the thickets of scientific investigation, and expose them to potential collaborators and new techniques. I was not so lucky when I moved to the University of Minnesota. My mentorship and inspiration had to come ex institutio, which it did in the person of Jack Widness.

People who know me well realize that I’m actually quite socially shy, and with my European upbringing, one does not speak to superiors unless introduced properly! As a new assistant professor at Minnesota, I had made an unusual discovery about rates of newborn iron deficiency in infants of diabetic mothers while doing research on protein biomarkers of malnutrition in the NICU. This was the quintessential serendipitous finding, but it turned out “John Widness” at Brown had spent five years characterizing the erythropoietic abnormalities in the fetus of the diabetic mother in sheep, monkeys, and humans. We had read his findings and wondered if the iron deficiencies that we saw in our patients were a consequence of iron being preferentially shunted into that polycythemic red cell mass. At a poster session at SPR in 1987, I gasped when I saw a poster about fetal hyperinsulinemia and erythropoiesis and there stood the author, Dr. Widness. I did something totally out of character and went up to him, stuck out my hand, and muttered something like, “Uh, Hi! I’m Mike Georgieff and I, uh, just quoted you in my paper” – my one paper. And, Jack, in his true form said, “I saw that. I have a bunch of sheep samples that I could send you to analyze!” That started a 30-year scientific and mentoring relationship that continues to this day. When students and interested scientists approach me, I always think “WWJD” (What would Jack do?) And the answer is, “Be generous.”

The ironic (if you’ll pardon the pun) moment of this story came when I was fortunate enough to present the Midwest Society for Pediatric Research Founder’s Award to Jack. I told the above story, expecting everyone to laugh but instead, there was total silence, and then everyone rose and applauded him! It struck me that many in the room had experienced similar encounters and that Jack had touched each of them in the same way. Bravo, Jack, on a great scientific and mentoring career. You are my true mentor and I am forever grateful.

Michael K. Georgieff, MD
Professor in Pediatrics and the Institute of Child Development
Head, Division of Neonatology
University of Minnesota Masonic Children's Hospital
University of Minnesota School of Medicine

A Great Friend and Collaborator

Jack was already a fellow at Women & Infants Hospital of Rhode Island when I joined Bill Oh’s program in 1977. We quickly became good friends. When I moved with my family to Iowa, we visited the Widnesses each summer in New England on vacation. So, when we were fortunate to recruit Jack to Iowa in 1988, it was a boost to me personally and to our program. Jack has brought tremendous energy and hard work to both his patient care and his scientific work, but one of his greatest attributes is his ability to find collaborators wherever he looks. A glance at his bibliography will show that he has worked and published with investigators from many institutions in the US and abroad. His ability to bring together people from diverse backgrounds to work toward a common purpose is best demonstrated by his leadership of the Iowa Neonatal Anemia Program Project Grant, which included investigators and consultants from 12 US and two European universities. Jack served as program director for the PPG through two five-year cycles, receiving the unbeatable priority score of 10 on his last competitive renewal.

I suspect you will hear a recurring theme in these tributes, that of Jack’s loyalty as a friend. I am certain his contact list is quite long, and no contact is ever deleted. He still enjoys his annual fly-fishing trip in Maine with college buddies from Amherst, where Jack was an all- American lacrosse player on the undefeated teams of 1967 and 1968.

My friendship with Jack is now entering its fifth decade. I am lucky to have made his contact list and to have remained on it all these years. I am saddened that I will no longer see him every day, but I am happy that Jack and Mike have returned to their beloved Lake Raponda, where Jack spent the summers of his youth and many happy weeks in all the ensuing summers. Beckie and I look forward to visiting Jack and Mike there and hearing the loons call as we watch the sunset from their deck. With admiration and warm affection, I congratulate you dear friend, and I wish you Godspeed.

Edward F. Bell, MD
Professor of Pediatrics
University of Iowa

Blood is Thicker than Water

I am honored to be counted among those academic friends who have been asked to contribute to Jack Widness’ Festschrift. In my case, our relationship might be best described by the phrase – “blood is thicker than water.” Although we are not related, it has been blood that has tied our two careers together over so many years. I first met Jack in the early 1980s and we started working together – in parallel at first – and then in association with Herb and Bob Schwartz. Bob was interested in the pathogenesis of the many complications of being an infant of a diabetic mother and had developed a hyperinsulinemic Rhesus monkey model for that purpose at Brown. Herb, a colleague at Stanford, had suggested that I join their meetings, as it might help me understand how infants of diabetic mothers had an increased risk for jaundice.

I liked Jack from the very beginning because of his experimental disposition and his propensity for meticulous and thoughtful analyses of any data that we might generate. For nearly a decade, we had no joint academic product to show for our many discussions about infants of diabetic mothers, alloimmunized pregnancies, hemolysis, and anemia. However, in 1994 we published our first paper together in Pediatric Research. Five papers followed over the course of the following decade. Over the years, we have exchanged ideas, pursued things independently, but repeatedly came back together, sharing our expertise to address a variety of issues related to hemolysis and anemia. Blood had tied us together over the years, each of us on our own paths, but often intersecting along the way.

Jack is still one of the most thoughtful, quiet, careful thinkers in neonatology. And although Jack says that he is retiring, I respectfully doubt it. I hope that from time to time, I will still get a call from him, asking me whether I might help him with some experiment, or problem to answer. Perhaps now it will be more often over a glass of wine among other old friends – or if we are lucky – with some younger, new ones who are ready to join us on (or take over) an investigative adventure. Blood is thicker than water.

David K. Stevenson, MD
Harold K. Faber Professor of Pediatrics
Senior Associate Dean for Maternal and Child Health
Division of Neonatology and Developmental Medicine
Stanford University School of Medicine

Grateful for Support and Encouragement

It is a great honor to contribute to the celebration of Jack Widness’ retirement. Most professional colleagues who never had the pleasure of working with Jack at Brown or at Iowa know him for his important work on fetal and neonatal hematology.

I had the distinct pleasure of working closely with Jack from 2003-2007 as the chair of the ONTPD (Organization of Neonatology Training Program Directors) while Jack served as an elected member of the executive council. Those four years turned out to be unrepentantly turbulent. I am not sure how I would have gotten through it had it not been for Jack – who was literally my right hand, sounding board and sometimes therapist.

Early in our tenure on the ONTPD Council, we faced a challenge from the surgical RRC (Residency Review Committee) of the ACGME proposing new language and guidelines for the training of surgical residents, mandating that all surgical babies in the NICU be on the surgical service. The ONTPD council opposed this due to the potentially detrimental effects this would have on the training of pediatric residents and neonatology fellows, and the management of our surgical patients in the NICU who would become the responsibility of surgical residents with little pediatric training or experience. This began months of contentious conference calls with the surgeons, meetings with the ONTPD, and dozens of emails between Jack and me. I could always depend on Jack for support, encouragement, sound advice, and timely responses. In the end, we prevailed, writing new language into the training requirements for both surgical and pediatric residents and neonatology fellows.

Another challenge we took on during this time was the match for neonatology fellowship. This was also a highly contentious and controversial issue with widely varying opinions. Once more, there were numerous meetings, conference calls, debates, and emails. Jack was again a supportive colleague, and with his help we were able to move neonatology into the match.

We were proud of what we accomplished and that it resulted in optimal care for babies and for bright futures for the residents and fellows who will follow in our footsteps. I could not have done it without Jack and wish him a content, fulfilling, and happy retirement.

Judy Aschner, MD
Professor of Pediatrics
Michael I Cohen MD University Chair, Albert Einstein College of Medicine
Physician-in-Chief, The Children’s Hospital at Montefiore

Jack, the Visionary

I vividly remember the day I met Jack. I was a neonatology fellow at the University of Florida, doing research on neonatal thrombocytopenia in the laboratory of Robert Christensen, and I was giving a talk at the Society of Pediatric Research Annual Meeting. At the end of the talk, Dr. Christensen told me he wanted to introduce me to his good friend, Jack Widness. I remember a kind face, a kind smile, and a firm handshake. Little did I know then that after Bob Christensen, Jack would go on to become the most important mentor in my professional life. A few years after that meeting, when I was a junior investigator at the University of Florida trying to make a path in research, Jack called me out of the blue and asked me to be part of a SCORE grant application. His laboratory had always been interested in erythropoiesis and red cell biology, and he had the wisdom to recognize that similar methods could be applied to the study of neonatal thrombopoiesis and platelets. Even though the SCORE grant did not get funded, his idea to merge these two fields was visionary. He connected me with Peter Veng- Pedersen, PhD, and Donald Mager, PharmD, PhD, to start doing modeling with platelets, and he introduced me to the use of biotin to label cells. These approaches opened new possibilities for my research that continue to this day.

In 2012, Jack invited me to join the PPG as a leader of a new project. This was a VERY bold and risky move: Jack wanted to take a very successful Iowa PPG on neonatal anemia and suddenly expand it to include thrombocytopenia, and a new geographically distant site in Boston. Of course, Jack's vision proved to be right, and the PPG was refunded. This trajectory, in my opinion, best illustrates one of Jack’s most remarkable attributes: he is a visionary, who moved science forward beyond his own (already impressive!) work by making connections no one else saw at the time. His vision enhanced and helped shape the careers of many scientists. I feel so blessed to have been one of them, and will forever be grateful to him.

Martha Sola-Visner, MD
Associate Professor of Pediatrics
Boston Children’s Hospital
Harvard Medical School